Churches as providers of HIV/AIDS care : a normative and empirical study

[摘要] ENGLISH ABSTRACT: There is, as yet, no cure for HIV/AIDS, a disease that has affected South Africansociety profoundly. While antiretrovirals (ARVs) are now available and havestemmed the tide of AIDS deaths, medicines alone cannot be seen as a long-termsolution. Treatment costs, finite resources, limited health-care capacity, morbidity andthe unpleasant side-effects of ARVs, make treatment an untenable solution.The Christian church in South Africa continues to retain a powerful position; it has asignificant affiliation; it is present in most geographic areas and inspires trust andconfidence. Furthermore, in my view, the church, by its very nature and calling, ismandated not only to demonstrate and provide care, but also to inspire care-giving.In the light of HIV/AIDS, what does care mean? Can it only mean rendering care thatis welfarist in nature? Or does the church have the mandate to look beyond immediatesuffering, to examine and address those issues that lie at the core of suffering?Research has demonstrated that issues such as poverty, injustice, stigma,discrimination, gender inequality and patriarchy fuel the pandemic. Ultimately, it isthe 'othering of people; the failure not to recognise God in another person and ourcommon humanity, that lie at the heart of the problem. These then, I suggest, are thevery reasons why the church must address these areas.But that is not all: if HIV/AIDS care is to be rendered in a developmental way, thenthere must be a thorough understanding of the disease: how is the virus transmitted,how can it be prevented and treated? It is also important to understand that there is nota single global epidemic but many local epidemics; the determinants and risk-factorsof these need to be recognised, as must the cultural, economic, political and socialcontexts that fuel the spread of the disease. The changing nature of society, the effectsof globalisation, the evolving nature of care owing to biomedical advances and eventhe 'privatisation of sex all need to be comprehended.Furthermore, any meaningful rendering of care requires the churches to examine whythey should be giving it and the values that underpin such care-giving. I make the casethat the churches are required to do nothing less than drive social change in situationsof suffering, injustice and abuse. An examination of the history of HIV/AIDS inSouth Africa illustrates that the churches have often failed to meet up to this calling.An empirical study was conducted as to how the churches render care at a moremicro, grassroots level, using a framework propounded by David Korten, whosuggests that authentic development must be people-centred, rather than growthcentred.Essentially, development must seek to increase personal and institutionalcapacities, guided by principles of justice, sustainability and inclusiveness. In theserespects, I argue, it accords very strongly with the Christian message. Korten suggeststhat there are four orientations (or generations) of rendering help but it is only thefourth generation that is truly developmental.Through the use of case study methodology, I sought to examine the manner in whichthe churches render care, in a region of the Western Cape, outside Cape Town, knownas the Helderberg Basin. The area is representative of many peri-urban areas in theCape: it is predominantly Christian, with a mix of different denominations and racialand socio-economic groupings. It allowed for an assessment of care initiativesafforded by mainline, charismatic and African Independent Churches and inparticular, sought to answer the question of whether churches engage with HIV/AIDSin a way that Korten would identify as developmental.From the research, it is clear that the church is hampered by its inability to talk of sexand sexuality; its knowledge of the issues surrounding HIV/AIDS is limited; it has notdone a sufficient amount to conscientise its followers; the church has yet to learn toutilise its networks; it lacks technical know-how and is unwilling to engage in thepolitical sphere.Social change is only possible if the church embraces a new vision of how to create abetter world. Additionally, I recommend that the church looks to the emerging churchmovement to achieve radical transformation.

[发布机构] Stellenbosch University