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Chipo is worried about her eldest daughter, Tatenda, whom she believes is being
sexually molested by her husband, Shamhu. Tatenda is 12 years old and is
beginning to show signs of a Sexually Transmitted Disease (STD). Chipo is even
more worried as she believes that her husband has HIV, the infection that will
cause AIDS.

What can she do? If she reports the matter to the police and her husband is
arrested, tried and imprisoned, how is she and Tatenda and the other four
younger children going to be able to live without Shamhu’s wages? If she reports
the matter to Shamhu’s family they will not believe her, even if they know that
she is telling the truth, as they will not want the stigma that goes with AIDS.
If she persists in wanting the family to take action they are likely to keep her
children and send her back to her own family who, in turn, will not want the
shame of a returned daughter in these circumstances.

Her own family would probably reject her and then she would be out on the
streets with no resources and might have to turn to prostitution for a living.
She knows that she is likely to have been infected with HIV by her husband and
so would pass on the disease…

What to do? Chipo is caught in a poverty and cultural trap. So she does nothing
and awaits the time when Shamhu and Tatenda will contract full AIDS and become
sick when she will have to nurse them at home before they die, knowing that she,
too, will follow them on this path and leave behind the four young children as
orphans.

Chipo muses about why her husband had acted so disgracefully. She knows he is a
loving husband but has to go to work in the city to keep them all. He returns to
his rural home during the holidays and sometimes on weekends when he has the bus
fare. She knows he is strong and virile and that her culture expects the wife to
turn a blind eye to sexual liaisons of husbands. She guesses that he knows he is
HIV+ and has omitted to tell her for shame and so she is unable to take any
measures that will protect her. She knows, too, that there is a strong cultural
myth around that says if a man is HIV+ he can be cured by having sex with a
virgin….. And Tatenda is obviously the easiest accessible virgin!

Although the above story is fiction it is by no means a fiction in the life of
many families in sub-Saharan Africa where AIDS had reached the proportion of a
pandemic similar to the Black Death that destroyed many European nations during
the late middle ages.

“A decade ago, HIV/AIDS was regarded primarily as a serious health crisis.
Estimates in 1991 predicted that in sub-Saharan Africa by the end of the
decade, 9 million people would be infected and 5 million would die – a
threefold underestimation.” This was the opening sentence of the Report on the
global HIV/AIDS epidemic of the United Nations Programme on HIV/AIDS, June
2000. It cites the number of people living with HIV/AIDS as 34.3 million at
present and the number of deaths, since the beginning of the epidemic, as 18.8
million; of whom 3.8 million were children. These are worldwide figures but
sub-Saharan Africa has about two thirds of these casualties with countries such
as Botswana having 35.8% of the adult population infected and South Africa 20%
and still rising. Zimbabwe, our own country, has 26.8% of the adult population
infected with a higher incidence of infected pregnant women, as high as 60% in
some border towns. Zimbabwe also has 900,000 children who have been orphaned by
the death of one or both parents from AIDS. This number is rising and by the
year 2005 it will be about one third of the child population under 15 years of
age. South Africa is following suit and, with a much larger population, will
have overall a much higher total number of people living and dying with AIDS.
In one area alone, Kwa-Zulu Natal, the rate of infection is 36% of the adult
population.

The plight of the orphaned children is heartbreaking. The lucky ones are those
who are being looked after by members of the extended family, aunts, uncles and
especially grandparents. One grandmother had 30 children to care for from her
own sons and daughters who had died from AIDS. But when the grandparents die,
who is left to care for the children?

Other children run what are now called “child-headed families” in which an older
child, up ten to fifteen years of age, will look after the younger brothers and
sisters. For most of these children school is not possible, owing to lack of
money and clothes. They survive by growing a few vegetables or begging on the
streets whilst relying also on neighbours to help them. Many of them become full
time street children with all the attendant problems of disease, abuse and
prostitution. Girls especially are subject to sexual abuse, even from relatives
with whom they may be living. Girls are also more likely to be infected with HIV
than boys: (for instance, in Zimbabwe 15% to 23% of girls in the 15 to 19 years
age range are infected whilst only 3% to 4% of the boys are). There are
biological and cultural reasons for this. Biologically a young girl engaged in
sexual intercourse is more open to infection because of torn tissues than a boy.
On the cultural side girls tend to be younger than their male counterparts and
can be the recipients of the myth that having sex with a virgin cures HIV/AIDS.
Furthermore, in countries of great poverty, the whole of sub-Saharan Africa, a
poor girl is enticed to have sex with a man for a new dress, food or even school
fees. The follow-up to this vulnerability often means that the girl is infected
with HIV in addition to often falling pregnant with the risk of giving birth to
a child that is also HIV+. About one third of babies born to HIV+ mothers are
themselves HIV+.

Poverty is a contributing factor to the AIDS epidemic. In Zimbabwe, and many
other African countries, at least 70% of the population live below the Poverty
Datum Line. This drives many women into prostitution as the only way that they
can provide for their children or parents. AIDS’ widows in poverty sometimes
resort to prostitution even if they are likely to be infected and so will pass
on the virus. Poverty and lack of employment also affect the young who have no
money for school fees, for recreation or for a Western life-style that they see
on someone’s television screen. Sex is available locally either free or for a
small fee and so they take to that willingly.

Prevention is the most important intervention in the fight against HIV/AIDS as
it is possible to prevent the transmission of the disease and so save millions
of lives in the future. As the main mode of transmission (more than 90% in
Africa) of the HIV virus, which causes AIDS, is through sexual intercourse, this
intervention must stress the need for people not to engage in sex before
marriage or outside marriage and to marry only an uninfected person. Young
people must be encouraged, before they are tempted to become sexually active, to
observe the commandments of God about sex. But this must not be done in a
negative way. Our Peer Education programmes stress positive relationships
between boys and girls, friendship and respect and involvement in healthy
recreational activities. The trained Peer Educators in schools and youth clubs
spread the word and encourage others. Research indicates that young people
obtain most of their information about sex from their contemporaries, not the
older generation, not even their parents.

The second intervention is caring for those who are infected and for the
families who are affected by this person’s illness. People with HIV/AIDS should
accept that they have the disease and be willing to communicate this information
to those who can help them. It is essential that they also inform their wives,
husbands or other partners so that they will not be at risk of contracting the
disease. In fact this is a moral obligation on their part.

In most developing countries, and especially in Africa, it is not possible to
obtain long term care in hospitals for AIDS patients, because of costs, lack of
equipment and lack of drugs, and so the concept of HOME-BASED CARE was
established. This means that the patient is cared for at home by a relative,
usually the wife, who has been taught how to care for an AIDS patient. Teams of
volunteer workers have been established in many places by government, churches
and voluntary organisations. These workers go from house to house assisting the
families, sometimes with drugs, and/or food and in many cases helping with the
household chores, or doing the shopping. When there is no money for shopping
they try to help with some financial assistance.

Home Based Care is a new and vital form of apostolate for Christians. Many of
those involved in this apostolate are themselves suffering from HIV/AIDS but not
yet to such an extent as to be incapacitated. This is the way they show their
love for others who are sicker than they themselves.

In recent years major advances have been made in the First World in the use of
drugs that delay considerably the onset of full AIDS to those that are HIV+.
However, these drugs cost up to US$800 per month and also require frequent
medical consultation to avoid side effects. Even if sold at a reduced price of
US $200, as some drug companies have offered, they are out of reach of poverty
stricken Africans, nor do they have the necessary medical back up.

The third intervention is the care of orphans. We do not call them “AIDS
orphans” as they are likely to be stigmatised and the vast majority of them do
not have the disease as they were born before their parents became infected. A
better expression is Children Affected by AIDS (CABA). A United Nations
definition of these orphans is one who has lost both or one parent to AIDS. The
majority of these children are looked after by the extended family, according to
African tradition, but these families themselves often have scarce resources and
are unable to provide school or medical fees for the children and so they need
help. The children that go to orphanages are those without any other relatives
and this is only recommended in extreme cases. If a family cannot be found, the
local community is often the one to help by supervising the children, some of
whom have a “child headed family”, an older brother or sister sometimes only in
their early teens.

In all programmes for orphans it is essential that they are able to carry on
with their schooling so as to be self sufficient, or find a job in the future.
The church has some programmes to provide school fees, uniforms and books for
these children. For abandoned HIV+ babies the church has also projects in some
countries where they are looked after by surrogate mothers. The church never has
enough funds and relies on donors, mostly from overseas, but essential funds are
still lacking.

In poverty-stricken countries oppressed by debt and international trade
barriers, donations will never be enough for those with HIV/AIDS and for
millions of orphans. The time has come for rich countries to acknowledge this,
and take positive structural action.

Jesuits everywhere, whilst involved in many other ministries, willingly make the
effort to reach out to those infected with HIV+. How pass over in silence men
such as Father Jack Gillick and all that this Jesuit in his eighties continues
to accomplish in Johannesburg, Father Angelo D’Agostino and his work for
abandoned children in Nairobi, the two Fathers Michael Kelly in Zambia, Brother
Kizito Makora and our scholastics in Zimbabwe, our novices in Tanzania and our
men in the Ivory Coast and the Democratic Republic of the Congo? The list of
Jesuits involved in HIV/Aids work in Africa is endless. How could it be
otherwise? Youth clubs, counselling, training programmes, hands-on involvement
in the hospitals and orphanages, the formation of peer educators…all this and
more so as to respond as best they can to the needs of God’s People. Whilst the
Society can be justly proud of their efforts, their only desire is that it were
possible for them to do so much more!

AJANews no. 23
What HIV/AIDS Can Do to Education,and What Education Can Do to HIV/AIDS

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