Southern Africans with AIDS Helped Through Namibia, Cape Town Dioceses
Episcopal News Service. August 19, 2004 [081904-3-A]
Carol E. Barnwell , Communications director for the Diocese of Texas
[Note: a version of this report also appears in the September issue of Episcopal Life, the national newspaper serving the Episcopal Church. Carol Barnwell was among the five women who visited South Africa and Namibia at the invitation of Episcopal Relief and Development.]
Marta struggled to her feet from the soiled blanket she rested on next to her mud hut in the northern Namibian bush. In the mid-afternoon sun the fragile grandmother of five unfolded herself painfully and slowly rose to greet the home-based care nurse from St. Mary's Health Center who came to check on her. Marta's body is wracked with tuberculosis, an opportunistic disease that strikes many suffering from AIDS. Marta's adult daughter has AIDS and at least one of the grandchildren has tested positive for the disease.
In nearby Etale, a group of preschoolers wait patiently in line to receive a piece of bread and a cup of juice at St. Peter's and St. Paul's Anglican Church. Some wear heavy jackets to ward off the relative cold. Others dig their callused feet and bare toes into the dry, sandy soil. The church's program for AIDS orphans and other vulnerable children three to six years old provides beginning education skills for 40 children but can only afford to give them something to eat once a week. There are 70 children here today.
Olga says the Mzamomhle Beading Group she belongs to near Cape Town, South Africa, helps relieve some of the emotional stress that comes from living with AIDS. The money she makes beading the sparkling red ribbon badges, bracelets and necklaces helps to provide food, shelter and the insurance she needs to be buried when she dies. Olga is 32.
Help offered through Episcopal Relief and Development
At the invitation of Episcopal Relief and Development (ERD), five women who are actively engaged in dioceses in the Episcopal Church traveled to Namibia and South Africa for 12 days in July to meet the people most affected by the HIV/AIDS pandemic. Brian Sellers-Petersen, ERD's director of West Coast operations, and local diocesan officials escorted the group. They visited joint programs of ERD and the Anglican Church responding to the poverty and HIV/AIDS in Southern Africa. Marta, Olga and the children are all beneficiaries of these programs.
The pilgrimage group included Peggy Cleary, an AIDS activist and past senior warden of St. Mark's Cathedral in Seattle; the Rev. Diane Corlett, rector of Church of the Nativity in Raleigh, North Carolina; Maggie Gellar, a pediatric intensive care unit nurse and deacon from the Diocese of Massachusetts; and Pam Payne, a women's health nurse practitioner and chair of the HIV/AIDS ministry commission in the Diocese of Los Angeles.
ERD's partnership with the Church of the Province of Southern Africa (CPSA) is one of the first steps made by ERD as it moved from being a granting organization to a more purposeful development agency. "The more than $200,000 we have provided for work in Southern Africa," said Janette O'Neill, ERD's program director for Africa, "was a considered response to hearing the priorities and needs of our partner, CPSA. We are also very involved in planning, evaluation, mentoring and staff support."
ERD's multi-year commitment has allowed a program of growth and expansion of HOPE Africa, with the budget meeting the needs of a growing organization that has shifted considerably over the past four years as well as supporting HIV/AIDS work in the Dioceses of Namibia and Johannesburg.
"Our initial emphasis was largely on training and employment of staff to build capacity and expertise to help the Anglican Church respond to the needs of the communities so disadvantaged under apartheid," O'Neill explained. A larger part of the budget recently has helped train clergy and lay leaders to facilitate development at the grassroots, she explained.
Diocese of Namibia focuses on orphans and home-based care
In the Diocese of Namibia, the church is providing the structure and training volunteers to respond to the devastating toll of HIV/AIDS and poverty.
More than 40 women greeted the American visitors with songs at the Anglican Church in Efalulula. A dozen have already received training to become home-based care workers; many more are anxious to join them. The women are also concerned about the number of AIDS orphans in their midst and want to ramp up their bread baking capacity by building two additional brick ovens to provide food and funds to help care for the children.
During a meeting in the church, one grandmother told how her neighbor had contracted HIV/AIDS. "Her husband went to work in a city and he was gone for six months," she said through an interpreter. "When he returned, he gave her HIV/AIDS." Unfortunately, it is a story that is played out often here. Men, desperate for work, move to urban, industrialized areas for extended periods of time and often have sexual relations with prostitutes or other women while away. They return infected, bringing more hardship home than when they originally left.
Additional volunteer training is scheduled at the church in Efalulula in August. The diocese provided three bicycles to help volunteers cover the distance between patients with more ease.
Odibo, a dusty, bleak town on the Angolan border, surrounds St. Mary's Health Center. St. Mary's provides both in- and out-patient care as well as training and supplies for home-based HIV/AIDS care workers. The coordinator of the program is Pelita Haimbodi. A registered nurse volunteer, she explains, attends a weeklong training session, learning about nutrition, hygiene and wound care in order to care for people living with HIV/AIDS. Each volunteer receives a supply kit and often walks or rides a bicycle fifteen miles to visit just one of their 8-14 patients.
The kits contain an instruction book and supplies: gauze pads, bandages, thermometer, calamine lotion, Vaseline, cough syrup, Tylenol for pain relief, plastic sheets to cover bed linens and a large carton of condoms. St. Mary's stock room to re-supply the kits is meager, with only a few cartons of each product.
According to an article in Newsweek magazine (July 19, 2004), people from affected communities are often better than experts at "raising awareness, shattering stigmas and motivating people to take charge of their health." The article said studies show a 93 percent adherence to drug therapy with community clinics and peer counselors as opposed to "hospital-based programs that never topped 63 percent."
With simplified antiretroviral (ARV) regimens finally available at affordable costs, grassroots groups can be extremely effective in treating patients and providing counseling about the spread of HIV/AIDS while they assess other issues critical to the patient's wellbeing. It is a holistic approach to treating the disease that affects one in four people in Namibia.
Home-based care also relieves some of the overcrowding at local hospitals and provides hope to many people who, without support groups and home-based care workers, would be shunned by their families and left to die. Simplified ARV regimens have proved to restore many patients to good enough health to return to work and be able to care for their children.
When the group visited Marta, they found the children chewing on berries from a Marula tree next to the fence. There was no other food available. One child had a ragged t-shirt tied on as pants. A little girl had a yellow discharge from her eyes and nose. Flies landed incessantly on their dirty faces but they didn't notice. The children's tummies were distended from malnutrition and worms.
Marta struggles to lie back onto her blanket as the group departs, exhausted from the brief encounter. Home-based care initiatives will identify these vulnerable children as part of their assessment and hopefully be able to provide help with food and basic medical care. The needs are overwhelming in this one small family alone.
"HIV/AIDS is just everywhere," said Namibia's Bishop Suffragan Petrus Hilukiluah, reminiscing on the confirmations he has been doing all summer. "You are often told that there are 'so many' candidates [but when you arrive you find] that one died or several died days ago so you have an unhappy service really." He explained the sorrow felt when confirmation candidates have lost one of their fellow students with whom they have attended classes throughout the year. "Sometimes you are asked to confirm someone in the hospital. Sometimes [they get to church] but he or she is lying inside the door because they cannot sit up and are very sick."
Shaking his head, Hilukiluah described a heartbreaking scene that is much a part of his episcopate. "Just last Saturday, I confirmed in Suman, and for the duration of the service [several confirmands] were lying outside," he said. "Nobody says they are suffering from AIDS. But it's clear, it's just obvious. It's everywhere, it's everyday."
"With HIV/AIDS the disease, the world for once is united in the fight against it. We were united in the fight against apartheid in this part of the world. And we managed with God's help to defeat it. So again by God's help we are united to fight this pandemic, and we will defeat it," Hilukiluah added.
Diocese of Cape Town takes broad approach to ministry
HOPE Africa is the social development initiative of the Anglican Diocese of Cape Town. Providing a dynamic and holistic model for community development, HOPE Africa empowers participants while delivering a wide range of programs and training. The Archbishop of Cape Town, Njongonkulu Ndungane, initiated this social outreach when he took office in 1996 and has remained a major supporter of the work and a champion in the fight against poverty in the province.
HOPE Africa has an annual project expenditure of 2.4 million rand or $383,233. More than a third, $135,000, comes from Episcopal Relief and Development. HOPE Africa's executive director, Delene Mark, believes the church is uniquely positioned to deliver training and programs to the underserved population of South Africa.
"Every community has the presence of a faith community whether it is the Anglican Church, Roman Catholic or Dutch Reformed," Mark explains. "There is a trained minister, a building, a vehicle, an office and a telephone and fax. That's our muscle."
Assessment and identification of the most effective programs have led HOPE Africa to help fund such diverse projects as computer skills training throughout the diocese; a marimba band at St. Mary's that keeps children occupied and off the streets of the "informal settlement" in Lwandle; a quilting project that employs 37 women in Hout Bay, and a hospice home for AIDS patients in Hawston on the Western Cape.
Among HOPE Africa's projects is the beading group to which Olga Buthelezi belongs. It was started at the invitation of an Anglican priest who was counseling AIDS patients and after assessment, HOPE Africa and the group agreed on the income-generating project that the members could do in their home and sell to visitors and churches abroad. Many participants also provide counseling to other HIV/AIDS positive neighbors.
Buthelezi's story is not unique. "I was working when I found out I was [HIV] positive," she said. "When I told the lady I was working for she fired me. She took her kids to the doctor to make sure I didn't infect them. I don't blame her because she didn't understand about the disease. I didn't understand myself." She found out she was positive when her four-month-old son became ill. Now a healthy four-year-old, her son is on medication but her husband still refuses to be tested.
The money she earns from the beading project keeps her from asking her family for help. "Your family can't help you. They don't want you near them. They think you are going to be their problem," Buthelezi said. Her priority is securing burial insurance. "You have to tell someone you trust so they can bury you when you die because you don't know who is going to go first," said the 32-year-old.
Beyond the crowded slums of Cape Town, HOPE Africa has helped establish numerous projects in the historic fishing village of Arniston on the Western Cape. With government regulated fishing, families in this rural area risked separation in order to find work. The focus then became creating sustainable opportunities locally.
After a feasibility study, done in cooperation with the South African government and the local population, HOPE Africa helped to fund construction of a small conference center, establishment of a crafts project, computer and small business training and funding tour guide training for several participants in the popular tourist area.
Vestry member Pauline Prins said the business training has helped "uplift the people" in this village of 200 families, 90% of whom are Anglican. "We now have personal budgets," she said.
"I used to buy the cheapest toilet paper and now I might buy a more expensive one because I can see the added value and ultimate savings. This small savings mean a lot in this community." Susie Kuhn's daughter got a secretarial job with her new computer skills. Tony Murtz used to work as the night teller at the local hotel. Now he is the manager. Vincent Jaars says the computer classes give him an advantage over other students. Many local men were trained in building skills by helping to construct the conference center and adjacent dormitories.
Mark, dark-eyed and tenacious, is quick to deflect any personal credit. "This community will give you what they have even if it means there will be nothing tomorrow. They have taught me so much. All the fancy college degrees in community development mean nothing," she says of the spirit of the Arniston's families.
Pam Payne, from the Diocese of Los Angeles, was impressed with how HOPE Africa has linked ministries together. "We tend to compartmentalize social ministry in the United States," she said. "AIDS is one thing, feeding is another," she added, citing the duplication of services by not taking a more holistic approach to services. "This is something I will take home," she said.
Massachusetts deacon Maggie Gellar doesn't see the buy-in from social ministry recipients in the US as much as it is apparent in South Africa. "Communities here [in Africa] seem actively involved in gathering their resources," she said. Mark said the role of HOPE Africa, and ERD in the process, is not one of trying to solve the problem but of facilitating people and process. "We live our lives in communion with people who are rich and poor. In order for all to live with dignity, we need to work with each other for the betterment of society in recognizing each other's needs."
Perched at the edge of the turquoise and royal blue surf of the Indian Ocean, the stone cottages are painted pure white and topped with fairytale thatched roofs. Their sturdy occupants speak Afrikaans and are descended from Malay, Indonesian and Dutch immigrants. The beauty of the scene, so different from the sandy bush of northern Namibia or the squalid "informal settlements" of Cape Town, belies the hardships and poverty of the local population.
The setting sun at the very tip of this vast continent sends golden and orange rays of light across the darkening sky illuminating the hopes and dreams of the poor, the afflicted in this corner of the Anglican Communion. ERD, in cooperation with the Dioceses of Namibia and Cape Town, has turned victims into partners as they set in motion the work of Christ in the world.
Carol E. Barnwell, communications director for the Diocese of Texas, is immediate past president of the national Episcopal Communicators organization. She was a member of the pilgrimage team to South Africa and Namibia.
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