AIDS in Africa: What Does the Christian Faith Require?
By Stephen McGarvey

The stirring film Hotel Rwanda tells the story of Paul Ruasesabagina, a hotel manager who helps prevent the slaughter of 1,200 refugees during the infamous Rwandan genocide of the early 1990s. In one scene when a journalist arrives back at Ruasesabagina’s hotel with video footage of the atrocities, Paul comments with relief, “I am glad that you have shot this footage and that the world will see it. It is the only way we have a chance that people might intervene.”

When the cynical reporter scoffs at Paul’s comment, Paul responds, “How can they not intervene when they witness such atrocities?” The reporter answers, “I think if people see this footage they’ll say, ‘Oh … that’s horrible,’ and then go on eating their dinners.”

This has too often been the case when it comes to Africa’s problems. The citizens of Western nations, the United States specifically, are largely insolated from the extreme poverty and tribal conflicts that plague sub-Saharan Africa. An occasional two-minute feature on the evening news provides hardly enough information to convey the immensity of most significant problems. In the 1980s Americans were largely focused on communism and the Soviet Union. And in the 1990s, with the USSR’s collapse, we focused almost exclusively on ourselves and America’s domestic concerns.

During these times Americans were largely ignorant of the genocide in Rwanda. We knew little of the civil war in Sudan and the dozens of conflicts across Africa. And we didn’t realize that the most devastating disease outbreak in perhaps the history of mankind was beginning to take hold in the populations of this often ignored continent.

The Greatest Apologetic?

During the “Prescription for Hope” conference hosted by Samaritan’s Purse a few years ago, author and apologist Ravi Zacharias told those assembled, “If the church of Jesus Christ rises up to the challenge of HIV/AIDS, it will be the greatest apologetic the world has ever seen.”

A bold statement certainly, but the devastation of HIV/AIDS around the world cannot be overstated. And the need for Christians to rise to the challenge is dire.

History will certainly record the HIV/AIDS pandemic as one of the most destructive problems to strike mankind. Black Death (bubonic plague) killed 25 million in Europe during the 14th century. The Spanish influenza pandemic in the early 20th century killed more that 50 million people worldwide. The HIV/AIDS pandemic has a worldwide death count of similar numbers. Some 25 million people have died of AIDS since its discovery in 1981. The latest statistics indicate that nearly 3 million people die from the disease every year, and more than half a million of those deaths are children. The latest World Health Organization statistics indicate that 33.2 million people worldwide are now infected with HIV, with approximately 2.5 million new people infected every year at the current rate.

“AIDS is the biggest public health problem the world has ever faced,” says Dale Hanson Bourke of International Justice Mission and author of The Skeptic’s Guide to the Global AIDS Crisis. “An estimated three million people die each year from AIDS, a death toll that has been compared to 20 fully loaded 747s crashing every single day for a year.”

And Sub-Saharan Africa has suffered from this pandemic more than any other region of the world. As home to only 10 percent of the world’s population, these nations have more than two-thirds of the world’s HIV infected people. There are many reasons for this disparity according to Bourke. The nations of this region are among the world’s poorest. Poorer countries tend to have poor public health facilities, fragmented communications systems, and unstable governments. “The rate of infection continues to grow in most countries of this region because there are still many people who have not been educated about the disease and how it spreads,” says Bourke.

HIV (human immunodeficiency virus) is one of the most insidious viruses known to man. An infected person may go for years without showing any symptoms, but can still pass the virus on to others. HIV can be transferred in only three ways: through sexual contact, exposure to infected bodily fluids, and mother-to-child transmission (in utero, during birth, or by breast-feeding). The virus attacks the cells in one’s body that fight disease, and gradually leads to AIDS (acquired immunodeficiency syndrome) where the victim is no longer able to fight off disease or infection.

Unlike most diseases in which the very young and the very old are hit the hardest, AIDS is incredibly damaging to the young adult to middle-age adult populations. This has led to an incredibly high number of children left orphaned by the HIV virus, especially in Sub-Saharan Africa. “Experts estimate that within the next few years there could be as many as 40 million orphaned children in Africa alone,” say Ronna Jordan, founder of National Day of Care, a group dedicated to creating opportunities for people to assist the growing number of AIDS orphans worldwide. “Africa may be quickly becoming a continent of children without parents, grandparents, orphanages, or church groups.”

What Are Our Hang-Ups?

Misinformation appears to have accompanied the HIV virus almost since its discovery. In his book The Invisible People, Greg Behrman chronicles the history of AIDS and how early opportunities to combat the disease were neglected because American leaders were misinformed. During the 1980s when HIV/AIDS first appeared on the global horizon, former Surgeon General C. Everett Koop was an early Reagan administration advocate for AIDS engagement and education. Yet, Behrman writes that Koop’s position ran afoul of the administration’s constituency of Christian conservatives, who considered AIDS a “homosexual” disease:

“Perhaps most famously, the Rev. Jerry Falwell proclaimed in a 1983 television sermon: ‘AIDS is God’s punishment…. The scripture is clear,’ Falwell preached. ‘We do reap it in our flesh when we violate the laws of God.’ [U.S. President Ronald Reagan’s] aide Patrick Buchanan joined Falwell, pronouncing: ‘The poor homosexuals—they have declared war upon Nature, and now Nature is exacting awful retribution.’ Ronald Godwin, director of the Moral Majority, averred: ‘What I see is a commitment to spend our tax dollars on research to allow these diseased homosexuals to go back to their perverted practices without standards of accountability.’”

Such sentiments led both the Reagan and (George H.W.) Bush administrations away from engaging the burgeoning pandemic at even the most basic levels. And while one could place blame on America’s leaders for inaction, one could also make the case that they were simply reacting to the misconceptions of the populace. “American Christians’ first encounter with AIDS was their domestic homosexual community and sex workers,” says Lisa McKay, director of training and education services at the Headington Institute, a group that provides psychological support and training programs for humanitarian aid workers. “There was a lot of stigma attached to AIDS in the United States when it first surfaced. Many Christians in particular considered AIDS the result of sinful activity, and some … believed that AIDS sufferers were simply reaping their just rewards.”

It’s true that most cases of HIV/AIDS in the United States are found in the homosexual community, and typical homosexual practices provide excellent conditions for the spread of the virus. But AIDS is not a uniquely homosexual condition. According to Dale Bourke, “[I]nternationally, HIV is primarily transmitted through heterosexual sex, intravenous drug use, transmission from infected mothers to their babies, and infection through the blood supply.”

In her book The AIDS Crisis: What We Can Do (co-authored with W. Meredith Long), World Relief’s Deborah Dortzbach chides Christians for neglecting to engage the HIV/AIDS pandemic:

“In North America we thought [AIDS] was a gay disease—a justifiable gay disease, in fact, that showed the consequences of sexual sin …. We couldn’t have been more wrong. AIDS isn’t confined and never really was. It’s just hidden much of the time. The virus copies itself, disguises itself … to do the sinister work of destroying the very system the body uses to defend itself from such invasions. The body withers, defeated by a particle sixty times smaller than a red blood cell.”

Raising awareness of the seriousness of the AIDS pandemic has been no easy task over the last 25 years. Meredith Long, also with World Relief, tells byFaith, “When we first tried to get church leaders in Kenya to an AIDS consultation in the late 1980s, we could not put together a large enough group to convene. AIDS was still ‘out there’ and they did not perceive it as a present problem or even a threat. It had not yet touched their daily lives—or, more accurately—they had not yet seen how it was already touching their lives and ministries.”

Assessing the Impact

Now with more than 40 million people worldwide living with HIV/AIDS, the number of people not impacted in some way by the disease is quickly shrinking. Ignorance about the AIDS problem is not limited to people outside the most troubled regions. But Long has seen compassion from believers when they come face to face with those who are suffering. “As long as American Christians are able to keep AIDS at an arm’s length, they seldom become engaged, but when they enter into the suffering of those living and affected by this disease, they are moved by Christ’s spirit to a compassionate response.”

Ronna Jordan agrees that many Americans are not aware of the extent of the HIV/AIDS pandemic, calling it a “little Holocaust.” “But there is good news,” says Jordan. “When we share the situation, the Church’s response is overwhelmingly positive.”

Jordan has led groups of volunteers to the regions of the world where HIV impact is at its worst. She believes that the more people who see firsthand the ravages of the disease, the more they will be convicted to get involved to help relieve the suffering. “You can see it on TV, but 100 percent of people come back from volunteer trips and say, ‘This is the worst thing I have seen in my life.’ The suffering of AIDS victims is far beyond anything we would encounter in this country. It has a huge impact on someone. What affects people the most is the scope of it. How big this is and how many millions of people are desperately suffering.”

And what truly makes a difference on the community in need, adds Mike Hattabaugh, executive director of National Day of Care, is when the volunteers return for a second trip. “Volunteers have an even bigger impact a second time,” he says. “Locals then believe you really want to make a difference. Consistency is key and an attitude of, ‘We are going to see this through till this community in need is out of crisis.’”

“Groups that World Relief has led to Africa to visit those living with HIV/AIDS suddenly see the people who live amidst suffering and fear but also with great courage and dignity,” says Meredith Long. “They also meet local church volunteers, church leaders, and staff members who not only work with people with AIDS but who love and respect them … . The Holy Spirit best does His work of transforming apathy … into engagement as we enter into relationships [with AIDS victims], not when we engage our minds … [with] impersonal statistics.”

The AIDS pandemic confronts us with a large group of people with very basic needs. For believers looking to emulate the example of Christ and to alleviate these great physical burdens, how these Africans became sick, impoverished, and destitute is of secondary concern. “Africa requires people with a servant’s heart—people who aren’t looking to aggrandize or find themselves,” writes James Cantelon in his book When Good Stood Up. “People who simply see that there’s a job to do and do it for the sake of love—people who pick up the basin and the towel and humbly wash the feet of the suffering.”

How Does a Biblical Worldview Inform Us?

Like many Christians who have found a way to fight the AIDS pandemic, Ronna Jordan believes the Christian Church is the only entity that can truly resolve this crisis. “The Church is the only entity that … has a mandate to solve this problem. We are the ones called [by our faith] to do it.”

“AIDS spawns ethical debate because HIV infection is most frequently transmitted by sexual behaviors that have a true moral dimension,” Dortzbach and Long write in their book. “Personal sin drives the epidemic. But structural evil—the evil incorporated into the very structures of society, such as injustice, inequity, greed, racism, or oppression—also plays a part, creating an environment that nurtures sin and multiplies its impact.”

Edward Green, a senior research scientist at Harvard’s Center for Population and Development Studies, believes there is more than just a scientific element to fighting the AIDS pandemic. “The dominant paradigm treats AIDS as a medical problem requiring medical solutions,” writes Green in The Hope Factor, a collection of essays by Christians involved in addressing the pandemic on some level. “But AIDS is largely a behavioral problem requiring a behavioral solution. Primary behavior change deals with the problem itself, getting at what is needed for the primary prevention, while the medical model deals with symptoms.”

Dick Day, executive director of Sub-Saharan Africa Family Enrichment, agrees. “The world is looking to the West for a scientific answer. Many people are relying on condoms, which do not address the main causal factors. Condoms provide a technical solution to a problem that can be addressed only through fundamental changes in social attitudes, values, and behavior. To combat AIDS there needs to be a transformation of one’s mind—a change of worldview.”

This is where the Christian worldview should inform perceptions of this pandemic. In addition to caring for the sick and advocating for a cure, Christians must be proponents of the Christian worldview perspective on sex. This is not to say the old attitudes of AIDS as God’s judgment on sexual sinners should paralyze our involvement. “All sin comes with a price. And many pay the bill who never did the sin,” writes pastor and author John Piper in The Hope Factor. “This means that we must speak carefully about the cause of AIDS. If any epidemic ever spread because of disobedience to God’s Word, it is AIDS. But millions are infected because of someone else’s disobedience, not their own.”

According to Ken Casey of World Vision’s HIV/AIDS HOPE Initiative, God’s Word cautions us against trying to tie specific consequences to specific sins. “Instead, our challenge is to encourage people to follow God’s law regarding sexual behavior and then enjoy the benefits of sexual purity and God-honoring lifestyles.”

“Christians must come to recognize those with HIV/AIDS not as hopeless sinners reaping the consequences of a wasted life, but as people God loves and values. And as we reach out to them in love and compassion they will see Christ in us,” writes Ken Isaacs of Samaritan’s Purse. “This is our calling. Apart from God’s grace we all would be hopelessly lost in our own sin. How can we respond any differently to people who are sick and perhaps living without any hope for eternity?”

Ronna Jordan believes that in spite of the theological and denominational differences among Christians, confronting the AIDS pandemic is one thing we should all agree on. “Jesus calls us to love our neighbors as ourselves. Our culture and the cultures of the world are just waiting for people to step up and do it.”

Groups working to relieve the suffering caused by the HIV/AIDS pandemic:

World Vision (www.worldvision.org)
Samaritan’s Purse (www.samaritanspurse.org)
World Relief (www.wr.org)
National Day of Care (www.nationaldayofcare.org)
Compassion International (www.compassion.com)

Stephen McGarvey is the executive editor of Crosswalk.com and Christianity.com for the Salem Web Network. He is also a freelance writer on issues of faith, culture, and human rights. McGarvey lives in the Richmond, Va., area with his wife and two children, and attends Sycamore Presbyterian Church (PCA) in Midlothian, Va.

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