KAMPALA, Uganda — When Pope Benedict XVI arrives in Africa March 17, he will no doubt address the continent’s AIDS crisis.
Steven Bwire will be one of the Catholics grateful to hear from him.
Bwire came face-to-face with HIV/AIDS in August 2003, when a swelling appeared on his cheek. When his wife learned that the swelling was related to HIV, she deserted him, leaving him with all their children. Bwire also had just lost his brother to AIDS.
A relative who knew about a Catholic program at Our Lady of Africa parish in Kampala, Mbuya, Reach Out HIV/AIDS Initiative, asked him to seek medical help.
“As expected, the result of the test was positive, but there was nothing I could do,” Bwire recalls. He was put on both cancer and antiretroviral drugs.
Above all, as a faith-based organization, people at Reach Out believe in what they are doing, Bwire said. “I am particularly challenged by the way the organization avails its services to all, without any religious, ethnic or political discrimination,” he said.
The parish-based organization also impressed Bush administration officials when they visited it in 2003. Reach Out became the first beneficiary in Africa of U.S. funds to fight AIDS.
Without steady funding, it was rough going for Reach Out in the early days. Father Joseph Archetti of the Italian Comboni Missionaries, the pastor who initiated the program with Danish Dr. Margrethe Juncker, saw clients in his office, and Juncker’s car served as a mobile clinic. There were no testing facilities. Volunteers signed up to work on a weekly basis.
When a group of American doctors came to Mulago Referral Hospital, they extended their visit to Reach Out and took blood samples from more than 100 clients. When the results came back, more than three-quarters of the clients urgently needed antiretroviral drugs, which they didn’t have because Reach Out could not afford them.
“It was such a heartrending revelation that totally threw us into panic,” said Rose Ochen, a nurse in charge of the antiretroviral therapy department. Ochen joined Reach Out in 2002, after working at the local military hospital.
In the meantime, one of the clients had gone to the government’s Joint Clinical Research Center, which needed clients for HIV/AIDS studies. “They would give them drugs,” Ochen recalled. “When the lady came with this news, it was like a miracle for us.”
They met with Joint Clinical Research Center officials, and, immediately, the studies began. But some clients whose CD4 count was at zero died, while children and pregnant mothers were not taken on. CD4 cells, or T-cells, help protect the body from infection.
Then, in December 2003, when officials from the Bush administration visited Uganda, they visited Reach Out and interviewed Ochen about their activities.
Some months later, the organization also benefited from the Global Fund to Fight AIDS, Tuberculosis and Malaria through the Uganda Ministry of Health — even as there has been some disquiet about the Church’s stand in the use of condoms in the fight against HIV/AIDS in political circles.
Last year, the Register spoke with secular experts who said that, in many places, condom promotion actually increases AIDS.
Edward Green is director of the AIDS Prevention Research Project at the Harvard Center for Population and Development Studies. He wrote Rethinking AIDS Prevention: Learning From Successes in Developing Countries and reported that, between 1989 and 2001, the average number of condoms per male ages 15 to 49 in African countries skyrocketed. So did the number of those infected with HIV. South Africa, Botswana and Zimbabwe had the world’s highest levels of condom availability per man. They also had the world’s highest HIV rates.
Norman Hearst is a family physician and epidemiologist at the University of California, San Francisco.
UNAIDS, the Joint United Nations Program on HIV/AIDS, asked Hearst to do a scientific review to see if condom promotions had reversed HIV/AIDS epidemics. His review found the contrary was true. Countries with the most condoms per man tended to have the highest HIV rates. UNAIDS refused to publish Hearst’s findings.
“Condom promotion in Africa has been a disaster,” Hearst said.
Nearly every country on the continent has vigorously promoted condoms to stem the tide of the AIDS epidemic there. But the epidemic has only grown larger.
Uganda, on the other hand, has experienced the greatest decline in HIV prevalence of any country in the world, according to the Heritage Foundation. The Ugandan public education campaign against AIDS mentioned condoms, but emphasized abstinence.
Studies show that from 1991 to 2001 HIV infection rates in Uganda declined from about 15% to 5%.
“The Ugandan model has the most to teach the rest of the world,” said Green. “This policy should guide the development of programs in Africa and the Caribbean.”
Jeff Spieler, chief of the research division in the U.S. Agency for International Development population office, said, “It just happens to be where the evidence is pointing.”
Archbishop Christophe Pierre, former papal nuncio to Uganda, in an interview with Catholic Monthly magazine, affirmed the Church’s role in fighting HIV/AIDS without resorting to condoms.
“The Church does not only tell a young boy or girl of 12 years to be protected from AIDS, but fully provides a human education, of which sexual education is part and parcel,” said the French Church diplomat, who is now stationed in Mexico. “The Church teaches what it means to have a human relationship and sexual relationship, insisting that one has a sexual relationship inside marriage and faithfulness for those who are married.”
“The fight against AIDS is … about education that helps people to rediscover what it is to be truly human,” said the archbishop. “People get sick because of a lack of education, poverty, etc., and once they discover their dignity, they can fight against the sickness. And I see many Church institutions helping affected people to ‘resurrect.’”
Food for the Sick
From the original 14 clients who visited the Reach Out clinic in 2001, the organization now has about 3,000 clients. Of these, 1,606 are on antiretrovirals. Reach Out has three clinics in Kampala, with a fourth branch in another diocese. It has a team of 22 professionally trained nurses and four medical doctors besides the administrative staff.
They have clinics open four days a week, and once a week they visit bedridden clients, whom they help with cooking, eating and bathing.
But Reach Out does not carry the whole weight of HIV/AIDS care alone. They encourage family support during home visits and train people in the care of their sick relatives to ensure that the client does not default on his medication.
Steven Bwire observed that some people still utter rude comments about HIV-positive people. He won’t get that at Reach Out, though. What touched him most when he joined Reach Out was the caring attitude of the staff.
“With the warm and friendly atmosphere, it was difficult to differentiate clients from staff,” he said. “Reach Out has a culture of exchanging greetings among staff and clients, and I believe that relieves clients from stigma.”
Sister Grace Candiru of the
Missionary Sisters of Mary Mother of the Church
writes from Kampala, Uganda.