NEW DELHI, India – The number of HIV and AIDS cases are at epidemic proportions in India. Now, a new clause will be added to Catholic dioceses’ prenuptial inquiry forms are asking prospective brides and grooms to inform their future spouses if they are suffering from “any communicable disease.”

The executive committee of the Catholic Bishops Conference of India made the change at its April 29-May 1 meeting in the Indian capital.

“It is true that this comes in the wake of the worsening AIDS scenario in the country,” said Bishop Bernard Moras, head of the Belgaum Diocese in southern India and chairman of the Catholic Bishops Conference of India's commission for health care apostolate.

While India has more than 4 million HIV-positive cases, according to government data, health experts say the figure is much smaller than reality. The U.S. CIA recently projected that India will have the worst AIDS epidemic in the world, with 25 million HIV-positive cases, by 2010.

Amid such gloomy projections, Indian states such as the southern Andhra Pradesh already have announced plans to enact legislation to make premarital AIDS testing mandatory.

Church officials have endorsed such action. The Nazrani Catholic Priests’ Conference – an unofficial forum of diocesan priests in the autonomous Syro Malabar Church based in the southern Kerala state – recently demanded changes to Syro Malabar Church statutes to make an AIDS-free certificate mandatory for church weddings.

However, Bishop Moras said, the Catholic Church “cannot approve such measures that violate the individual's right to privacy.” All the same, he pointed out that the Church is “aware of the seriousness of the issue raised and the duty to safeguard the interests” of those who enter wedlock in good faith.

So, when the parish priest fills out the prenuptial inquiry form, which is to be signed by the engaged couple, he will remind the partners of their duty to reveal and the right to ask each other whether one is suffering from any serious ailment.

“But our role does not end here,” Bishop Moras said. The Catholic Bishops Conference of India's standing committee, he said, has urged all Church personnel “to respond seriously to the [AIDS] problem facing the nation.”

“We have decided to ask all our commissions and the institutions to be sensitive to this [AIDS] challenge while planning their activities,” Bishop Moras said. “None of our institutions should turn away a patient simply because he is suffering from AIDS.”

Outcasts

As many who suffer from AIDS are becoming “outcasts” in their own families and even denied access to hospitals for treatment, Bishop Moras said, “we have the duty to make a serious effort to stop this stigmatization.”

He cited the widely reported case of two orphaned AIDS-infected children in Kerala, one of India's most progressive states, with a 91% literacy rate. The HIV-positive Christian children – Benson, 5, and Bency, 7, whose parents died of AIDS – were expelled from school under pressure from parents who feared their children, too, would be infected if they mingled with the siblings.

Reluctant to take on people's fears, Kerala set up a school exclusively for HIV-positive children.

“Even medical staff in our hospitals used to shiver when they first came across an AIDS patient,” said Father Sebastian Ouseparambil, director of the Catholic Hospital Association of India, which has more than 3,000 Catholic hospitals and health care centers under its umbrella.

However, with intensive training beginning in 1993, Father Ouseparambil said, the Catholic Hospital Association of India has been able to prepare a team of nearly 700 committed Church health workers to deal exclusively with those suffering from AIDS. The Church now runs 36 hospitals across the nation dedicated to the care of HIV/AIDS patients who are denied treatment in major government hospitals, even in New Delhi.

Catholic Hospitals

A 31-year-old HIV-positive Christian widow living in a Church AIDS rehabilitation center in Chennai tearfully told a reporter she was thrown out of her home soon after her husband died of AIDS. While her two older children are studying at a boarding school, her youngest child, 5, is also infected and stays with her at the rehabilitation center, called Poorna Jeevan(Complete Life). All 13 residents at the center – most of them widows in their late 20s and several college students – have been disowned by their families after being diagnosed with AIDS.

The “family discriminates the most” was the common refrain from those afflicted with AIDS, according to a 2001 study conducted by UNAIDS, the joint U.N. program on HIV/AIDS. The study, “AIDS-Related Discrimination, Stigmatization and Denial,” found that discrimination occurs in most hospitals, even after death. Insurance firms even deny benefits to families of those who die of AIDS.

The study singled out Catholic hospitals for their “unconditional care” for stigmatized AIDS victims.

“Church-run hospitals and a few other private ones [in Mumbai] had opened all their treatment facilities to patients with HIV and AIDS. Indeed, Catholic hospitals were in the unusual position of having a written policy on AIDS that clearly stipulated the provision of unconditional care to patients with HIV,” the UNAIDS study said.

Condom distribution, of course, is not on the Church's agenda, even though it is on the United Nations'.

Meanwhile, the Indian Church has opened a new front in its bid to educate the public against “disowning and ostracizing” those with HIV. The Catholic Bishops Conference of India's commission for health care in 2000 instituted a chair on HIV/AIDS at India's leading university, Indira Gandhi Open University, with a contribution of 5 million rupees ($106,000). Even the curriculum for two diploma courses for health workers run by the chair is jointly prepared by Church workers and university staff.

“The response [to the courses] is very good,” said Father Alex Vadakkumthala, executive secretary of the health care commission. More than 2,000 health workers employed in government and private health care have already enrolled in the courses.

“Even ordinary health workers lack proper knowledge about AIDS and its infections,” Father Vadakkumthala said. “We need to educate the public on how to prevent AIDS. Our motto is ‘prevention is better than cure.’”

Anto Akkara writes from New Delhi, India.