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Participants in Recent HIV/AIDS Study Speak Out

Do religious organizations play a significant role in the fight against HIV/AIDS? That’s the question behind a recent study by the Global Health Council. Voice of America reporter Cole Mallard has the story.

The study is entitled: “Faith in Action: Examining the Role of Faith Based Organizations in Addressing HIV/AIDS.”

It’s intended to encourage discussion between members of faith-based organizations, FBOs, and others active in fighting the disease.

Among the six countries participating in the study, three are African – Kenya, Uganda and South Africa.

Dr. Isaac Nyamongo is with the Institute of African Studies at the University of Nairobi in Kenya.

“The aim of our study was to explore the perceptions of key decision makers about the involvement of FBOs in HIV/AIDS work … and our hope is that this study will provide a basis for making informed decisions. FBOs we hope will also understand how they’re perceived, and what people think FBOs can do.”

Dr. Erasmus Otolok Tanga - a researcher working with Uganda’s Institute of Public Health - said the effect of FBOs in developing countries is “quite enormous.”

“We find that the FBOs provide nearly 50 percent of all health care, and they’ve been very efficient in carrying out the services to people living with HIV/AIDS, and they have very strong infrastructure.”

Another study participant was Johannah Keikelame, a lecturer in Health Sciences at the University of Cape Town in South Africa. She said FBOs play an important role in providing spiritual support, emotional and pastoral care and counseling for people with HIV/AIDS.

“FBOs are an additional strong resource because government cannot do it alone … they really make a difference … the vast majority of issues are dealt with by faith based organizations … they instill hope, and they restore hope, they help people to die in dignity … FBO’s engage with people on [a] daily basis, so its part and parcel of people’s lives … they are the first level of care and contact at grass roots levels … most of them reside in communities, therefore they’re accessible, and they are also trusted by their communities.”

Dr. Nyamongo said those interviewed for the study say churches have become more involved in dealing with HIV/AIDS, and there’s a reason for that.

“There’s an increase in the number of patients who are also members of churches … We have situations in some countries where even the clergy are now coming out openly to say … we’re infected. And this is something that has now … opened the eyes of the faith based groups that [it’s] a problem within the church.”

Dr. Nyamongo said one of the ways the church is getting more involved – particularly in poor countries – is to lobby the government more intensely. He said governments must understand that FBOs need to have a stronger voice in public policy making. One example is getting greater access to anti-retrovirals, and bringing the cost down.

Some said faith-based organizations rely too much on ideology and not enough on science. Dr. Nyamongo said FBOs base their programs on a “mixture” of the two.

He said, ”Ideology and science seem to conflict. In places where science is taken into account, it only, in my opinion, plays a smaller part. The faith based groups need to be able to recognize the importance of using empirical data in their activities so that support for the patient goes beyond just providing spiritual support.”

Dr. Otolok-Tanga said FBOs are moving more toward practicality in treating HIV/AIDS.

“In Uganda currently there is that move of ensuring that there is empirical evidence in their activities, such that they are able to document and see what contributions their efforts have made towards the delivery of effective HIV/AIDS health care.”

Still, one of the issues FBOs struggled with is the use of condoms. Whereas non faith-oriented organizations promote them, FBOs are concerned with what they see as moral issues surrounding condoms.

“The reason behind the reluctance of some of these FBOs [to] promote condoms is related to morality … the church is opposed to the underlying habit, and thinking, and the logic behind condom use – that it is okay for you to go and have sex with as many men and women as you want as long as you’re protected. That is the mentality that the church is against, not the use of condoms per se.”

Condoms are part of what is commonly known as the A-B-C approach of AIDS prevention – “A” for abstinence, “B” for being faithful, and of course, “C” for condoms.

Johanna Keikelame of the University of Cape Town says FBOs have difficulty with condoms because of moral issues. But she said the real issue is clarification. She added that many do not realize that the condom, proven safe, is the only means of preventing HIV/AIDS when people engage in sex.

She said for the FBOs, the “C” for condom in the ABC approach has been replaced with “C” for choice. She says:

“(It’s either) you promote ABC, abstinence, be faithful and use a condom … now if we cloud it with choices then we are not sending the correct message. We are running away from the real issue …”

She said the choice of having sex or not having sex leaves open the dangerous possibility of relying on moral decisions to save one’s life. In her words:

“(Definitely)the beliefs and the values held within the FBO community … have a great influence on making decisions with regard to making those choices: should I use the condom, or shouldn’t I use the condom? So those values need to be addressed.”

The report said faith based organizations indeed play a valuable role. Governments are becoming more aware of their influence. The report also said governments appear to be open to FBO funding and their participation in future public policy decisions.

The report made the following recommendations for faith-based organizations: Better coordination with other health sector groups, forming partnerships, promoting compassion while dissuading stigma, improving the link between moral responsibility and scientific evidence, and developing more effective monitoring and evaluation procedures.

The Global Health Council report said among all who fight HIV/AIDS -- faith-based and non-faith based alike – “when it comes to global health, there is no ‘them’—… only ‘us’.”