Faith makes a difference in AIDS care

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FISH HOEK, 19 October 2006 (IRIN) – When Rev. John Thomas brought churchgoers together to serve people living with HIV/AIDS seven years ago, donations came from individual pocketbooks. Their work created a buzz, and by 2001 donations were pouring in from individual congregations around the world. But few orthodox donor agencies took note, reflecting an ambivalence – and sometimes scepticism – towards faith-based organisations.

“Corporations, major foundations, and government bodies all had a degree of suspicion that ‘Actually, all you want to do is proselytize,'” said Thomas, senior pastor of Fish Hoek Baptist Church and founder and chairman of the board of Living Hope Community Centre. “There was a sense that we were about the ‘pie in the sky,’ or just interested in hallelujah.”

But the sentiment has changed in recent years, as faith-based organisations, or FBOs, demonstrate a capacity to deliver services in local communities. South Africa is at the heart of the world’s HIV/AIDS pandemic; according to a UNAIDS report issued earlier this year, one in five adults is living with the virus. South Africa boasts thousands of faith-based organisations tackling the fallout – from modest projects launched by individual congregations to multi-million dollar initiatives.

FBOs do not yet receive universal support within the international aid community; some religious perspectives on HIV/AIDS prevention, particularly around the importance of condoms, clash with orthodox public health approaches. But attitudes towards FBOs are shifting as efforts to contain the epidemic falter.

Living Hope is just one example. Since its inception in 1999, the Christian organisation has become a major service provider in the Deep South peninsula near Cape Town. In addition to hosting a community centre, it manages a home-based care programme with 20 caregivers, distributes food baskets to people living with HIV/AIDS, and provides counselling and prevention education.

Since 2004, it has operated a 20-bed hospice for palliative care, the only one of its kind in the area. In seven years, Living Hope’s full-time staff has grown from 5 to 110. Today, the organisation’s US $800,000 annual budget is supported by donations from major international organisations, including the United States’ President’s Emergency Plan for AIDS Relief (PEPFAR), United Nations Global Fund to Fight AIDS, Tuberculosis and Malaria, and the European Union.

“If you had said to me seven years ago that international bodies would write a cheque to what is in essence a church-based trust, I would have said, ‘Never in a thousand years,'” Thomas said. “But we are being funded, because people see our delivery on the ground and our integrity in accounting.”

It’s also part of a trend, as international donors seek innovative approaches to a regional public health crisis that shows little evidence of slowing down.

“There’s currently more of a focus on FBOs and we’ve been receiving a greater number of questions from different nongovernmental organisations,” said Nelis du Toit, manager of the Christian AIDS Bureau of Southern Africa.

“Churches are very connected organisations within communities,” du Toit continued. “The church structures have been there for so long, all over the country and in rural areas. Often, while other NGOs and state or governmental organisations [struggle] to get things set up, the churches are there already. Also, I think there is a bit of feeling that other NGOs or even government-related activities are not always very effective.”

Faith plays an important role in South African society; according to South Africa’s 2001 census, 83 percent of the population identifies as Christian, Muslim, Hindu or Jewish. That’s spurring some NGOs to broaden their approach.

“The largest social network on the continent is without a doubt the churches, but from a public health point of view, we’ve hardly talked to them at all,” said Dr Garth Japhet, executive director of Soul City Institute for Health and Development Communications in Johannesburg.

Japhet has designed a new multi-media education project called Heartlines in collaboration with religious groups. Launched in July, Heartlines mobilised congregations around the country to lead conversations about how values shape individual behaviours. According to Japhet, the project’s explicit connection with faith groups offers a new opportunity to tackle South Africa’s social and public health problems.

“The end point is about social development, but instead of taking HIV/AIDS and just looking at condom use, it looks at partner reduction, it looks at trust,” Japhet said.

Institutional Advantages of FBOs

When it comes to service delivery in poor areas, religious institutions can offer advantages over their secular or unaffiliated counterparts. “We can attract all kinds of professional volunteers to the party, who wouldn’t come except in the name of Christianity or another faith,” said Thomas of Living Hope.

He noted that the organisation operated for the first 18 months solely thanks to retired professionals, including a doctor, community nurse, and bookkeeper. “That degree is fairly unique to FBOs, because there is a sense that ‘I want to do this for God, not just for other people.’ Whether Muslim or Hindu or whatever, there’s this love for God that says, ‘I’ve got to do something beyond myself.'”

The grassroots nature of many FBOs is also an asset when providing services on the ground.

“Every church has its own unique way of setting up their programmes, adapting and moulding themselves to the needs of their communities,” said Ashley Petersen, field worker with Fikelela AIDS Project, affiliated with the Anglican Church Diocese of Cape Town.

Petersen noted that of the 132 Anglican churches in the area, 94 have established some sort of community response to HIV/AIDS. Some have created home-based care programmes, while others choose to create food packs for HIV-positive support groups. A few churches focus on income-generating projects. Collectively, the diocese funnels resources to youth education campaigns, and to a township emergency foster care home for 24 children, of whom 13 are living with HIV.

Petersen said ongoing stigma about HIV/AIDS remains a challenge inside the church, just as it is in broader South African society. Part of Fikelela’s campaign involves distributing T-shirts and signs that read, “This church is HIV/AIDS friendly,” and “Our church has AIDS.” He said the shared sense of values of religious institutions can help members to educate one another and generate relevant responses to local problems.

“It’s not a one-size-fits-all approach,” Petersen said. “We all have the same way of worshiping, but we can adapt to the needs of our communities.

Increasing International Credibility

While local delivery has played a large part in the changing attitudes towards FBOs, some cite policy changes under US President George W. Bush for bolstering the public’s perception of religious service organisations.

“George W. Bush has elevated the status of FBOs and given them a degree of credibility,” said Thomas. About 40 percent of Living Hope’s budget is funded by PEPFAR, the initiative created under Bush’s administration. Bush has routinely called for partnerships with religious charities and PEPFAR has regularly funded FBOs worldwide.

In 2005, United States Agency for International Development (USAID) granted US $591 million to FBOs, totalling 14 percent of all grants, according to a March report by the White House Office of Faith-based and Community Initiatives. Overall, the same report said, the US federal government awarded FBOs a total of $2.1 billion, or 11 percent of all competitive social service grants, up 7 percent from the previous year.

Faith’s Varying Place in Programmes

While FBOs in South Africa are predominantly affiliated with Christian churches, other faiths have started outreach programmes in local communities. Among all FBOs, the role of proselytizing or spreading overt religious doctrine varies.

“It’s not really part of our programme,” said Kim Heismann, development and marketing manager of the Cape Town office of MaAfrika Tikkun, a Jewish-led charity organisation in South Africa. “We’ve tried to have the programmatic activities be relevant to the communities where we’re operating.”

MaAfrika sponsors a food kitchen in the nearby township of Delft, which serves 300-500 every day, including a weekly project to support those living with HIV/AIDS. It’s a project based in a community where most identify as Christian, and local volunteers begin each meal with a Christian prayer and readings from the Bible.

“We’ve got no Jewish people in the Delft community,” said Nasheema Ismail, project coordinator for MaAfrika Tikkun food kitchen. “But when we tell them where the food is coming from, they are very grateful to MaAfrika Tikkun, and they are very grateful that the Jewish community got involved in Delft.”

But other organisations, such as Living Hope, explicitly share their faith with the community they serve.

“We are here to share the Gospel of our Lord Jesus Christ in a meaningful way,” said interim director Trevor Gray. “We do not lie down that you have to listen to our Bible thumping, although it is part of our ethos. We take the approach that we’ve got to earn the right to share the Gospel. We’re here to share the love of God, and, if necessary, we’ll tell them why.”

All reporting by Gretchen L. Wilson, © 2006

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