THE TEACHINGS OF THE LOCAL CHURCH ON HUMAN SEXUALITY
5.2 THE TEACHINGS OF THE SACBC ON HUMAN SEXUALITY
5.2.6 The Church's Response to AIDS
Bishop Dowling5, in Munro (2001), in his article, 'The Church's Response to AIDS' describes the situation ofHIV/AIDS in South Africa Using September 2000 statistics, he notes that the province of Kwazulu-Natal is already having a negative rate of population growth. He analyses the devastating effects of the pandemic in the region. He cites political reasons as one of the major causes of the spread of HlV/AIDS. White supremacy and racism coupled with capitalism led to many people being dispossessed of their land. This led to the destruction of the culture of the people, which created an alienated and rootless population, "a society whose moral and social fabric has been shattered" (2001: 16). Another reason for the spread of this pandemic is poverty. He says HIV/AIDS 'lhrives in overcrowded situations, where people have minimal to very poor nutrition, and where their social condition and poverty can drive them to liaisons and relationships which are fraught
5Bishop ofRustenburg.
with dangers" (2001: 17). A holistic approach to
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IAIDS is needed. Community- . based care coupled with value-based awareness and prevention campaign is needed.The Church is called to have a response, which is based on the values of the Gospel, values of compassion, solidarity and justice.Inan interview by Williarns in
Byamugisha (2002) Dowling sees the Catholic Church as responding to the AIDS crisis through home-care, orphan care and ministering to the dying. He sees the Church as still struggling in the area of morality and theology surrounding
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prevention. Itis struggling to get a meaningful message to where people are. Itis easy to adopt a pharisaic approach, telling people to keep God's law. Such an attitude would be blind to the realities of millions of people, especially women who have lost their loved ones and are trying to make a living. Meeting such people in their situations and listening to them will help the Church to develop a theology that is not skewed. Dowling believes that caring should assure those dying that God loves and treasures them. The Church is thus called upon to protect life, even the life of those women whose option and choice has been taken away by the socio- economic and cultural situations they find themselves in. Insuch situations Dowling believes people should be invited, even challenged, to use a condom in order to prevent the transmission of death, or to protect themselves from infection
"especially in abusive and destructive relationships" (2002:95). Due to the influence ofHumanae Vitae condoms have been seen as contraceptive measures.
Dowling challenges the Church to see condoms as incidentally contraceptive and primarily for the prevention of the transmission of death in this context.
Dowling represents a watershed in the teachings of the Southern African hierarchy on the issue of
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AIDS. His stance with regard to the use of condoms in the face of the AIDS pandemic makes him a controversial figureinthe structures of the SACBC. His concern for life, together with his experience of the situation of poverty-stricken areas, makes him want to respond compassionately and mercifully to those who are infected by the H I virus. He theologises from the context of human pain and suffering and from his fist-hand experience of people dying from AIDS. He also notes the situations that aggravate the spread of Aids, like poverty and unemployment. Due to his stance on the issue of AIDS and the use of condoms I had an interview withhimand askedhimto respond to questions,~hichI asked.BISHOP DOWLING'S RESPONSES TO OUESTIONS
(May I begin by stating that I am not a theologian; I do not have degrees because I was never able to study for them. I have spent my whole life 'theologising in the context' particularly around issues of injustice and abuse of human rights, the global economic system, international debt issues, poverty and underdevelopment,
democracy and reconciliation, environmental justice, IDV/Aids and so on.
Therefore, whatever I hold as a personal opinion is simply the fruit of my own personal reflection on various issues in the living context of people's lives as I experience that reality. Inno way am I am expert on anything; if I have any claim at all it is simply that I have not formed opinions aboutall these issues in 'ivory towers' from a theoretical perspective.Ithas come from real personal experience, e.g. of the situation faced by single women, totally impoverished as economic refugees, living in shacks next to mine hostels, and whose only option in life is how to survive for one more day. I have sat in those shacks with those women.)
Question 1: Explain this controversy about you, the bishops and the condom issue.
1) Background
InJune 2001, I was in the USA as the SACBC AIDS Office liaison bishop, to discuss the AIDS programmes and projects in five countries that are being administered by the SACBC AIDS Office, especially with Catholic Medical
Mission Board (CMMB) and Catholic Relief Services (CRS). That visit was part of our ongoing evaluation of the partnership and the programmes, and to discuss a new initiativeviz. the provision of a Mother to Child Transmission prevention
programme in seven pilot clinics and hospitals.
InFebruary 2000, when Archbishop Buti Tlhagale and I went to New York to sign the agreement with Catholic Medical Mission Board, I was interviewed by Tracy Early of Catholic News Service who asked if the Bishops of South Africa had made any statement on the condom issue. I said that at some time in the future we would
probably issue a pastoral letter on AIDS, and that perhaps the issue of condoms . might be dealt with within that letter.
This time, on 28 June 2001, I wasagaininterviewed by Tracy Early ofCNS, and she reminded me of his question one year before, and whether there had been any progress on the issue. I told her that three bishops were preparing a pastoral letter on sexuality, which is the fundamental issue in terms of AIDS. However, a pastoral letter tends to be fairly short. At the same time I told her the SACBC AIDS Office was preparing a longer reflection document, more in the line of a pastoral statement, within which the issue of condoms would be treated among other items. The first draft of this statement would be presented to the forthcoming SACBC Plenary Session in July for comment and possible acceptance. I expressed the hope that the reflection document would be accepted.
He asked me then what was the thinking on condoms. I told him the bishops had not discussed this yet, and so he asked me to give my own viewpoint. I proceeded to give him what is my personal view, and carefully. I tried to present the context as holistically as possible, and spoke to him and clarified my stance for about 30 minutes.
My personal stance on this issue comes out of much reflection, not to say anguish over the enormity of the suffering of people in the AIDS pandemic, of the complex issues which have to be faced, all of which I have experienced in a very personal way in my own ministry and support of AIDS programmes in the diocese here. In no sense, therefore, was I trying to speak for the Bishops' Conference. I had been asked a question which I did not know would be posed, and I tried to respond honestly, and not shirk from facing the issues as sincerely as I could, mindful always of my view that as Church we must tryto speak a word and be a presence of life and hope in what are, often, very complex situations.
2) Myresponse
What I said was basically the following. I stated right away that as Church we are committed to a 'culture of life' from conception to death, and not to a 'culture of
death'. We promote what supports a 'culture oflife'.Intenns of the context of . AIDS and prevention, I stated unequivocally that as Church we hold the position
that the only complete safeguard against infection by the III Virus and AIDS is abstinence from sex before marriage, and faithfulness to one's partner in marriage.
If someone does not follow this then, in my opinion, we would call for a change of lifestyle by that person in view of avoiding becoming infected with the virus.
However, we live in the real world, which is complex in tenns of the views,
decisions and actions of people. We live in a world where people choose not to live according to the values espoused and promoted by the Church, or who simply decide how they will live and act without any thought or reference to such values.
Inthat context, and in the very real context of the vast problem of AIDS affecting millions in our land (5 million \Vith HIV, 1 million orphans projected by 2005), the issue then becomes one oflife and death. The question then is stark in terms of its possible outcome, viz. that a person has the capability through a sexual relationship of transmitting a virus that can cause death to another person. Responsibility for one's choices and for one's actions towards another person has the potential either to protect from or to cause potential death, if one is infected with the III Virus and one chooses to enter into a sexual relationship with another person.
In that context, the use of a condom can be seen not as a means to prevent the 'transmission of life' leading to pregnancy, i.e. as contraception, but rather as a means prevent the 'transmission of death' or potential death to another.
The Churchinits education and prevention programmes must, besides its major emphasis on education in life-giving and life-preserving values, alsotryto give people accurate and comprehensive information about condoms, including their failure rate, so that wetryto help people become fully informed in view of taking responsibility for their choices and actions, i.e. to build up an informed conscience, as far as this can be done with people. There are also sensitive cultural issues surrounding sexuality as well as condoms that need to be addressed wholesomely and holistically.
Several important issues were addressed by the Prime Minister of Mozambique, HE. Pascoal Mocumbi, in his address to the United Nations on 25 June, a speech that I heard. (SeeAppendix 2.)
3) Further personal reflectionsbyme
One cannot, therefore, treat the issue of condoms in isolation or simply from one particular aspect. The fact that so much effort has gone into promoting 'safe sex' through the use of condoms, and our
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infection rate is still rising, shows that there are other issues that need to be faced. Even the focus on 'safe sex' through using condoms, for example, does not protect a person from an assault on their personal dignity through force and sexual violence. Hence the need to promote values which ensure and enhance the dignity and worth of people, self-respect, respect for the rights of others, especially women and children, and a mature sexuality which will enable people to recognize and accept that they need to take personal responsibility for their decisions and actions, especially when such decisions could be a matter of life and death for another person.It is within that context of values that I am trying to situate the issue of the 'use' of condoms. If we simply proclaim a message that condoms cannot be used under any circumstances, either directly or through not trying to articulate a proper response to the crisis we face, then I believe people will find difficulty in believing that we are committed as Church to a compassionate and caring response to people who are suffering, often in appalling living conditions. The fact that condoms are not 100%
safe in every case cannot be advanced, in my view, as an argument that they should never be used in any circumstance. We live in an imperfect world, and sometimes even imperfect results at least can save some lives.
We need to be able to speak a word of life and hope to people who have to face very stark choices. Ifa husband becomes infected with the HI Virus, the wife could also become infected and both could die leaving their children as orphans. Itis so important that the wife at least should continue to live and care for her children with whatever support can be provided by others and the community. Inother words, to opt for what is 'the greater good' in this difficult situation, so that life can be
protected and promoted. People in such a situation need to feel cared for, accepted, . loved and supported, and the Church should be right at the heart of such a response.
We need to enable people to really feel that no matter what has happened in their
·life, we as Church will walk with them, accompany and support them in that caring, compassionate and deeply respectful spirit right to the point of death, and beyond death for those who are left behind.
The issue of the possible use of condoms cannot, therefore, be dealt with unless at least all these issues and values are taken together to provide the context within which we view the question as a matter of the 'prevention of death' for people who may be living in all types of circumstances, such as a single woman who
desperately seeks a way out of hopeless poverty and is almost driven or forced into seeking liaisons which offer her a way out, but which at the same time hold the potential of death for her through becoming infected with the IDV. Such
impoverished women, in my view, do not have any options at all in life except how to survive - and the only way to survive for them is more often than not, being forced into prostitution.
The ethical issue for me is a profound question ofjustice, therefore, and we need to 'create' a moral theology around the issue of 'survival' (which is the only issue for millions of poor people), and not a moral theology which only speak to an 'ideal' situation. The question for me is simply this: what do we as Church say to a 23 year-old women, an economic refugee from countries to the north of us (therefore, illegal and unable to access any grants), who has one or two little children, who is desperately trying to find food in a miserable shack with no water or toilet or anything, and whose only way out is to offer sex to a miner from the hostel who has money?
There are so many real people living in such real conditions, and I believe we, as Church must struggle to discern answers to real questions, and above all face the real questions with humility. That may mean that we humbly admit that sometimes there are no answers to some of the difficult issues and questions, but that always we can offer people the experience of the compassionate, caring God who is with people no matter what.
5)Summary of my position
I consider that when we take all these issues and values into account, and when people for whatever reason cannot or choose not to follow the values we promote as Church (people both within and outside of our Church community), then the bottom line is the real possibility that a person could transmit a death-dealing virus to another through a sexual encounter. Inthat context, such people who are living with theillVirus must be invited and challenged to take responsibility for their actions and their effect on others, and should use a condom in order to prevent the transmission of potential death to another.
And for the women - who are my primary concern and focus in this issue, and who are precisely discriminated against politically, economically, culturally and socially - they have, in my view, a basic right to life. Their life was not only precious when it was conceived; their life is precious until the moment they die, and beyond death.
That life should be protected, and in a situation which is totally beyond anything remotely approaching what would be regarded as 'acceptable', never mind 'ideal', that person needs to have options which will enable her to protect her life from a potential death-dealing virus.
Inmy view, this is taking both the spirit and content of our moral and ethical tradition as Church (the principles of 'double effect', 'the lesser of two evils' or preferably 'the greater good', 'no harm or violence'), which is a 'living' tradition, and trying to apply this to very complex situations at times. For me, this is not only a matter of promoting chastity as a value, therefore, but also a matter ofjustice in terms of the potential for death in another person.
We cannot compound one human failure in terms of chastity - where someone engages in sex for whatever reason or because they are 'forced' to by economic conditions - with what I would regard as a far greater failure in justice by insisting that people who have no options atall, must follow the moral ideals that we proclaim as Church when their living situation precisely prevents taking any moral decision except how to survive. That is a question ofjustice, and not just morality
in the narrow sense. And in particular situations, we have totryand discern what is the 'greater good' and promote that. In the end the question may be fairly simple: in this context, with this particular person in this situation, what is required so that there may be life and not death?
That was basically my position, with its nuances and so forth. Itcaused a storm of discussion two years ago. The bishops met a couple of weeks later, and as you know rejected my viewpoint, and made a very strong attack on condoms as opening the way to promiscuity and, indeed, as a possible cause of the AIDS pandemic reaching the proportions it has. You have the 'Message of Hope' issued by the bishops. I personally do not agree with the attack they made on condoms. They did, however, indirectly address the question of what to do in the case of a sero-discordant couple, and basically stated that they must make a decision in conscience.
Where they differ from me is also in terms of the approach. I think they would recognise that in the 'internal forum - i.e. a priest meeting someone with this problem - a 'pastoral solution' must be found. They disagree with the fact that I brought the debate into the public domain.
Question 2. Do you believe that the SACBC is responding effectively to the AIDS pandemic?
Yes I do. You can get a whole range of documentation on the excellent programmes being implemented by the SACBC AIDS Office from the Office itself There is no doubt that the Catholic Church isin the forefront and is doing far more than most in terms of creative and holistic programmes concerning prevention and education (particularly through peer ministry by young people and young adults), the home- care and counselling system in parishes and villages, orphan care and day-care centres for orphans, hospices, and on a whole range of advocacy issues at national and international level regarding access to treatment, ARVs and so forth.
Question 3: What more can the Church do to show solidarity with those infected and affected byHIVIAids?