HEALTH-AFRICA: Thou Shalt Not Condomise
Moyiga Nduru
http://ipsnews.net/africa/interna.asp?idnews=28101
JOHANNESBURG, Mar 31 (IPS) - Muslims and Catholics do not see eye-to-eye on many issues. But when it comes to practices which they fear will allow the encroachment of unacceptable secular values - abortion, gay marriage and condom use - they quickly close ranks to form a united front against the threat.
This explains why South Africa's Religious Leaders' Forum, which includes members of the Catholic, Muslim and Hindu faiths, has disagreed with Health Minister Manto Tshabalala-Msimang on the need to use condoms in fighting AIDS.
During a meeting held earlier this year in the commercial hub of Johannesburg, forum leader Ashwin Trikamjee said that for moral and religious reasons, the body placed "a greater emphasis on faithfulness and abstinence as opposed to the use of condoms".
In an
interview with IPS, Ahmad Kathrada of the Jamiatul Ulama - an Islamic group based in the coastal city of Durban - said his organisation had education initiatives to promote these two behaviours, and that there were no circumstances under which Muslims were allowed to use condoms.
"It is against the teachings of Islam (on) illicit relationships and fornication," Kathrada noted.
These words were echoed by Ali Abdel-Nour, who teaches Somali refugee children in Johannesburg about Islam.
"Young people find it hard to adhere to the principles of abstinence and faithfulness. This is why young Muslims are encouraged to marry early to avoid indulging in illegal sexual habits," he said.
Repeated efforts by IPS to get comment from the Catholic Church about its stance on condoms were unsuccessful.
However, Cardinal Wilfred Napier of the Southern African Catholic Bishop's Conference is said to voiced fears that condoms were not an effective AIDS de
terrent,
during the February meeting of the Religious Leaders' Forum.
In an interview with the British Broadcasting Corporation last year, Cardinal Alfonso Lopez Trulillo, in charge of family affairs at the Vatican, said the H.I. virus was "roughly 450 times smaller than the spermatozoon. The spermatozoon can easily pass through the net that is formed by the condom."
His remarks were later condemned by the World Health Organisation, which said that correct condom use reduced the risk of HIV infection by 90 percent.
Such comments have resonance in Africa, where religion plays a significant role in many communities. According to the latest figures available from the Vatican, Africa registered a 4.5 percent increase in the number of baptised Catholics in 2003 - the highest such increase globally.
The continent is also the region most affected by HIV, being home to 70 percent of all people who have contracted the virus, according to the Joint United Nation
s
Programme on HIV/AIDS (UNAIDS). In South Africa alone, 5.3 million people are infected with HIV.
This has caused certain AIDS activists to despair about the role of religious institutions in fighting the pandemic.
Molefe Tsele, General Secretary of the South African Council of Churches, takes a more liberal stand in the condom debate, however - publicly criticising the claims of certain Religious Leaders' Forum members that the prophylactics are not an effective way of preventing the spread of HIV.
"All credible scientific studies conclude that the virus that causes AIDS cannot pass through a latex condom. When used properly, condoms are effective in halting transmission of the virus," he observed, in a statement put on the Council of Churches website.
Tsele has also expressed reservations about the effect that the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) is having on condom use.
The 15-billion-dollar initiative places
considerable emphasis on abstinence, saying a refusal to have sex before marriage constitutes the best way of avoiding AIDS.
Condom use is not forbidden. However under PEPFAR, distribution of the prophylactics is mostly aimed at the members of so-called "high risk" groups, such as sex workers. The 'U.S. Five-Year Global HIV/AIDS Strategy Report', issued in 2004, speaks of promoting condom distribution amongst "specific at-risk populations...These groups include prostitutes, sexually active discordant couples (where only one partner has HIV), substance abusers, and others."
But, says Tsele, "This message creates the false impression that sex within marriage is not 'risky' unless the couple know that one partner is infected."
"In fact," he adds, "women are particularly vulnerable to infection, often by husbands whom they incorrectly presume to be faithful. Fidelity alone is not an adequate defence against HIV."
The discord between Africa's relig
ious
leaders concerning AIDS prevention may be viewed with interest in other parts of the world, such as Asia, where HIV is gaining momentum - and where faith is central fact of life for many.
Perhaps they might end up drawing their best lessons about the interplay between religion and AIDS from Senegal.
As IPS reported last year, government and religious leaders in this West African country have compromised on matters such as condom distribution, opening the way for Catholic and Islamic institutions to play a key role in fighting the pandemic.
The results have been impressive. According to UNAIDS, HIV prevalence in Senegal currently stands at less than one percent. (END/2005)
=============================
HEALTH-SENEGAL: Cardinals and Khalifs Unite Against AIDS
Mercedes Sayagues*
http://www.ipsnews.net/new_nota.asp?idnews=24549
DAKAR, Jul 8 (IPS) - It's 13:30 in the Senegalese capital, Dakar, on Friday. Traffic stops around the Old Mosque. The sound of babouches shuffling on the pavement replaces hooting. Thousands fill the streets.
When the muezzin calls, they kneel, bow and pray in perfect unison. It is a moment of intense collective spirituality - and a chance to ponder the more earthly problem of AIDS. The sermon dwells on how to avoid contracting HIV, and the fact that people who are infected with the virus must be helped, not shunned.
On Sunday, Catholics will hear a similar message during Mass.
This partnership between religion and public health has been one of the pillars of Senegal's anti-AIDS strategy. And, its success is beyond dispute -- a point worth noting as delegates from around the world prepare for the Fifteenth International AIDS Conference, to be held in Bangkok from Jul. 11 to 16.
HIV prevalence in Senegal remains low, at 1.4 percent of the 10-million-strong population. This amounts to some 80,000 HIV- positive people.
Although Senegal shares some of the problems common to West Africa such as poverty, it has managed to pull off what other nations in sub-Saharan Africa have not: implement rapid response and prevention programmes for AIDS.
While many of t
he
continent's leaders under-stated the significance of the pandemic for years, or responded to it apathetically, Senegal's government swung into action as soon as the first six cases of AIDS were diagnosed in 1986. A team of respected scientists and doctors persuaded the then president, Abdou Diouf, that this might be the country's only opportunity to contain the spread of HIV.
By the end of 1986, a national AIDS body was working to guarantee a safe blood supply, measure the spread of the epidemic, expand existing programmes for control and treatment of sexually transmitted diseases - and reach out to sex workers. These persons must be registered and have regular medical check-ups, where they are provided with information about AIDS, and free condoms.
But AIDS officials soon realized that the health sector could not win this ba
ttle
alone. Religious leaders, non-governmental organizations (NGOs)and community groups had to do their part.
With its network of thousands of mosques which enjoy high attendance for Friday prayers, Islam's potential to encourage prevention and solidarity was huge.
A rich variety of religious organizations, sports and cultural clubs, women's groups, village and neighborhood associations was thus tasked with AIDS prevention nationwide.
"The AIDS response was built on the lively and complex local human architecture," says Gary Engelberg, Director of Africa Consultants International - a Dakar-based NGO that focuses on cultural and health-related activities.
This contrasted sharply wi
th the
way in which religious leaders reacted to AIDS in other countries.
The first instinct of many was to associate the spread of HIV with loose morals, condemn those infected - and oppose AIDS awareness initiatives like condom distribution in schools. This was done because of fears that it might encourage promiscuity amongst pupils.
In Senegal, government and religious leaders reached a tacit agreement. Clerics would preach abstinence and fidelity but would not oppose condom campaigns. In turn, condom promotion would be "soft" and stress responsible sexuality.
"Each actor has an area of responsibility and we complement each other," says Bamar Gueye, National Coordinator of the Islamic NGO, Jamra.
Senegal is a deeply religious country. Ninety-four percent of citizens are Muslim, and four percent Catholic. Muslims networks or "confreries" are very strong, while the Catholic Church's influence derives from the many schools and clinics it runs, as well as its dynamic youth movement.
"We needed to work with religious leaders to succeed," says Ibra Ndoye, Executive Secretary of the National Council for the Fight against AIDS (CNLS), and a key architect of the response since 1986.
In briefings with Islamic leaders, health officials explained the disease and why preaching that AIDS was a divine punishment for sin would increase stigma and discrimination.
"After training, we realized we should not stigmatize sex workers or p
eople
with AIDS," recalls Gueye.
In 1988, Jamra signed an agreement with government concerning the Muslim response to AIDS. Staff from the NGO and health officials started to visit imams, khalifs and traditional authorities to discuss the epidemic. Slowly, the perception these leaders had of HIV/AIDS changed.
In 1991, top Islamic leaders heard their first account from an HIV-positive person of what it meant to have contracted the virus.
In 1992, a "community train" staffed by volunteers conducted AIDS prevention nationwide.
In 1995, Jamra published a guide on AIDS in French and Arabic, which gives factual information about HIV/AIDS and explains how living according to Islamic princi
ples can
prevent its spread.
The guide advises against female circumcision, wife inheritance, premarital sex, anal sex and sex during menstruation. Use of condoms within marriage is allowed. By the late 1990s, many imams were supporting a grassroots campaign to stop female genital mutilation.
Today, the Society of Women against AIDS in Africa (an NGO headquartered in Dakar) reports that rural imams support their promotion of the female condom among married couples. The imams ruled that a wife has the right to protect herself from infection.
The involvement of the Catholic Church was slower, partly because Cardinal Hyacinthe Thiandoum (who died in May) was deeply opposed to condom promotion.
But in 1991, a group of young Catholics began promoting AIDS awareness in schools. These efforts resulted in SIDA Service, an NGO that specializes in AIDS prevention, voluntary testing and counseling (VCT) - and in care and treatment of HIV-positive persons.
Its founders set out to change the Catholic hierarchy's attitude, visiting each bishop and archbishop in the country from 1992 to 1993. "It wasn't easy, but we were known for our religious commitment so the bishops listened," says Paul Sagna, Executive Director of SIDA Service.
Their efforts crystallized in a conference, 'AIDS and Religion: the Responses of Christian churches', held in Jan. 1996.
Today, each of the seven dioceses has a SIDA Service committee with several "antennes' (outreach
points)
in the community. The activities of these committees include prevention, testing, counseling and care of people who have contracted HIV.
SIDA Service started the first free VCT facility in Dakar in 2000 and now runs eight of the dozen VCT facilities in all regions.
To avoid stigmatisation of its clients, SIDA Service in Dakar renamed itself the Cardinal Hyacinthe Thiandoum Centre for Health Promotion (Centre de Promotion de la Sante Cardinale Hyacinthe Thiandoum).
Fittingly, in November 1997, Dakar also hosted the First International Conference on AIDS and Religion, sponsored by the Jointed United Nations Programme on HIV/AIDS (UNAIDS) and the European Union.
The partnership a
dvanced
further in May 1999 with the launch of the Alliance of Religious Leaders and Medical Experts Against AIDS (Alliance des Religieux et Experts Medicaux Contre le SIDA) comprising Jamra, the Association of Imams of Senegal, SIDA Service and CNLS. The Alliance conducts AIDS prevention and training and organizes national and international conferences.
As various researchers have noted, certain aspects of Senegalese culture have assisted the country to contain the spread of HIV. These include conservative attitudes towards sex, low levels of alcohol consumption and universal male circumcision (which affords men a degree of protection from HIV).
However, there's no denying that roping religious leaders into this battle was of great importance.
Today, the vir
tues of
a partnership between religious and public health institutions have become part of conventional wisdom. Sixteen years ago, however, this was a groundbreaking approach to fighting AIDS - and sadly, still a rarity in other African states.
* Mercedes Sayagues is currently doing a best practice study on AIDS policies in Senegal for the South African Institute of International Affairs, at the University of the Witwatersrand in Johannesburg. (END/2004)
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