Global Report

by Sharon Mumper

A special report on AIDS and missions

"We used to laugh off the stories of evil spirits in Tanzania sucking the blood out of the traders who went there," says Flora Mubi, team leader of Youth With a Mission’s Ugandan Christian music, dance, and drama group Heart-song, renowned for its creative approach to AIDS education and evangelism. "While we were laughing, the disease was spreading into central Uganda, and people started seeing their relatives die."

Although in the last 10 years AIDS has spread to virtually every country on earth, the World Health Organization (WHO) estimates that over half of the world’s HIV infections have occurred in sub-Saharan Africa. (HIV is the virus that causes AIDS.) Most of the 21 members of Heartsong, based at YWAM’s center in Wairaka, Uganda, have lost family members to the disease, according to a report in YWAM’s International News Digest last year. According to WHO, in some cities in East and Central Africa, up to a third of the men and women aged 15 to 49 had been infected by 1992. It is likely most, if not all, will succumb to AIDS, leading to predictions of disaster for the regional economies, political systems, and societies.

But Africa does not stand alone on the edge of the abyss. In the United States, the country with the largest number of reported AIDS cases, the of new infections apparently has decreased. However, in other parts of the world, notably Asia, the rumbling of an approaching storm is just beginning to be heard. In South and Southeast Asia, WHO believes the rate of infection is spiraling as it did in sub-Saharan Africa in the early 1980s. This time, however, the adult population potentially at risk is not 225 million, but nearly twice as large.

At current rates of infection worldwide, WHO estimates conservatively that by the year 2000, a total of 30 to 40 million men, women, and children will have been infected with HIV. By then, WHO officials say, there will have been about 10 million cases of AIDS. Some 10 million children under the age of 10 will have been orphaned as a result of AIDS. Sadly, 90 percent of these infections, AIDS cases, and orphans will have been in poor countries-those least able to shoulder the political and economic burden of the disease that WHO no longer calls an epidemic, but a pandemic, a global epidemic.

"We will be held responsible"
What impact do these projections have on mission planning, strategy, and methods? So far, very little, although some agencies have developed AIDS-related personnel policy guidelines. The first to seriously tackle the issue of the growing pandemic were medical mission agencies, especially those working in Africa.

In 1987, as the outlines of the disaster began to crystalize, some 35 relief, service, and mission agencies met to discuss the ramifications and implications of AIDS for international organizations. In a consultation hosted by MAP International and the Billy Graham Center of Wheaton College, Wheaton, III., the group produced guidelines to help organizations develop AIDS-related personnel policies.

A few mission agencies, like SIM International, have developed strategy papers outlining possible church and mission roles in dealing with people affected by the disease.

Acknowledging that the mission has significant resources to offer in some of the most seriously affected areas of the world, the SIM Task Force on AIDS concluded that the agency and the churches related to it "have an obligation to become involved and will be held responsible for our response."

Some mission agencies have mounted significant responses to AIDS, says Evvy Hay, director of Health Training Resources, MAP International. But under the "yet to do" column she lists raising the consciousness of all mission agencies regarding AIDS policy development and outreach ministries.

Many agencies have simply not yet encountered the disease in the course of their work. HIV/AIDS is by no means evenly spread throughout the world.

Africa: The churches remain "sanitized"
The first missionaries to encounter AIDS were medical professionals in East and Central Africa, which continues to be Africa’s worst-hit area. Uganda is probably the most seriously affected country in Africa, with Tanzania a close second. Oddly, some countries have been barely touched by the disease. Nigeria in West Africa has had a low rate of infection; many Nigerians still refer to AIDS as "the white man’s disease."

South Africa has now moved to the epidemic phase, according to AIDS researchers. They conservatively estimate 300,000 people are infected with HIV, and they predict by the turn of the century more 10 percent of the adult population will carry the virus. Experts fear the disease could deliver a knockout punch just as a new, multiracial democracy is climbing into the ring.

In Africa, as in most regions out of North America, Australia, and Europe, the primary mode of AIDS transmission is heterosexual intercourse. Infection has rapidly through prostitute communities their transit-worker customers are thought to be behind HIV’s leapfrog from one country to another. The rapid urbanization of much of Africa has also contributed to the spread of AIDS, as young people leave their villages and behind in the quest for a new life in the city.

At least as many African women are affected by AIDS as men. By 1992, some 750,000 HIV-infected babies had been born to HIV-infected mothers, says WHO. By A.D. 2000, Africa’s total will be 4 to 8 million

Already over a million children orphaned by the disease; In some villages an entire generation has been lost. Elderly people who ex-to be supported by their children in their waning years now to care and provide for their grandchildren their children left behind.

The churches in Uganda, the hardest-hit country, have been on the front, lines of outreach to people with AIDS, says Robert Wenninger, a missionary physician in Zambia, In Uganda, the government has the cost of printing millions of copies of a tract by missionary physician Richard Goodgame, in which medical fact and biblical principles provide a foundation for AIDS prevention.

Wenninger regrets that churches in most other African countries "hold known AIDS victims at arms length." Although church-employed AIDS project workers given material and spiritual help to HIV/AIDS victims and their families, the churches are not ready to receive those converted through their ministries. "The congregations remain sanitized," he says.

Nevertheless, churches are becoming increasingly aware of the disaster threatening their continent. An "All-Africa AIDS and the Church Consultation," organized by the Association of Evangelicals of Africa and Madagascar (AEAM) and MAP International, of Kenya will be held November 13-21. Organizers hope to stir evangelical churches to become involved in AIDS prevention education and community health and homecare programs.

Latin America: "We don’t worry about AIDS"
If Africa’s evangelical churches are slowly coming to terms with a disease that has ravaged the continent for a decade, Latin America’s evangelical churches have yet to confront the monster behind the closet door.

"We don’t have to worry about AIDS in my church," one Pentecostal pastor in Guayaquil, Ecuador, told Madelle Hatch, head of research and communications for MAP International’s Latin America office. "I could never imagine one of my members having AIDS; it just won’t happen," he told her.

While many of the mainline churches In Latin America are active in AIDS prevention education and in caring for patients, the conservative, evangelical churches, which form the majority of the continent’s Protestant population, by and large are uninvolved.

"They see it as a disease of groups with which they have little or no contact," says Hatch. In fact, they are going to have AIDS patients in their churches In the future, she asserts. The disease has only in the last few years gained a foothold in Central and South America, and Is just now beginning its wildfire spread.

There is every indication Latin America’s epidemic will surpass that of the United States. With a population only a little over half that of the U.S., Brazil has roughly the same number of HIV-Infected people-about 1 million.

In regions where the disease is having more impact, in Central America and the Southern Cone, church response is more encouraging, says Hatch. In an attempt to meet the threat of AIDS head-on, MAP International’s Latin America office last year began a quarterly AIDS newsletter and is planning an AIDS prevention and sex education pilot program for use In Ecuadoran churches.

North America: "No thank you"
In North America, as well, mainline churches are more likely than evangelical churches to be involved in AIDS education and care of people with AIDS. For years, the disease seemed to be confined to homosexuals and drug abusers, people with whom the evangelical churches expect to have little contact.

When MAP International sent letters last year to 102 churches In Brunswick, Georgia, offering AIDS education programs, the organization received only two responses-one was "No, thank you."

The U.S. Centers for Disease Control and Prevention (CDC) have also attempted to mobilize churches and other religious Institutions. Overall, they say, the response from the religious community has been positive.

The situation is serious. WHO estimates the U.S. alone is responsible for 13 percent of the world’s total AIDS cases. Although the rate of infection appears to have flattened, the number of AIDS cases is expected to continue to soar as those currently infected with the virus come down with the disease. By the mid-90s, some experts predict there will be 50,000 to 60,000 new cases a year.

Europe: Three countries lead the pack
People everywhere love to regard AIDS as a foreigner’s disease. In Europe, where AIDS has long been seen as an American problem, HIV infection continues to mount, especially In homosexual and drug-abusing communities. By the end of last year, some 81,000 cases of AIDS had been reported, with just three countries responsible for nearly two-thirds of the total. With 21,000 reported cases of AIDS, France led the pack, followed by Spain and Italy.

For the first time, Eastern European countries were beginning serious effort. By far the highest number of reported AIDS cases was in Romania, where because of poor medical practices Western health officials said people were more at risk of contracting HIV in the hospital than outside it. This concern led AIDS care Education and Training (AECT), a Christian health organization in Britain, to establish courses for Romanian health care officials.

Perhaps because evangelicals in Europe traditionally have been active in social services. ACET is only one of a number of European Christian groups creatively working in AIDS prevention and care of people with AIDS.

Middle East: Donning the cloak of secrecy
Muslim reluctance to admit having a problem associated with Western decadence has cloaked the issue of AIDS in the Middle East with secrecy. Most North African and Middle Eastern countries either do not report AIDS cases to WHO or report what are widely assumed to be only a fraction of the total.

Within the countries, neither sex education nor AIDS is considered an appropriate matter for discussion. As a result, world health authorities are alarmed by the potential for the spread of sexually transmitted diseases like AIDS. Although by 1992 these countries had reported only a total of 3,000 incidents of HIV infection, WHO suspects the true total is closer to 50,000.

Rich Arabs vacationing in Southeast in large number in cities such as Bangkok, where in some brothels up to 80 percent of prostitutes have tested positive for HIV.

Asia: Distant rumble of a gathering storm
In fact, AIDS seems to have hit Southeast Asia at full stride. Al- thought Thailand’s first recorded AIDS cases occurred years after AIDS had settled into the U.S., the rate of infection there is already double that of the U.S. It could have been predicted: Bangkok for year has been recognized as the sex capital of the world, and sex tourism has been a big source of income.

Government authorities have gone on the offensive against the disease. That is not to say they are closing down the sex industry in which the infection is incubated. But they have launched an aggressive AIDS education prevention campaign.

Giant India, where the potential for disaster Is even greater, could a lesson from its little neighbor. AIDS experts fear the worst for the subcontinent, where government authorities refuse to admit the extent of the problem or to take measures to combat the spread of AIDS.

As In the early days in Africa, HIV Infection Is traveling track of prostitutes service the nation’s truck drivers, 75 percent whom are thought to use prostitutes. Some authorities predict in five years India will lead the world in numbers of people affected with AIDS.

In the world’s largest country, China, the disease has hold, but so far is limited to isolated high-risk groups. Although at first China refused to admit the problem, a few years ago Beijing reversed its policy and leaders are now working with WHO to develop programs to impede the spread of AIDS.

The last region of the world to be hit by the disease, Asia, is now experiencing the sharpest rise in numbers of infected persons. Considering the massive size of the region, the world’s AIDS experts are frantic to limit the spread of the disease. There is, however, little indication the world has learned the lessons of AIDS* first devastating decade.

There is little evidence, either, that the church or missions are mobilizing their resources to deal with the disease, its victims, or the anticipated upheavals in society.

"I know personally some wonderful, loving, and caring Christians," says medical missionary Robert Wenninger of Zambia. Nevertheless, he says, "The churches have an enormous blind spot to the greatest African epidemic and social crisis this century and perhaps the greatest opportunity for Christians to reach a hidden people, the ‘unclean lepers’ of the 20th century, the people with AIDS."

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