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AIDS And You Contents


An Urgent Response to AIDS

Unless something changes over 200 million men, women and children will die because of AIDS. Already more than half a billion people know a friend or relative who has died - just one of the 40 million adults and children with AIDS, buried or cremated by the start of 2002. Yet despite all that, this new epidemic is spreading faster than ever among the poorest nations, killing four times as many people every year as a decade ago.People just don't realise the danger - or don't want to think about it.

I will never forget the first person I met myself with AIDS: a young student desperately ill in a hospital side-room. He was anxious, restless, sweaty, fighting for every breath, suffocating in his own secretions and gripped with terrible fear. He had a gas mask over his face and tubes running into his body.He was totally alone in that awful room and about to die.

I was so shocked that anyone in a London teaching hospital, with all the facilities in the world, should be abandoned in such a state.But that's how things were back in 1987, a time when no hospice in Britain would accept someone with AIDS, when some nurses refused to visit people with AIDS at home and when some of my fellow doctors refused to prescribe appropriate medicines.

Just because these people had the wrong diagnosis.


From that moment on I was involved. Here on that ward was a human being made in God's image, in great need. How could I respond other than to care and help, laying aside any personal feelings I might have had about lifestyles, and the means by which he had become infected?

His family didn't even know he was ill (he was afraid they would reject him and wanted to take his secret to the grave) and the medicines he was getting were doing nothing to relieve his suffering.It was as if 20 years of hospice medicine had been thrown out of the window.

I was trained as a cancer doctor, looking after those close to death at home.For several years I had kept my distance from AIDS - someone else's specialty and not an illness I was naturally drawn to, in fact the opposite - but when I saw for myself the ghastly reality, the stigma, the shocking rejection of sick people by fellow professionals, and all on my own doorstep, I realised that the skills some of us had in care of those dying of cancer needed to be extended urgently to those with AIDS as well.

But it wasn't just care workers that were rejecting people with AIDS, the church was also caught up with finger pointing and moral debates, and taking very little practical action.I had been just as bad in some ways, finding every excuse in the book not to get involved with this strange new illness.And then I realised how heartless I had been, and how my attitude had to change radically.

That young man died peacefully, several days later, with the right treatment, and with his loving family by his side, but the whole episode shook me profoundly.I would never be the same again.

This book was originally published in 1989, as a shorter version of The Truth about AIDS, to encourage a practical compassionate response to AIDS by churches of every denomination, focussed on community care and schools prevention.It has been revised and updated once more at the request of people from all over the world, who have asked for a short "action" book about AIDS from a Christian perspective.

Almost everything I warned about in 1989 is sadly today a reality, yet in all the great suffering and grief of many millions of people there is still hope that the future may not be a repeat of the past. What is very upsetting is that so many of the lessons of the African epidemic back in the late 1980s have not yet been learned in other parts of the world fifteen years later.Even now we still see denial by governments and entire nations who seem to think that somehow "it will never happen to us. We will only have a few cases".And still the prejudice and fear remains in many places.

With over 80 million already HIV infected the epidemic is still in the earliest stages. Mumbai alone is seeing over 1,000 new infections every night and India could see more HIV cases over the next 15 years than there have been in the entire world until now.African-style spread across Asia is beginning to take place in many other countries.History is now repeating itself, on a vast and tragic scale, yet with worryingly few signs of the kind of aggressive multi-level government responses we saw in places like Uganda 15 years ago.

Christians are now leading the fight against AIDS in many nations.In South Africa, Archbishop Desmond Tutu estimates churches and Christian organisations are providing over 60% of HIV community programmes in Africa.In India the Christian response to AIDS has already mobilised well over 25,000 workers, part-time or full time, all of whom are involved in care or prevention.This is a remarkable achievement, a people-movement across the nation.We know this through the Christian AIDS National Alliance (CANA) in Delhi, a growing network of several hundred Christian agencies.

We also see it in the ACET International Alliance, a global community of independent agencies, some grown from small beginnings back in 1988, all seeking to make a compassionate response in the name of Christ. We see it in hundreds of missionary and development organisations like Operation Mobilisation, Samaritan's Purse and Tear Fund.

Uganda is a wonderful example of what can happen when governments and Faith-Based Organisations (FBOs) work in partnership.The AIDS Control Programme has seen a dramatic fall in infection rates, particularly among the young - from 22% to less than 8%.This could not have been achieved without church support. It's a sign of hope for the future.

Christians from every tradition can unite easily in two simple aims:

· Unconditional, compassionate care for all affected by HIV / AIDS

· Effective prevention respecting and upholding the historic teachings of the church

So often as Christians reacting to AIDS we do nothing or rush to open our bibles, or teachings of the church, to declare that something is wrong. Yet in our response we can loose sight of God's mercy, love and forgiveness - and the reality that many are infected through actions of others rather than their own behaviour. It is possible to be technically correct in interpreting God's standards yet terribly wrong in our own attitudes.

Take the example of Jesus with the woman caught in adultery recounted in John's Gospel - really the story of the missing man. Here are a bunch of angry men, looking for an excuse to lynch a woman, yet two people sinned and the man is nowhere to be seen. In Jesus' day there was a hierarchy: woman sex sin punished by death, other sin was more or less acceptable, while man sex sin was hardly worth fussing about.

Jesus loathed their double standards.

He cut right through them with just one sentence: "If any one of you is without sin let him be the first to throw a stone". "Yes you sir, who's eyes have never strayed to the top shelf of the news kiosk, you who have never been jealous, spiteful, rude or have never gossiped behind someone's back, you who are the perfect wife, you who have never lost your temper with the children, you who have never told a half-truth or broken the speed limit. Come and cast the stone."

No one moved. Jesus stared them all out until they all left one by one - the oldest first. In one sentence Jesus totally destroyed any possibility of judging others according to a ranking of sin. All of us have sinned and fallen short of God's glory, all are utterly dead outside of God's grace.

When it comes to pointing the finger, Jesus forbids us to put ourselves on a pedestal. He was the only person on this earth who had the right to condemn yet he says to the woman "neither do I condemn you". He also adds "go now and leave your life of sin".

As Christians we get confused between the two things Jesus said: either we rush to make moral statements, tripping up over judgmental attitudes along the way, or we rush to express God's mercy and love, falling into a deep hole where there is no longer a clear moral framework. The Jesus way is to hold infinite love and perfect standards in tension together - something we need his help to do.

Let us be absolutely clear that the teaching of scripture from Genesis to Revelation is constant regarding the wonderful gift of sex union, as a celebration of love and friendship between a man and woman committed together for life. God loves sex, it's the waste of sex outside marriage that causes him grief. The bible makes clear that all sex union outside marriage is wrong.This has always been the teaching of the church - in common with the Jewish faith and Islam.

Sex is shown to be a mystery, a spiritual event when two become "one flesh". We see the physical side of this whenever a sperm fuses with an egg. Half a cell from a woman fuses with half a cell from a man to form literally one flesh: a new unique individual full of future personality and identity.

So how do we live with these tensions? The way of Jesus is clear: we are called to express the unconditional love of God to all in need regardless of how they come to be so.

If someone is seriously hurt in a car crash just outside my house I rush out to help. I don't walk away just because I find out he's drunk and that is why there was an accident. Nor do I start preaching anti-drunkenness sermons in the ambulance or on the ward. I do however talk about the story wherever I go, pointing out dangers of drinking and driving.

With those affected by HIV/AIDS we are called to be helpful, to care and express love.

We are there as servants to help as the person wishes and it is a privilege to do so. Many are shocked to find Christians involved who care deeply while unable to endorse certain lifestyles.

I often think about the story Jesus told of the prodigal son who took his inheritance and went to spend it on himself many miles from home. What would have happened if he had become infected with HIV while away and had died before having had time to think again? I imagine his father reading the newspaper over breakfast one day and seeing the death notice of his own son. I imagine him breaking down in tears as he calls his wife: "He never phoned, he never wrote, and in ten years we had no news except through friends of friends".

Many people with AIDS today are dying without hope and without God. I think of our heavenly Father, tears pouring down his face, not wanting any to perish, nor to be separated one day more, yet with sadness releasing people to go their own way.

Those with AIDS are lepers of today facing fear and rejection. When Jesus touched the leper he made history - still talked about 2000 years later. It was the most powerful demonstration of the love of God that he could possibly have shown other than his own sacrificial death.

When a church volunteer goes into a home that person carries the presence of Christ. Jesus has no body of his own: the church is his body. We are his hands, his feet, his smile, his voice, his heart, his touch.

The only part of God that people see could be the life of Jesus in you or me. As we go into the home, and give someone a hug, bring water or medicines or food or take someone's hand we too are making a bit of history: a powerful declaration of God's love, a prophetic statement of his heart to people who often feel totally alienated from the church.

There is also a time for explaining God's design for living. Faced with a world disaster resulting largely from ignoring God's ways it would be unimaginable for the church to be silent. It is a fact that if everyone kept to one partner for life, and ceased injecting drugs, HIV would be wiped off the face of this earth in less than 30 years. It is also true that continuing without restraint over the same period could cost over 200 million people's lives.

As we will see, condoms reduce risk but are no answer for the long term. Are governments honestly expecting a couple where one or other may have HIV to go on using condoms for 50 years "just in case"? What happens when they want to have children or when it breaks, leaks, falls off or fails in some other way? Pregnancy rates are high with condoms. The pill produced the "revolution" in the 1960s not the condom.Condoms are also a very expensive option for countries with millions of the poorest people, and tiny budgets - only $2 per person a year to spend on health.We have to find more sustainable, culturally appropriate solutions for the 2 billion people who earn less than $2 a day.

That's why The World Health Organisation declared: "the most effective way to prevent transmission of HIV is to abstain, or for two uninfected individuals to be faithful to one another. Alternatively the correct use of a condom may reduce the risk significantly". (World AIDS Day 1990)

The only way for many partners to be sure of safety may be HIV tests. In some countries up to a third of women with AIDS have been celibate and then monogamous, yet are dying because their husbands were infected through other relationships. This is a controversial and sensitive area. Anyone considering a test needs expert advice first.

How to help:
Compassionate care for the ill and dying, saving lives through prevention, and community development go hand in hand. Those involved in care often have the greatest credibility and impact. Then people can see the reality of the illness, change behaviour and be motivated to help the dying and orphans left behind. But changing behaviour can be hard when someone is destitute and takes risks every day selling her body to survive.Poverty, poor education and AIDS go hand in hand. The poorer people are, the faster AIDS usually spreads.

Is your church or organisation prepared at leadership level for AIDS ? Any growing church may find people with HIV as members as a result of previous lifestyles.

People with AIDS can be very sensitive to reactions: will this new person accept or reject? As with cancer a person can swing rapidly from anger, to denial, sadness, despair, hope, optimism, questioning, resignation, fighting, giving up, wanting active treatment, or even wanting to die.

Be sensitive to where the person is today, helping the person understand that in the midst of great uncertainties about the future, your own constant support and friendship is not in doubt, just as God's faithfulness and love is not in doubt.

There may be deep wounds from the past, and feelings of worthlessness. Guilt over unintentional passing of infection on to others, guilt over surviving when so many others have already died, and guilt about lifestyles may all be present. Feelings of isolation and loneliness may be intense. Fear of the process of dying is often far greater than the fear of death itself.

The greatest need is often for simple practical help rather than just for comforting words or a listening ear. Wiping someone's bottom or cooking food can say more about your care for the person and their children than six hours of sitting in a comfortable chair. Many want to counsel someone with AIDS - but who is really prepared to go the extra mile? And when life is over, the children remain.Ten million have been orphaned already. Who looks after them?And who is fighting to save the lives of the next generation of young parents, warning them every day about the risks of AIDS? These things are what this book is about. Yet while HIV infection spreads ever faster, so does the Christian faith with more people becoming followers of Christ around the world over the last twenty years than has ever happened in such a small time before, especially in the poorest nations.My prayer is that this spread of life-changing faith will help prevent the spread of HIV, and will provoke new compassion, care and understanding. Patrick Dixon June 2002

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