Partnership in Hope: Gender, Faith, and Responses to HIV/AIDS in Africa
Over the past three years I have experienced a new journey, one that is both marvelous and terrible. It is marvelous because of the companionship, the partnerships, along the way. It is terrible because it is a journey into the heart of the HIV/AIDS pandemic that for now is concentrated predominantly in the Southern Hemisphere of our world.
I have been asked to share the experience of this journey, even though it is not finished—not for me, not for anyone along the way, not for our sisters and brothers who are sick and dying.
The journey itself is worth reflecting on, though it makes little sense without projecting a destination, understanding the particular paths to be followed, and identifying the people who have become partners at different points along the way.
Beginnings of a New Initiative
Three years ago I woke up to the massive problem of the spread of HIV/AIDS. I finally saw the wildfire raging across lands and peoples, overwhelming women and men and children, leaving devastation in its wake. It was almost by accident that I woke up to what had already become a genuine pandemic. AIDS as a disease was not a new concern for me, since I had seen its indiscriminate attack on persons in my own country. A beloved nephew of mine died of AIDS in 1995, and I had shared his journey for many years before that. It was my love for him, no doubt, that helped motivate me to take the first step leading to the longer journey that I had not yet envisioned but of which I now write. When an invitation came to speak at the White House World AIDS Day Summit in 2000, I knew I would have only a few weeks to prepare, in a month already pressed to overflowing with both ordinary and extraordinary deadlines of all kinds. Yet, with my nephew in mind, I agreed to do it.
The summit of 2000, quite unlike previous conferences, aimed specifically to engage religious leaders from the world’s South—from countries whose economic resources are relatively, though radically, depressed and whose political power is marginalized. The organizers of the summit obviously thought that religion and religious institutions are important if the spread of HIV infection is to be contained and if care is to be provided for those already ill and about to die. Religious leaders—sheikhs, imams, archbishops, rabbis, and patriarchs from South Asian and East Asian countries, Latin America, and Africa were to gather to address the issues. My task would be to participate, to listen, to ponder the realities being discussed, and to provide a theological response in the last session. To do this I would have to know something about the AIDS pandemic before I went to the summit. I began a kind of crash course for myself, reading everything I could get my hands on in the short time available. And so began my awakening.
At the summit I heard religious leaders, one after another, speak of the problems of HIV/AIDS in their own contexts. They all spoke of the need for compassion; they told of the work of religious groups caring for the sick and dying, attempting strategies for prevention, and engaging in advocacy for their people. Yet all acknowledged the need for greater efforts on both their own part and that of their co-believers. My personal response to their words was one of deep sympathy for these leaders and their people, and appreciation for the situaitons they so eloquently described; but I was also confused by the relative lack of attention given to some questions directly related to the substance of religious traditions themselves. Are there, for example, any ways in which religion has shaped beliefs, attitudes, and practices that either contribute to or prevent the spread of HIV? Little was said about the impact of religious teachings on sexual practices, the status and roles of women, and the connections among gender, race, and poverty in the context of AIDS. Perhaps implicit in the whole summit was a recognition of the relevance of such questions, yet explicit attention to them was largely missing. The words spoken about compassion raised little controversy; words about sex, the place of women, and a gendered analysis of poverty might have been controversial.
My theological response, then, was to make explicit the questions about sexuality, women’s status, and the relevance of these to other factors, such as poverty, illiteracy, racism, political instability, and the many other burdens borne by peoples who must now also deal with HIV/AIDS. When the summit was over I returned home, now with these questions a part of me.
Several months later a staff member of the United States Agency for International Development (USAID) came from Washington, D.C., to New Haven, Connecticut, to talk about the summit and some of the agency’s future plans. I learned that this individual and another USAID staff member wanted to explore the possibility of partnering with a school such as Yale Divinity School (YDS). USAID was beginning a new program focused on women in community-based organizations (including faith-based organizations) in the Southern Hemisphere. The new program was already named the CORE Initiative (Communities Organized in Response to the HIV/AIDS Epidemic). The two staff members hoped, through this program, to address issues such as sexuality, stigma, and the situation of women, particularly in Africa. One of the program’s goals would be to meet with African women, to listen to their needs, hopes, and ideas for responding to HIV/AIDS, and to find ways to support them in their own contexts. The question raised to me at this meeting was whether I would work with the CORE/USAID staff and whether YDS as an institution would be amenable to sharing in such work. My answer was that I would consult with my colleagues. It appeared that a new path was opening on my journey to the heart of HIV/AIDS in Africa.
In the ensuing months several YDS women faculty members, alumnae, students, and I met to consider the proposal that USAID had put forward. We agreed that we would be willing at least to explore the proposal further. We wanted first, however, to consult with African women to hear their interest in and possible concerns about such a project (in particular, we were aware of negative attitudes toward USAID in some parts of Africa). One of our group, Letty Russell, communicated with Musimbi Kanyoro, who was then the coordinator of the Circle of Concerned African Women Theologians. Kanyoro responded cautiously but not negatively. Next, we met with African women students at the Divinity School and eventually with the then-incoming dean, Rebecca Chopp. Finally, we invited the two USAID staff members to meet with all of us. In that important session we learned not only more about the proposal but also about the experiences of our own African women students—of HIV/AIDS in their families, churches, villages and towns, and countries. Though a multitude of questions and contingencies remained for us, we decided to move forward. Thus the YDS Women’s Initiative regarding HIV/AIDS in Africa was launched.
Impetus for Response
Why did we agree to form and participate in this initiative? We wanted to do it, together with African women theologians and the church workers, for at least three reasons. (I speak here for myself, but I believe my concerns represent, at least in part, those of my colleagues as well.) First, the situation of HIV/AIDS in sub-Saharan Africa was and remains dire. Of the 40 million adults and children estimated to be living with HIV/AIDS, 29 million are in Africa (and 28.5 million of these are in sub-Saharan Africa). In some countries in the south of Africa, 1 in 4 adults is infected. In Botswana the infection rate for adults and children is nearly 40 percent, and in Zimbabwe it is approximately 33 percent. In Kenya alone, it is estimated that 700 people die of AIDS each day. The virus has already killed nearly 14 million people in this region of the world. Predictions are that these numbers will double by the year 2020. Whole generations are infected and die. Fewer and fewer parents, teachers, or doctors remain to care for children or for anyone who has AIDS. There are already millions of orphans. One religious community in Uganda is caring for 5,000 orphans. Individual stories multiply: a woman in Zimbabwe is herself sick with AIDS, but she cares for her own children and the children of her brothers and sisters (who have died of AIDS), and she has put together an orphanage for 250 more children in the same situation. In some villages no one is alive over the age of fourteen. The statistics go on and on, and despite the many efforts to stop the spread of the disease, the numbers continue to escalate. Moreover, it is not only people in rural areas or in the poorer sections of cities who are infected and dying. The rate of infection among university students, for example, is massive; and traditional explanations for this (for example, that it is due only to lack of knowledge about HIV/AIDS) fail to help us understand.
The second reason we wanted to embark on the Women’s Initiative at YDS was our growing awareness of the disproportionate burden that women bear in the midst of the pandemic. As HIV/AIDS continues to burn its way across the world’s South, women are at greater risk than men when it comes to infection and death. In sub-Saharan Africa an estimated 12.2 million women carry the virus, compared to 10.1 million men. In some countries young girls are 50 percent more likely to be infected than are young boys. What accounts for all of this? Many factors are involved (such as women’s greater anatomical and physiological vulnerability to the transmission of HIV), but most come down to the ways in which African women and girls are socially subordinate to, and economically dependent upon, men. African women speak now (out of contexts in which silence is the order of the day) about the gender bias that leaves women with little or no power over their sexual lives; without such power they have little control over occasions of infection. By far the major method of transmission of HIV is heterosexual sex. Practices differ from country to country, region to region, and tribe to tribe in Africa, yet it is not uncommon that women are coerced into marriages not of their own choosing, and into marital sexual relations even if they suspect that their husbands carry the AIDS virus. Widows are forced into sexual relations with relatives of former husbands. Adolescent girls in rural areas are often ritually initiated into sexual activity by older men who are already infected. In the cities countless girls who lack the minimal education given to boys and who are unable to gain employment turn to older men, exchanging sexual favors for entertainment, security, even livelihood. In this same way women are driven to prostitution to support themselves and their children. Moreover, there is growing evidence that a large share of new cases of HIV infection is due to domestic violence; and in settings of political instability and warfare, women and children are targeted for sexual abuse. To make all of these matters worse, women with HIV/AIDS are more likely to be stigmatized than are men. Even if women have been infected by their husbands, they may be blamed, shamed, exiled, and even killed.
In addition to being sexually vulnerable, women consistently bear the greater share of caregiving for those who are affected by and infected with HIV. It is women who care for the sick and for the orphans; it is women who must see to the dying. At the same time, most women in sub-Saharan Africa (as in the world generally) do not have the economic, social, and political power that is needed for effective responses to HIV/AIDS. They experience ongoing blatant exclusions from leadership and decision-making roles in their tribes, churches, and nations. It should not have surprised me, for example, that the religious leaders at the 2000 White House World AIDS Day Summit were, almost without exception, male. Gender bias, both obvious and subtle, is everywhere, like the air one breathes, and we need not notice it until a crisis such as AIDS reveals it.
Our third reason for undertaking the Women’s Initiative at YDS was that it would allow us to respond to the AIDS pandemic as theologians. Here was a project for which our training and capabilities specifically as theologians and ethicists could be genuinely useful, indeed central. We had gradually become convinced that religious traditions have been both a part of the problem regarding the spread of HIV and a part of the remedy. We recognized that if religious traditions have anything at all to say to situations such as the HIV/AIDS crisis, they must speak about God (or whatever is for them ultimate) and about our responsibilities to one another in relation to God. They must speak, then, about the possibilities of hope for those whose hope is threatened or shattered in the face of disease and death. Moreover, if religious traditions have anything to say that is a healing word, a strengthening and promising word, in such situations, it must be a word that is embodied in deeds. Short of this, religious traditions will be, as they have all too often been in relation to the spread of HIV, more a part of the problem than a part of any remedy. The first response of most persons who stand in religious traditions and have any understanding at all of the AIDS pandemic is compassion. But “compassion” is an empty word unless there is a clearsighted recognition of what compassion requires.
All the major world religions have had something to say in response to the large questions of people’s lives, including the question of suffering. Far from being completely irrational, religions have helped to make sense of parts of life in relation to wholes, of aspects of life that philosophy alone has not been able to fathom. In so doing, they have given meaning both to ordinary and extraordinary experiences of persons, and they have shed light on our responsibilities to one another. In the YDS Women’s Initiative our questions became, What does all of this mean in the context of the suffering and potential suffering surrounding HIV/AIDS in sub-Saharan Africa? What is required of faith communities, for example, as interpreters of the pandemic and as transformers of some of its causes? Every kind of care is needed—for prevention, treatment, and ongoing support of all who are affected by the pandemic. Care is needed both in ways religious groups and institutions can give and in ways they cannot by themselves provide. Religious caregivers can organize clinics, reach out to rural areas, advocate for desperately needed medicines, personnel, and equipment, and raise prophetic voices in calling the world to respond. But faith communities must also critically review their role in shaping beliefs, constructing attitudes, and reinforcing behaviors that have contributed to the spread of AIDS. Just as religious traditions are profoundly influenced by the cultures in which they are embedded, so cultures are shaped and reinforced by the religions that are a part of them.
Take, for example, the response by churches, mosques, and temples to issues of sexuality as they are relevant to the spread of HIV. Though there have been in the last year signs of change in this regard, silence has generally surrounded these issues. Cultural expectations, frequently informed and reinforced by religion, make questions of sexual behavior, marital fidelity, sexual orientation, and prostitution highly sensitive. Behind the silence lies, to some extent, a concern for privacy, perhaps even a belief that everyone knows the answers to such questions. Yet, in a deeper sense, the silence represents profound fear and shame, and the tendency to the self-protection of families and communities that results from shame at an individual member’s breaking of perceived taboos. This shame can result even if the taboos are customarily broken, as in the tacit acceptance of married men’s need for prostitutes as partners when they must travel away from home to secure employment. When it comes to HIV, a whole chain of stigmatization may be falsely imposed on individuals (as in blaming wives for their husbands’ infection); and it is not a simple matter to change the focus of the stigma in the public mind.
Sometimes the response within religious traditions is simply to reiterate moral rules prohibiting behaviors that happen also to put persons at risk of infection. Such a response has often not been very successful. Indeed, it has all too often heightened the shame and stigma associated with AIDS, and it has prevented behavioral changes that might be preventatives against the disease, such as the use of condoms and the achievement of greater freedom of choice on the part of women. Religious traditions do not hesitate to rethink their moral rules in the social, political, and economic spheres of human life when situations demand it. All too often, however, a taboo morality (bolstered by both religion and culture) holds sway in the sexual sphere, a morality whose power depends on resisting critical examination, thus preventing the transformation of traditional beliefs as well as practices.
Similarly, the problems that follow from gender bias are not foreign to religious traditions. In fact, there is a particular claim on faith communities that has not yet fully been met. The United Nations may declare international years of women, and particular countries may introduce measures to protect women from abuse and to assist them with their children. The new African Union may articulate women’s rights that must be respected and secured. But if faith traditions do not address the gender bias that remains deep in their own teachings and practices, changes for women may come too late to protect them from AIDS. This surely is the time for those who stand in religious traditions to press the question of the role of patriarchal religions in making women invisible, subordinate, and passive in the face of what destroys them.
One more consideration must be taken into account here. The work that we were undertaking in the YDS Women’s Initiative would be cross-cultural as well as interfaith work. Insofar as faith communities in Africa must critically review their role in shaping beliefs, attitudes, and behaviors relevant to HIV/AIDS, how could our own work as primarily North American theologians and ethicists be useful to this task? Sensitive to the ongoing temptations to intellectually colonize peoples in other parts of the world, but also reminded by our friends in the Circle of Concerned African Women Theologians that our role could not be simply that of passive listeners, we took seriously the fact that we are co-believers in shared religious traditions. The traditions with which our project would be concerned are, by and large, traditions of world religions. Hence, the questions raised regarding these traditions in the context of HIV/AIDS, even in Africa, are questions for us all. Within Christianity in particular, the time has come when the concept of “world church” may finally be given content. No longer is the issue primarily the “inculturation” of this faith and its practices throughout the world. Rather, to understand Christianity as a “world church” is to recognize that the Christian gospel is not meant to be only or even primarily a Western European or North American gospel exported like the rest of Western culture to other parts of the world. God’s self-revelation can be not only received but also given in every language. Out of every language and culture it can be spoken as well as heard. No single culturally influenced interpretation can therefore exercise total control over its forms. Yet many of the problematic aspects of Christian teachings (as well as those of other world religions) regarding, for example, sexuality, gender relations, family structure, and institutional roles, have been exported by a Western church around the world. Insofar as any of these exported teachings have contributed to the stigma surrounding AIDS, the constraints on women in responding to AIDS, and the obstacles to preventing HIV/AIDS, they require critique and reconstruction, a task for us all.
Meaning of the Past in the Present, Meaning of the Present for the Future
In the end, which of course is not an end but only a reflection in medias res, what can be said about this journey thus far? Some insights stand out: there is a shared responsibility for the dying that continues to threaten. Fourteen million, and counting, are dead. The causes of the pandemic are complex and confusing. Yet it is clear that no one in our shrinking global community lacks a reason to respond. Whether it is because we are all sisters and brothers in the human race, or because we share in religious traditions, or because we affirm solidarity among women across the globe, or because some of us in our countries or traditions are implicated in the oppressive conditions that fuel the pandemic, this is a situation from which it is difficult to justify our turning away.
Feminists and womanists have learned to respect other traditions, cultures, beliefs, and convictions. It is not up to women in one part of the world to critique cultural practices that involve women in another part of the world. Yet when cultural practices harm women (and children and men) and when multitudes die from those practices, then if women in the cultures at stake rise up to critique the practices, we can stand with them in solidarity. Just as Western women have critiqued our own culture and the role of religion within it, we should not be indifferent when other women offer critiques in their contexts out of experiences of their own.
Womanists have taught feminists not to use the stories of some women to enhance the productivity of other women. This is a lesson none of us can forget. But partnerships can be formed around genuinely common tasks to which everyone may contribute and from which everyone may gain. Out of the experience of such partnerships come imperatives for all—imperatives to care for one another and, in doing so, to resist the forces of diminishment and death. It is possible to share journeys, both marvelous and terrible, from which none of us can turn back.
Margaret A. Farley is Gilbert L. Stark Professor of Christian Ethics at Yale Divinity School. The recipient of eight honorary degrees, the John Courtney Murray Award for Excellence in Theology, and a Luce Fellowship in Theology, Professor Farley is a past president of the Society of Christian Ethics and the immediate past president of the Catholic Theological Society of America. She is the author or editor of five books, including Personal Commitments: Beginning, Keeping, Changing. She has published more than seventy-five articles and chapters of books on medical ethics, sexual ethics, social ethics, historical theological ethics, ethics and spirituality, and feminist ethics. She has served on the Bioethics Committee of Yale-New Haven Hospital and on the Ethics Committee of the American Society of Reproductive Medicine. She is also co-chair of the Yale University Interdisciplinary Bioethics Project.