CHRISTIAN AID CHURCH LEADERS’ VISIT TO HIV/AIDS PROGRAMMES IN SOUTHERN AFRICA, 8-23 FEBRUARY 2004

MEMBERS OF THE GROUP :

Leader : Dr Paula Clifford, Christian Aid UK

Bishop David Atkinson, Church of England
Rev Denzil John, Baptist Union of Wales
Bishop Basil Richards, Church of God of Prophecy
Mrs Alison Twaddle, Church of Scotland
(for S Africa only : Bishop Benjamin Argak Kwashi, Anglican Church in Nigeria)

Christian Aid partners visited :

      In Zambia : 	Catholic Diocese of Ndola Integrated AIDS Programme
      		Copperbelt Health Education Project (CHEP)
      
	In S. Africa	Diakonia Council of Churches, KwaZulu Natal
      Church of the Province of Southern Africa (Anglican) (PCSA)	
      
      Pietermaritzburg Agency for Christian Social Awareness (PACSA)
			(Conference attendance only)

An introduction

Christian Aid’s aim in organizing the visit was to enable this group to see how its partner church organisations are dealing with the growing spread of HIV and AIDS in Southern Africa. Christian Aid hopes that as a result, the church leaders will be able to engage with their congregations and ask them to support Christian Aid in this work

The visit was extremely well organized and the pre-visit one day briefing in London was intensive and supplemented by reading and video material circulated in the weeks before departure.  The programme itself was very full with relatively little unstructured time.  The “free” time was largely in the evenings and the group took advantage of this space for reflection on the events and encounters of the day and for prayer.  This proved to be a vital source of refreshment and mutual pastoral care, particularly on those days which had involved  distressing encounters with very sick people and conditions of extreme deprivation. 

The group dynamics were interesting, given our geographical and ecclesiastical diversity. (How strange it seemed to hear the deferential term “Bishop” being applied, by the Anglicans we met in Cape Town, to people who, for the best part of two weeks, had been simply David and Ben.)  Apart from some stimulating discussion about the meaning and practice of baptism; the agony of the Anglican communion over homosexuality; and the current  debate about divorce and remarriage in the Pentecostal churches, we found that, theologically, we were very close, particularly with regard to HIV /AIDS.  None of the group had any notion of the virus as a punishment from God or of people living with HIV/AIDS as sinners in deserved torment.  I mention this because these attitudes are apparently present in some of the churches in the region – as perhaps they are here – and one of the major issues which emerged for us, was that of  the stigma attaching to the virus and the potential role of the churches in countering it. 

Range of projects
In visiting the partner organizations with which  Christian Aid is working, the group was able to see a range of initiatives covering health care, education, youth work, child care, counselling, income generation, peer support, and the overcoming of stigma and discrimination. In addition, attendance at the two day conference organized by the Pietermaritzburg Agency for Christian Social Awareness afforded the group the opportunity to engage with church and community representatives discussing the underlying issues of HIV/AIDS incidence and transmission relating to poverty, gender and culture. 

Partnership visits

1. Catholic Diocese of Ndola Integrated AIDS programme.
This programme was established in 1993 by the then Bishop and local Catholic sisters to provide holistic care for PLWHA and their families, to prevent further spread of the virus in the communities, to promote community development and to campaign for the human rights of the infected and affected.

The main activities of the community include :
* Home care programmes looking after the chronically infected in 27 shanty compounds
* Care for children affected by AIDS in their families (including those orphaned)
* Increasing awareness of HIV/AIDS amongst those living with the virus and the general population in the townships and to provide information to the general public through local radio
* Training nurses and community volunteers for care, counselling an education
* Helping vulnerable groups in the compounds, particularly women, with income generation schemes and micro credit facilities

The response to the pandemic in terms of home based care has very much been led by the Churches.  Government run programmes are less developed and the government recognizes this, diverting its own efforts more towards prevention campaigns. 
The group visited Chisilano Multifunctional Centre to see work being done in health education, income generation and home based care.  We met many of the 39 volunteers, some of whom had themselves first come into contact with the programme as patients and had then trained as volunteers. It emerged that families often refuse to care for, and indeed disown, people who disclose that they are HIV+.  This has motivated PLWA to act themselves and their involvement has played a part in the struggle to overcome stigmatization.  People who become volunteers and receive training feel useful, they have a role, they meet others and begin to live more positively.
Income generation here mainly involved design and production of greetings cards; sewing and knitting (1 knitting machine, 2 sewing machines) and the production of coffins – a particularly salutary discovery, but one which makes perfect business sense, given the high rate of demand.
We were given the opportunity to accompany volunteers on home visits.  I went with Edith to visit Beauty, who had been with the programme for one year.  Beauty was 43 and unmarried.  One child had died and the two remaining were 16 and 21, but were not in evidence.  All other family members had abandoned Beauty when she became very sick with TB, one of the most common opportunistic infections following HIV /AIDS.  The programme brought basic medication and advice about nutrition and hygiene, but the most significant benefit for Beauty was the human contact.  
As we walked back to the centre from Beauty’s house I discovered that Edith, her volunteer, had also lost a daughter to AIDS and, as a result, was caring for her grandchild, Harriet, as well as her other eight children.  She believed that her involvement in the project and the training she was receiving would help her to keep her children well.  
Most of the volunteers were women, although some men were involved in the peer support group and the income generation. It was not felt appropriate for men to work as volunteers because traditionally they are breadwinners and should not therefore work for  no reward.  When the women were asked about their motivation, the reply from one was that it is better to do something – and the Bible tells us that we should care for the sick, feed the hungry and give the thirsty something to drink.
A brief interview was arranged for the radio station which operates out of the diocesan offices – again every chance was being taken to get the message out to the wider community that the AIDS issue must be addressed.

The next day we visited Chipata shanty compound near Kitwe to see some of the HIV/AIDS education work among children.  Sister Joyce stressed the importance of reaching children before they become sexually active and the group was shocked to discover this meant explaining HIV transmission to children as young as six. (An older class of 13 year olds had previously been discovered to be 100% sexually active.)  Even some of these little ones had already experienced sex, either through abuse by an adult or by experimenting amongst themselves.  Simple songs “A friend with AIDS is still my friend” and powerful drama workshops were used to introduce topics covering sexual behaviour patterns, cultural myths and attitudes to PLWA. The drama we witnessed had been written by a class of 11-12 year olds and reflected the home circumstances of many.  A drunken father brings home no money, spending any that he does manage to earn on drink.  Eventually his wife, in desperation, sends the young daughter out to earn money by prostitution.  Two young men of the neighbourhood are emboldened to force her to have sex and are so thrilled by the experience that they set about planning a series of similar conquests.  When the drunken father puts in another appearance he professes shock and anger, blaming everyone but himself.

We saw this play performed in the school setting, but the dramas are taken out into the community and performed regularly in the market place.

A parent-to-parent group has begun to meet. This started when parents reacted badly to the sex education their children were receiving, believing them to be too young.  However, their discussions became learning experiences and, as their understanding of the extent of the AIDS epidemic and its rate of spread increased, their overriding concern was for the protection of their children.  They now support the education programme and feel that they have been given permission to discuss and act with regard to a hitherto taboo subject.  Women have found it easier than men to become involved in this, but men are gradually volunteering to act as peer educators and speak to others.  

Volunteers have undertaken house to house visitation of the community speaking about the wide ranging programme – home care, food aid, orphan support, income generation (here these involved craft work and also the establishment of fish ponds) , health education, social care.  Typically no-one would admit at the time of the visit to needing care, but they would follow the volunteers back to the centre later.  The stigma is still such that people will avoid open association with the project, and its prominently labelled care van.  However, the benefits do become apparent and gradually more people become involved and this in itself  reduces the stigma.  Motivation comes from seeing people in the family die and feeling the need to do something about it.  Abandonment of sick family members is happening less often.  People feel a sense of solidarity and community and this is vital in motivating volunteers to continue through difficult times. 

One home visit was undertaken, to Margaret, a very sick person of 26 who has one 6 year old child, three others having died.  Margaret was coughing badly from TB and suffering pain throughout her body.  The visit was difficult and therefore short.  It felt like intrusion, but then Margaret asked, through an interpreter, for prayer and one of the group was able to hold hands with her and pray, which although the language was foreign to her, seemed to give her peace. 

The final visit with this CA Partner organisation was to its voluntary counselling and  testing centre (VCT) in the grounds of the government hospital.  Patients are referred to Mrs Makarani and her colleague from the home care programme.  Pre-test counselling is offered and the procedure explained.  Samples are taken for testing at the hospital and a next day result service operates.  Thirty patients a week are seen – mostly young men, with few couples attending.  Male testing reveals more negatives than positives ; female testing reveals more positive results.  Gender has a huge bearing on the prevalence of the virus – women are more physically susceptible and less socially and financially empowered to make decisions about their own sexual behaviour.  Counsellors are all trained on an 8 week course and are often asked to accompany patients when they disclose their status to their family. Fear of the reaction is the major factor in this.  Increasingly churches are  insisting on the need to have a test before a marriage can be performed and this has led to an increase in the uptake.

A  meal with the acting Bishop and senior diocesan staff was arranged for the last evening of the visit.  This was largely social but the commitment to the programme was evident, particularly in the case of Chanda Fikanza, the co-ordinator, who had given up a more prestigious and better paid job to return to the diocese and its AIDS work.  He had a wider understanding than some of his colleagues with regard to world economics and political influence and was motivating the team to improve its own understanding while helping others.


2.  Copperbelt Health Education Programme  (CHEP)
CHEP, based at Kitwe, was founded in 1988 by the local Rotary club with the aim “to collaborate with all sectors of the community to develop the knowledge, values and skills to promote personal responsibility and promote a healthy lifestyle.”  More recently the priority has been to accelerate the community’s own response and build capacity.  CHEP is now an independent non-profit making company with a Board of 8 and a multidisciplinary management team headed by a medical doctor, Antoinette Chilese Phiri.
The strategy with regard to AIDS has evolved from an initial campaign based on fear, through a programme to impart knowledge, to the current focus on promoting behaviour change.
Although not a church organization, most of the CHEP staff appear to have a strong Christian commitment and many of the programmes (eg home based care) are delivered through the agency of the churches.  CHEP claims as one of its successes the persuading of the church to become an active player in the HIV/AIDS campaign.  Gaining the support of tribal chiefs in addressing the AIDS issue has also been a priority and has met with success.
In the Copperbelt – the onetime economic engine of the country – 16-17% of the population is HIV+.  The collapse of the mining industry has led to high unemployment and resulting poverty. This has led in turn to falling numbers in education and increased numbers of sex workers as a means of providing income.  Zambia receives $4million in international aid and has some $7 billion of debt .The application of the IMF HIPC level rules mean that 9000 trained teachers cannot be employed because that represents too high a spending proportion of the GNP.  This is something which the churches can address through advocacy, eg the Oasis Forum for theological reflection and bodies like Citizenship for Better Environments.
Range of CHEP programmes visited: 
* Gender and advocacy work
* HIV/AIDS policy development - work place programmes
* Young people’s centre – games for life, teenage mothers, peer support
* Education
* Income generation – for women ; for rural youth

Evelyn Lumba, who heads the gender and advocacy section, spoke to us passionately about the weight of tradition in the relationship between the sexes.  There is a need for basic education and ongoing support to help girls gain economic independence and control of their own lives. The use of commercial sex as a means of financial support is a major factor in the spread of AIDS, as is the abuse suffered by many orphaned girls who are taken into the homes of male relatives as dependents.  Hence the importance of the income generation projects which we visited.

One of these , the Bwafwano sewing project, was employing some 15 women and girls in producing garments using 8 treadle-operated sewing machines.  It was explained that seven original members of the group had gone on to set up their own businesses. The garments were being sold from this same outlet, as commercial shops were not willing to accept them without the kind of finish produced by overlocking stitch. The project did not have access to a machine capable of doing this.  Individuals in the group spoke about the difference the project had made to their lives, eg following widowhood.  They spoke about self-reliance, self respect, freedom from dependency, improved standard of living and improved health. Beatrice said “when my husband died I was able to keep the family together because of the training I had here”. One of the younger girls spoke about the project’s enabling her to continue to fund her schooling and of the scepticism of others that she could be doing this other than by prostitution.  The slogans on the wall included :  “We are fighting against poverty, hunger, disease and exploitation”  and “Walk the Talk – the sooner the better”.

A second income generation programme visited was in the rural context of Misaka, a settlement beside the highway from Kitwe to Ndola. Here young people are engaged in building a centre as a base for their peer educator work in drama, games, HIV / AIDS awareness.  Income is generated through growing crops for sale – such as cabbages.  The young people are responsible for cultivating their plot of land, planting, tending, harvesting and marketing.  Sylvia showed us her allotment with justifiable pride.  Others  were already seeking to emulate her success.  Much of the leadership in this place was undertaken by young people who had themselves been helped by the project.  Home visits are also carried out, making contact in the community where some 4300 people have neither school nor clinic, although there are 3 churches and 7 taverns. 

The young people’s centre in Kwacha Township is another place where the leadership potential of young people is being fostered.  The “games for life” project offers a range of sports activities which attract and occupy youngsters and provide a context in which HIV / AIDS education is delivered.  Time out is taken in a game of volleyball to do a spot check on AIDS awareness.  Participants are called at random to pick a card and answer the question on it – for example : “What does HIV stand for?”  “Is AIDS a punishment from God?”  “Can you get it by shaking hands with someone?”.  Inside a specially designed card game is used to tell the story of a man who is HIV+ and how he copes with this news.  Posters on the wall reinforce the message.  A caption under a group photo says “One of these guys has AIDS and you can’t tell by looking which one it is”

Jonathan, a young volunteer who came as a youth to the centre himself, says that it is the positive results of the programme which motivate the volunteers.  This is seen as a value added to the whole community – seeing an increased response to the offer of VCT  (volutary counselling and testing)  and a change in people’s behaviour.  Mercy and Charity are involved in the teenage mothers and childcare group which offers support to single girls with babies.  Mercy herself was an adolescent mother who came to the project for help.

Isaac Mumba, who heads the HIV /AIDS policy unit, took us to one of the remaining working companies in the Copperbelt to see the workforce training programme which has been set up to provide peer support in the industrial setting.  Isaac is doing painstaking work helping companies to set up AIDS policies with regard to employees, addressing questions of employment protection, insurance, counselling and healthcare.  This is part of the much wider campaign to destigmatise HIV+ status.  The Head of Human Resources accompanied us and the meeting in the staff canteen was rather stilted, with management being anxious to answer questions on behalf of workers.  However, there has clearly been progress and benefit.  Interestingly one young man, when asked what the churches might do to help, launched into an attack on the unseemly dress sense of young women and the churches’ lack of action on this. He drew specific attention to the short (knee length) skirt of one of our group, a Dutch VSO volunteer with CHEP, and clamed that this behaviour was causing all the men in the room to salivate and want to have sex – now.  This angered the men in our group, who felt that any blame was being shifted to the girl and to external groups like the church, with no acceptance of personal responsibility for behaviour.  For me it underlined again the significance of cultural context and practice.  

At Chambishi shanty compound we visited a Churches’ Health Education Training programme.  The driving force here was John Chilumba, a Baptist minister.  He met us first at his house in the township where he was anxious to show us his office and computer, but where his wife was kept very much in the kitchen and barely acknowledged.  Once at the shanty compound we met representatives of the churches involved in the programme.  There was a welcome from a children’s group with an excellent standard of drama and verse and also a youth choir with wonderful singing – all of this with explicit references to HIV / AIDS.  Grace, from the UCZ, in answer to a question about Church involvement with AIDS, said strongly that no sermon should be delivered that did not have a reference to HIV/AIDS within it.  

The school we visited served incredible numbers of children in very cramped conditions – over 700 children taught by a staff of 8, only two of whom were trained teachers..  Over 200 of the children were double orphans and the majority might be termed as OVC (orphaned and vulnerable children).  Not all the children attend all the time, due to family needs for crop harvesting and lack of warm clothes in winter.  Two schools serve the compound which houses some 25,000, although it is impossible to establish accurate numbers.  The confidence of the children in the classes visited was striking – particularly in their enthusiasm for drama and dance to explore HIV /AIDs issues.

The home care work here was similar to that seen in Ndola.  The visit we made was to a very sick woman  (TB) who also had a sick child of about three.  Other children in the family appeared to be healthy.  I later discovered that the woman, Mary, has a husband who is still in the picture, though he did not put in an appearance while we were there.    When asked if she had family around to help her she revealed that her parents were dead and implied that her family would not have abandoned her had they lived. The best thing about the home care programme for her was  “the knock at the door and someone coming in to visit me.”  On returning to the school building we were shown the counselling room – very small and bare with no seats.  Leaflets and condoms were there for distribution, but there were also indications within the area that condom distribution was not universally favoured.  One poster referred to increased promiscuity as a result of condom distribution.

Before leaving CHEP there was a final briefing with the leadership team who welcomed our feedback and were anxious to improve their programme and be more active in motivating the churches to get involved.  Christopher’s thesis on the theological aspects of this will make interesting reading when complete.

3. Diakonia Council of Churches, Durban, S Africa
We flew from Ndola to Durban at the start of  the second week of the visit.  The contrast between the two countries was immediately striking. Much more wealth was apparent in Durban and our first encounter was with an interfaith group hosted in a comfortable middle-class home.  Our contact was a Diakonia staff member, Sue Brittion  and our hostess a Jewish woman named Paddy. These are two very empowered women who had been comrades in the anti apartheid struggle and are now involved in an interfaith peace group, with a particularly concern for HIV/AIDS. We were joined by two Muslim doctors, Shakira and Ibrahim, a married couple – health care professionals who also do voluntary HIV/AIDS clinic work in the Muslim community.  They confirmed that it was difficult within their faith community to speak about sexual issues. However, they were able to run education programmes involving women and children in addition to testing and counselling programmes and some home based care.

Particular difficulties cited in S Africa were the reluctance of government ministers to face up to the reality of the situation and the masking of evidence through unreliable data gathering – statistics are skewed by the reluctance to record AIDS as a cause of death on certificates, for example.  Great disappointment was expressed with regard to govt action, or lack of it and the delay in rolling out the ARV programme in particular. 
The offices of the Diakonia Council of Churches were very pleasant and well equipped and the staff, under acting director, Nomabelu Mvambo-Dandala, welcoming. Our group was invited to lead staff prayers following breakfast on the first day of our visit.  

Following an introduction to the work of the Council from Sue Brittion, we visited two community projects supported by Diakonia.  We were accompanied by two Diakonia staff members engaged in HIV/AIDS work, Tracey Semple and Thuli Thabethe. The first of these projects, just outside the city of Durban, was based in the grounds of the Anglican Church in KwaMashu.  There a mobile unit had been set up as a clinic and voluntary testing centre. The previous month 164  people had attended the centre, many referred from a nearby Dept of Health clinic. Sinesha and Zineth, the mainstays of the centre, expressed disappointment at the level of support they were receiving from the local congregation. This was borne out by the “arm’s length” attitude of the priest who happened to arrive at the church during our visit.  The stigma of HIV+ status is still a huge issue for many.  Disclosure can lead to loss of employment, which in turn leads to inability to continue treatment.  Coupled with a perceived lack of political will, the attitude of some churches has led to despair among those working at the sharp end – “I don’t know who can talk for us”, said Sinesha. 

The second place visited in KwaMashu was a resource centre based in a Methodist Church.  Here the leaders faced the dilemma of scarce resources and different pressing needs.  Diakonia were hoping that income generation projects would be the priority use for their funding, but the team leader felt that the people’s hunger should have first call on her budget.  “How can you teach people anything or expect them to work if they are starving?”.  Three young adults who were HIV+ met us and spoke about their experiences.  All valued the support of the project, particularly the opportunity for peer support and the availability of extra food.  While one of the two young women, who had been diagnosed during pregnancy, felt that her faith had sustained her during that time, the young man related how his church community had ostracized him once his status had become known.  This attitude appears to be more common among the Pentecostal / independent churches.   The level of support from the host congregation here appeared better, with the minister in particular being anxious to offer help.

The rest of our time with Diakonia was taken up in attending a 2 day conference in Pietermaritzburg organised by the Pietermaritzburg Agency for Christian Social Awareness (PACSA). The title of the Conference was “Gender, Poverty and HIV/AIDS.” This was of particular interest given that these two issues :  gender and poverty, had emerged during the visit as key factors in the spread of the virus.
Women played the major roles in the organisation and presentation of the conference, notably Daniela Gennrich, Director of PACSA,  and one of the main presentations concerned the results of a research project into how women cope with the effect of poverty and AIDS on their lives. Thirty women from a poor area were interviewed over the course of a year and their responses compared with those of a smaller group of more economically stable women and some men from the same area.  Two of the group made the presentation to the conference. This brought home the effects of fear of repercussions from disclosure of HIV+ status – loneliness and unnecessary suffering.  The research led to the women in the group forming a peer support group through which they now feel empowered to raise issues with decision makers, health service providers, churches and communities.  A telling footnote indicates that almost half of the original group are now dead.

The conference was very informative and worthwhile. Presentations included : 
* Development of personal and organisational skills in communities
* Involvement of municipal authorities
* Effects of the pandemic on agriculture (reduced workforce & loss of skills)
* Freedom from women’s economic dependency on men
* African women’s lack of power to negotiate safe sex
* Networking and support
* Government and community based responses; advocacy
* The church and responses to HIV/AIDS and poverty

The role of the churches came in for particularly close examination.  There was evidence, even within the conference dynamic, of the tendency towards male dominance, despite the organizers being women.  Theological training content was criticized for largely ignoring the subject and the widespread judgmental attitudes found.  Bright spots included the ministry of Spiwo Xapile (Presbyterian, C of S connection) and his congregation, where an HIV/AIDS focus is included in every service, and the testimony of Gideon Myambugisha, a Ugandan Anglican priest who has been living with HIV/AIDS for 18 years. After he disclosed his HIV+ status to his Bishop, he was asked to undertake the specific role of speaking out about the reality of living with the virus as a Christian priest and to find ways to equip, empower and engage the Church.  This has been his life’s work, “to live to be a channel of Christ’s grace.”  

4.  Church of the Province of Southern Africa
This final leg of the visit took us to Capetown where the HIV/AIDS programme of the CPSA is based.  The rich / poor divide appeared even more marked here, the city itself being vibrant, cosmopolitan and wealthy while the surrounding area is home to several townships where unnumbered thousands live in very poor conditions.  
Our initial briefing session, at the CPSA offices, was led by Rev Colin Jones, who outlined what he saw as the main opportunities and challenges ahead for the churches.  At the Provincial level he saw a clear advocacy role, eg in accessing the global fund and in promoting fruitful partnerships involving civil and governmental agencies.  Duplication of effort was identified as a negative factor as was the tendency to parochialism.  The CPSA has a particular opportunity in that it covers several countries in Southern Africa.
He was convinced of the role of poverty in accelerating the spread of the virus and of the negative effect on the family unit of the urbanisation of rural families.  However, the increased incidence of the virus among  educated prosperous married couples begged the question of the effect of affluence on urbanized rural families.
Interestingly, he made no mention of gender as a contributing factor until challenged. He then became anxious to agree and mentioned it frequently thereafter.  

The following day we visited the beautiful, apparently sleepy little town of Wellington, where the Scottish Missionary, Andrew Murray lived and taught in the 19th century.
Logy Murray (no relation) heads up the Christian AIDS Bureau of Southern Africa from a base there.  A Christian social worker involved with AIDS patients went to the Church for help in the early 1990s and got a very negative reaction.  This led to a new focus on the problem of stigma and discrimination and the founding of “Channels of Hope”. This programme, managed by Rev Nelis du Toit, sets out to give congregations an opportunity to make a real difference in their own community. It operates on the basis that :
> the whole church should be involved – not just a few committed individuals
> each congregation develops its own action  plan linked to community partners 
> facilitators are trained (5 day course)
> the trained facilitators have mentors
> follow-up reports are made 
Help is given with sermon ideas for including an AIDS theme in worship, and other resources available in print form or on the net.  There is networking with other agencies, eg  PanAfrican Christian Aid Network (PACANET). Participating churches are varied – Dutch Reformed, Uniting Reformed, Uniting Presbyterian (Sandra Duncan is one of their lecturers), Moravian.  There is a selection procedure for the training which includes in its criteria an understanding of the Christian response to AIDS.  For many in the “rich white” churches, the disease was perceived as a disease of “poor blacks” – this in turn contributed to the stigmatisation of PLWA.  The programme addresses these issues and others where the church can speak out prophetically – eg on economic issues.  The hidden nature of the epidemic in affluent areas is tied to the financial capacity to get drug treatment, thus masking the incidence of HIV/AIDS.

From this leafy haven we made our way back towards the city and the township of Khayelitsha, one of several on the outskirts of Cape Town.  It is huge, ramshackle, easy to get lost in (we did), but incongruously criss-crossed with an excellent road system and dotted with occasional state of the art community centres.  Clearly a place where efforts are being made with and without external help to improve conditions, but it seems like the proverbial elastoplast on a gaping wound.  I found it intellectually confusing and emotionally draining.
Our visit here was to the Fikelele Centre for orphaned children.  This is a newly built centre where some 40 AIDS orphans are cared for while foster families are found. The facilities and equipment were excellent – a sharp contrast with what we had seen in Zambia.  
We also visited the church hall of Holy Trinity church where a range of small enterprises were selling their products – traditional beadwork, artwork from recycled junk, sewing, leatherwork, music CDs etc.
It was to this church that we returned on the Sunday morning for worship.  This was a fairly traditional Anglican liturgy plus a lot of extra singing – and time given over to us, as visitors, to speak about our own backgrounds and what we had learned from our trip. There were also other visitors - members of a youth movement. The welcome was very warm and the congregation eventually very numerous. AIDS posters, symbols and information were very evident, e.g. :  “This is an AIDS friendly Church.”  Most striking of all was the large statue of Jesus above the altar – black, with African features – wearing a white robe with the red AIDS ribbon pinned to it .  That, for me, summed up the essential lesson of the visit : that we are all living with AIDS and all face the challenge to respond.

Conclusion
As this was my first visit to any country in the developing world, there were many learning opportunities for me. I feel that I now have a greater understanding of :
* the effect of the HIV/AIDS pandemic in Southern Africa
* the realities faced by people living in poverty with limited opportunities
* the resilience of the human spirit and the durability of faith
* what the different Christian traditions hold in common and what differentiates us
* the significance of Christian Aid as development agency and witness to the gospel
* the urgent need for a committed response to HIV/AIDS from the churches.

ALISON TWADDLE,  April 2004








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