AIDS and Environmental Health in India

By Karuna Roy

[ Ed. Note : In August 2002, a week prior to the UN World Summit on Sustainable Development in Johannesburg, South Africa, an international Anglican conference was held in nearby Hartebeespoort, Gauteng province. Approximately 50 representatives of Anglican churches from around the world came together to discuss environment and sustainable development issues. Four participants from India were among a large group of attendees who prioritized HIV/AIDS as a critical worldwide environmental concern – noting that health issues are environmental issues. The following article discusses the work – strategically and specifically – that is being done to address the AIDS pandemic by the Church of North India (United), an ecumenical church that embraces several mainline Protestant communities.]

Air pollution, waste and debris, poor hygiene habits and hygienic conditions are a serious threat to the environment and their repercussions reflect on humankind. Above all, the effects of infectious diseases such as malaria, tuberculosis and HIV/AIDS are a challenge to the society and a matter of great concern. Even with greater awareness, HIV/AIDS continues to be one of the most serious public health issues. There is a lack of effective treatment for millions of people, and stigma, fear and denial are attached to it. Cure is still a question mark.

The Church of North India (CNI) Synodical Board of Health Services (SBHS) has accepted the challenge. Through its HIV/AIDS programme it shoulders the responsibility of catering to people. It provides effective and updated knowledge on HIV/AIDS, care for the infected, and support from friends, families and co-workers. It respects and protects patients' rights.

Introduction

The CNI Synodical Board of Health Services was established in 1974 to promote and carry out appropriate medical services and training. With eight regional health boards, 60 hospitals, and 22 nursing schools, the SBHS provides community health work, the AIDS programme, and useful medical knowledge in the spirit of service and sacrifice for the benefit of all persons, irrespective of caste, creed, community or nationality.

SBHS's MISSION is “In Christ, fullness of life for all.” Its VISION is "Towards empowering local congregation for holistic engagement of mission.” SBHS is trying to visualise that congregations and communities:

•  are motivated and ministered on health, healing and wholeness in order to establish a healthy community;

•  are educated by providing complete and accurate information on various health aspects;

•  as individuals/groups are provided with basic counseling concepts and skills;

•  are provided with information and all relevant materials on nursing, community health and HIV/AIDS;

•  are aided through the seminars and workshops conducted at the diocesan and regional levels;

•  are empowered to assess and analyze their own problems and develop solutions;

•  are given opportunities to learn and be educated on various issues related to health, especially women who are   poor and illiterate;

•  are transformed into loving, caring and sharing people, who work together for the benefit of the congregations and communities.

Objectives of the HIV/AIDS Programme

•  To increase awareness in communities regarding HIV/AIDS -its causes, modes of transmission, signs and symptoms, prevention and care, etc.

•  To bring about a change in the behaviour of women as housewives, working women, women in prostitution, tribal women, young women and adolescent girls.

•  To empower women to make decisions about themselves and other family members, especially children, so that they can be protected from HIV/AIDS.

•  To bring about a change in men's attitude and behaviour. To make men realise the importance of a healthy life, by protecting themselves and their families from HIV/AIDS and other fatal infectious diseases.

•  To empower adolescents and youth to use contraceptives to protect themselves from HIV/AIDS and other fatal infectious diseases.

•  To conduct and organise programmes such as the AIDS Teen Peer Educators' Training Programme (where teens teach teens), radio shows, rallies, and seminars;

•  To produce and provide HIV/AIDS Awareness materials;

•  To empower communities to support affected individuals and their families;

•  To develop hospices and community centres for people affected with HIV/AIDS.

Target Groups

•  School/College Students

•  Youth and Women (Working, Housewives, Grass-roots)

•  Truckers

•  Jail Inmates

•  Commercial Sex Workers

•  Others    

We look at the church, the church looks at us, and the eyes that look at each other have a perfect vision. The one eye focuses on pastoral leadership, which means we are benefited by the care, compassion and concern that is generated through this leadership. The second eye focuses on congregational support, which means that the congregation, through this leadership, turns into a provider for others.

Our Church Care Structure :

We look at the church, the church looks at us, and the eyes that look at each other have a perfect vision. The one eye focuses on pastoral leadership, which means we are benefited by the care, compassion and concern that is generated through this leadership. The second eye focuses on congregational support, which means that the congregation, through this leadership, turns into a provider for others. As providers, we must focus our priorities, and we've chosen HIV/AIDS.

Strategies Adopted to Fight Issues Related To HIV/AIDS:

1- Behaviour Change

•  as far as our thinking and life style goes.

•  towards sex and sexuality. For the adolescent, the word can be “DELAY” , for the youth it can be the “RIGHT CHOICE” and for the other categories, it should be “FAITHFULNESS” towards the partner and the same one partner always.

•  on condom use which is for “harm reduction,” understanding that a complete change with abstinence is for “complete protection.”

2 - Reducing Vulnerability

•  the most vulnerable groups as far as HIV/AIDS is concerned are children, adolescents, youth and women. The church has a responsibility against gender bias activities.

•  the church must guide men who belong to vulnerable communities such as migrant labourers, truckers, military forces, jail inmates, etc. Due to their risk behaviour, they expose themselves and their families to HIV/ AIDS and other infectious fatal diseases.

3 - Reaching Out

•  People with HIV infection or AIDS may not come to us, but the church must reach out to people irrespective of caste, creed, community or nationality.

4 - Empowerment

•  on relationships – pre-marital, marital, extra-marital and multiple partners.

•  against sexual harassment within joint families and at work place etc.

•  against child abuse

•  against flesh trade

•  against socio-cultural malpractices (among certain communities and tribes prostitution is considered a norm, etc.)

•  towards making the right choices in life.

5 - Values

•  Family Values

•  Spiritual Values (Moral Theology)

•  Ethical Guidance

•  Self Motivation

6 - Feeling Responsible

•  Community-based work on HIV/AIDS has to be carried out through strong leadership and voluntary congregational involvement with full commitment to cater to the underprivileged and the marginalised.

7 - Modifying the Quality Of Life

•  To work on lives to bring about improvement by changing, adjusting and altering the quality of life.

8 - Ongoing Service

•  Church service is not a one-time job but an on-going service where follow-ups are required. Moreover, HIV/ AIDS needs constant monitoring.

9 - Psychological Support

•  where counseling is an important component in solving problems. If we have the convincing quality, then we are born counselors, if not we should develop this quality.

•  by taking special care in providing mental support.

•  where the church becomes responsible in   providing overall support to the needy.

10. Rehabilitation

In case of HIV infection –

•  the church, with a developed attitudinal change, must accept the HIV infected and treat them equally as other members of the congregation.

•  the church must stress and assist with full family support and home base care.

•  the church must work on bringing about attitudinal change in other people so that they acept the HIV-infected (the fear factor may remain in the background).

•  It is the responsibility of the church to provide mental and physical support to the needy.

In order to achieve the above 10-point target the church continues to mobilise and equip itself through Capacity Building, Health and Personality Development and Life Skill Management. The church is a heart that throbs with care, compassion and concern for people who are:

          C – crying

         H – hated

         U – understated

         R – restricted

         C – crushed

         H – hurt

All these expressions become prominent with HIV/AIDS. A church with care, compassion and concern, providing overall comfort, is a complete church because it converts such people into becoming:

          C – caring

         H – humble

         U – united

         R – reachable

         C – compassionate

         H – healed

We are able to provide a factual platform for environmental health, but we accept and acknowledge that problems such as HIV/AIDS are at a crisis point. We need to pay serious heed to this problem that is continuously and rapidly mutating in shape and size. It is a definite threat.

With the above objectives and a well-defined care structure, we are able to provide a factual platform for environmental health, but we accept and acknowledge that problems such as HIV/AIDS are at a crisis point. We need to pay serious heed to this problem that is continuously and rapidly mutating in shape and size. It is a definite threat. To achieve a sound, healthy environment, we have to cross barricades. These barricades are not our problem alone, but faced by many who are:

•  Fighting poor hygienic conditions and habits;

•  Trying to balance between various cultures, traditions, norms, languages and practices;

•  Fighting poverty and illiteracy;

•  Making a place and standing among the government and non-governmental organisations (NGOs);

•  Fighting NGOs with a different outlook in terms of awareness messages. We say, “Condoms are safe but not 100% safe, abstinence is the safest.” Other NGOs say, “Use condoms and have sex as you want irrespective of age and stage.” The emphasis in our case is on abstinence.   In their case, it is on condom use, which makes it contradictory at our level and confusing for the masses;

•  Still not completely aware of HIV/AIDS being a threat to humanity because -

•  A majority of the population is rural-based where illiteracy is still a major issue and the capacity of understanding is rather low;

•  Furthermore, the methodology of communication differs.

But we continue to especially work with children, adolescents, youth, and women, not forgetting that all people are at very high risk. The two leading causes for HIV infection are risky sexual behaviour and contaminated needles. As sex talk is still considered a taboo here, the church can only bring it out in the open so much, though it addresses the issue through sermons. Condom use is discussed, abstinence is still prioritised. We talk of population stabilisation and disease control. We raise our voices on sex and sexuality. We must work on lives of safety and protection.

In India, the church is responding to this environmental health crisis through HIV/AIDS programmes of the CNI Synodical Board of Health Services. We offer a platform to those who are still skeptical about open discussion of these issues. This is the role of the church. We can help.

Mrs. Karuna Roy is coordinator of the HIV/AIDS Programme of the Church of North India's Synodical Board Of Health Services. Based in New Delhi, she may be reached by email at roykaruna13@rediffmail.com.