This thesis begins by outlining the magnitude of the HIV/AIDS crisis in the Southern African region, together with the challenges it poses to the Church in Southern Africa. The thesis will therefore reflect on a selected number of complex social issues related to the retrovirus. These issues include poverty, gender, the breakdown of family systems, orphans, stigma and discrimination. Also included is a theological reflection to the HIV/AIDS pandemic together with the related social issues. As the thesis builds up, I will develop a contextual approach to the HIV/AIDS crisis which I will also pose as a challenge for the Southern African Church to consider in its strategies in the battle against the retrovirus. In developing this contextual approach indigenous resources and assets which includes talents, skills, gifts, and values, especially those embedded in the ubuntu-hunhu way of life will be considered. Guiding this reflection and exploration into the capacity of ubuntu-hunhu way of life together with the resources and assets embedded in it and the development of the contextual approach will be the Asset-Based Community Development (ABCD) model. / Thesis (M.Th.)-University of KwaZulu-Natal, Pietermaritzburg, 2005.

This thesis focuses on the concerns of rural and urban women living with HIV/AIDS in the Walvis Bay area. The development of effective pastoral care and counselling models in the study of Walvis Bay women is the approach of this thesis. It is an interpretation, from a women's perspective within the Walvis Bay tradition of their status, role, culture and experiences. The purpose of my research, is to try to address women's crisis of HIV/AIDS through pastoral care and counselling. It is my hope that the women of Walvis Bay area will regain their dignity, that they will be empowered and the interaction between healing, sustaining, guiding and reconciling models will be implemented as a tool to deal with their crisis. Although this study focuses on the women in the Walvis Bay area, the questions and sufferings concerning the issue of HIV/AIDS is similar in the rest of Namibia. The main emphasis of this study is in chapter five and six. Chapter five discuss reconciliation and the dynamics of the process of social reconciliation with the women in Walvis Bay contracted with HIV/AIDS. This includes the uncovering of the truth of HIV/AIDS, the destroying of the narratives of lies and the establishment of the reality of the spread of the epidemic of HIV/AIDS. Chapter six discusses the need for effective models of pastoral care and counselling for urban and rural women in Walvis Bay. By doing so it will transform relationships in trust, harmony and peace. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 2001.

This dissertation examines the participation of the church and Christians in the lives of women who are infected and affected by HIV/Aids in South Africa. To this end two Christian facilities; Sparrow Village and St Francis Care Centre, were examined in order to gain insight into the ethical issues of knowledge of patients and caregivers, the prevention measures being taught and the care facilities available to women in the plight in which they find themselves. A partial survey was conducted into the current policies and contributions by the church in an attempt to assess new ways to combat the disease. Medical information was examined as to what the virus is and how it is transmitted and reasons why women are particularly vulnerable to the virus. The dissertation seeks to understand practical ministerial ways in which the church should participate in women’s lives while being sensitive to the cultural, social and political and economic elements involved. / Systematic Theology & Theological Ethics / M.Th. (Theological Ethics)

Thesis (M. Th.)--University of Stellenbosch, 2006. / ENGLISH ABSTRACT: In September 2002, the Anglican Church of Southern Africa authorised a set of liturgical material for use in the church in an attempt to make congregations aware of the extent of the impact of HIV/AIDS on the church and the community in the nations in Southern Africa in which the CPSA is active. This research explores the relationship between Worship and Pastoral Care in the context of HIV/AIDS by examining the development of this liturgical material and offering a critique of it in the light of the impact it had on a number of parishes. A general review of published material found little with a specific focus on the relationship between Worship and Pastoral Care, and the search was extended to approach this relationship from a number of directions in an attempt to find factors that had a bearing on the hypothesis that the community at worship is the primary point of pastoral care. The hypothesis was examined from two directions. The first considered a biblical perspective. This approach considered the images of God presented in the Old Testament, a number of the healings of Jesus in the gospels, and Paul’s comments on the celebration of the Eucharist in 1 Corinthians 11 against the social background of meals shared within the community. The imperative that worship should be inclusive, with a particular emphasis on the poor and marginalized was established. The second direction considered a theological reflection on AIDS and established a number of criteria against which the liturgical material could be critiqued. An important section of this work considered the impact of prejudice and discrimination that has led to the stigmatisation of those living with HIV/AIDS and their reluctance to disclose their status and needs. This remains an important obstacle to the ability of the church to provide appropriate hospitality and care. Interviews were conducted with the Rectors and leaders of the Parish AIDS Task Teams in six parishes within the Diocese of Cape Town to look at the ways in which the material was used, and the impact that it had on the pastoral work of those congregations. The liturgical material is then examined in the light of the theological criteria established, and against the impact that it had on the pastoral work of the parishes. Particular issues recognised in this section were the use of inclusive language and the absence of any emphasis on Repentance and Confession. The importance to Worship and Pastoral Care of compassion, personal contact with persons living with AIDS, grace and hospitality are some of the conclusions made. Suggestions were made for further research and development in terms of stigmatisation, language and appropriate liturgical formation and training. / AFRIKAANSE OPSOMMING: In September 2002 het die Anglikaanse Kerk in Suider Afrika ‘n stel liturgiese materiaal gemagtig vir gebruik in die kerk in ‘n poging om gemeentes bewus to maak van die gevolge van VIGS op die kerk en die gemeenskap in die lande waarin die Anglikaanse Kerk in Suider Afrika werk. Hierdie navorsing ondersoek die verhouding tussen Aanbidding en Pastorale Sorg in die konteks van VIGS deur die ontwikkeling van die liturgiese materiaal te ondersoek en ‘n kritiek voor te gee in die lig van die gebruik van die materiaal in verskeie parogies. Die algemene oorsig van die gepubliseerde materiaal het min gevind met ‘n spesifieke fokus op die verhouding tussen Aanbidding en Pastorale Sorg. Die ondersoek is toe uitgebrei om die verhouding te nader van verskeie rigtings in ‘n poging om faktore te vind wat ‘n houding het op die voorstel dat die gemeente by aanbidding die primêre punt van pastorale sorg is. Die onderstelling is ondersoek uit twee rigtings. Eerstens is dit genader uit ‘n bybelse perspektief. Hierdie benadering het die verskillende beelde van God soos dit in die Ou Testament voorkom, verskeie genesings van Jesus in die evangelies, en Paulus se kommentaar oor die viering van die nagmaal in 1 Korienthiërs 11 teenoor die agtergrond van die maaltye in die gemeenskap in aanmerking geneeem. Die imperatief van inklusiewe aanbidding, met ‘n besondere klem op die armes en ander wat dikwels oor die hoof gesien word, is hierdeur gevestig. Tweedens is VIGS teologies oorweeg en verskeie kriteria gevestig waarteen die liturgiese materiaal gemeet kon word. ‘n Belangrike deel van hierdie werk het die gevolge van vooroordeling en onderskeiding wat gelei het tot die bestempeling van mense wat met VIGS leef en hul huiwerigheid om hul status te openbaar, en dus hul nood te laat weet. Dit bly nog ‘n belangrike hindernis vir die kerk om die geskikte gasvryheid en sorg te kan verskaf. Onderhoude is met predikante and die lede leiers van die VIGS Spanne in ses parogies in die Bisdom van Kaapstad gehou om te sien hoe die materiaal gebruik is in eredienste, en die uitwerking daarvan in die pastorale sorg wat die gemeentes aangebied het. Die liturgiese materiaal is dan beoordeel in die lig van die teologiese maatstawe gevestig, en die uitwerking van die materiaal in die pastorele sorg van die gemeentes. Die gebruik van inklusiewe taal en die afwesigheid van spesifieke materiaal in verband met Skuldbelyding is besondere sake wat in hierdie deel erken was. Die belangrikheid vir Aanbidding en Pastorale Sorg van medelye, persoonlike kontak met persone wat met VIGS lewe, genade en gasvryheid is gevolgtrekkings wat gemaak is. Voorstelle vir verdere navorsing en ontwikkeling in terme van bestempeling, taal en passende liturgiese formasie en opleiding is gemaak.

Thesis (MTh (Practical Theology and Missiology))--University of Stellenbosch, 2009. / The basic premise of this study is that a spiritual approach to care and support of people living with HIV, by means of a holistic pastoral model, would provide the Reformed Church of East Africa's Plateau Mission Hospital with an integrated dimension in their community-based care programme for people living with HIV/AIDS. This will go a long way in assisting the RCEA's diversification of the existing medical model, particularly in the Plateau Mission Hospital’s catchment area with its ever-increasing cases of infections, deaths, rejections, church-related stigma, orphans and vulnerable children. The researcher proposes the use of a spiritual model in dealing with PLWH in the Plateau Mission Hospital because this will help to address some of the unresolved theological issues that come to the fore when addressing matters concerning the health and illness of people living with HIV and AIDS. The researcher does this with acute awareness of the importance of integrating other approaches in the care and support of PLWH. For a holistic approach to be effected, the social development, medical, psychological and holistic systemic approaches to care must be considered. The holistic systemic approach used by the biomedical personnel and other caregivers should regard the person as a relational and social being acting within a cultural context. On the other hand, the biomedical model serves us with accurate diagnoses and sophisticated methods of treatment within which modern medicine is practiced. Similarly, the psychosocial model considers the influence of the social environment not only to the challenges that PLWH face, but also on the care they should receive. However, research has shown that there is an increasing need for holistic care in health care systems. This calls for the inclusion of spirituality within the developing bio-psycho-social approaches in addressing health and illness, particularly for people living with HIV and AIDS, in order for them to attain holistic healing. Plateau Mission Hospital, being a church-based institution within the jurisdiction of the RCEA’s southern presbytery, can be an effective vehicle for pastoral care of people living with HIV and AIDS. The organization is strategically placed and has the capacity (resource persons) to engage in a holistic ministry. The paper also aims at unlocking the RCEA’s resources to become more involved in all rounded existential issues of PLWH in the hospital’s catchment area. In this study, it is presupposed that, although the Hospital has a history of medical and social development work and chaplaincy office, it lacks emphasis on the spiritual dimension, and yet this focal point is important in terms of the immediate HIV/AIDS context at Plateau. The researcher established that the training that the personnel at the medical facility have undertaken promotes a clinical approach to all issues of health (prevention and treatment after prescription), even to people living with HIV/AIDS. Methodology. The first methodology for data collection that the research employed was literature review. In this case, library and church documents were reviewed to gather information on related matters. The areas reviewed were related to spirituality, care and healing in the context of HIV, pastoral care and theology in the context of HIV, and biomedical approaches in relation to the care of PLWH, and documentation (Plateau Hospital Reports, the RCEA’s constitution and Care Departmental Reports) on the RCEA’s approach to Hospital care to PLWH by means of the CBHC programme at the Plateau Mission Hospital in Eldoret. The websites were also consulted for purposes of data collection. The second method was conducting specific oral and written interviews with the Hospital’s CBHC staff, PLWH, congregational and church leadership on matters of the proposed spiritual care of PLWA. The areas interviewed were for the spiritual needs, those involved in the care and support of PLWH, improving existing interventions, the challenges encountered in the care for PLWH, the unfulfilled needs of PLWH and how spiritual care could improve the quality of the lives of PLWH. The third method of data collection was participant observation. The researcher was involved in the activities being studied. This method entailed participant observation during normal diaconal care activities in the RCEA’s Plateau parish congregations that the researcher implemented, for instance visiting people living with HIV/Aids, taking gifts to children affected by HIV. In meeting with volunteer caregivers during visits, while joining the CBHC team during follow-up meetings with PLWH in their homes, data was collected. The researcher had patient consultation during days for voluntary counseling and testing and informal meetings with volunteer caregivers. Presentation of the Thesis - Outline of Research This study is divided into five parts. Chapter 1 will examine the background to the study considering the problem statement, research questions, research objectives, hypothesis, justification, the scope of the research, the methodology used, limitations and delimitations. In Chapter 2 the paper will explore The Kenyan Scenario: Medical work and the involvement of the church within the community. This will cover the Kenyan national HIV updates, Uasin Gishu updates, Ainabkoi divisional statistics, the background to the Reformed Church of East Africa, Plateau Mission HIV ministry covering the psycho-social approach to community-based care of CBHC in the Reformed Church of East Africa in the Plateau Hospital catchment area. The paper will examine the medical care offered to people living with HIV/AIDS, such as the treatment of opportunistic diseases, administration of anti-retroviral drugs and the prevention of mother-to-child transmission and voluntary counseling and testing. The paper will also examine the social and developmental activities and services rendered to PLWA and the orphans and vulnerable children by means of compassionate care. CBHC networking with congregations, and Moi Teaching and Referral Hospital will also be highlighted. The paper will also highlight the gaps experienced as a result of the focus on medical and social developmental approaches to the care and support of PLWA and OVCs. Chapter 3 is largely the analysis of interview responses, and presents the findings of field research at the RCEA Plateau Mission Hospital’s selected area of study. This will indicate the seriousness of the unattended needs in this case the spiritual needs and the magnitude of the problem in the health facility but, by implication, affecting the church. This will need a change of stance, namely that of regarding HIV as a medical problem that the hospital needs to address, and view it as a collective need for all key players in church, hospital and community. Chapter 4 will look at the challenge HIV poses to the spiritual care of PLWH in Plateau Mission Hospital. The chapter will contain a literature review on the holistic approach in the care and support of people living with HIV. The section will look at understanding the needs of people living with HIV, pastoral care of people living with HIV, practical theology, biomedical and bio-psycho-social models in the care of PLWH. The study will also examine the relevance of God-images, systems approach, the role of the church and a spiritual care approach in the holistic healing for PLWH by means of pastoral care. Chapter 5 will conclude the paper and will shed light on the importance of the proposed approach to be integrated into the current strategy (pastoral care model with a spiritual-care approach). It is hoped that the recommendations that will be made at the end will strengthen the high demand for a holistic-care ministry to people living with HIV and the affected families in the RCEA Plateau Mission Hospital.

Thesis (MTh (Practical Theology and Missiology))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: The focus of the thesis is on the HIV and AIDS-related stigma and stigmatisation of people who try to live positively with HIV/AIDS within the pandemic. The basic assumption is that there is interplay between the HIVAIDS-related stigma as a cultural phenomenon and the negative perception of the human body. Since a human being is created corporeal and re-created due to the fact that human embodiment is a fundamental ingredient for the understanding of soul, It is argued that in a pastoral approach, a person should be understood holistically. Anthropology within the traditional kerygmatic approach focused mainly on the notion of sin (corruption totalis) within the theological understanding of God’s judgement (judgemental attitude). I have proposed that pastoral anthropology should adopt constructive paradigms and point towards the integration of embodiment (wholeness) in a realistic approach rather than emphasising the notion of sin and forms of dualism. The thesis departs from an eschatological and pneumatological view of the human being, in which the concepts of resurrection and hope are equally crucial. I further argue that a Christian spiritual perspective on embodiment is potentially destigmatising itself. In terms of a pastoral hermeneutic I have shown that in destigmatisation the transformation of the HIV and AIDS-related stigma corresponds to the transformation of the mindset and paradigm of a person (habitus). Through the process of destigmatisation people discover meaning and are enabled to live fully embodied and responsible lives. The thesis is designed as a literature study based on text analysis and hermeneutical reflection. Moreover, in order to develop a pastoral anthropological view, the Scripture is used as a reference point. / AFRIKAANSE OPSOMMING: Die navorsing fokus op die fenomeen van stigmatisiering binne die HIV/AIDS pandemie. Die kernargument is dat stigmatisering as 'n sosiaal-kulturele konstrukt binne die netwerk van verhoudinge direk in verband staan met 'n bepaalde destruktiewe persepsie wat die vraagstuk van liggaamlikheid onmiddellik raak. Vandaar die verdere fokus op die verband tussen liggaamlikheid en die verstaan van die menslike siel binne die raamwerk van 'n pastorale antropologie. Die teologiese invalshoek is die eskatologiese paradigma, die mens as 'n pneumatiese wese en nuwe skepping. Liggaamlikheid deel gelykoorspronklik aan hierdie nuwe wees-funksie van die mens sodat verstaan van die mens as „beliggaamde siel“ en „besielde liggaam“ alle vorme van dualisme in teologiese antropologie teëwerk. Die totale mens is as ‘n beliggaamde mens geskep sodat in pastorale antropologie die menslike persoon holisties verstaan moet word. Om menswees bloot vanuit die perspektief van sonde te benader hou nie rekening met die realisme van die Bybel wat die mens binne die raamwerk van die wysheidsliteratuur sien vanuit die perspektief van genade en vernuwing. Eensydige fokus op die paradigma van sonde dra by tot destruktiewe veroordelende houding (judgemental attitude). Volgens die aard van kruisteologie is die „smet“ en „stigma“ van sonde daar oorwin. In die lig van die opstandingsperspektief is die „dood van stigma“ totaal uitgewis. Hierdie opstandingperspektief moet verreken word in teologiese model wat gerig is op prosesse van destigmatisering binne pastorale hermeneutiek. Die implikasie hiervan is die transformasie van stigmatisernde paradigmas en die skep van pastorale houding (habitus) van begrip en medelye. Deur ‘n dergelike proses van destigmatisasie word mense in die kern van hul weesfunksie kwalitatief bemagtig ten einde vervulde lewens te kan ly. Die tesis volg kwalitatiewe benadering. Dit is voorts literêre studie gebaseer op teks-analises, kritiese reflektering en hermeneutiese metodologie.

Thesis (MTh)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: A research study was conducted in the form of a literature review to explore the situation of HIV and AIDS stigma in Khayelitsha in order to propose a Pastoral Approach for church leaders in that township. In this regard, the research study established that HIV and AIDS related stigma is the main barrier to any effort in fighting the HIV and AIDS epidemic. The aims of the research were to understand the causes and the effects of HIV and AIDS stigma, examine the Church as a healing community, construct a biblical and theological reflection on HIV and AIDS stigma, and make recommendations useful for the church in dealing with HIV and AIDS stigma. The research indicated that 'stigma‘ is a term that was used throughout history to mean a mark put on people who are regarded as different from others. In terms of HIV and AIDS, stigma is seen as an attitude shaping the way PLWHA are treated in the community. Among the causes of stigma related to HIV and AIDS are the fear of HIV and AIDS as a dangerous and infectious disease, the link between HIV and AIDS and sexual immorality, lack or distortion of information about HIV and AIDS, lack or withdrawal of resources from PLWHA, gender imbalance, and gossip and insults directed at PLWHA. According to research, the effects that come from HIV and AIDS stigma are devastating. They include fear of disclosure of HIV and AIDS status, difficulty in providing care and support for PLWHA, and acceleration of death for PLWHA. As for the biblical and theological reflection on HIV and AIDS stigma, it has been established that leprosy was the biblical disease compared to HIV and AIDS. While the OT model isolated people living with leprosy, Jesus accepted them and healed them in the NT. The OT model has often been used by the church to marginalise PLWHA on the grounds that it is God‘s punishment for sexual sin. The research does not deny the fact that God punishes sin through disease, but it is important to note that disease is not found to be the only form of God‘s punishment, and, in fact, one may not conclude that every disease is a consequence of sin. After all, God dealt with sin by punishing Jesus, who died on the cross to pay for the debts of sinners, and they are now allowed to enter God‘s kingdom freely. The Church is thus meant to be a community where holistic healing takes place through activities such as the teaching and preaching of God‘s word, koinōnia and diakōnia, as well as through prayer. In that sense, PLWHA are also included in the Body of Christ as charismatic beings, and should receive care spiritually, emotionally, relationally, and physically just as they also contribute uniquely to the wellbeing of the Church. The research suggests that in Khayelitsha, church leaders should join hands against HIV and AIDS stigma. They first of all need to confess any former failure to take action, and then work on a paradigm shift in order to change the way they have been dealing with PLWHA in their churches. In obedience to the mission of Jesus Christ, the Bible should be interpreted in a way that does not stigmatize PLWHA, but rather stimulates church leaders in Khayelitsha to stand up and take care of those who are suffering. / AFRIKAANSE OPSOMMING: Die konteks van die studie is die situasie van MIV en VIGS binne die Township van Khayelitsha. Dit fokus op die vraagstuk van stigma ten einde 'n pastorale benadering vir kerkleiers in Khayelitsha te ontwerp. Alhoewel die faktor van deelnemende waarneming 'n rol sal speel, is die navorsing hoofsaaklik 'n literatuurstudie. Die voorveronderstelling van die navorsingsontwerp is dat stigmatisering binne die spesifieke kultuursituasie van Khayelitsha een van die groot stremmende faktore is om die epidemie doeltreffend te bestuur. Die verdere doel van die navorsing is om die oorsaaklike faktore asook die effek van stigmatisering binne hierdie Township te verken; om te bepaal wat word pastoraal verstaan onder die term "Die Kerk as 'n Helende Gemeenskap"; om vanuit 'n Bybelse perspektief teologies na te dink oor stigma binne die epidemie asook om voorstelle te maak vir doeltreffende kerklike leierskap. Die term 'stigma‘ in die geskiedenis is gebruik om mense te etiketteer as verskillend en hul sodoende van 'n bepaalde gemeenskap te isoleer. Stigmatisering dui dan op 'n bepaaldelewenstyl en houding wa tmense watleef met MIV & VIGS binne 'n bepaalde sosiale konteks te hanteer. Daar bestaan 'n noue verband tussen vrees en stigmatisering. Dit is die vrees om deur die virus geïnfekteer te raak. MIV & VIGS is inderdaad gekoppel aan die vrees vir dood en sterwe. Daarbestaanook die assosiasie van seksuele immoraliteit. Voorts is daar die faktor van ontoepaslike inligting oor die toestand en die gevaar van onvoldoende medikasie en ondersteuningstelsels. Die virus dring die gender-vraagstuk binne en gee aanleidng tot skinder en suspisie. Dit is bevind dat een van die groot stremmende faktore is die vrees om te ontsluit. Mense wil nie hul status weet nie. Daar is dikwels probleme rakende ondersteuningstelsels in die Township wat nie doeltreffend is nie. Toepaslike sorg ontbreek ook. 'n Bybelse en teologiese refleksie sien dikwelsm elaatsheid as 'n ekwivalent van die virus. In die OT is mense dikwels vanuit die gemeenskap geban. Daarteenoor het Jesus melaatses aanvaar en genees. Die verband met melaatsheid gee dikwels daartoe aanleiding dat mense wat met MIV & VIGS leef, gemarginaliseer word en dat MIV & VIGS as 'n straf van God op seksuele sonde gesien word. Die navorsing erken die verband tussen sonde en straf. Die verband sonde-siekte kan egter nie kousaal oorsaaklik gesien word as 'n verklaringsbeginsel nie. Die verband is nie logies-reglynig nie. Die feit is dat Jesus ons straf gedra het en dat sy plaasvervangende lyding 'n ander teologiese dinamika in die verband sonde-siekte-straf inbring. Sondaars is bevry en kan die koninkryk van God binnekom. Die kerk is dus die gemeenskap waarbinne holistiese heling kan plaasvind deur middel van lering en prediking van God se woord. Koinonia, diakonia en gebed speel ook in dié verband 'n rol. Mense watleef met MIV & VIGS moet as integraal in die gemeenskap van gelowiges gesien word. Hulle is geregtig op sorg. Hulle moet spiritueel, emosioneel, relasioneel en fisiek versorg word. Hulle kan 'n rol speel in die welsyn van die kerk en deel ook in die charisma van die Gees. Die navorsing stel voor dat kerkleiers in Khayalitsha saam hande moet vat in die stryd teen MIV & VIGS. Die kerk moet bewus wees van mislukte pogings in die verlede. Die kerk benodig 'n paradigma skuif ten opsigte van bedieningsbenaderings. In die lig van die sending van Christus moet die Bybel nie geïnterpreteer word om te stigmatiseer nie, maar om mense te versorg en kerkleiers te motiveer om toepaslike strategieë te ontwikkel om mense wat ly pastoraal te hanteer.

Thesis (MTh)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: This study, in addition to problematizing a one-dimensional approach to health and well-being within the HIV and AIDS discourse, also aims to highlight the need and promote the idea for integrative community pastoral care as fundamental in responding to the HIV and AIDS epidemic. In developing such a framework for an integrative approach to healing and care, it becomes clear that a number of paradigmatic shifts in pastoral care are called for. In the past most of the prevention and intervention strategies within the discourse on healing within the HIV and AIDS epidemic, focused on the people living with HIV and AIDS (PLWHA) and the medical science in its search for cure and effective antiretroviral medication. Little attention use to be given to issues of care as the primary focus appeared to have been on behaviour change strategies. However, as the complex nature of the epidemic and its impacts became more apparent, it gradually dawned on all disciplines that the virus entails more than an individual ailment as a medical concern. With the realization that the epidemic penetrates the quality of life and the basic structures for livelihood and meaningful living on all levels, came the acknowledgement that it has become a systemic and community issue. Any endeavour to be engaged with the epidemic should therefore shift from a merely personal (individual focus) and a medical (pharmaceutical focus) approach, to a community approach. Healing and prevention must also become a systemic and communal endeavour, and thus the reason to connect, in this research project, healing with a community approach to the HIV and AIDS epidemic. In the process of developing a framework for integrative care and counselling, the study explores the notions of health and well-being and provides a theological framework for understanding these concepts from a community perspective. This framework necessitates a number of paradigmatic shifts, particularly with regards to understanding the ecclesial identity of the church as a community of care. Both the understanding of health and well-being and that of an identity of care culminates from the understanding of God‘s passionate involvement in the human predicament of suffering, as implied by a theopaschitic approach. In order to develop an inclusive framework of care to be taken up in the ecclesial identity of the church, a number of metaphors for a community of care are explored as alternatives to the traditional kerygmatik model of the church. / AFRIKAANSE OPSOMMING: Hierdie studie lug nie net die problematiek rondom 'n eendimensionele benadering tot gesondheid en welstand binne die MIV en VIGS diskoers uit nie, maar poog ook om die behoefte aan 'n integrerende gemeenskaps-benadering tot die MIV en VIGS epidemie te beklemtoon en sodanige benadering te bevorder. Dit word duidelik dat sodanige raamwerk vir 'n integrerende benadering tot heling en sorg sekere paradigmatiese skuiwe binne pastorale sorg vereis. In die verlede het voorkoming en intervensie strategieë met betrekking tot die MIV en VIGS diskoers meestal gefokus op die mense wat met MIV en VIGS leef, asook op die mediese wetenskap se pogings om 'n geneesmiddel en effektiewe antiretrovirale medisyne te vind. Min aandag was gegee aan die kwessies wat verband hou met versorging, en dit wil voorkom asof die klem eerder primêr geplaas was op strategieë om gedrag te verander. Groter bewuswording van die komplekse aard van die epidemie en sy gevolge het egter geleidelik gelei tot die besef onder alle dissiplines dat die virus meer as net 'n individuele siekte van mediese belang is. Die besef dat die epidemie lewenskwaliteit, en die basiese strukture van menslike bestaan en 'n betekenisvolle lewe, op alle vlakke binnedring, het uiteindelik gelei tot die begrip dat dit 'n sistemiese en gemeenskap probleem geword het. Enige poging dus om die epidemie aan te spreek moet daarom beweeg van 'n persoonlike/individuele en mediese/farmaseutiese benadering na 'n gemeenskaps-benadering. Genesing en voorkoming moet daarom 'n sistemiese en gemeenskaplike poging wees, en daarom ook die rede om, in hierdie projek, genesing in verband te bring met 'n gemeenskaps-benadering tot die MIV en VIGS epidemie. Ten einde 'n raamwerk vir 'n integrerende benadering tot versorging en berading te ontwikkel, ondersoek die studie die konsepte van gesondheid en welstand, en poog om 'n teologiese raamwerk te ontwikkel wat hierdie konsepte verstaanbaar maak vanuit 'n gemeenskaps-perspektief. Hierdie raamwerk noodsaak sekere paradigmatiese skuiwe, veral met betrekking tot die verstaan van die ekklesiale identiteit van die kerk. Die verstaan van beide gesondheid en welstand asook die van 'n identiteit van versorging spruit voort uit die verstaan van God se passievolle betrokkenheid by die menslike dilemma van lyding, soos geïmpliseer deur 'n theopaschitiese benadering. Ten einde 'n inklusiewe raamwerk van versorging te ontwikkel wat uiteindelik deurslaggewend in die ontwikkeling van die ekklesiale identiteit van die kerk kan wees, ondersoek hierdie studie 'n aantal metafore vir 'n versorgende gemeenskap as alternatiewe tot die tradisionele kerygmatiese model van die kerk.

Thesis (PhD)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: This qualitatively oriented Practical Theological research journey, informed by the philosophical ideas of postmodern, contextual, participatory and feminist theologies, postmodern and social construction epistemologies was based on a participatory action research through the therapeutic lens of narrative inquiry. The thesis is about the spiritual problems and spiritual needs of people living with HIV and AIDS and how they can be addressed as part of a holistic approach to their care within the primary healthcare delivery system in Zimbabwe. The research curiosity was prompted by the HIV and AIDS policy in Zimbabwe that advocates for a holistic approach to the care of HIV and AIDS patients within the primary health care delivery system. The recognition that healthcare has to be holistic for the best outcome for patients creates an expectation that spiritual care will also be incorporated into clinical practice. However there is a puzzling blind spot and a strange silence about the spiritual problems and spiritual needs of people living with HIV and AIDS within the HIV and AIDS policy. This has had the effects of reducing intervention programmes to purely medical, psychological and sociological. This research sought to correct such an approach by highlighting the role of spiritual care in the healing process of people living with HIV and AIDS as part of the holistic approach to their care. The core information, on which this research is based, comes from the experiences of people living with HIV and AIDS who are receiving care within the primary health care delivery system in Zimbabwe. It sweeps away statistics and places those questing for spiritual healing at the core of the study. All the participants in the study affirmed that the why me questions as a summation of their indescribable and unimaginable spiritual pain felt in the spirit were directed to God. They confirmed that their spiritual problem was spiritual pain and their spiritual need therefore was spiritual healing from the spiritual pain of which God is believed to be the healer. The belief that God is the ultimate healer of the spiritual pain stood out from the midst of problem saturated narratives of spiritual pain and suffering as the unique outcome to reconstruct the alternative problem free stories of healing. The research opted for an approach that is informed by the experiences of people living with HIV and AIDS. In the light of the stories shared by the participants in this study, it became evident that there is an existing need within the Primary Health Care delivery system in Zimbabwe to provide spiritual care to people living with HIV and AIDS. The research aimed at co-creating a spiritual care approach in which those living with HIV and AIDS as well as those working with them can be empowered to re-author the stories of patients‟ lives around their self preferred images. The narrative approach was explored in this research as a possible therapeutic approach that could be used to journey pastorally with people living with HIV and AIDS in a non-controlling, non-blaming, non-directive and not knowing guiding manner that would permit the people living with HIV and AIDS to use their own spiritual resources in a way that can bring spiritual healing to their troubled spirits. The research also emphasizes the position of the people living with HIV and AIDS which they can inhabit and lay claim to the many possibilities of their own lives that lie beyond the expertise of the pastoral caregiver. The strong suggestion emerging from this study is that a spiritual care approach to healing must of necessity be integrated into the holistic approach to the care of people living with HIV and AIDS in Zimbabwe. The wish of participants that their spiritual well-being be considered in their health care adds momentum to this suggestion. Hence the research argues for the inclusion of a spiritual and pastoral approach to spiritual healing which links the patient‟s spirituality and pastoral care. The research does not claim to have the solutions or quick fix miracle to the complicated spiritual pain of people living with HIV and AIDS and neither claims to have the power to bring any neat conclusions to the spiritual healing of people living with HIV and AIDS. However, the research has the potential to stimulate a new story of spirituality as a vital resource in the healing process of people living with HIV and AIDS and ignoring it may defeat the purpose of a holistic approach to the care of people living with HIV. The re-authoring of alternative stories is an ongoing process but like in all journeys, there are landmarks that indicate achievements, places of transfer or starting new directions or turning around. Hence this research process may be regarded as a landmark that indicated a new direction in the participants‟ journey towards spiritual healing. / AFRIKAANSE OPSOMMING: Hierdie kwalitatief-georiënteerde Praktiese Teologie navorsingsreis, geïnformeer deur die filosofiese idees van postmoderne, kontekstuele, deelnemende en feministiese teologie, postmoderne en sosiale konstruksie epistemologie, is gebaseer op deelnemende aksie-navorsing deur die terapeutiese lens van narratiewe ondersoek. Die tesis handel oor die spirituele probleme en navorsingsbehoeftes van mense wat met MIV en vigs leef en hoe dit aangespreek kan word as deel van ʼn holistiese benadering tot hul sorg binne die primêre gesondheidsorg-diensleweringstelsel in Zimbabwe. Die navorsing-belangstelling het ontwikkel na aanleiding van die MIV en vigs beleid in Zimbabwe wat ʼn holistiese benadering tot die sorg van MIV en vigs pasiënte in die primêre gesondheidsorg-diensleweringstelsel bepleit. Die erkenning dat gesondheidsorg holisties moet wees om die beste uitkoms vir pasiënte te bied, skep ʼn verwagting dat spirituele sorg ook by kliniese praktyk ingesluit sal word. Daar is egter in die HIV en vigs beleid ʼn raaiselagtige blinde kol, ʼn vreemde stilte oor die spirituele probleme en spirituele behoeftes van mense wat met MIV en vigs leef. Die gevolg is dat intervensie-programme gereduseer word tot slegs mediese, sielkundige en sosiologiese programme. Hierdie navorsing streef om dié benadering reg te stel deur die beklemtoning van die rol van spirituele sorg in die heling-proses van mense wat met MIV en vigs leef as deel van die holistiese benadering tot hul sorg. Die kerninligting waarop hierdie navorsing gegrond is, vloei voort uit die ervarings van mense wat leef met MIV en vigs en sorg ontvang binne die primêre gesondheidsorg-diensleweringstelsel in Zimbabwe. Dit vee statistiek van die tafel af en plaas diegene wat soek na spirituele heling, in die hart van die ondersoek. Al die deelnemers aan die ondersoek het bevestig dat hul “Waarom ek?” vrae, as opsomming van hul onbeskryflike, ondenkbare geestelike pyn, aan God gerig is. Hulle het bevestig dat hul spirituele probleem spirituele pyn is, en dat hul spirituele behoefte dus spirituele genesing is van die spirituele pyn, die pyn waarvan geglo word dat God die geneser is. Die geloof dat God die opperste geneser is, het uitgestaan te midde van die probleem-deurdrenkte narratiewe van spirituele pyn en lyding as die unieke uitkoms om alternatiewe probleem-vrye verhale van heling te herkonstrueer. Die navorsing het ʼn benadering gekies wat geïnformeer is deur die ervarings van mense wat leef met MIV en vigs. In die lig van die verhale wat die deelnemers aan die studie gedeel het, het dit duidelik geword dat daar ʼn behoefte is dat spirituele sorg ook aan mense wat leef met MIV en vigs verskaf word in die primêre gesondheidsorg-diensleweringstelsel in Zimbabwe. Die doel van die navorsing was om saam ʼn spirituele sorg benadering te skep waarin diegene wat met MIV en vigs leef, sowel as diegene wat met hulle werk, bemagtig kan word om die stories van pasiënte se lewens te herskryf in terme van pasiënte se verkose beelde. Die narratiewe benadering is in hierdie studie ondersoek as ʼn moontlike terapeutiese benadering wat gebruik kan word om pastoraal te reis met mense wat leef met MIV en vigs op ʼn manier wat nie kontroleer, beskuldig, voorskryf of weet nie, maar wat mense wat met MIV en vigs leef eerder begelei en toelaat om hul eie spirituele bronne te gebruik op ʼn manier wat spirituele genesing vir hul gekwelde siele kan bring. Die navorsing beklemtoon ook die posisie van mense wat leef met MIV en vigs waarin hulle spirituele moontlikhede, areas van hul lewens kan eien en bewoon, moontlikhede wat buite die bereik van pastorale versorgers lê. Uit hierdie studie vloei ʼn sterk suggestie dat ʼn spirituele benadering tot genesing noodwendig geïntegreer moet wees in die holistiese benadering tot die sorg van mense wat leef met MIV en vigs in Zimbabwe. Deelnemers se wens dat hul spirituele behoeftes ook in hul gesondheidsorg oorweeg word, gee aan dié suggestie verdere momentum. Derhalwe argumenteer hierdie navorsing ten gunste van die insluiting van ʼn spirituele en pastorale benadering tot spirituele genesing wat die pasiënt se spiritualiteit en pastorale sorg verbind. Die studie maak nie daarop aanspraak dat dit antwoorde of ʼn wonderbare kits-oplossing bied vir die gekompliseerde spirituele pyn van mens wat leef met MIV en vigs nie, of spirituele genesing netjies afsluit nie. Die navorsing het egter wel die potensiaal om ʼn nuwe verhaal te stimuleer van spiritualiteit as ʼn deurslaggewende bron in die genesingsproses van mense wat leef met MIV en vigs. Om spiritualiteit te ignoreer, mag dalk die doel verydel van ʼn holistiese benadering tot die sorg van mense wat met MIV en vigs leef. Die herskryf van alternatiewe verhale is ʼn voortdurende proses, maar soos alle reise, is daar landmerke wat prestasies aandui, en ook punte van verplasing, rigtingverandering of selfs ommekeer. Hierdie navorsing kan beskou word as ʼn landmerk van ʼn verandering van rigting in deelnemers se reis na spirituele genesing.

Thesis (PhD (Curriculum Studies))--University of Stellenbosch, 2009. / The HIV/AIDS crisis in South Africa has reached pandemic levels, with over 1 000 deaths per day. The church in South Africa represents a largely untapped resource for addressing this problem. One of the largest Evangelical church groups in South Africa is the Assemblies of God (AOG/SA). This church group consists of three culturally distinct fraternals: The Group (white), The Association (coloured), and The Movement (black). Although they function under one executive committee, these fraternals have remained organizationally distinct even after the dismantling of apartheid laws in 1991. On the issue of HIV/AIDS, all three fraternals have remained largely quiet and uninvolved. They have made no attempt to strategize on a unified response to the pandemic, nor have they attempted to promote culturally relevant curricula capable of empowering their pastors and theological students to respond effectively to this crisis. The research consisted of two phases, following Rothman and Thomas's Intervention Research model (1994), with special emphasis on the design and development component. The first phase identified and assessed educational, cultural, and religious factors relevant to the development and delivery of a clergy-focused multicultural curriculum intervention addressing the HIV/AIDS pandemic in South Africa. Data-gathering strategy for the first phase consisted of semi-structured interviews with ethnographic notions. The target groups for the first phase of the research included 15 credentialed AOG/SA pastors and the three fraternal leaders. The leaders and fraternal members participated in semistructured interviews designed to establish cultural and religious points of divergence pertaining to topics surrounding the AIDS pandemic (e.g. sickness, death, sexuality and gender roles). The second phase of the research consisted of the development and delivery of a curriculum intervention. Integrating the cultural and religious factors identified in the first phase of the research, the nine-day curriculum intervention was presented to 34 tertiary-level theological students in two culturally distinct venues. The content of the curriculum primarily emphasized aspects of gender, tradition, and culture as they relate to HIV/AIDS and surrounding issues. The intervention utilized three curriculum theories that were deemed relevant to the educational context of South Africa: humanistic curriculum theory, social reconstructionist curriculum theory and dialogue curriculum theory. Data-gathering strategies for the second phase of the research utilized both quantitative and qualitative instruments with ethnographic notions. The quantitative instruments included the Scale of Basic HIV/AIDS Knowledge (SHAK), Personal Reflections of Men with HIV/AIDS (PRM) and Personal Reflections of Women with HIV/AIDS (PRW). Reflective journaling was used to acquire qualitative data from student participants. Scores significantly improved on the SHAK in both venues. Scores on the PRW improved in both venues, significantly so in one. Unexpectedly, scores on the PRM declined at both venues, although not significantly so. Males with HIV/AIDS were viewed more negatively by both genders at the end of the intervention in both venues. Reflective journal entries indicated that students at both venues clearly perceived a need for the church to be involved in the pandemic; many proposed that sex education should be taking place within the context of church youth ministry. Affective responses were markedly positive for those suffering with AIDS, particularly females. The data clearly indicated that the curriculum was effective in two culturally distinct venues.