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Churches as providers of HIV/AIDS care : a normative and empirical study

Thesis (PhD)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: There is, as yet, no cure for HIV/AIDS, a disease that has affected South African
society profoundly. While antiretrovirals (ARVs) are now available and have
stemmed the tide of AIDS deaths, medicines alone cannot be seen as a long-term
solution. Treatment costs, finite resources, limited health-care capacity, morbidity and
the unpleasant side-effects of ARVs, make treatment an untenable solution.
The Christian church in South Africa continues to retain a powerful position; it has a
significant affiliation; it is present in most geographic areas and inspires trust and
confidence. Furthermore, in my view, the church, by its very nature and calling, is
mandated not only to demonstrate and provide care, but also to inspire care-giving.
In the light of HIV/AIDS, what does care mean? Can it only mean rendering care that
is welfarist in nature? Or does the church have the mandate to look beyond immediate
suffering, to examine and address those issues that lie at the core of suffering?
Research has demonstrated that issues such as poverty, injustice, stigma,
discrimination, gender inequality and patriarchy fuel the pandemic. Ultimately, it is
the “othering” of people; the failure not to recognise God in another person and our
common humanity, that lie at the heart of the problem. These then, I suggest, are the
very reasons why the church must address these areas.
But that is not all: if HIV/AIDS care is to be rendered in a developmental way, then
there must be a thorough understanding of the disease: how is the virus transmitted,
how can it be prevented and treated? It is also important to understand that there is not
a single global epidemic but many local epidemics; the determinants and risk-factors
of these need to be recognised, as must the cultural, economic, political and social
contexts that fuel the spread of the disease. The changing nature of society, the effects
of globalisation, the evolving nature of care owing to biomedical advances and even
the “privatisation” of sex all need to be comprehended. Furthermore, any meaningful rendering of care requires the churches to examine why
they should be giving it and the values that underpin such care-giving. I make the case
that the churches are required to do nothing less than drive social change in situations
of suffering, injustice and abuse. An examination of the history of HIV/AIDS in
South Africa illustrates that the churches have often failed to meet up to this calling. An empirical study was conducted as to how the churches render care at a more
micro, grassroots level, using a framework propounded by David Korten, who
suggests that authentic development must be people-centred, rather than growthcentred.
Essentially, development must seek to increase personal and institutional
capacities, guided by principles of justice, sustainability and inclusiveness. In these
respects, I argue, it accords very strongly with the Christian message. Korten suggests
that there are four orientations (or generations) of rendering help but it is only the
fourth generation that is truly developmental.
Through the use of case study methodology, I sought to examine the manner in which
the churches render care, in a region of the Western Cape, outside Cape Town, known
as the Helderberg Basin. The area is representative of many peri-urban areas in the
Cape: it is predominantly Christian, with a mix of different denominations and racial
and socio-economic groupings. It allowed for an assessment of care initiatives
afforded by mainline, charismatic and African Independent Churches and in
particular, sought to answer the question of whether churches engage with HIV/AIDS
in a way that Korten would identify as developmental.
From the research, it is clear that the church is hampered by its inability to talk of sex
and sexuality; its knowledge of the issues surrounding HIV/AIDS is limited; it has not
done a sufficient amount to conscientise its followers; the church has yet to learn to
utilise its networks; it lacks technical know-how and is unwilling to engage in the
political sphere.
Social change is only possible if the church embraces a new vision of how to create a
better world. Additionally, I recommend that the church looks to the emerging church
movement to achieve radical transformation. / AFRIKAANSE OPSOMMING: MIV/VIGS is ‘n siekte wat Suid-Afrika onmeetbaar beїnvloed en waarvoor daar tot
op hede geen genesing is nie. Antiretrovirale middels (ARVs) is weliswaar beskikbaar
en het die gety van VIGS sterftes gestuit maar medisyne kan nie alleen as die
langtermyn oplossing gesien word nie. Behandelingskoste, beperkte hulpbronne en
vermoë om gesondheidsorg te lewer, morbiditeit en die negatiewe newe-effekte van
ARVs bring mee dat slegs mediese behandeling ‘n onhoudbare oplossing is.
Die Christelike kerk in Suid-Afrika behou steeds ‘n magsposisie; dit het ‘n
beduidende lidmaatskap asook ‘n teenwoordigheid in meeste dele van die land en
boesem vertroue en sekerheid in. Dié kerk is na my mening gemandateer deur haar
besondere aard en roeping om nie alleen sorg te bewys en te voorsien nie maar ook
om versorging aan te moedig.
Maar wat beteken sorg, gegewe die aard van MIV/VIGS? Kan dit slegs die lewering
van welsyngerigte sorg beteken? Of sou die kerk die mandaat hê om verder as
onmiddellike lyding te kyk en ondersoekend die kwessies wat aan die wortel van
lyding lê, aan te spreek? Navorsing het aangetoon dat kwessies soos armoede, onreg,
stigma, diskriminasie, geslagsongelykheid en patriargie die epidemie aanvuur.
Uiteindelik is dit die objektivering (“othering”) van mense - dit is die onvermoë om
God nie in ‘n ander persoon en ons gemeenskaplike mensheid te herken nie - wat die
hart van die probleem is. Ek betoog dat hierdie die redes is waarom die kerk hierdie
kwessies moet aanspreek.
Om ondersoek in te stel of en tot watter mate die kerk sorg verskaf in verband met
MIV/VIGS het ek die raamwerk van David Korten gebruik. Dié raamwerk stel voor
dat outentieke ontwikkeling mensgesentreerd eerder as groeigesentreed sal wees.
Ontwikkeling moet essensieel streef na ‘n toename van persoonlike en institusionele
vermoë, gerig deur beginsels van geregtigheid, volhoubaarheid en inklusiwiteit. Ek
toon aan dat hierdie beginsels baie sterk ooreenkom met die Christelike boodskap.
Korten stel vier hulplewerende oriëntasies (ook genoem generasies) voor maar dit is
eintlik slegs die vierde generasie van hulp wat werklik ontwikkelingsgerig is. Maar dit is nie al nie. Indien MIV/VIGS versorging ontwikkelingsgerig gaan wees,
moet dit gegrond wees op ‘n diepgaande verstaan en kennis van die siekte soos onder andere, hoe die virus versprei word en hoe die siekte voorkóm en behandel kan word?
Dit is ook belangrik om te verstaan dat daar nie slegs ‘n enkele globale epidemie is
nie maar verskeie lokale epidemies. Die veroorsakende en risiko faktore van hierdie
epidemies moet daarom geїdentifiseer word en so ook die kulturele, ekonomiese,
politieke en sosiale konteks wat die verspreiding van hierdie siekte aanhelp. Die
veranderende aard van gemeenskappe, die effek van globalisering, die ontwikkelende
aard van gesondheidsorg vanweë die vooruitgang in die mediese wetenskap en die
“privatisering” van seks moet alles in ag geneem word.
Betekenisvolle versorging vereis dat kerke ondersoek instel na waarom die versorging
aangebied word en die waardes onderliggend daaraan. Ek stel die saak dat daar van
kerke verwag word om sosiale verandering te stuur waar mense swaarkry,
onregverdig behandel en misbruik word. ‘n Ondersoek na die geskiedenis van
MIV/VIGS in Suid-Afrika illustreer dat kerke dikwels misluk het om aan hierdie
roeping gehoor te gee.
In opvolging van die bostaande argumente het ek navorsing uitgevoer oor hoe kerke
sorg op ‘n mikro of voetsool-vlak aanbied. Hiervoor het ek die genoemde mensgesentreerde
ontwikkelingsraamwerk van David Korten gebruik. ‘n Gevalstudie
benadering is gevolg in die Helderbergkom wat geleë is in ‘n streek van Wes-
Kaapland buite Kaapstad. Hierdie gebied is verteenwoordigend van baie
buitestedelike gebiede van die Kaap: dit is oorwegend Christelik en sluit ‘n
verskeidenheid van denominasies, rasse en sosio-ekonomiese groeperings in. Die
gebied maak ‘n oorsig moontlik van die sorg-inisiatiewe van hoofstroom,
charismatiese en Afrika onafhanklike Kerke, en in die besonder van ‘n identifikasie
daarvan of kerke betrokke by MIV/VIGS dit doen op ‘n wyse wat Korten sou tipeer
as ontwikkelingsgerig. Uit hierdie navorsing het dit duidelik geword dat die kerk gekniehalter word deur ‘n
onvermoë om oor seks en seksualiteit te praat; die kerk se kennis beperk is wanneer
dit kom by kwessies wat handel oor MIV/VIGS; dit nie genoeg doen om lidmate
bewus te maak van VIGS kwessies nie; dit nog veel te leer het oor hoe om netwerke
aan te wend; dit tegniese kennis kort en onwillig is om met sake van politieke belang
om te gaan. Sosiale verandering is alleen moontlik indien die kerk ‘n nuwe visie voorhou oor hoe
om ‘n beter wêreld te skep. Ek beveel ten slotte aan dat die kerk let op die ontluikende
kerkbeweging om radikale transformasie te verwesenlik.

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/71797
Date12 1900
CreatorsFerreira, Clive J.
ContributorsGroenewald, Cornie, Swart, Ignatius, Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Sociology and Social Anthropology.
PublisherStellenbosch : Stellenbosch University
Source SetsSouth African National ETD Portal
Languageen_ZA
Detected LanguageUnknown
TypeThesis
Format357 p. : map
RightsStellenbosch University

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