Church and HIV/AIDS
Church anti-AIDS network
At a time when the HIV/AIDS epidemic is rampant in Russia and Eastern Europe, it is very important that the Russian Orthodox Church should take part in the work to help prevent and overcome this disease. The Church is called to use her social initiatives and spiritual influence to help put an end to the spreading of the epidemic and to oppose society's moral degradation as the principal cause of so rapid an increase in the number of drug users and HIV-infected people.
Since it is a new sphere for our Church, connected with various aspects of church teaching, liturgical and pastoral practice and diakonia, her supreme authorities decided to establish a mechanism called to ensure coordination and consistency of church initiatives undertaken in this area.
On April 10, 2002, representatives of the following four church organizations engaged in the development of the Church's social and educational work met in St. Petersburg:
The meeting decided to establish a Church Anti-AIDS Network, a special mechanism made up of the four above-mentioned organizations with the task to coordinate the church anti-AIDS work. Recommendations were formulated concerning the structure of the Network and plans were worked out for carrying out joint programs in various areas of anti-AIDS work.
Each member of the Network has a considerable experience of church social work respectively in Russia, Belarus and Ukraine and they all have been involved for the last two years in the HIV/AIDS problem in its various aspects. In this issue of the Newsletter we shall introduce our readers to this direction in the work of the above-mentioned organizations.
Anti-AIDS work of the Russia Round Table
The Russia Round Table (DECR) began its work on the HIV/AIDS problem about a year ago. Since that time a substantial research work has been carried out and a number of projects developed for various areas of this problem. The principal task of these projects is to promote a change in the attitude of the Church and society to the problem of HIV/AIDS. To this end, the following tasks should be accomplished:
Overall, the anti-AIDS work of the Russia Round Table has developed in the following two directions: first, the primary prevention of HIV and secondly, work with people living with HIV/AIDS. The primary prevention implies various programs for children and teenagers, aimed at educating them for Christian values, moral purity and chastity, matrimonial faithfulness and responsibility, as well as restoring family traditions, forming resistance to harmful passions for drugs, alcohol, early extramarital sexual relations, etc. The programs will be used both in the school education system and out-of-school work in youth clubs, Sunday schools, summer camps, etc. As the educational work for prevention should continue day by day and involve both family and school, some activities under these programs presuppose advisory and methodological work with parents, teachers and medics.
The second area is work with people with HIV and their families. It implies first of all the training of Russian Orthodox clergy for work with HIV-positive and affected people as well as the training of church social workers for various forms of work, such as:
Pilot projects have been developed in all these areas, with methods worked out, educational and informational aids prepared, and project staff trained. It is planned to spread this experience to various dioceses of the Russian Orthodox Church.
Concrete work has already started in some of the above-mentioned areas. Thus, several training seminars were held on work with HIV-positive people for students of some theological schools. The primary task of these seminars was to give information on the HIV infection, the ways of its transmission and the nature of this epidemic in Russia and to train for work with those HIV-infected people who bring their spiritual and psychological problems to priests. Prayer and requiem services were held in Orthodox churches on the commemoration days of those who died of AIDS and on the World AIDS Day, and since December 2001 prayer services for the health of people with HIV and their families have been held on the last weekend of every month in various cities in Russia, Ukraine and Belarus. The development of training programs for nursing people with HIV and preventing drug-addiction and AIDS among children and teenagers and a number of other programs are under way.
Among important areas of work under church anti-AIDS programs is preparation and publication of information materials to help clergy and laity form the correct vision of this complex problem and get actively involved both in preventive work and spiritual aid to those with HIV who appeal to the Church.
In carrying out the church anti-AIDS program, the Russia Round Table cooperates with both the church initiatives who have an experience of this work and secular organizations. Cooperation with secular organizations implies an active use of their experience and buildups, taking into account of course the specificity of church work and the assessment from Christian perspective of methods used by these organizations in their anti-AIDS work. Secular organizations, in their turn, have begun recently to show a great interest in cooperation with the Church. The reason for it is the desire to consolidate all public forces in resisting the epidemic, on the one hand, and the awareness that this complex problem cannot be overcome without identifying and solving the underlying spiritual problems, on the other.
Margarita B. Neliubova
Anti-Aids problem in the programs of the Christian Interchurch Diaconal Council
About two years ago, prompted by a radical aggravation in the epidemiological situation in some regions in Russia, we in the Christian Interchurch Diaconal Council (CIDC) in St. Petersburg began discussing a possibility of our participation in the programs to overcome HIV and support people suffering from HIV/AIDS.
At that time it was already clear that, whether we want it or not, we would have to face the problem of HIV/AIDS eventually. We would have to determine our attitude to it, to reflect on our role and place in the worldwide movement against this mysterious disease and to join this movement.
All our discussions two years ago were internal, non-formal and no real actions were taken simply because we did not know what to do. We were not alone in our search and hesitation. Our colleagues in Moscow, Belarus and Ukraine asked themselves and one another the same questions.
It was difficult for church organizations to discuss this complex problem. The opinion that prevailed at that time was as follows: "AIDS is a result of sinful life. Therefore, those who suffer from it simply get what they deserve and are subjected to a fair punishment by God". Many priests and lay people in the Russian Orthodox Church and other Christian confessions believed that the problem of AIDS had nothing to do with the life and concerns of the church community. "Our people will not contract AIDS!" they would insist.
Now we all understand that the principal reason for this attitude lied in the absence of information about the real scale of the problem. Two years ago perhaps only medical specialists and infectionists were fully aware that the situation concerning the spreading of the HIV in Russia was nearly catastrophic.
Another reason that affected the church public opinion was the lack of reliable information on the ways in which the HIV is transmitted. For a long time it was believed that HIV/AIDS was a threat for only homosexuals, sex-workers and people given to indiscriminate sexual relations - the sins condemned by the Church - and believed to be a fair punishment for them.
By the end of 1999, the situation had aggravated so much that in some regions, including unfortunately St. Petersburg, the beginning of an epidemic was officially admitted.
As is known, the AIDS epidemic in Russia is peculiar in that it began to a considerable degree amidst the injected drug users.
For the last 5 or 6 years, the Church accumulated a considerable experience of work with drug abusers. Rehabilitation centers and programs launched by Christian parishes and organizations brought good fruit, and young people who wished to get rid of their dependence on drugs began drifting towards the Church as the last resort. The number of HIV carriers among them grew with each month, and we may state today that it is the problem of drug-addiction that has brought AIDS into the church social effort.
The theme of HIV and AIDS began to be voiced at seminars and round-table conferences on drug addiction ever more frequently. Private talks grew into open and honest discussions involving both priests and lay people, secular NGOs and specialists.
A real breakthrough occurred at the Christmas Readings held in January 2002 in Moscow and especially at its section on the Participation of the Russian Orthodox Church in Programs for Preventing and Overcoming HIV/AIDS. For the first time, church people, experts and officials of major international foundations discussed together, on official level, possibilities for cooperation in overcoming AIDS. They produced a number of recommendations and appeals to the ROC clergy and laity to become a basis for the development and publication of appropriate documents.
This event was followed up by a meeting of representatives of the Russia Round Table (DECR), the Round Table for Interchurch Aid in Belarus, the Interchurch Aid Committee in Ukraine and the CIDC in April 2002 in St. Petersburg. The meeting resolved to establish a Church Anti-AIDS Network, the first structure of this kind to be established in the CIS and unite the efforts of various Christian confessions in overcoming HIV/AIDS.
The Network will make it possible for church organizations to work on the AIDS problem on a quite new level. Much attention was given at the meeting in St. Petersburg to the development of mechanisms enabling partners in various CIS countries and cities to exchange experience, methods and other useful information. The experience of church organizations in the work on AIDS as compared to that of secular NGOs and governmental organizations is tiny. At the same time, the situation is so acute that the Church should intervene resolutely and immediately. This is why it is so important today that church organizations should unite their efforts, identify common priorities and act together in the most urgent areas.
The April meeting also agreed that one of their priorities for church organizations would be work with HIV-infected and AIDS-diseased inmates of prisons. Using this opportunity, we hasten to share information concerning one of the pilot projects in this area, called "Imena" (names).
Diseases have been eternal companions of inmates of Russian prisons. Given the over-population of our prisons and detention centers, tuberculosis has become something customary for them. But a few years ago, the inmates came to face a new trouble, AIDS, and it turned out that a prisoner could be imprisoned again.
There are some 3000 HIV-infected inmates in the prisons and detention centers in St. Petersburg today. In most cases, they are singled out in special units and given separate isolated cells, which precludes their communication with HIV-negative fellow-inmates.
The absence of any information concerning the side effects of the disease and the ways in which the virus is transmitted has given rise to incredible rumors, stigmatization of those infected with HIV and fear among the prison personnel.
The HIV-infected inmates are forbidden to work at workshops existing in many penitentiaries, because it is believed that they can infect others through industrial injuries or cuts. For the same reason, they cannot attend prison vocational schools. Teachers of specialized general education school at penitentiaries refuse to come to give lessons to special units members for the fear of infection.
The Imena pilot project has been functioning for several months now at Penitentiary No. 7, called popularly "Yablonevka" and Pre-Jail Detention Center No. 1, or "Kresty", in St. Petersburg, through the efforts of the IMENA+ public company and with the support of the Christian Interchurch Diaconal Council (CIDC). The aim of the project is to change the quality of life for the HIV-infected inmates and to change the attitude of the HIV-negative fellow-prisoners and the prison personnel towards them.
The project has provided for the establishment of small creative workshops for the special units, in which they can produce souvenirs and other hand-made articles, using traditional prison technique, such as modeling figures and sculptural composition out of chewed-up bread.
The finished products are sold and the returns are used to buy food, medicines and other necessities for the HIV-infected inmates.
This past January, a one-day display was organized at the gallery of the famous St. Pete's Mitky artists to attract public attention to the problem of inmates with HIV. Such actions are planned to be held on a regular basis.
Specialists and volunteers, invited by the project, come to prisons regularly to counsel and talk to both the HIV-infected inmates and those around them, seeking to give them true information about the HIV/AIDS.
Once in every three months, inmates are asked to answer some questions in writing to determine the level of their knowledge and to see what ideas and notions have prevail among them. The questionnaires are thoroughly analyzed and the information thus obtained is used to plan future work.
As was already mentioned, the project has functioned for only several months and today it is too early to sum it up or evaluate its effectiveness and results, but the need for such initiatives does not raise any doubts.
Tatyana Bakulina, IMENA+
HIV/AIDS in Ukraine and the Church's participation in overcoming this problem
Among numerous social problems facing Ukrainian society today, the protection of people's health against the threat of spreading incurable and lethal diseases is one of the most serious ones. The unfavorable social situation, the general aggravation of people's living conditions, the sharp stratification of society caused by the inequitable distribution of social benefits and opportunities for citizens to enjoy their vital rights, including the right to adequate medical aid - all this leads to a situation in which even minor health disorders tend to generate a whole complex of problems affecting society. The most serious among these problems is the spreading of socially dangerous diseases, such as tuberculosis, drug-addiction and HIV infection. The HIV infection has spread to Ukrainian regions unevenly. The most affected areas are in the east and south of the country where the socio-demographic situation is the least favorable.
Demographically, young people from 15 to 35 have proved to be the group most vulnerable to HIV/AIDS disease, and that in a situation where the mortality rate in general exceeds the birth rate. Consequently, the most active and able-bodied part of society is threatened with exclusion from the social context. The natural problems involved in the physiological condition of HIV cases are aggravated by their psychological and social stigmatization with unpredictable consequences for them themselves and those around them.
The Church as part of society and a living social organism cannot but feel concern for the problem of HIV/AIDS. She cannot help giving her own spiritually-considered and mystically-experienced response to the problem faced by the whole society, namely: how can she help people who are threatened today with full social and psychological isolation and face an imminent death? how can she help overcome the new sophisticated division of people according to their somatic status? finally, how can she help a society in which the resources of the state are limited and ineffective while the moral foundations are questionable? The first and natural response of the Church lies organizing spiritual life and care for people suffering from this disease. Historically this mission has been fulfilled with the participation of sisterhoods and brotherhoods organized in the parish life context under the direct guidance of the Church. At present, church communities and parishes with their sisterhoods and brotherhoods are founded in many hospitals in Ukraine.
Parishioners of the Church of the Forty Martyrs of Sabastia led by their rector, Rev. Nikolay Betsko, founded in June 2000 an Orthodox nursing sisterhood, dedicated to the Icon of Our Lady "The Inexhaustible Cup". The sisterhood works at the First City Clinic in Kiev, where an HIV/AIDS prevention and treatment center is located. The sisters give spiritual support to patients in various wards but pay special attention to those treated in the ward for infectious diseases, namely, drug-addicts, HIV-infected and AIDS patients. The sisterhood conducts the initial catechization of patients who are mostly young people who never turned to God before. Sisters talk to them, distribute Orthodox spiritual literature to them and prepare them for church sacraments. Sisters' news-letter, a mini-newspaper published by the sisterhood, represents its first printed product, the prototype of its future full-fledged newspaper. Sisters have also arranged work with patients' families who also need a special spiritual care and support. Many patients have found it easier to find their place in the Church and to partake of holy sacraments after their association with the sisters. Participating in the liturgical life together with other parishioners, they find spiritual peace and harmony with those around them.
Through the efforts of the rector of the hospital chapel and his coworkers, a Theotokos House of Mercy, a charitable society, has been founded and launched. Its aim is to give professional social and psychological assistance to people with HIV and drug-addicts. Another aspect of the Church's participation in overcoming the HIV/AIDS problem is the establishment of professional non-governmental organizations based on Orthodox spirituality and uniting specialists in various fields to give effective complex aid to the needy.
In Nikolayev in southern Ukraine where the HIV problem has become vital as every tenth city dweller, in an unofficial estimation, is infected with HIV, there is a Zgoda (Accord) charity, which has been working intensively for several years now. It is an example of professional organization of work based on Christian moral principles and church guidance in the person of Archpriest Vladimir Astakhov serving the charity as spiritual director. The charity was founded in January 1998 by people professionally involved in problems of drug-addiction and HIV/AIDS. Among its members are psychologists, physicians as well as people with HIV and former drug-addicts. The idea of the charity was born after these people were introduced to the experience of their Russian colleagues. The charity has managed to carry out a number of regional and networking projects during a few years since its inception. The Project for Training Personnel in Seven HIV-affected Cities in Russia, Ukraine and Belarus for Drug-Addiction Prevention Technologies provides for internships in St. Petersburg. Under this project, specialists from Nikolayev come to St. Petersburg to exchange information on the project progress with their partners in St. Petersburg, Kaliningrad, Yekaterinburg, Tver, Minsk and Odessa. A two-month-long monitoring to examine problems involved in giving medical and psychological aid to people with AIDS has been carried out. The charity's psychologists have undertaken to set up a self-support group for people with HIV who were infected through injecting drugs and a self-support group of parents of HIV-infected drug-addicts. The charity has worked in cooperation with Regional Radio and Radio Nikolayev, Yuzhnaya pravda regional newspaper and the Saturn TV Company to promote education and prevention. It helped to prepare several radio and television programs and newspaper articles on the prevention of drug-addiction and HIV/AIDS. From June 2001 to June 2002 the charity has been engaged in the implementation of the Volunteer Students Project designed for work towards prevention of drug-addiction and HIV/AIDS on the basis of "equals teaching equals" principle. Under this project, specially trained volunteer students have worked in 10 educational institutions in Nikolayev. The project partners are the Nikolayev State Pedagogical University and the Regional Center for Prevention and Treatment of Drug-Addiction, Alcoholism and AIDS Diseases. The charity has initiated another project, called "Establishing a Social Rehabilitation Center for Young HIV-Infected Drug-Addicts", in 2002. It is financed by the Norwegian Church Aid. At present, the charity has as its partners many regional and international ecclesiastical and secular organizations.
It is quite clear that organizations emerging in various parts of the country and working in close cooperation with the Church need not only spiritual guidance. Their work should be also coordinated on the basis of a view of the problem shared with the Church. Therefore, it is relevant to mention here the efforts which have been made in the framework of inter-church cooperation with religious and secular, both governmental and non-governmental, organizations. The Coordinating Committee for Inter-Church Aid in Ukraine is one of the non-formal church-public bodies taking an active part in this work. Among the practical tasks of the Committee is to render organizational, methodological and financial support to projects for aid to people in need and to integrate and harmonize the efforts made by various ecclesiastical and secular structures for social protection. The Committee has arranged close cooperation in overcoming HIV/AIDS with similar structures in the Russian Federation and Belarus. It is a member of the church network for HIV/AIDS prevention together with the Russia Round Table/DECR, Moscow Patriarchate, the Christian Interchurch Diaconal Council in St. Petersburg and the Belarus Round Table. The Committee's plan for the nearest future includes conducting several seminars and consultations with various specialists in HIV/AIDS problem and representatives of various CIS regions. Integrated work on social problems within the canonical territory of the Russian Orthodox Church and active cooperation with traditional confessions in social service is a key priority for the Coordinating Committee for Inter-Church Aid in Ukraine.
Summing up the work carried out today by the Church and its structures, it is possible to single out three aspects of the Church's participation in overcoming HIV/AIDS problem. These are traditional charity, social work through professional organizations and regional coordination on the basis of a common church approach.
Shifting the public awareness towards spiritual principles, creating a moral climate conducive to the social rehabilitation of people with HIV, interacting with specialists in various fields, participating in the work of professional organizations and promoting education - these are the principal components of the Church's social policy, so much demanded by today's society.
G. P. Taraniuk
Church social work for overcoming HIV/AIDS: Belarus
The social situation in the republic is critical at present. Over 40% of the population are poor or almost poor. The group of the permanently poor makes up 7% of the entire population. A considerable part of the families falls into the category of the occasional poor (once in 3 months). Compared to 1990, the number of the poor has increased 20 times. The grievous economic situation is at the bottom of growing negative social phenomena, such as illegal labour migration, development of sex industry, drug traffic and crime. It has also contributed to the growing incidence and spreading of sexually transmitted diseases and HIV-infection.
Until mid-1996, Belarus was among countries where the extent to which HIV/AIDS was spread was rather small. A radical increase in the number of the HIV-infected people occurred in 1996 when over 1000 new cases were identified for a short period of 6 months, mostly among drug users in Svetlogorsk, Gomel Region.
As of April 1, 2002, the total number of people with HIV in the republic was 4213, that is 44,11 for every 100.000 people. The epidemic has involved 122 administrative territories. The number of new regions is increasing every month. For the first three month of 2002, the HIV infection was registered in 11 more administrative territories.
Most of the HIV-infected are young people from 20 to 24. Their ratio is 41,44%, while young people from 25 to 29 have the ratio of 26,54%. The principal cause of the infection is injection of drugs - 76,95%. In 2002, the prenatal transmission has been the cause of the HIV infection in 62,08% cases. There is a growing tendency of infection being transmitted sexually - as 27,16% in 2001 has increased to 36,52% in 2002.
The spread of the HIV infection among women has led to a growing number of children born from HIV-infected mothers. In total, there are 229 of such children in the republic; before 1996 they were 6, in 1996 - 10, in 1997 - 15, in 1998 - 35, in 1999 - 40, in 2000 - 51, in 2001 - 62; and for the first three months of 2002 their number is 10. At present, 23 children born of HIV-infected mothers have been diagnosed as HIV-infected. In total, there are 30 HIV-infected children from 0 to 14 years of age in the republic.
There are 23 pre-AIDS people, and 9 in the AIDS stage. The lethal outcome has been registered in 201 HIV cases, including 30 people who died of AIDS.
The HIV infection is spreading against the background of a moral decay and declining family values in society. Thus, the behaviour patterns have dramatically changed among the youth in recent time. The new behavioral models, such as early sexual activity, tend to increase the risk of being infected with HIV and sexually transmitted diseases. Studies have shown that 38,3% of the teenagers from 14 to 17 have already had an experience of sexual relations. Three quarters of the young people in the 18-21 age group live in sexual liaison; the same is true for 96,7% of young people from 22 to 24.
There is a sharp polarization in social behavior observed among the youth in response to the changed conditions of life. Increased individual freedom and decreased social control in a situation of socio-economic instability lead to the growth of various kinds of abnormal and self-destructive behavior, the most dangerous being drug-addiction. The number of drug-addicts is rapidly growing. According to official figures, their number has increased 7 times since 1990. At present, the principal cause of the spreading of HIV infection in the republic is the sharing of needles and syringes by drug-addicts. Beings well informed about the danger of infection and about protective methods, drug-addicts still practice high risk behavior sharing syringes and cups and ignoring contraceptives. They often have as their sexual partners the people who do not use drugs. Beginners among drug users are less informed about the risk of infection. Official sources of information on HIV/AIDS are difficult to be accessed.
Another evil to which children tend to get addicted earlier than before, namely from 13 or 14 years of age, is alcohol. The consumption of alcohol is growing among young people; there is also growing alcoholism among women.
In spite of the fact that the Belorussian law forbids any discrimination against people with HIV/AIDS and measures have been taken to ensure their social protection, those with HIV confront many problems of social, psychological and spiritual nature. While epidemiologists and infectionists offer post-test counsel in AIDS prevention centers, their main aim is to collect epidemic anamnesis and to subject patients to clinical examination. No counsel by professional psychologists is available. The absence of purposeful psychological and spiritual support is one of the reasons why most people with HIV do not change their sexual behavior pattern to a less risky one and continue to use drugs after being notified of their diagnosis. Social allowances paid to HIV-infected children and patients in pre-AIDS and AIDS stage are small, about 8 US dollars a month, which cannot improve the quality of a child's life in any tangible degree. In 2000, children began to be abandoned in maternity houses by their HIV-infected mothers. At present they are under the care of the state.
Non-governmental organizations, including international ones, have rendered substantial assistance in developing social work in overcoming HIV/AIDS problems in Belarus. The non-governmental section in the republic has not matured yet, but it is possible to state already now that the involvement of non-governmental organizations in HIV/AIDS prevention work has had many positive aspects. The organizations engaged in various projects for the prevention of AIDS and sexually transmitted diseases have shown their preparedness and competence. However, with all the success of particular NGOs, the contribution of the non-governmental section to the preventive work has not yet been sizeable enough.
The Belorussian Round Table for Interchurch Aid (BRT) has made its own contribution to the prevention of HIV/AIDS and aid to people with HIV. It should be noted that until recently church social structures were not involved in support for people with HIV in any practical degree. Indeed, these people could not themselves appeal to the Church for fear of being misunderstood, rejected or condemned due to many stereotypes that settled down deep in people's consciousness.
These reasons and the urgency of the HIV/AIDS and drug-addiction problem prompted the BRT in 2000 to set up a special HIV/AIDS Program. Its first stage planned to be completed within a year was devoted to preparatory work. The preparation included studying the problem, establishing contacts with public, governmental and other structures involved in aid to people with HIV, and examining the practical experience of prevention and rehabilitation work. The program preparation project enabled its initiators to analyze the current situation in Belarus and to establish contacts with organizations capable of promoting the program and assisting individual public and church initiative groups in their actions for preventing HIV/ADS and rehabilitating its victims.
The Program itself was launched in 2001. Administered by the BRT, a social church structure, it actualized 14 HIV/AIDS prevention and rehabilitation projects. These included 2 projects for the rehabilitation of people with HIV in Minsk and Svetlogorsk; 1 project for HIV/AIDS education and exchange of experience; 1 communicational project for creating a site and a chat on HIV/AIDS, 1 project for program administration, 9 prevention projects targeted at special groups including 1 project for recently released convicts, 1 project for juvenile delinquents, 1 project for difficult teenagers, 1 project for injected drug users with hepatitis C, and 3 projects for schoolchildren and youth in Vitebsk, Minsk, and the Machulischi urban-type community. Out of these 14 projects, 8 were carried out by church organizations and 6 by public organization.
The Belorussian Orthodox Church has also taken part in joint activities together with governmental and public organizations. For instance, it participated in the World Aids Day, observed on May 19, by conducting requiem services for the victims of AIDS in several Orthodox churches in Belarus.
The Belorussian Orthodox Church has just entered the diakonical service for preventing the HIV epidemic and giving assistance to those with HIV/AIDS. This work therefore, just as any initiative, requires special efforts, inspiration and, most importantly, spiritual support and understanding on the part of the supreme church authorities.
In writing this article, the author used the materials on the HIV/AIDS situation in Belarus produced by the Republican AIDS Prevention Center: "A situation analysis", "Incidence of the use of injected drugs and the HIV infection in Belarus: An express-evaluation", "Memorandum on the current AIDS situation".Top of the page
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