"Aids, Ancestors and Salvation"

(Address of Bishop Kevin Dowling at the Launch of Fr Peter Knox's book)

Christa was a little girl whose story will never grace the pages on which important life events are captured. But Christa was a little girl who captured my heart totally, who touched my life and my journey with experiences too deep, too precious, to translate into words. As such, she will always remain in my heart, and this is a simple but beautiful gift from God to me.

Christa came into my life through the HIV hyper-epidemic, a “little one” among hundreds of others whom I have been privileged to encounter, love, and serve together with the HIV team with whom I minister. Her mother had died of AIDS-defining diseases, leaving her to be cared for by an elderly grandmother. She became very sick and when she was discovered through our network of home-carers it was clear she needed to be admitted to our hospice in-patient unit – she was indeed very ill. We fought so hard for her, but she was too ill, too weak, and kept going down. A very painful growth developed in her throat such that she could not eat properly. That was when I discovered that she loved ice-cream – and also that ice-cream slid down that pain-filled throat easily, without adding to her discomfort. I used to love coming in from my work and going into the room in the hospice where she lay with four others. And then I would present her with the ice-cream. I will never forget her beautiful, gentle, humble little smile as she whispered to me: “Thank you, Bishop Kevin”.

Christa used to love reading from the Bible, and when her voice was still strong enough she used to read verses to the others in her room. As the days went by I knew she was dying, that we would not be able to “save” this vulnerable “little one” in spite of the devoted love and care of the staff. One Sunday morning I had to go out into a remote rural area of the diocese. That morning early, Tabea – one of the carers in the hospice who looked after Christa – came into her room. There she was reading her Bible. Tabea said: “Christa, would you like me to bring you something, like very soft porridge?” And Christa looked up at her and said very peacefully and quietly: “No……thank you……I think I am dying. Please call my grandmother…..” Tabea ran out to the nursing station a few steps away and phoned the grandmother. She came back and Christa just closed the Bible, folded her hands, closed her eyes and ever so peacefully went to God.

That a 13 year old girl could die like that, in such peace and dignity, is something I will always ponder on in reverence…………

“A person is a person through others” – the powerful African proverb which reflects, illustrates so clearly the social dimension of a person’s self of self, their personal sense of identity. Quoting Fr. Stuart Bate, Fr. Knox writes: “People who contract HIV go through a process of cultural and social isolation which is in many ways more ‘sickening’ than the clinical symptoms themselves.” (pg. 204).

The phenomenon of HIV in our cultural context not only brings physical death but an ever deepening social “dying” which can be so destructive of the human person – the stigma, fear, exclusion and marginalisation from the community and society, when it happens, is truly a “dying” and a “death”. Another dimension……I have watched a mother’s face in our hospice so many times – etched with anxiety and fear about what is going to happen to her baby or children. Moving on, the profound pain of orphans who traditionally would have been taken into an extended family now having to nurse mothers and go through stages of loss as they experience the sometimes slow death of a parent and then are left feeling so alone because the extended family has also been wiped out by the disease. And then, with so many young people dying, the importance of being regarded as, of becoming an ancestor linked in the culture to producing offspring, a value even in Western culture where the passing on of the family name is also prized. All this is a major challenge to understanding the mystery, the meaning of “salvation” in the context of AIDS, which is explored thoroughly by Fr. Peter Knox in this book
My experience with Christa illustrates another profound truth which must be at the heart of the response to the HIV hyper-epidemic, viz. that there is a difference between “curing a disease” and “healing an illness” as Fr. Peter Knox affirmed so succinctly.

I believe this is what the care team with whom I worked enabled Christa to experience. We could not cure the disease, but I truly believe she was healed of her illness because of the holistic care response we provided for her day after day, through which there was an interface between the physical, emotional, cultural, and spiritual dimensions of her frail but very precious little being. This was a “salvation” experience for her, I believe, even though she could not have articulated that.

After several years of very personal ministry with those living and dying with Aids-defining diseases, I would like to affirm that one basic thesis in Fr. Knox’s book is profoundly true for me, viz. that our call is to enable those infected and affected to “find restored identity and belonging in a world marked by the deadness of anomie, in which they are increasingly alienated from village, family, tribe and community” (pg. 205). This provides the avenue for salvation to become a living reality for these very special “little ones” in our world of today.

Quoting Richard Hardy Fr. Knox writes: “We might not find a concrete answer to these questions [of suffering and death] other than that everything is to be lived as consciously as possible; and we can do that only if others are there with us in the process. Here is the very heart of community and what it means to live in the presence of the sacred.” (pg. 206). Fr. Knox clearly shows that the ancestor cult can indeed be a locus of the sacred in the lives of those infected and affected by HIV, and that we need to integrate this awareness and understanding of the ancestor cult into the important objective of providing a holistic response to the unique being of the one who is ill and in need of healing. In that sense, the spirit world of the African worldview, and the spirit and spiritual world of Western culture pose the same challenge to us in terms of “healing the illness” and bringing about the experience of salvation in the concrete circumstances of the sick and dying person, and those affected by that mystery of dying.

I found this a fascinating book in terms of its insights, and especially Fr. Knox’s use of the Kairos Document as a template for a contemporary analysis of the AIDS pandemic from the perspective of the soteriology or salvation mystery implicit in the ancestor cult (State Theology), the explicit soteriology of the classical Christian Church theology, and the comprehensive but focussed prophetical theology of salvation.

“The ancestor cult’s ritual processes, developed over generations, aim to reconcile an ill person with the family, the ancestors, close friends and neighbours, in order to achieve the ultimate good of social harmony.” (pg. 222). In other words this is a healing of relationships with God, the family and the ancestors…… “it re-integrates a person in a circle of relationships which will sustain him or her for the final years, months, or days of life.” (pg. 210). This can bring about a sense of peace, a deepening ability to “let go” and accept what “is” by the sick person, that very spiritual ability to “abandon oneself” into the spiritual, the spirit world, the God who is so present in that total relational context.

Conversely, our Sacrament of the Sick, often accompanied by the sacrament of reconciliation, could have a similar objective – bringing about reconciliation between the individual, God, and the community. What we can learn from the ancestor cult is to give much greater importance to the presence and active participation of family members and the faith community during the celebration of this Sacrament, so that a loving, caring and supportive experience can be made present which can enable those sick people to come to peace, to let go, and to abandon themselves into the love of the God who is so incarnate in the love of the community which is present in that process of dying.

On the other hand, the prophetic dimension of the truly Christian response must also inspire us to fulfil a particular dimension of the prophet’s calling, that of denunciation of the systemic factors that contribute to the spread of this disease and which deepen the experience of suffering in those infected or affected by the disease. Firstly, the systemic reality of HIV being a disease especially of the poor and everything which leads to the further impoverishment of the personhood of the economically poor individual and family – their shocking living conditions, malnutrition, inability to access quality health care, unemployment, and so on – all of which bring about a sense of hopelessness and thus contribute to the rapid approach of a death in isolation. But there is another focus, just as important and just as systemic. Both the Christian Churches and the followers of the ancestor cult cannot be remiss in confronting the realities of our appalling levels of gender-based violence, male domination in gender relations, rape of women and children, the culture of an entitlement to sex which can be further expressed in multiple concurrent sexual partnerships becoming a virtual way of life in our current context….all of which play a critical role in the spread of this disease.

“Salvation” is at the heart of the discourse in this book, but it is a salvation that is viewed holistically. Central to living with this disease, especially if one has been saved from death and “healed of illness” through anti-retroviral therapy, is the ability to live positively – and for this there needs to be a holistic regimen based on a relational context of family, friends and community providing affirmation, love and support which enables the sick person to discover a sense of meaning and purpose in living and in all that their life entails; adequate nutrition and vitamin supplements, etc.; and a spirituality which brings into a unity a life-enhancing relationship with God, one’s immediate and extended community, creation, and one’s ancestors.

In the same way, for those who are terminally ill the holistic regimen is of equal importance: medical treatment and palliative care, pain control; surrounding the person with a community of love and compassion which gives them a sense of belonging and of being accompanied by carers who spend hours and hours being present to the person just as they need – talking, counselling when necessary, remaining in silence holding their hand, and so on; the spiritual dimension whether through the ancestor cult or the more traditional Christian responses of prayer and spiritual nourishment either through the individual carer, or through the carers praying and singing as a community in the presence of the sick person; the gentle assurance, repeated time and time again and in different ways to a dying mother “do not worry, do not be afraid…….when you go, we will take care of your beautiful little girl, we will find a home for her, we will make sure she goes to school, we will make sure she grows up and remembers you, her mother, and to thank God that you, her mother, gave her so much love and care – trust us, we will never, never let you down”. I have seen and experienced how people like this in our hospice come to peace, gradually are able to “let go”, and then die in peace and with a beautiful dignity. Christa is just one such story.

This book stretched my thinking and imagination, and it challenged me to recognise the different sources of what can be truly life-giving in this HIV pandemic. For me, what made it special is the way it uncovers potential mutual enrichment through personal encounter with diverse cultures. This is something that will take flesh when we discover and understand the richness of all that the ancestor cult and the Christian tradition can offer towards reaching the goal of “healing this illness” in the most vulnerable and marginalised people of our society. I congratulate and thank Fr. Peter Knox for pushing the boundaries and opening wider perspectives in regard to how we can live our calling to bring about holistic salvation in the context of this pandemic.
+Kevin Dowling C.Ss.R.