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Aids: a Christian perspective
Jennifer M. Phillips
In the Great Vigil of Easter according to the Episcopal Book of Common Prayer, the new fire is kindled for the lighting of the Paschal Candle in the darkened church. The Deacon carries the Candle into the midst of the congregation and announces, "The Light of Christ", to which the people respond, "Thanks be to God!" Then from the central light, fire is passed to each person's hand taper and the room becomes full of light. "You are the light of the world" (Mtt. 5:14) said Jesus to his followers on the mountainside; and so we contemporary followers are called to be.
The discernment of what it means to be light to the world must be made anew as the Christian communities meet each new aspect of darkness in the world. In our times of much worldwide change, often tearful, we seek to bring and to be holy illumination. The darkness which is AIDS asks this of us, and we respond, sometimes well, sometimes poorly, bringing light by means of care and compassion, understanding, prayer, and education.
AIDS, the final clinical manifestations of infection by the Human Immunodeficiency Virus (HIV), is a global disease, moving slowly but steadily from its centers of early concentration into new regions on every continent, hidden for the first eight to ten years, on average, of its latency before symptoms begin to be evident, but transmissible from the time a person is infected through the remainder of life. Its routes of transmission are well known and seem invariable: through sexual contact, oral, anal or vaginal, between members of the same or opposite gender, via body fluids containing white blood cells invaded by the HIV virus; through perinatal exposure from infected mother to infant; through exchange of infected blood products via intravenous needles or equipment contaminated with blood and used to inject drugs or vaccinate or tatoo or pierce ears, or blood products used for transfusions, or contacted through cuts or mucous membranes.
The darkness of AIDS
AIDS has been compared to the Black Death, the Bubonic plague that spread through Europe several limes in the Middle Ages, but it is a plague in slow motion. There are futurists who predict that by the time the virus runs its course, one out of five people in the world will have been infected, and to date the disease AIDS seems invariably fatal, though sometimes after many years of illness, more often in three to five years. Unlike the Black Death, AIDS comes to us in a world cocky about its technological accomplishment in the medical arena, in which a wealth of resources for investigation and treatment are shared very unequally among nations. The Christian Churches, as several of the other major faith communities of the world, confront the issues AIDS raises as a global network which could become a reconciling presence and a conduit of resources, information, and personnel from places of abundance to places of need. AIDS stirs up, however, political differences, cultural distinctions and values, religious questions, and the necessity of conversing about the most intimate and volatile of human concerns: death, sexual behavior, the family, drug use, contagion. The very language people and governments choose to speak about AIDS has profound impact upon the responses of individuals and the policies of agencies and states. One may choose a language of exclusion or inclusion, a language that enjoins urgent response and change or promulgates pessimism and an approach of avoidance and containment.
Michael Foucault first drew attention to the political and ethical dimensions of the term "epidemic". AIDS was referred to as an epidemic disease fairly soon after its emergence in the urban centers of the United Stales in the early eighties. The language of epidemic has mobilizing power. It proclaims emergency and summons those who have resources to respond in extraordinary ways. In times of epidemic, the normal social contract is torn open to admit the suspension of accustomed rights to privacy, choice about medical treatment and monitoring, free mobility and social interaction and behaviors. Information, both that generated by research science and clinical practice and that about individuals and groups can be exchanged in ways which are either wider or more constrained than usual. Power and authority over aspects of peoples' lives is wielded by certain others; some, (perhaps doctors, state epidemiologists) have power given to them; others (patients, persons believed to be actual or potential vectors of disease) have power taken away. In religious communities, epidemic language may accomplish an abrupt change in the topics of conversation and study and the kinds of social action and ministry to respond to the perceived crisis. AIDS has prompted the churches to begin talking about sexual behavior and drug use with an explicitness that was highly unusual before the epidemic was recognized. Task forces have been created, study commissions set up, and emergency care plans drawn in those denominations and faith groups who have heard the clarion language of epidemic. The language of "epidemic" tends to be a language of victims and helpers, of the clean and unclean. It may bring a tremendous outpouring of helping energy, yet also trigger massive fearfulness and denial in some quarters.
More sinister is a second term becoming associated with AIDS: "endemic". As the saturation of viral infection increases in certain communities of people, (initially gay men, increasingly intravenous drug users and their sexual partners, and some geographical areas: parts of Africa, inner cities, and neighborhoods of color in the U.S. and western Europe) the pockets of disease become visible and identifiable. Where a large portion of a population is infected over a long time period, disease is said to have become "endemic". The language of "endemic" is the language of pessimism and chronicity. It shifts the focus from eradication and cure to containment and palliation. An endemic disease is built-in, in modern parlance, it goes with the territory, sort of an occupational hazard of belonging to an affected population. It suggests an allotment of a certain amount of resources over a long term and the creation of structures and policies to limit spread from areas where disease is expected to other areas. Subtly, the language of endemic may lead to blaming the sick for their own illness. In the global conversation about AIDS, such thinking underlies some of the ways the United States and European countries talk about African and Caribbean nations as regions rife with illness, dirt, contagion and ignorance. Racism slips into the scientific discourse about the "dark continent". It also colors the reactions of a heterosexual majority to a homosexual minority with accusations about "dirty, unhygienic, and unnatural" sexual behaviors of "those queers and perverts", and to intravenous drug users not regarded as medically or psychologically ill but as morally bankrupt and disposable sub-human and alien beings. Even the church must walk carefully in order to avoid the us/them dichotomy that surrounds endemic disease. At its least humane, the church responds to "endemic" by labeling the plight of the affected as the judgement of God and the just desserts of the afflicted. They are condemned as offensive members of Christ's Body and amputated and isolated along with any parts seen as affiliated with them, and then the church washes its hands and turns back to its own internal concerns.
The truth of AIDS
The truth of AIDS is that it is a global disease; HIV infection is and will be everywhere and there is no way to close borders against it or quarantine the infected, most of whom look and feel well. Nor is there yet a test that will immediately and reliably tell who is and who is not infected and a potential vector. The most helpful language we have to choose at this point is that of "pandemic" disease. The discourse of "pandemic" is a discourse of inclusion. Everyone is affected in some measure and everyone is called upon to respond. National boundaries become secondary to awareness of a shared plight, a common ground. Humanity is the infected population. Resources must be shared on a global scale and knowledge exchanged with the goal of collaboration toward treatment, cure, prevention, and care not only of the sick but of their loved ones and dependents, their neighbors, and those who are fearful. For those in the Christian tradition, the language of "pandemic" reminds us of our foundations in faith: humanity created by one God in a world which is good but touched by sin and destruction and mortality, and the saving and reconciling and healing intent of God toward us made manifest in the human being Jesus who dined with the poor and outcast and unclean, laid hands upon and lodged with lepers, with women, with the disfigured, insane and crippled.
The Christian community searches its Scriptures for a proper response to the AIDS pandemic and hears an ancient mandate reiterated by the Jew Jesus from his still more ancient tradition: visit the sick, teed the hungry, clothe the naked, encourage the imprisoned, intercede for the suffering (Mtt. 25:35ff, et al). We also hear the warning, "judge not that you be not judged" (Mtt. 7:2). Care for all God's people and especially the little ones and outsiders is enjoined upon followers of Christ under the authority of the Commandment to love the neighbor as the self and God wholly.
Mobilized in Ministry
Having heard the calling of God in Scripture and in the long tradition of care for the sick and those regarded as unclean through centuries of the church's history and in our own reason as we witness the suffering and need of the world, we in the Church are to become mobilized in ministry. The proclamation of God's Good News requires not only word but also action. With other communities of faith, we may set up home care networks to assist those ill at home, not able to get hospital care, households caring for a sick person, and people with HIV related illness who are alone. We may organize blood drives to help to remedy the shortage of blood products created by those unable or unwilling to donate blood because of HIV infection or fear. We may provide food, clothing and housing assistance to bereft dependents, to those who lose their jobs because of AIDS illness, and to the sick homeless. We may give space and personnel to staff drug rehabilitation programs, host Narcotics Anonymous meetings, and provide counseling; perhaps religious centers might even make clean needles available to those unwilling or unready for drug rehabilitation but desiring to avoid contracting AIDS or passing HIV infection to others. We may lobby politically for humane policies and services from our governments. We may start support groups and prayer circles to assist the ill, the frightened, and the bereaved. We may coordinate parish volunteers to help a family foster or adopt an infant or child with AIDS and bear the emotional and physical burdens of care with them, or take in a sick adult in the same manner. As those called to be "the light of the world", we may join with others who are seeking to provide education to adults and youth, not only within the churches, but throughout the society. We may pray aloud in our liturgies for healing, for strength, and for the allaying of fear, and offer special liturgies of healing with anointing and laying on of hands in parishes where these are traditional. We may visit those with HIV infection in prison who are often abused by fellow prisoners, ostracized and isolated in cells or hospital wards. With our Jewish neighbors we are called to the work of the repairing of the universe to which God calls us. Interfaith collaboration is not only sensible but necessary if we are to knit together the broken fragments of the world as it is being devastated by AIDS.
The AIDS sufferer — Image of God
For Christians, there is a special mandate to look for the face of Christ, the invisible God made manifest to us, in every other person, without discrimination. Mahatma Gandhi was once quoted as saying, "If you don't find God in the very next person you meet, it is a waste of time looking for him further". Looking for Christ in the face of the person with AIDS is not always easy. Seeing God behind the color, foreign language, different sexual behavior, pattern of drug use, and the ravages of disease that may be disfiguring and wasting requires that we look at one another as much as possible with the eyes of God, the eyes of Compassion and Mercy; and because we are not God we look also with the eyes of humility without judgement or scorn recognizing our common humanity with the unlovely other. In the wasted and drawn and pained and scarred faces and bodies of those dying of AIDS we may see the one who hung upon the Cross. With the women who loved Jesus, we may participate in the washing and laying him in the tomb, as we open our communities for funeral and memorial services not only for church members, but for those who lost their faith, were ostracized from their own churches, or never heard the Gospel but came or sent friends looking for godly people to lay them to rest.
When the loss and change brought by AIDS becomes overwhelming, as it is already in some parts of the world and will be soon in others, we are called to help one another grieve and remember. Cities, nations, and the globe may ultimately need to find corporate ways to express grief, so as not to settle into the paralysis of depression. Christians come to this labor of grief with a special identity, as witnesses of the Resurrection. This does not mean that our loss is not real. We see only too clearly the premature deaths of children and young adults, the waste and sadness exacerbated by human patterns of intolerance and hatred. As Jesus mourned for his dead friend Lazarus, we also weep. We know, however, that death is not the last word, but that God has all our living and dying in hand. We hear and proclaim a promise of eternal life. We are called to put aside our modern embarrassment in speaking of heaven and remember the one through whom God conquered death. As we tell our story of faith again and again to each other and the world we increase our hope and strengthen ourselves for service. When despair cries out "God is dead; God is not here", we tell what we have seen and heard, that the crucified one is alive and has gone before us. Our experience is of a living God. Through the distinctions of many faiths we join to affirm this.
We band together to create safe spaces to hear and tell each other's stories. We listen to the stories of people affected by AIDS; bereaved parents and children, gay men, persons of many ethnicities, prostitutes, doctors and nurses, prison wardens, researchers, lesbians, clergy, people from overseas and from all walks of life. Listening we hear of our shared creatureliness and of the activity of the divine in our midst. In the face of profound loss and change, people of faith in the midst of the particularities of their experience of the living God, testify to the unchanging love of the one who made us for Godself, , who knew us in the womb and called us by name, who engraves us on the palms of the divine hands, and who will never suffer us to be lost.
The Reverend Dr. Jennifer M. Phillips is Rector of St. John the Evangelist Episcopal Parish in Boston. She worked for eight years as a hospital chaplain and has been active in Aids mim istry since 1984, serving on the Aids Action Committee in Boston. She is a member off the Episcopal Province of New England AIDS Task Force. Dr. Phillips has written widely on aspects of caring for AIDS sufferers, contributing to many publications. Among them are Comfort in Caring: Nursing the Person with HIV Infection (Boston, Scott, Foresman/Little Brown 1989) and a chapter on "Psychological Issues" in AIDS: An Educational Reference Manual(June 1988), of the Massachu- setts Hospital Association. In 1988 she received the Severinghaus Award for contributions in religion and ministry in the area of community AIDS work presented at Wellesley College.
