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RESEARCHdegree of consideration if either prevention or diseasemanagement is to succeed. I will show why HIV/AIDSstrategies cannot follow a strictly biomedical solution,reveal the strengths that FBOs provide, and examineofficial Catholic policy on contraceptives. Through myvalidation of Catholic FBOs, whose beliefs appear themost problematic, I hope to simultaneously validate theparticipation and actions of FBOs from other religiousaffiliations.African Specific ObstaclesIt is essential to identify country specific behaviorsand beliefs that foster the spread of HIV/AIDS in orderto understand how to create successful prevention andtreatment plans.I. GenderIn sub-Saharan Africa women account for 60 percentof HIV/AIDS cases. 5 African societies “encouragethe abuse of women … [and] view sex as male conquest”which creates a greater need to provide supportdirected towards marginalized women. 6 When combatingpoverty and starvation, women are more vulnerableto contracting HIV/AIDS due to their increasedprobability of engaging in for-profit sex. 7 Biologically,women also face an added threat because of the increasedamount of surface area exposed on female’sgenitalia compared to male’s, the greater amount of semenpresent during sex compared to vaginal fluid, andthe increased amount of HIV in semen compared tovaginal fluids. 8 These social and biological factors helpto explain why HIV/AIDS affects women most severelyin sub-Saharan AfricaFurthermore, the migratory labor pattern in Africaincreases sexual concurrency and threatens traditionalfamilial units. 9 When combined with women’s socialstatus, the results are detrimental to African women’sability to protect themselves from HIV/AIDS. A studyamong Zambian women showed that “only 11% ofwomen believed that they had the right to ask their husbandsto use a condom.” 10 As a means for preventinginfection, condoms are not a complete solution, becausethey require the consent of the male sexual partner,women-controlled prevention techniques are needed. 11II. Scientific Model of HealingFor medical ailments, Westerners often look for ascientific explanation and derive a technical solution,whether it is a pill, vaccine, or surgery. 12 In many cases,physicians have achieved great success when implementingWestern healing to other contexts. It seemsonly natural that physicians follow a similar model forHIV/AIDS, with condoms providing the solution toprevention and antiretroviral drugs (ARVs) prolongingthe life of HIV-positive patients.However, medical approaches to HIV/AIDS differfrom other cases in biomedical healing because a curedoes not exist. ARV treatment requires lifelong treatmentthat is exponentially costly due to unpredictablefuture complications, whether disease remission or contractionof a different infection. This difference is crucialbecause Africans possess an inherent skepticism towardsa strictly technical model of healing. Historically,African models of healing encompass the total personwith “the real cause … in the social, religious realm.” 13Given a distrust of modern medicine, disease preventionmethods and chronic disease management proveproblematic. Regular condom use requires behaviorchange. Additionally, ARVs are more cumbersome thanone vaccination. Patients need to take medicine continuously,visit their local hospital and clinic, and possiblyattend continuous counseling. This new, endlessmethod of medical treatment appears like a completelyforeign process.III. Cultural Obstacle to TreatmentMany African patients completely avoid diagnostictesting and treatment. In part, this may result frompoor healthcare access, but it also results from culturalbeliefs and the stigmatization of HIV/AIDS.Most diseases merely shorten one’s life or impairproper bodily functioning. HIV/AIDS is more deadlybecause it also compromises one’s ability to produce aviable lineage. HIV/AIDS not only disrupts sex, a lifegivingprocess, it uses this process to transmit death. 14Thus, HIV/AIDS not only prevents one from producingtheir own offspring but also represents a failure to continuetheir ancestors’ legacy. Thus, an infected personwill not only suffer as an individual but will also havedetrimental effects on his community and its future.In Africa, a diseased individual traditionally representsthe physical manifestation of a disordered community,the result of unhealthy relationships among the livingor dead members of the community. 15 Africans mustquestion the foundation of their community in order todetermine the deeper significance. A sick communitymeans no cure and no hope for the future which makesHIV/AIDS highly stigmatized and feared. This fear maydeter many from seeking diagnosis.Africa’s history of colonialism and racial conflictalso discourage many Africans from seeking out medicalhelp and adhering to medical advice. Due to the sophisticationof medicine, the average African has no mannerin which to gauge the accuracy of the physician’sadvice. Their instinct, based on the knowledge of animperialistic past, ultimately influences their decisionsand serves to disrupt Africans’ trust of ARVs, medicinesdeveloped by foreign whites. 16 Because HIV/AIDS preventionand treatment require lifelong commitment andbehavior change to produce effective results, this distrust– whether slightly or deeply ingrained – decreasesthe likelihood that Africans will adhere to only modern14 NORTHWESTERN UNDERGRADUATE RESEARCH JOURNAL
RESEARCHmedical treatment. Many experiment with traditionalAfrican healing since healers claim to have a cure toHIV/AIDS. 17 Alternating between medical and Africanhealing causes additional difficulties because ARVs willnot produce the desired results, further impairing Africans’trust in the foreign man’s advice.The beliefs regarding the motives of the foreign doctor,the fate of an HIV victim, and the limitations ofmedicine all have a presence in African culture and needproper consideration. Even if sufficient funding existedto provide Africans with condoms, ARVs, and propermedical attention from physicians, HIV/AIDS transmissionsand deaths would likely persist. In order for Africato achieve significant progress, the social and culturalcomponents of the problem also need attention.Catholic ResponseI. StrengthsThe Catholic Church complements medicine bypromoting the social aspects of HIV/AIDS treatmentand offering a comprehensive model for healing. Technicalhealing addresses the physical component of thedisease, and African healing aims to cure the disease bytargeting the disharmony and disorder present in thecommunity. Christian healing shares similarities withboth:healing is ... the involvement with Jesus…witheverything that diminishes our humanity, the powersof evil, the various contemporary idols of death.Health is therefore more than a mere absence of illnessin whatever form, but implies wholeness, fullness oflife. 18The story of the Gospel acknowledges that a completeprocess of healing requires patience, friendship,and love. 19 Furthermore, Catholics believe that theBody of Christ connects the diseased with the healthy. 20Instead of occupying a distinct space from the healthy,this approach to healing directly promotes solidaritywith patients and helps to eliminate HIV/AIDS relatedstigmas. The Church approaches healing as a lifelongprocess that needs broad community-based supportrather than a single-factor based solution. This approachcomplements Africans’ perception of health inwhich one’s community is directly linked to healing. 21In addition to providing a holistic model of healing,the Church has a long history of protecting themarginalized. The disadvantaged have the least abilityto obtain the medical attention they need, but they havethe highest risk of disease contraction. In addition tohealthcare, Catholic FBOs cover a full range of servicesfrom education to micro financing. Their commitmentto social justice enables them to target the social andeconomic components of the disease by empoweringwomen and eliminating poverty. The Church looks forpeople in need and acts as their advocate without anyother agenda.The Catholic Church’s last major strength lies in itsVOLUME 7, 2011-2012extensive grass root ties. It established itself in Africalong before the HIV/AIDS crisis began and has alreadygained trust and community support: “Catholic massesin Africa…are not American priests in Africa; theseare African priests in African parishes. I was the onlywhite in the entire church.” 22 With the leadership ofthe Catholic Churches in the power of Africans, it isapparent that the Catholic Church has gained the trustand support of African communities. Trust will enableagencies to help change social norms and values regardingsexuality, gender, and disease management.II. ContraceptivesWhile the Catholic Church may effectively addressthe certain components, objections arise due to Catholics’opposition to contraceptives. Even if condom useis not a panacea, a complete denial of its importanceblocks progress. The Catholic Church believes that allpeople have the ability to abstain from sex until marriageand maintain fidelity within marriage, but we canconclude from simple observation that people do notunanimously adhere to Catholic teachings in practice.Additionally, condoms prevent the spread of HIV betweensero-discodant couples within a marriage, andmedical clinicians recommend the use of condoms duringsexual relations between two HIV positive people inorder to prevent re-infection. 23 Thus, even in a chasteand faithful marriage, condoms have a necessary place ifone or both partners are HIV positive.Observations and evaluations indicate that CatholicFBO volunteers focus on different issues when in thefield than those residing in developed countries. Problemssuch as disease, poverty, death, and hunger provefar more pressing than issues of sexual freedom. 24 ChrisCarroll, a <strong>Northwestern</strong> sociology graduate student,described that during his fieldwork in South Africa thenuns heavily focused on ways in which they could stopthe HIV/AIDS epidemic, and depending on the location,some nuns would keep condoms in their parishesto distribute. 25 New York Times journalist, NicholasKristof, has observed similar practices on the ground,one priest whom he met said “that if he were pope, hewould build a condom factory in the Vatican to savelives.” 26 Practicality, rationality, and sympathy outweighorthodox policy in the midst of the HIV/AIDSepidemic. Instead of focusing on issues of sexuality,Catholic FBOs focus on solving social and structuralinequalities. Many FBOs still teach traditional programsgeared towards abstinence. This type of programhelps to provide a long-term methodological approachfor addressing behavior change. In order to achieve a90 percent reduction in HIV/AIDS prevalence rates by2031, a global health forecasting report indicates thatthe average number of sexual partners needs to decreaseby 70 percent. 27NORTHWESTERN UNDERGRADUATE RESEARCH JOURNAL15
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ABOUT THE CONTRIBUTORSShaon AhsanSh
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