When it comes to combatting AIDS, doctors and clergy don't always see eye to eye. Physicians zero in on the virus that causes the scourge. Ministers tend to highlight the moral lapses--from social injustice to sexual behavior--that help spread the disease. They could be allies in combatting the epidemic, particularly in Africa where doctors are few and preachers many, but instead they often seem to work at cross-purposes, divided by mistrust and skeptical of one another's motives.
Enter Peter Okaalet, 52, a physician who decided in the late 1980s to go to seminary in an attempt to bridge the gap. From his base in Nairobi, where he serves as Africa director for a Christian medical-assistance group called MAP International, Okaalet has spent the past 12 years working with ministers--and by extension their congregations--to refine and in some cases redefine their response to AIDS. To that end he has run countless seminars in Kenya and elsewhere and helped establish master's degree programs in pastoral care and HIV/AIDS at 14 seminaries and Bible colleges in eastern and southern Africa.
Why focus so much energy on ministers and churches? "People forget that churches also have hospitals in Africa," Okaalet says. "Most of the mission-based hospitals are in the rural areas where governments cannot reach. Where the road for the four-wheel-drive stops, the pastor gets on his bicycle. Where the bike path stops, the pastor lays it aside and goes on foot."
The path gets rocky at times. Many religious communities, Okaalet finds, progress through four phases in their response to the AIDS crisis: an initial "holier than thou" attitude of condemning others; helpless resignation in the face of the enormity of the epidemic; concern that if they become involved in AIDS issues they will be ostracized; and, ideally, wholehearted involvement. The trick to helping groups out of the early stages, says Okaalet, who has lost three brothers to AIDS, is to provide accurate information and realize that "the messenger is as important as the message."
By way of example, Okaalet recalls a ministers' workshop that MAP organized in Zambia. The leader was a dynamic young woman named Bridget who was HIV positive but didn't reveal her status at first. Toward the end of the program, after she had reviewed how HIV is spread, she told the participants that she was infected. "They were shocked," Okaalet says. "She didn't look like somebody with HIV." They were even more stunned to learn that she contracted HIV from her husband, who was a minister, and that he became infected after having sex with a woman he knew had AIDS because he had been counseling her about her illness. Bridget's husband was too scared and embarrassed to tell his wife what he had done. After listening to her story, the pastors realized they could no longer think of AIDS as something that happens only to someone else.
Both Bridget and her husband have since died. But the efforts to educate ministers and their congregations and help them face the epidemic continue. "For a long time the church was very quiet," Okaalet says. "We are beginning to respond, but we have to do more."