Funerals--The USA and Malawi

I remember my first funeral well. Some older person in our church had died, but I didn’t know him or her, and the funeral was to be held in Grand Saline, about 50 miles away. My Daddy was the song leader in our little congregation, and he needed a tenor. I was taken out of school, it was about the 7^th grade, and carried to help form the quartet that would comfort family and friends with songs of heaven. It was a good, hands-off, impersonal preparation for my second funeral.

A few weeks later a boy in our small town (about 95 in my graduating class) was killed. He was one grade ahead or behind me; I think his name was George. He had lived, just around a corner or two, but we were not good friends. His single mom tried, but he ended up being one of the boys my mom didn’t want me to play with. That’s why he died. The square dance club met in the City Auditorium, an old frame building out by the rodeo arena. I was in that Auditorium only once or twice in my life. It was just the other side of the railroad tracks from down-town and our houses, mine and George’s, and about a mile down the tracks the other side of Main Street. Drinking was strictly prohibited in the Auditorium by the Baptist members who’d broken into square dancing, but not alcohol. The Methodists conceded, but some folks kept a flask under their front seat to loosen up their turns between dances. And in a small town, nobody locked their car.

The County was dry, and booze hard to get, but George had figured this one out. While the fiddle scrawled and the gentleman called, George was helping himself outside. He was pretty drunk when the dancing ended for the evening, but he made it to the tracks without being discovered. He didn’t make it home. He just laid down on the ties and gravel between the rails to rest a bit. He was drunk enough to sleep in that unlikely bed, but not enough to sleep through the 2:30 train that came through town. He was too low on the track to be seen until he raised his head just before the train reached him. I remember a few things about the funeral: almost everyone from school came; they didn’t open the casket; and it was generally very quiet but for his mother sniffling up front, fighting back the pain.

Malawian funerals are not quiet. No one is fighting back the pain. Men and women who are close to the deceased wail almost continuously, even through the hymns, except when a preacher calls for quiet for prayer or an exhortation. Most of the rest of the time, during visitation (12-36 hours) and the trek to the grave a host of mourners including the close family wail, and contort the body, some walking around outside the house where the body lies and calling on the deceased “mkazi wanga, mkazi wanga” (“my wife, my wife”) or “mlongo anga, mlonga anga” (“my sister, my sister”). My friend Steve Kay, who out of his own profound experience speaks and writes well about grief, especially male grief and its expression, would admire the Malawian men I think, bent at the waist, arms wrapped around their bent heads, weeping and crying, wailing and calling of their loss and for the departed. I am also reminded of the Biblical stories of funerals, where Jesus quieted the mourners before challenging death itself.

The body lies in state in the front room of a small hut, usually for less than 24 hours, but occasionally longer if some family must come from afar. Wailing women fill the small room, surrounding the body, covering the floor, spilling down the hall toward the bedrooms. A thin path through the legs from the door to the head of the deceased, and sometimes out the back door allows others to view the body, or at least the face, where only a small portion is visible, the rest, including the mouth and nose, wrapped in cloth. The closest female members of the family are literally and bodily supported by other family members, propped up where they are sitting on the floor.

Male family members visit the body periodically, joining the wailing on entering the door, and sometimes continuing in the courtyard as they walk off their grief outside. Clusters of men and women sit in their respective, quite separate areas all around the house, sometimes stretching throughout the neighborhood, but in these circles quiet respect reigns. Stores in the close neighborhood are “closed” though discrete sales through a cracked door allow life to continue in this world of many funerals. Some women bring in food (meaning nsima, the boiled corn meal which is the staple of diets throughout this part of Africa), while others stir the flour into pots of boiling water and prepare greens, beans or meat to add “relish” to the center of the meal. I’ve never seen a small funeral or memorial service. Honoring the dead is a core part of African life, and everyone shows up who knew the deceased and knows of the death. All the neighbors are there, and friends and relatives from near and far. Everyone is fed. Contributions are made, and a list of civic leaders who contributed, and how much they gave, is announced at the formal service before the shift to the graveyard. The village chief speaks of the deceased. An obituary is read. Singers sing. A preacher preaches.

When the grave is ready, or some other social marker unknown to me is reached, the body is witnessed by as many as possible as it is being transferred into the coffin. The tapping sound that followed puzzled me until I remembered the two hammer-bearers entering the house. The wailing, which had grown with the transfer of the body, swelled even more as the lid to the simple casket was nailed shut. The casket was moved to the bier, and the trek to the grove of trees marking the graveyard began, women leading if the deceased is female, men if male, but never mixing. Sometimes the grave is near, sometimes far.

At the graveyard there is more singing. More preaching. And more wailing, but now by isolated family members overcome by the grief of the moment. Some are comforted by others. One by one family members may be removed from the scene by friends or other relatives, perhaps because their display of grief is too much for that moment of the service, or perhaps for fear that the depth of their grief might become harmful to them on witnessing the burial. One wailing young man fell flat on the ground and was carried out, apparently unconscious. Later another followed suit but was left to lie. At one point a young woman near the grave stood, turned, gasped deeply, and let out a short but forceful cry which ended with her swoon to the ground, arms and legs flailing. Four women lifted her by her four limbs and carried her out despite the jerking of the appendages. Most sat quietly as the casket was lowered, the dirt returned, and the preacher preached on. A choir sang a few songs.

When thunder and lightning neared, women began to slip away. “Mvula! Rain!” One said to Beth. “You’re going to get wet! Tiyeni. Come with us.” The preacher continued. Men soon followed. The preacher himself soon gave up and the feeding began: nsima and goat. The rain mercifully held off another 30 minutes. Then we were on our way home, hurrying against the approaching darkness to get to the highway and then the city before the multitude of bicyclists and pedestrians scurrying home fade into the obscurity and danger of nightfall on the busy road.

Funerals in southeastern Africa have a major effect on business productivity, not only through the loss of skilled employees in their prime years (Malawi lost 6,500 teachers to death in the last three years) but also due to the massive social participation that is required of the living. Funerals take at least one day, often two, and not uncommonly three days away from work, and each worker attends multiple funerals a year. We attended three last week. Employers are expected to be major benefactors toward the costs of funerals in their role as the primary sustenance of the family. Funeral support is in the budget of every major business as a line item, but in one recent year a major civic unit drained that item long before the year was over. Some control of HIV (50% of those needing treatment in Malawi are getting it) and an increase in the line item budget for funerals have avoided the problem of running out of help in subsequent years, but deaths continue in large numbers.

The west has a short attention span, and the current waning attention to the African HIV problem is evidence of that. The US and Europe are moving on (actually around in a cycle) to attack once again Maternal-Child Health. While some shifts in AIDS budgeting may need to occur, the need for western government to support availability of the expensive medications needed to treat HIV still exists. Write your senators or representatives today. Western Christians need to support widow and orphan care by local agencies and churches in Africa. Just as the effects of previous efforts are beginning to be observed, the West is backing out. This is not the time to back out, but rather the time to press forward, to make treatment available for everyone lest the wailing never stop.

A Needless Death-II

She was about 25. She hadn’t done well in school, so at a young age she had decided to try her hand at something else where she might do better—marriage.

She found a man to marry her and they began their life together. No wedding, just a coming together with an announcement to the community: “We’re married now.” Two children were born. One died of malaria, and the community became suspicious of HIV.

A divorce occurred. Her brother did not know why or what the circumstances were. Now she was a single mom with one surviving child, and HIV.

Her test had been positive, and at some time she had begun on antiretrovirals, life-saving medicines that have normalized the life span of HIV patients who are diagnosed early in the disease’s progression and while they are still young—if they take their meds like their lives depend on it; they do. She was young, but apparently not diagnosed early. The hospital was not very far away, but she was sick a lot, and going even a few kilometers on foot was a problem when sick. She was very poor, and probably ashamed of her status. It was not easy to get a ride. So she missed an appointment and then ran out of meds. She may have stopped and started her meds several times. And then she died.

Primary Cause of Death: Unknown, but some opportunistic infection, possibly tuberculosis, malaria, or cryptococcal (fungal) meningitis.

Secondary Cause of Death: Acquired Immune Deficiency Syndrome—AIDS

Tertiary Cause of Death: Infection with the Human Immunodeficiency Virus--HIV

Contributing Factors: Stigma, Shame, Poverty, Unfaithfulness, Single Motherhood, Social Isolation. All these are things which the church must address in its God-given mission to help the helpless, defend the fatherless and the widow, offer forgiveness to the guilty and hope to the hopeless, to love the apparently unlovely whom Jesus loved enough to associate with, to care for, to speak up for (as his Father and ours has done since the beginning of time), and then to die for that we (yes, we are among them) might live to tell the story to others who need to hear it and to live that ongoing story in relationship with them.

A Needless Death

She was 40. Her oldest child was 20, her youngest 7. Her second child, like thousands of other children across Malawi, is waiting the results of standardized testing at the end of “Form 2”, his sophomore year in high school. These results will determine whether he enters Form 3 or repeats the first two years.

Her husband died about four years ago, and she tested positive for HIV. She steadfastly refused everyone’s efforts to get her to take anti-retroviral medication. When she came down with active tuberculosis she also refused treatment falsely stating that she had several small children at home whom she could not leave for the intense initiation of treatment at the District Hospital. Instead, she returned home to the little house she occupied with all her children. Finally they convinced her to go to the hospital and begin treatment, where she died shortly after admission.

There really is no reason for anyone to die early of HIV. A recent study, admittedly in the west, found that people who started treatment for HIV early in the course of the disease and who were younger (I believe that was not yet 60) at the time of initiation of treatment were as likely to live to an old age as their peers who were not infected with HIV. While the medication that has been available in Malawi until recently (the protocols are undergoing revision) are not the regimens that are currently recommended for initiation of therapy in the U.S., they served my patients extremely well in the opening days of multi-drug treatment, leading to prolonged suppression of the virus for those who took them as if their lives depended on it. As it turned out, their lives did depend on taking them exactly as indicated, always. Some people had been on the medications for 10 years or more with no evidence of the virus in their blood since starting them.

Medications are not as readily available for many Malawians as they need to be. Some people have to walk many miles to get to a center that offers the life-saving drugs. That may have been part of the problem for this woman. Yet, that does not seem to have been the case. She was in contact with people who could treat her, and her family could have cared for her children intermittently. Her brother, a friend of mine and the source of this information, is a medical professional who tried to persuade her. Why did she not submit to treatment?

The reasons for this sister’s actions will probably never be known. She may not have held any hope for the medications. She may have heard how “horrible” they were, and difficult to take, full of side-effects, and thus refused, not wanting to add insult to injury. Often, however, stigma is the problem. People are afraid to take the medications because then people will know that they are HIV positive. “And we know good people shouldn’t be HIV positive.” Sometimes, however, the stigma is so deep that people stigmatize themselves. The worst kind of racism is that in which people hate themselves or others of their own kind because they belong to the group. This is also probably the worst kind of stigma around HIV. “Because I am HIV-positive I am a no-good, worthless person. I deserve to die.”

I have had a few other patients who had such an attitude. One never took medications for HIV and she died of her disease eventually, after being pulled “out of the fire” on several occasions for opportunistic infections. She was a deeply religious woman, Roman Catholic, and she made statements to the effect that she deserved to suffer, that her suffering might somehow save her. For another similar case, see my blog at this site, “Shame, HIV, and the Body of Christ”, February, 2010. I wonder if something like this was not working in the sister who died today.

At any rate, I am deeply saddened and very angry on the occasion of this needless death. Needless! All of us must die, but this woman need not have died leaving a seven year old and a son anxious over his grades, and others. She need not have died leaving her children with neither parent. The death of her husband should have been a wake-up call that saved her. But she refused to look to the help that was there. Why do we continue to accept death from the evil one when we could take life from the Father of us all? Pray that as we increase in linguistic skills and embark on this ministry we will be able to join the Lord in offering life, to compellingly offer the resources of the Kingdom of God for life, convincing the wounded and afflicted to reject the Evil One’s seductively compelling offers of death.

Shame: HIV, Death, and the Body of Christ

He glided behind me as he passed the front desk. I didn't have to be there, and he didn't need to stop there, but he seemed to avoid being seen. Somehow I knew he was my last patient of the day. We hadn't met, but as I perused his slim chart, it was evident there were problems. We'll call him Mr. P. The amount of HIV virus in Mr. P's blood had dropped, but not nearly as fast or far as it should have. There were suggestions that he had been on several medications since his infection was discovered, but the documentation was not all there. Then there were his current meds. All of them, nearly a month's worth in most of the bottles, had been last filled seven weeks ago: one bottle was nearly full, another was dosed at half the amount it should have been, and there was only one pill left of one of the meds. "And I don't get paid until Friday," he said from under the bill of his cap. "That's when I can refill it." Three more days. Missing a single dose of your HIV meds each month can increase the risk of resistance developing over the year by 10-15 percentage points. This man, like many of our patients, needed help taking his meds.

He looked to be in his 60's or 70's, but he said he was only 45. As we talked about his disease and what was going on, he wouldn't look at me. On several occasions I asked him to, and he did. Briefly. And then the head was down again, the bill on the cap shading his eyes, hiding his face from my attempt to know him.

"How has this disease affected your life?"

"It's affected me a lot. I'm angry. Angry a lot. I don't know how I got it," the voice spoke from behind the cap.

"Does anyone else know about your disease?"
"My sisters. They know."

"And they've handled that OK?"

"Uuuuh-húh. Oh-Kay. One of them is ok. One of them, she has me drink out of a plastic cup." There was a silence.

"And then . . . she throws it away?"

"Uuuuh-húh," the voice swung up in affirmation.

"But my other sister, she's ok. She feeds me. Lives across the road from me."

His brother-in-law had brought him to the clinic, the husband of the sister "across the road". Without lifting his face Mr. P affirmed that the in-law knew of his disease and that he would sign a release for me to talk with the brother-in-law and sister. I went over a number of things with them, separately, in person with the brother-in-law in Mr. P's presence, and then on the phone with his sister after he'd left. We talked about the CD4 lymphocyte, what that white blood cell normally does, how HIV infects it, then destroys it while diverting the CD4 from its primary mission of protecting us to the role of producing more HIV viruses. We talked about resistance, and the need for adherence to the medication regimen, the need to use a pill box, and possibly for someone to assist him. Then I mentioned to Mr. P's sister his hidden eyes.

"He won't look at me," I began.
"No. He won't look at anybody. Me neither."

"Has he always been this way, or just since he knew he was infected?"

"Just since he's been infected."

Then it hit me! He's ashamed! He's ashamed to be infected with HIV. He's so ashamed that he can't look at anyone. For those who don't know, he's afraid they'll learn, as if by looking into his eyes they would see deep within his brain the "HIV" in red letters, stenciled on the gray matter of his mind. For those who do know, he's ashamed. I was almost overcome with anger and sadness at this man's situation, this man who is now almost Gollum-like, shriveled and be-deviled, his "image-of-God" humanity defaced more than usual because of this disease, the way others deal with him because of the disease, and his fears of what he might receive. Head down he tries to hide in his own dark cave between the bill of his cap and the flaps of his partially zippered jacket. It may be that some of his shame is due to his guilt for how he caught the disease, but that is not my impression. Yes, few know, but of those who do, only two treat him well, treat him . . . normally. And he is overcome with anger, fear, and shame.

This shame, and the fear of it, immobilizes people around the world, keeping them from getting tested in a timely fashion when treatment is most affective and complications are least likely, driving them into caves of despair when they know they are infected, afraid of rejection, loneliness and death, not the stopping of that pumping muscle in their chests, but the death of their spirits through loss of interaction with the rest of us who've been imparted spirits from the One who is Spirit. These fearful ones have not known Him, except through those whom He has created, those He seems to have given life, and now the "living" will, thinks Mr. P, withdraw and leave him absolutely alone, dead. Those who claim to live forget that it is their privilege, their responsibility, at precisely this moment to offer life.

I praised Mr. P's sister and praised God in her presence because she is accepting him, affirming him, loving him, she and her husband. When I see him again I will inquire about shame and if it is confirmed I'll discuss the possible why's of it. If he is guilty, I will offer him the forgiveness that God has given me. "Your sins are forgiven you." "Neither do I condemn you. Go, and cease your life of sin." That is how the Lord dealt with shame. And he has sent us to do the same.

Meanwhile, I am saddened and angered by the way we are, "we" being what too often passes for church, community, and even family in this man's life. That which should be gracious, loving, offering forgiveness, even at the cost of its own life, but rather is too often, especially in this situation, proud, exclusive, condemning: polished, beautifully painted gift boxes full of dead men's bones. "If you were blind, you would not be guilty of sin; but now that you claim you can see, your guilt remains."

Lord, do what is necessary to open eyes, minds and hearts, to impart fear where it needs to be, and courage where it needs to be, so that this disease may be stopped not just in its destruction of bodies, but in its destruction of souls, its defacing of your image in those you made to bear it. Teach the church to be your body, courageous not only in righteous living but also in gracious offering of forgiveness, love and hope, that men and women may know they are loved by you, and can truly live in you.

HIV Transmission in Africa: What More than Sex?

The work of arresting the spread of the HIV epidemic has centered around changing sex practices: reducing the number of partners, encouraging fidelity between partners, delaying the onset of intercourse, preferrably until marriage, and using barriers such as condoms during sexual relations. There has been much discussion over the utility of some of these as compared to others, but not much disagreement over the fact that sex is what the spread of HIV is all about. The Anglican Canon Gideon Byamugisha from Uganda, mentioned in my last post on condom use, first raised the question for me as to whether there might be other activities equally important as sex for the spread of HIV. He referred in his teaching DVD to a scientific paper showing that about 70% of a small cohort of Rwandan women with HIV had a history of only one sex partner who himself was negative for HIV infection. How did the women get it?

In the summer of 2003, Dr. David Gisselquist, then of Penn State University Medical Center, Hershey, and his colleagues published a review of data collected before 1989 on risk factors for acquiring HIV. Across this multitude of papers they reviewed, some of high risk groups and some of the general population, he came to the conclusion that the most common risk factor, accounting for 48% of the HIV, was exposure to injections or procedures in the health care system, defined as either western or traditional health care. About 25-29% of HIV transmission in women, and 30-35% in men were due to sexual behavior. These papers were published in the International Journal of STD and AIDS in the summer of 2003, generating considerable discussion via letters to the editor and other correspondence.

Gisselquist has subsequently been vilified by many but none have adequately contested his review of the data. He himself notes that the data are far from perfect, that in the early days of the epidemic there was little knowledge to improve the precision of the data collected. He still admits that sex may be the predominant form of passage, but that health care of various sorts is so important that it must be addressed, and studied carefully, not ignored as is being done now. What did not happen, but could have, however, was the careful analysis of the data that was collected (such as Gisselquist has now done) and the subsequent careful design of studies to answer the questions it presents. Why did this not happen?

First, as Gisselquist describes it, the data from the US and Europe were very good, showing that homosexual behavior and intravenous drug use were the predominant causes in the industrialized west, with heterosexual behaviors coming in a distant third. But there was good evidence and consensus that homosexuality and intravenous drug abuse were extremely uncommon in Africa and non-contributors to the HIV epidemic. Thus says Gisselquist, "most infections were assumed [emphasis mine, BS] to derive from either sexual or health care exposures. The 90% estimate for adult HIV from sexual transmission hence rested on the belief [emphasis mine, BS] that health care transmission was very low, despite abundant evidence to the contrary." And what about those women who said they had only had one sex partner ever, and he was negative for HIV? They were and are often dismissed as "unreliable historians"--liars.

Several anecdotes suggest the accuracy of Gisselquist's data-driven conclusions. First, Sam Shewmaker, an African missionary born and raised in Zambia, was travelling with his wife between two African countries by land. It was brought to their attention at the border that their cholera vaccinations had lapsed. In order to bring them into compliance with the regulations of the country they were visiting, the health worker at the site went to a jar full of milky liquid to fish out a needle to use in injecting them. Questions arose in their minds: How long has the needle been there? How long has the liquid been there? Was it properly diluted when prepared? How does the worker know which of the many needles was used last? They were able to persuade the worker to spare them the injection with the promise they'd get another on their return to their own doctor in just a few weeks.

In 1985, Dr. Monte Cox, then a missionary in Kenya and now the Dean of the College of Bible and Religion at Harding University's Searcy, Arkansas, campus, took his two year old son to the pediatrician for immunizations. Dr. Cox and his son were waiting in a room with 11 other parent-child pairs when the doctor came into the room with one syringe full of vaccine and began to work around the room injecting one child after another. Dr. Cox's boy was last. "Are you going to use the same needle to inject all the children?" he asked.

Looking at the speaker, then the needle and back to the speaker, the doctor retorted, "Well! Not your child", then left the room, returning a bit later, presumably with a new needle.

In 2004 while speaking in the village of Ateiku in western Ghana, I apologized for having left a slide of a syringe in the section of the presentation on risks for HIV infection, acknowledging that they did not have the problem of IV drug use in their village. A woman on the front row inquired during the question and answer session, "You are right that we don't have any IV drug use in our village, but if addicts sharing needles could spread HIV, wouldn't it also spread HIV when the mid-wife uses the same instrument to test all the women in her clinic for anemia?" I assured the woman that she must see a new lancet taken from an unopened paper before it is used to check her for anemia.

The data Gisselquist has published have powerful possibilities for reducing stigma in us and in Africans. Nobody knows precisely how a given individual got his or her HIV, especially in Africa, though this should not matter, particularly to Christians. People are in need. Many of us have solutions. Sharing is the right thing to do, no matter how someone got infected. Our work involves sharing these ideas with church leaders so that they can be better informed and transformed to be the life-sharing neighbors, both in prevention and in care, that are needed in villages full of disease, fear and death.

And then there's the barbershop.

John: Infected and Affecting Others--for Good

John was not the average participant at our most recent seminar in Nduha, Tanzania, about 1.5 hours south of Mwanza, Tanzania’s second-largest city. (Mwanza lies on the southern shore of Lake Victoria near the borders of Kenya and Uganda with Tanzania.) John had known he was infected with HIV for several years, and had been on anti-retrovirals (ARV’s) for most of that time. According to Kevin Linderman, the missionary who was our primary contact for this seminar, John had frequently made casual public remarks about his medications in contexts that revealed his status, but John had never had the occasion to openly address the problem of HIV before other church leaders. Our seminar provided just such an opportunity.

One of the most powerful events in our five-nation teaching tour in 2005 was a presentation by the female president of the Kenyan Association of Religious Leaders Infected with or Affected by AIDS (KenAReLAA). We shared with John about the positive effect of her talk on the church leaders attending that seminar, and asked if he’d like to address his group. While encouraging him with the thought that his presentation could be equally powerful, I offered him the option of just answering some questions about his feelings about the disease and its effect on his relationships, and we assured him that he should feel under no obligation to speak at all. We left him to think about it overnight.

The next day John told us he was ready to speak. I thought he was just going to answer some questions, but when he got the floor he took off. Though I can’t tell you all (or even most) of what he said (my translators were more interested in listening to John than telling me what he was saying) I can tell you that it was powerfully delivered and captured the attention of our group. Among other things, he addressed the problem of the prejudices of his friends and neighbors. John said he knew many people were wondering what woman he picked this up from. John answered with the testimony of his life.

“When I planted the church in your village,” John asked, indicating one of the participants, “did I pick up a woman there? And when I planted the church in your village,” he asked another, “what woman did I pick up there? And how about your village,” he asked another. “When I planted the church there was I with a woman?” John had planted churches in many villages, and his faithfulness to his wives was as evident as his evangelistic skill. He had come to those villages on behalf of the King of kings, and his life reflected that commitment.

Yes, John had been a polygamist. His first wife had died some years ago (perhaps of HIV-related infections), and he had divorced his third wife after repeated instances of unfaithfulness on her part, perhaps another opportunity for infection. He now lives faithfully with his second wife, who was present in the seminar and who avidly supports the many facets of his ministry. John is now a grandfather, and through his encouragement his children have all been tested and found to be negative for HIV.

I asked John how long he took to reveal his HIV status, which was discovered during hospitalization for a nasty leg infection that wouldn’t get well. He told his immediate family about two months after the diagnosis, then his extended family after a year. He began to tell other church members after about two years. The reason for his delay: fear; fear of rejection. While some of his relationships have suffered since his diagnosis, John’s aggressive defense of his life’s record has stood him well, and the unquestioning support of his family has been an added comfort.

Our seminars attempt to address the stigma of HIV infection in several ways:
1. Recognition that all of us are sinners, whether we have HIV or not.
2. Recognition that those who have sinned in ways other than sexually are just as much sinners, and thus in need of God’s grace as those who have sinned sexually.
3. Recognition that there is good evidence that a great deal of the HIV in Africa, at least early in the epidemic, was acquired through other than sexual means (more about this in a later blog).
4. Recognition that our task on earth as the Body of Jesus Christ (the church) is to invite all sinners back to God for healing, not condemnation. This was Jesus’ work, which he did not only in word, but also in his attitude and social behavior, and which he expects us to continue as his followers.
5. Recognition that those infected with HIV are in great need of care in many ways: socially, physically, mentally, emotionally, and often spiritually and financially, and that the church is the best institution to deal with these needs because it is really the only institution that can deal with all of them.

John’s participation in this seminar added a very special dimension to it. He is a respected leader of the churches in his area and the father of many of them. His ministry has the opportunity to acquire additional power for the Kingdom as his weakness (his HIV infection) becomes a Kingdom strength, a point for connection with his neighbors whose lives are being crushed by their HIV infection, no matter how they acquired it. It is a blessing to know John and to count him a friend and partner in the work we are doing.

A Pertinent, If Unexpected, Question

“I need to ask you . . . ,” the question began innocently enough as I recently closed my presentation regarding our proposed work in Africa to our church of 19 years and opened the session for questions. What followed, however, was anything but conventional. Mary, one of our senior sisters, mother of one of our elders, wife of a former elder, a godly woman whose ministry is praying for others, had literally stepped forward from her seat in the second row, taken both of my forearms in her hands, looked me in the eyes, and asked her “question”, “I need to ask you . . . for your forgiveness.”

“When I first heard that you wanted to go to Africa, I was very much against it,” she continued. “I told you so, and even wrote you a letter saying that I was sure that you had been called by God to be with us, and that you shouldn’t leave us because he still wanted you here. But I was wrong. I now understand why you want to go, and you need to go. What you want to do is needed and right, and you should go, and you will have my blessing, support and encouragement.”

Mary had from the beginning opposed our thoughts of moving to Africa, and had, as she confessed, even written us a letter explaining that God had brought us to Redlands, and therefore we must stay in Redlands. I had come across the letter the night before as we sorted through papers, tossing, saving, packing. But now Mary saw things in a different light.

She now understood the danger HIV presents to many African peoples, that we might play a meaningful role in helping some communities escape or recover from the scourges of this disease, that it would be good, perhaps even the will of God Almighty that we would move to Africa to engage this ministry, even as he had brought us to Redlands. So Mary would support us in this ministry, encourage us, pray for us. Would we forgive her for having opposed us?

Mary’s “question” and confession were no doubt more helpful in galvanizing the support of our congregation behind our new efforts than her own opposition had been in encouraging similar reluctance in others. Our answer was, “of course”, and the outpouring of encouragement and well-wishing from so very many of you has been very greatly appreciated as we make these transitions. Leaving has proven much more difficult than we anticipated, and your encouragement has increased our appreciation for you while making our going a little easier. Thank you all, and especially Mary, very, very much.