Confronting the AIDS pandemic in Namibia

Intermountain Catholic

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Maryknoll Missionary Father Rick Bauer enjoys the time he spends with children who have been orphaned by AIDS in the Republic of Namibia. Namibia, previously known as South West Africa, is bordered by South Africa in the south, Angola and Zambia in the north, and Botswana and Zimbabwe on the east. The world's 31st largest country, Namibia is the second most sparsely populated. Namibia has one of the highest levels of income disparity in the world; 50 percent of Namibia's population survives on just 10 percent of the national income. Fr. Rick is director of Catholic AIDS Action, offering home and community-based care for families coping with AIDS. Catholic AIDS Action has more than 1,500 active volunteers providing services for more than 6,300 HIV+ clients, their family members, and their support systems. Treating HIV/Aids is one thing, Fr. Rick said. ?Providing food for those afflicted when their appetites return is another.? Maryknoll photo by Sean Sprague, used with permission

SALT LAKE CITY –– The complaints brought back to the offices of Catholic Aids Action by the organization’s more than 1,500 native volunteers reflect how much progress has been made in treating HIV/AIDS in the African country of Namibia in the past several years - and how little progress has been made meeting the most basic needs of the poor there.

"Our clients are on anti-retroviral therapy (ART)," Maryknoll Missionary Father Rick Bauer told the Intermountain Catholic. "But as they begin to feel better, their appetites return. They get hungry, which is a good sign. But the country is so poor they have no food. Before long, the pain of hunger is worse than the fear of AIDS, so they make an impossible decision. They stop taking ART."

The poverty problem in Namibia is not the extreme starvation problem the world sees in the Sudan, Fr. Rick said. "Namibians do not suffer from clinical starvation. They are malnourished. They get meals, but sometimes those meals are days apart."

Namibians are hungry, but they are not hungry enough to come to the attention of the large charitable organizations that provide food on a nation-wide basis, Fr. Rick said. And donors to HIV/AIDS programs sometimes don’t understand that people living with HIV/AIDS need both the anti-retroviral drugs and food.

"Namibians being treated for HIV/AIDS, malaria, measles, and other diseases that plague the poor are not dying. They are underfunctioning; they are in pain. Their bodies don’t get the proper number of calories, so their brains don’t develop properly, and their bodies don’t either."

These particular problems make confronting the HIV/AIDS pandemic in Namibia unique, Fr. Rick said. Namibia a country of 824,288 square kilometers and sparsely populated with about 2 million people. "It’s under the radar of most major aid organizations."

What makes Namibia different from Tanzania, where Fr. Rick spent 6 years doing HIV/AIDS work, is that in Tanzania, fruits and vegetables can be grown.

Namibia is spanned by the Namib Desert, stretched along its west coast, and the Kalaharo Desert, along its southeastern border with Botswana. "Nothing grows in Namibia, especially in the south, and if a person has no money, he or she doesn’t get anything to eat."

Keeping people fed is a huge challenge in Namibia, Fr. Rick said. "If we get food, delivering it to the villages is an enormous job. When representatives of aid organizations visit Namibia, often they stay in the capital city of Windhoek." As director of Catholic AIDS Action (CAA), Nabibia’s first church-based response to the country’s HIV/AIDS crisis, Fr. Rick begs donors and aid organization representatives to go out into the villages where CAA volunteers offer care and support to those afflicted with HIV/AIDS.

With 90 employees, 1,500 volunteers, and just 22 vehicles, it’s all they can do to get themselves around the country, let alone the tons of donated food that are needed.

"Our volunteers are often family members of our clients, and we give them extensive training. Otherwise, home-based care in Africa is often home-based neglect," said Fr. Rick. "We meet with our volunteers monthly, helping to keep them motivated and providing them with the counselling they need to constantly deal with the needs of people with HIV/AIDS.

Fr. Rick meets with his staff and volunteers monthly. Their sessions always begin with the Word of God. "We sing, we often pray the rosary; we acknowledge that God is leading us in our ministry."

Prayer is followed by emotional and psychological work directed by Fr. Rick, who earned his Master’s degree in social work from the University of Utah. "We do a lot of stress debriefing. We talk about our successes."

A third vital part of their monthly meetings involves collecting statistics; doing the paperwork that will get their program further funding. "We never leave the first two elements of our meeting out, they help us cope with the third element – the numbers," he said.

Fr. Rick said he can expect to lose about five percent of his volunteers each year; half of those die. "When we lose a volunteer because the training we’ve given them has allowed them to get a good job it is nice, though. Namibia has 60 percent unemployment."

Often, Fr. Rick finds himself providing food for CAA clients, volunteers, and even staff members, from his mission account with the Maryknoll Fathers and Brothers. Originally ordained for the Diocese of Salt Lake City, Fr. Rick joined the Maryknoll Fathers and Brothers after serving people with HIV/AIDS with the order in Tanzania.

"Today, CAA, a department of the Namibian Catholic Bishop’s Conference, has 14 offices in nine of the 13 political regions in the country," he said. "We work closely with the Lutherans in the other four regions, and other non-governmental aid organizations (NGOs) whenever we can. CAA’s four main focuses are home-based family care and counselling, youth education and prevention, care and support to orphans and vulnerable children, and voluntary counselling and testing."

Over the years, Fr. Rick said, AIDS treatments have changed.

"We have 35,000 people in treatment now. It used to be that we had 200,000 or 300,000 people in need of treatment. We estimate we have 105,000 in need of treatment now. The ART regimens have been a phenomenal success."

Of great assistance has been President George W. Bush’s 2003 President’s Emergency Plan for AIDS Relief administered by USAID, said Fr. Rick. It poured nearly $24.3 million into Namibia in 2004 and more than $42.6 million in 2005 to support a comprehensive HIV/AIDS prevention, treatment, and care program.

For years, Fr. Rick said, people have claimed that Africa’s high rate of AIDS has been due to the continent’s poverty and to its cultures’ maintaining the low status of women. "But recent surveys have proven that higher rates of HIV/AIDS are still being seen in cultures in which people have multiple concurrent sexual partners and in cultures in which male circumcision is not practiced.

"We don’t yet know what to do with this information," he said. "If we put out the news that we had a vaccine with a 70 percent effective rate on the market, people would jump at it. But it isn’t easy to ask people to change their sexual habits or to change that which is culturally ingrained.

Fr. Rick said the most important patient is always the one who is right in front of you right now, even if he or she is choosing to go off ART rather than face the painful pangs of hunger.

"We want to give them every opportunity to succeed; to survive. When they say, ‘I can’t stand the hunger.’ I have to say: ‘Let me see what I can do.’"

You can help Maryknoll Missionary Father Rick Bauer’s ministry to the people of Namibia by contributing to his mission account.

Donations may be sent to: Mary-knoll Fathers and Brothers, P.O. Box 302, Maryknoll, N.Y. 10545. Please make checks out to: Maryknoll Fathers and Brothers and put a note on the memo line: For the Mission Account of Fr. Richard W. Bauer.