Increasingly, the church leadership in Malawi are reaching out to people with AIDS, both in their congregations and in the community at large, including prisons and orphan care centers–thanks in part of our Pastoral and Congregational Care Training (PACCT) program.

In the photo above, a prisoner with AIDS is segregated from the other 150 inmates in a local Malawian prison I visited in March 2007.

AIDS orphans and neglected prisoners with AIDS are two of the most vulnerable and needy groups of people with the virus in Malawi. When they are able to access ARV medical treatment, they can live with AIDS as a chronic disease. When they are prevented from receiving treatment, they die, sometimes alone.

‘AIDS as we know it is 25 years old!

When I was a pastor in San Francisco in the early 1980’s, we began hearing about a strange new form of cancer among gay males in San Francisco and New York City. The medical establishment called it “GRID” (Gay-Related Immuno-Deficiency). By 1984, HIV was identified as the cause and the disease became known as AIDS.

Patient Zero was identified and designated by the CDC as the first carrier of the deadly virus in America in 1981, as the disease spread rapidly first among the homosexual community and those who had received a blood transfusion. Earlier stands of HIV and related viruses are now believed to have originated in Africa in the 1940’s or 50’s, first in monkeys and then in humans, and the original viruses continued to undergo transmutations as the disease evolved.

As a volunteer chaplain on the AIDS unit at San Francisco General Hospital from 1989-1991, I witnessed the ravages of AIDS and tried to offer the ministry of presence to mostly gay men and IV drug users who were dying.

In 1983, Malcolm, the first person I knew who was HIV positive, came to my house church in San Francisco. Born and raised in the Church of the Nazarene, he wanted to reconnect with the church of his youth that he had left because he was gay. I remember church members being afraid to drink from a common cup at communion for fear of catching the AIDS virus in human saliva. Malcolm thus stayed away from worship services and Bible Studies, preferring personal visits and spiritual support in time of need. When he finally died, his mother and his partner requested that the funeral take place in a Nazarene Church, which it did and served to change many attitudes toward gay persons with AIDS.

In 1986 I performed my first AIDS funeral for an IV drug user. Charles was a homeless man in the city in San Franciso, and the church I pastored was the only place he could call home. With no known family members, I remember claiming his ashes at the city morgue, and burying him in the small side yard of our urban house church near Golden Gate Park.

In 1987, one of our Sunday School kids, Joey, at eight years of age, contracted AIDS from a blood transfusion when he was born. After bringing much joy into our church community, Joey died soon after his 13th birthday party. (He was very special to me, and the inspiration behind my book on AIDS in the Church: The Samaritan’s Imperative.)

There are many stories behind AIDS statistics. By 1988, the number of cases in America reported to the CDC totaled 55,000. By 1991, a year after I had left my church to become Director of the United Methodist AIDS Project in San Francisco, the cumulative number of AIDS infections in America had reached 270,000—most of whom had already died or would eventually die. The disease had doubled, and would continue doubling, every 18 months.

Today, 25 years after, we no longer speak of AIDS as a ‘gay cancer’ or an ‘American disease’. The AIDS pandemic has spread to every corner of the world. Over 25 million people have lost their lives to the disease and over 40 million people today are living with HIV. While the disease has lost some of its original stigma, AIDS still is interpreted apocalyptically by many as a specific form of divine judgment, especially in Africa.

The face of HIV/AIDS today is that of a young woman, between 15-24, living in sub-Saharan Africa or Asia. Here are the alarming numbers behind the new face of AIDS:

Of the 40 million people have HIV/AIDS worldwide, 63% of them live in sub-Saharan Africa. 20% of them live in Asia—where new cases of HIV/AIDS are on the rise.

Five people die of AIDS every minute!

In the same amount of time, nine more people are infected with HIV

Over 25 million people have died of AIDS since 1981

The same number who are now infected in sub-Saharan Africa: 25 million!

Half of those living with HIV in Africa are orphaned or abandoned children. The common estimate is that 12 million kids have been impacted by AIDS.

Malawi is particularly vulnerable to famine and disease, and suffers disproportionately from extreme poverty and AIDS. Currently, AIDS infects 14% of the population and accounts for over 85,000 deaths per year, leaving 950,000 AIDS –affected orphans.

In addition to AIDS, there are other killers in Malawi: TB, malaria, dysentery and cholera are among them. The contaminated water supply contributes to infant mortality and accounts for why 1 out of 5 children die before reaching 5 years of age.

In the photo above, I’m holding an orphan with AIDS who needs medical treatment but lacks transportation to get to a clinic and nutrition to make the treatment effective.

In the photo below, segregated prisoners with AIDS go untreated, unloved, forgotten by the world.

My encounters with these and others with AIDS in Malaria, in part, motivates me to return to pastoral ministry with persons with HIV/AIDS that I had left in San Franciso in 1991.

The PACCT program, for me, fulfills a personal calling and meets an urgent need in Malalwi for pastoral and congregational care and training in the many issues of HIV/AIDS in the churches.

I am deeply grateful to the three American churches that have sponsored a PACCT workshop for pastors and lay leaders in Malawi in 2007: Central Presbyterian Church in Summit,NJ; Celebration Community Church in Celebration, Florida; and Basking Ridge Presbyterian Church in New Jersey.