South African bishop battles church in battling AIDS

National Catholic Reporter, April 16, 2004 by G. Jeffrey MacDonald

For a soft-spoken country priest with a gentle smile, Kevin Dowling has an uncanny knack for ruffling feathers. But to him, conflict and controversy seem a small price to pay in a home-front war against a rampaging AIDS virus.

Over the past four years, this Catholic bishop of Rustenburg, South Africa, has grabbed headlines worldwide for challenging his church's absolute ban on condom use. He has also gained reputation as a fierce government critic by assailing policies that haven't dented the disease that now infects close to 30 million in sub-Saharan Africa and kills 600 a day in South Africa alone.

Now Dowling is bringing his battle to a new front: the minds and purses of developed nations, beginning with the United States. On March 30, for example, he delivered his plea for help to about 200 people at Boston College.

"We're at risk of losing entire nations to this disease," Dowling said, noting for instance that almost 39 percent of Botswana's population is HIV-positive. "Are we going to become a global community or a world where nations always compete with each other in a way that causes the poor and marginalized to always fall through the cracks? We cannot do it alone. We need a global solidarity movement."

Dowling's priority is a project to establish 24 church-run treatment clinics across South Africa. More broadly, South Africa needs $200 million by 2005 to treat about haft of the 5.3 million who suffer from the disease. To reach these goals, Dowling said, Western nations will need to follow where the private sector has already gone to help subsidize treatment programs beyond the reach of African budgets.

Over the long term, Dowling aims to convince the world that the Catholic church brings a compassionate and relevant response to today's crisis. Toward that end, he aims to reshape church policies that prohibit all forms of birth control. His authority to address the subject seems to be growing with each year spent studying AIDS and ministering to its weakest victims.

"He is the AIDS bishop," said James Keenan, professor of moral theology at Weston Jesuit Theological Seminary and visiting scholar at Boston College. "Not many bishops are actual AIDS ministers, but he is. There is not a bishop in the world who has done more work with AIDS patients. That's why we brought him here."

In his presentation at Boston College, Dowling showed clips from a news report featuring his work at Freedom Park, a shack village for mostly illegal immigrants near one of the world's richest platinum mines. In the clip, the bishop's bright white shirt and clerical collar give sharp contrast to the residents' dark skin and the muddy floors of their unlit, makeshift homes. He listens as young, single women tell of their desperate search for money to feed children and siblings. He concludes that some turn to prostitution as their sole alternative, and for them the church's ban on condoms becomes a "death-dealing" code.

To date, the Vatican has not censured him for defying the church's prohibition on contraception, Dowling said, because "I'm too small-fry to worry about, way down at the bottom of Africa."

Yet his attempts "to construct an ethic and moral theology around survival"--and to render condom use as a pro-life measure or even a moral imperative in certain circumstances--have led a number of church officials to publicly discuss their view of condoms as evil instruments.

"Condoms may even be one of the main reasons for the spread of HIV/AIDS," wrote members of the Southern African Bishops' Conference in July 2001 in the aftermath of Dowling's advocacy for condom usage. "Apart from the possibility of condoms being faulty Or wrongly used, they contribute to the breaking down of self-control and mutual respect."

Last year, Vatican Cardinal Alfonso Lopez Trujillo said condoms could not be trusted to prevent the spread of HIV. The World Health Organization quickly condemned the Vatican claim as "incorrect" and "dangerous."

At his speech here, Dowling faced further criticism from a Catholic physician in the audience:

"Condoms are not the answer," said Dr. Gilbert Lavoie of Boston. "People realize they only bring half the pleasure, so they stop using them. Let the public health people focus on the condoms. You [Dowling] focus on the abstinence."

Despite a wave of criticism, Dowling believes the church might be making progress to overcome its stigma in southern Africa as an out-of-touch and uncaring institution. The church provides more AIDS services in the region than any other nongovernmental agency, he said. What's more, Catholic hospitals and clinics now hand out information about the potential health benefits of condoms, although they stop short of distributing condoms on site. And the more the church publicly debates prohibitions on condoms, he said, the more the conversation "brings the church into ridicule and causes us to reconsider."

To advance his cause, Dowling has gained support from a number of Catholic theologians in North America and Europe. For Margaret Farley, a Yale University ethicist and advocate for HIV-infected African women, Dowling is charting an important course by identifying that African women are seldom free to make ideal moral choices.