Sister Miriam Duggan, the Congregational Leader for the Franciscan Missionary Sisters for Africa, recently spent some time in Australia spreading the word about her work combating HIV/AIDS in Africa. She has a unique insight into the problem, being a qualified gynaecologist and obstetrician.
Along with Sr Kay Lawlor, Sr Miriam has been largely credited with reducing the rate of HIV/AIDS in Uganda through the program, Youth Alive.
At the Lincare conference in 2002, Sr Miriam reported that the AIDS prevalence rate in Uganda had fallen from a peak of 28.9 per cent to 9.8 per cent, according to United Nations figures. More recently, this has fallen to 6.9 per cent.
On the other hand, in Botswana - whose HIV/AIDS prevention measures include heavy promotion of condom usage - the AIDS rate is 36.5 per cent.
Sr Miriam sees a number of reasons for Uganda's relative success.
Philly Bongole Lutaaya, a popular Ugandan musician in the 1980s, became infected with HIV. At this time the word "sex" was taboo, there was a stigma surrounding AIDS and many Ugandans still believed AIDS was due to witchcraft.
Lutaaya was determined to expose the real reason for the spread of AIDS. He communicated the truth through his songs, helping to break down the barriers that had prevented the issue from being more openly spoken about.
"The other thing is that the President in the country has always promoted abstinence and faithfulness", says Sr Miriam.
"The use of condoms is not the ultimate solution in the fight against HIV/AIDS", said President Yoweri Kaguta Museveni at an AIDS conference in Thailand. He caused much controversy when he said the best ways to stop the spread of AIDS are abstinence and faithfulness in marriage.
President Musevani's emphasis in combatting AIDS has been to address the behaviours and practices that lead to its spread. Programs have been set up and operated involving both the Church and the State. These focus on combatting peer pressure to be promiscuous, advising young people to abstain and encouraging the older to be faithful in marriage. The problems of alcohol and drug abuse are also addressed.
Faith also plays a large part. "I believe that through the power of prayer, through praying with them, the addictions of these people can be broken, so we encourage them to pray when they feel their temptations", says Sr Miriam. Religious affiliation is not a factor here, since all faiths uphold that marriage is sacred and sex outside of marriage is wrong.
To maintain the programs' momentum, each time the Sisters move into a new district they select people for further training, including university students. They have been able to take the programs into places where Sr Miriam and her colleagues would have difficulty accessing due to time constraints or language difficulties.
"The UN have made quite a few statements saying that maybe they need to look at this type of program and encourage it", says Sr Miriam. This is quite change in attitude from their initial emphasis, which consisted of the heavy promotion of condoms and counselling.
Meanwhile, the US Government over the past 18 months has set aside substantial funding to promote abstinence programs as well.
Sr Miriam comments: "There are still some people who don't believe it will work and others who don't want to believe that it will work. But they can't destroy the evidence that is there."
Interestingly, she has had more trouble persuading her Western medical peers outside of Africa who still believe condoms are the solution to AIDS. Most medical experts in Africa are more than ready to hear what she has to say and ultimately agree with her.
Condoms, Sr Miriam points out, do not address the larger issues. These include faithfulness within marriage and the spread of other sexually transmitted diseases (STDs) such as Chlamydia that leads to infertility. Studies have also shown that the chance of cervical cancer increases with the number of different sexual partners a woman has.
"It's not just about AIDS", says Sr Miriam, "it's about family, about future, about life and if we didn't have AIDS tomorrow I'd still be promoting abstinence and faithfulness."
She believes John Paul II's Theology of the Body forms a basis on which a sound sex education can be built. Sex must be treated as a beautiful life-giving act when in marriage, while the promotion of faithfulness in marriage and family is essential to any sex education program. Young people need a different message that makes them want to treasure and protect the gift of procreation given to them by God.
Such a wholesome sex education is especially needed in Africa, even apart from AIDS. Many Africans are moving to the cities where their cultural values have been eroded, families have been scattered due to wars while the media has brought permissive, anti-family Western values into Africa.
On the prevailing attitude to sexuality, Sr Miriam comments: "I think that there's a real call within all this to really look seriously. I think the pendulum has swung far enough in the free sex society. It's backfiring, it's breaking down marriage, it's increasing divorce, young people have been psychologically wounded through not being able to cope with the sexuality they are taught. Maybe there's a call there to go back to God's ways".
Anh Nguyen is an organiser with the Thomas More Centre. Readers wishing to assist the work of the Franciscan Missionary Sisters for Africa can send donations to Sr Miriam Duggan, c/- AD2000, PO Box 186, North Melbourne, Vic 3051. These will be forwarded directly to the Franciscan Missionary Sisters for Africa.