South African Bishop tells of life-and-death crisis

Hearing Bishop Kevin Dowling describe the "kiddies" back home in his diocese, an American might picture carefree little children at play.

But Bishop Dowling ministers at a hospice in Rustenburg, South Africa, and the children he recalls so fondly come from families decimated by HIV/AIDS.

During a recent visit to the Albany Diocese, he showed slides of some of them. In one picture, a mother stares at the camera, obviously very ill. Nearby, her 12-year-old daughter's face is frozen in an expression of worry and fear.

Losses

That mother, said Bishop Dowling, has since died of AIDS. The 12-year-old is now the head of a household of younger siblings. She no longer attends school.

"She's battling with her feelings; she can't cope," the Bishop said with frustration. "She needs so much material support -- money for food, clothing -- and how are we going to provide schooling for these kids?"

The AIDS pandemic in sub-saharan Africa is creating thousands more such orphans each year. Three of every 100 homes there are in the care of a child -- and a severely traumatized child at that, the Bishop noted.

"I believe this is the most difficult and complex problem we are going to face" as a result of the AIDS crisis, he stated.

In his diocese, more than 400 orphans are being helped through a new program funded by the Nelson Mandela Children's Fund, but countless more children need help.

Donors

Bishop Dowling came to the U.S. to receive the International Person of the Year Award from the National Hospice and Palliative Care Organization, but he also stopped in the Albany Diocese to visit with supporters of the Tapologo Hospice in his diocese.

Among them are the Rensselaer-based Community Hospice, which has been partnering with South African Hospices for several years now, and two parishes that have begun regularly sending contributions to Tapologo: St. Clement's in Saratoga Springs and Nativity/St. Mary's in Stuyvesant Falls.

"It's a remarkable gift that the Albany area, all these communities, have entered into relationship with me," Bishop Dowling told The Evangelist. "It's really what I believe 'Church' is all about: the body of Christ [making] a difference in the lives of the poorest in society."

He hoped that, during his visit, the thousands of Catholics from the Diocese who have donated money toward his Hospice programs would come to understand the difference they have made. He called it "an immense relief" that "we don't have to worry about where the next dollar is coming from."

Hospice

Tapologo Hospice opened in late 2004. Until then, the hospice program in the Rustenburg Diocese had consisted of "care teams" who visited the dying in their homes and were able to provide only the most basic of care.

Often, those caregivers stopped by in the morning only to find that their patients had died during the night -- alone, afraid and in terrible pain. The care teams begged for a place to bring the dying where they could find dignity and comfort in their last moments.

Two years later, Bishop Dowling boasted, "11 teams of home care nurses can make a decision: 'This person has no family to care for them and is reaching the terminal phase; they can be transported to the inpatient unit.'"

Improvements

In the past 22 months, Tapologo Hospice has admitted 687 patients. Of those, 289 have died, nine of them children. But federal funding from the U.S. for antiretroviral drugs has meant a better quality of life for the remainder.

The Bishop noted that there has also been a positive side-effect: The social stigma that prevented many in Africa from admitting they were HIV-positive is breaking down.

Seeing peers who were near death improving rapidly with the right medication has made others eager to come forward and admit their own HIV status.

Major needs

Yet the need still far outweighs Tapologo's ability to meet it. For example, about 500 patients can be served by the drug program, but 200,000 people live in the nearby shack settlements, and Bishop Dowling once estimated that a quarter of them are infected with HIV.

The Bishop is now trying to raise money for a new program: foster homes in each community in his diocese where AIDS orphans can be cared for, nurtured and educated by foster families.

He cited an African proverb: "Your child is our child."

"If they're not HIV-positive already, we can have a future for them," he stated.

The children who came to Tapologo Hospice already dying of AIDS are the ones who affect the Bishop most. He remembered a little girl who wanted desperately to go home on Christmas Day to be with her friends and who cried all day, no matter how hard the staff tried to comfort and amuse her.

Nelson's life

Bishop Dowling also remembered a seven-year-old boy named Nelson. Already dying of AIDS in Rustenburg's hospital, Nelson developed meningitis that left him blind and partially deaf. But the hospital didn't have an end-of-life program, so he was discharged that way.

Tapologo Hospice heard about Nelson and took him in. "I was there when he arrived: a frightened little boy, curled up in a ball," Bishop Dowling said.

Not long afterward, the Bishop saw the dying boy again. This time, Nelson said that "it's so nice here: Every morning the sisters wash me, and they give me food to eat...and they love me."

Eighteen months after Nelson's death, the Hospice staff still break down when they talk about him. But "I believe he was able to die not frightened, not lonely," said Bishop Dowling.

Life and death

In addition to helping patients "come to some completion before the end moment of life," the Bishop wants to spend "so much more time on keeping people alive."

He appreciates the "tremendous generosity" of those who are helping to make that possible.

"In the two days I've been here, so many people have met me and I've seen tears in their eyes," aware of the need for their involvement in the fight against AIDS on the other side of the world, he said. "That's very special."

(To contribute, send checks to the Community Hospice Africa Fund, 295 Valley View Blvd., Rensselaer, NY 12144, or go to www.communityhospice.org and click on "Africa Fund.")

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