Dolentium Hominum N

DOLENTIUM HOMINUM N. 35 Ð Year XII Ð No. 2, 1997

JOURNAL OF THE PONTIFICAL COUNCIL FOR PASTORAL ASSISTANCE TO HEALTH CARE WORKERS

ARCHBISHOP JAVIER LOZANO, Editor-in-Chief CORRESPONDENTS REV.JOSÉ L. REDRADO, O.H., Executive Editor REV.FELICE RUFFINI, M.I., Associate Editor REV. MATEO BAUTISTA, Argentina MONSIGNOR JAMES CASSIDY, U.S.A. REV.RUDE DELGADO, Spain REV.RAMON FERRERO, Mozambique REV.BENOIT GOUDOTE, Ivory Coast EDITORIAL BOARD PROFESSOR SALVINO LEONE, Italy REV.JORGE PALENCIA, Mexico REV. GEORGE PEREIRA, India REV. CIRO BENEDETTINI MRS.ANVERLINDE, Belgium DR. LILIANA BOLIS PROFESSOR ROBERT WALLEY, Canada SR.AURELIA CUADRON REV. GIOVANNI D’ERCOLE, F.D.P. DR. MAYA EL-HACHEM DR.GIOVANNI FALLANI REV. GIANFRANCO GRIECO REV. BONIFACIO HONINGS EDITORIAL STAFF MONSIGNOR JESUS IRIGOYEN REV.JOSEPH JOBLIN DR. COLETTE CHALON REV.VITO MAGNO, R.C.I. DR. ANTONELLA FARINA DR. DINA NEROZZI-FRAJESE PROFESSOR MATTHEW FORD DR. FRANCO PLACIDI SR.MARIE-GABRIEL MULTIER REV.LUCIANO SANDRIN REV.DAVID G. MURRAY, M. ID MONSIGNOR ITALO TADDEI DR.SIMONA NOVELLI DR.GUILLERMO QWISTGAARD

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Spedizione in a.p. - art. 2, comma 20/c, legge 662/96 - Roma Contents

3 A WORD OF GREETING TO OUR READERS 59 At This Sanctuary Many Have Found Liberation and Comfort 5 APPOINTMENT Cardinal Fiorenzo Angelini

6 Access to Health Care 61 The Sick Need Our Human Warmth Archbishop Javier Lozano John Paul II

61 Our Lady Teaches Us That Illness MAGISTERIUM Is a Call to Conversion and Penance John Paul II 10 Addresses by the Holy Father 62 Cardinal Angelini’s Words to the President of the Republic TOPICS 2 In Health and Illness 18 Our Conflict with Pain and Death: Jesus Christ Gives Life Meaning In Search of Meaning Rev. José L. Redrado 63 The Meaning and Value of the World Day of the Sick 27 The Health Apostolate in Lebanon Cardinal Fiorenzo Angelini on the Way to the Jubilee of the Year 2000 65 The Heathcare Ministry on the Sr. Celestine Abou Jaoudé Threshold of the Third Millennium Archbishop Javier Lozano 36 What Should Be Done About AIDS? Dr. Ntari Benoit 69 Innovating Experiences in the Health Ministry Most Rev. Javier Osés TESTIMONY 74 Challenges for the Portuguese 40 Religious Assistance Agreement Health Apostolate Between the Venezuelan Bishops’ Rev. Vitor Feytor Pinto Conference and Public Hospitals Fatima: A Moving Experience 42 The Course of the Healthcare Ministry in Peru, 1988-1996 77 As a Mother with the Mother Peruvian Bishops’ Conference Alessandra Ciattini

48 Bases for Creating a Bishops’ 79 My Experience of Fatima Commission for the Health Ministry Gloria Tarin Congolese Bishops’ Conference 80 Encounter and Prayer Antonino Bagnato ACTIVITY OF THE PONTIFICAL COUNCIL

54 John Paul II’s Letter to Cardinal Angelini

55 Note by the Permanent Council of the Portuguese Bishops’ Conference for the World Day of the Sick 1997 The illustrations in this issue 56 At Fatima Mary Has Dried have been taken from So Many Tears Le porte dell’Europa Rev. Vitor Feytor Pinto (Milan/Rome: Cosmopoli, 1992). A Word of Greeting to Our Readers

On August 20, 1996 I was named President of the Pontifical Council for Pas- toral Assistance to Health Care Workers by the Holy Father, John Paul II, and on Jan- uary 8, 1997 I took office. By way of these remarks I wish to introduce myself to our loyal readers and place myself at their disposal in this mission received from the Pope. I was already familiar with the Journal Dolentium Hominum—Church and Health in the World, which I had come to appreciate for both its content and its magnificent format. Our Journal is a tool for making known the Magisterium of the Pope and the 3 Bishops regarding health-related subjects; it is a forum for discussion of theological, pastoral, and ethical topics; it is an instrument for coordinating all the health organizations and institutions in the Catholic world on the basis of personal experiences and testimonies; it is a source of accurate information. It is intended for the Bishops’ Conferences, the Nuncios of His Holiness, physicians, nurses, pastoral workers at health facilities and sanatoriums, parishes, other centers where care is provided, hospital chaplains and priests active in any area of the health ministry, men and women religious at hospitals, and scholars and re- searchers at theological or pastoral institutes and medical schools. In this issue we touch upon topics, testimony, and activities. The subjects include the conflict connected with pain and death, the health apostolate in our day, and AIDS. Testimonies reach us from Venezuela, Peru, and the Congo. We recapitu- late the events connected with the Fifth World Day of the Sick in Fatima, Portugal, as well as the significance and value of this Day, and also deal with the health apostolate on the threshold of the Third Millennium, the experiences aimed at renewing it, the challenges facing the health ministry in Portugal, and three moving experiences in Fatima. Our Journal thus provides a means for us to draw closer to the Word of God and enable it to be heard. May the Word made flesh, Jesus Christ, make use of this publication to continue to offer the sure hope of resurrection everywhere, in the midst of our pain and our death.

+ Javier Lozano

Access to Health Care

ADDRESS BY ARCHBISHOP JAVIER LOZANO, PRESIDENT OF THE PONTIFICAL COUNCIL FOR PASTORAL ASSISTANCE TO HEALTH CARE WORKERS, TO THE FIFTIETH WORLD HEALTH ASSEMBLY IN GENEVA, MAY 7, 1997

1. For me it is a great pleasure and an honor to speak on behalf of the Holy See Delegation to convey to the distinguished Delegates the gratitude of the Catholic Church for all the efforts which WHO unceasingly makes to improve the health of peoples, along with my Delegation’s and my own attention to and interest in the sessions of the Fiftieth World Health Assembly. 6 The significance of this WHO Assembly is clear to all; it is being held exactly one year after the celebrations commemorating the Fiftieth Anniversary of WHO’s foundation. A simultaneous look at the Organization’s past and future enables us to appreciate its generally positive balance sheet, forcing us to turn our attention for a moment to a certain number of challenges and demands posed by the world of suffering and health. If the international community rejoices at the reduction and even eradication of some diseases, like poliomyelitis and Guinea worm, between now and the year 2000, as a result of systems of control and specific programs for a more effective fight and the use of new, perfected vaccines, its concern nevertheless persists over so many millions of disinherited human beings who go on suffering and dying because of infectious diseases like malaria, diarrhea, pneumonia, and others.

2. In the epidemiological plan, new, emerging diseases, like the hemorrhagic fever caused by the Ebola virus, bovine spongiform encephalopathy (the “mad cow” disease), and the illnesses now reappearing, like cholera and tuberculosis, make up another chapter for concern and keep the Organization in a state of constant alert. As WHO recently brought out in its 1995 Health Report, there is a continual increase in the illnesses linked to modifications in lifestyle and diet, alcoholism, tobac- co and substance abuse, and so on, and this is the cause of the growing death rate due to transmissible diseases. With this epidemiological balance sheet, comprised of bright and dark spots, WHO is becoming the guarantor of a new pact among the nations based on equity and solidarity, on the way to a new policy and strategy of health for all in the course of the twenty-first century. The Holy See Delegation is happy about ongoing efforts within WHO to work out a health policy and strategy forming part of a perspective on human development which is socially, economically, politically, and culturally sustainable. This approach lends itself to better evaluation of the impact on health of human factors which are macropolitical, macroeconomic, social, demographic, and environmental. Among the factors determining health which weigh heavily against the success of the Health for All programs, there undoubtedly appear the scourge of poverty and the increase in the number of the poor, estimated to be 1.3 billion in 1995. The gap between rich and poor—which goes on growing, and not only between the northern and southern hemispheres, but within single countries—is at once a serious threat to the progress made and a severe curb on the Health for All policy in the twenty-first century. 7

3. The Holy See Delegation approves of a Health for All strategy based on the human person and integrated into a global, sustainable dynamic of development in which man can never be a means, because he is its crafter and end. In this respect, I would like to illustrate my viewpoint with three observations relating to the consulta- tions now being carried out concerning an updating of the world strategy of Health for All. The Catholic Church, with its 21,757 health institutions, wishes to take an active part in defining the new health policy. When consulted on the key statements of that policy, a large number of them feel that one of the leading problems is access to medical care, particularly to medicines. This problem will affect all countries, not just the least protected ones, but also the so-called rich countries. It is linked to the aging of the population, to the increasingly flagrant discrimination between rich and poor, and to cutbacks in social security systems, where privatization is on the rise. In this sense, access to medical care is a worldwide problem. If equity is not to become a “dead letter,” a sort of cheap slogan, the following points are seen to be important. a) To reduce the cost of medical care and medicines, taking them to relatively low levels, thanks to a new policy of primary care and essential medicines involving both rich and poor countries. b) To base a policy of this kind on solidarity among generations, different people, the healthy and the sick, the various groups or sectors, and the rich and the poor. To sum up, it is urgent to introduce into the new strategy the notion of societies of mutual solidarity in access to medical care and to essential medicines in particular. Since the health reforms taking place in most countries are involved and the tendency is to define policy and evaluate effectiveness on the basis of the economic and financial costs connected with illness and incapacity, my Delegation makes its own the fitting and relevant observation by the Director General of WHO in his Address to the Ninety-Ninth Session of the last Executive Council, when he stated that it is appropriate “to take into account the social and political cost of illness, suffering, and inequalities in access to health care and development, with the social disintegration, political instability, and violence which they entail.”

4. Finally, with respect to reproductive health, my Delegation would like to stress that this program directly concerns human life and cannot be limited to a stage of human existence. Man is a whole, with his physical, psychic, emotional, and relational dimensions. Consequently, conception, coming into the world, and sexual relations 8 form part of a totality which commits the person to a dynamic of relation involving both the family and society. Health linked only to the sexual and reproductive function would be a curtailment and to some extent a contradiction of the very definition of health which has been drafted by WHO—that is, a state of physical, psychic, and social well-being of the individual.

5. If integral human development becomes the strategic framework for WHO’s new policy, this means that the human person must be its end and its measure. To reaffirm respect for his dignity, his right to life and to quality in health and to recall the nations’ right and obligation as regards cooperation and solidarity based on respect and the responsibility of each and every one constitute the best moral guarantee of a health policy in keeping with WHO’s original mission, projected towards the third millennium. I would like to conclude by adopting the intention of the Director General regarding the current significance of the founding values of the Organization, which must accompany reforms at present. “The day after the Second World War, resources were insufficient, but the will to rebuild a world that would be humane imposed very clear choices. The vision of the founders of WHO was inspired by their faith in the value and equal dignity of all human beings. Their determination to act together for peace and security through health development was rooted in an acute awareness of the interdependence linking all peoples and all nations. We want to embrace their vision and their determination, reaffirming our commitment to Health for All in a spirit of equity, solidarity, and responsibility” (Dr. Hiroshi Nakajima, Address to the Ninety-Ninth Session of the Ex- ecutive Council of WHO, Geneva, January 1996). Magisterium

Addresses by the Holy Father Hospitality Is a Distinctive Aspect of Christian Charity

In an audience on March 8, 1997, the Holy As an example of this, I like to recall the Father received the Italian volunteers form- passage in the Book of Genesis which tells of ing part of Our Lady of Lourdes Hospitality Abraham and the three mysterious guests at and the members of the Boston College Uni- the oaks of Mamre (cf. Gn 18:1-10). In the versity Chorale. likeness of three passing strangers, the an- During the encounter, which took place at cient patriarch welcomed God himself. Hos- Paul VI Hall, John Paul II delivered the fol- pitality finds its fulfilment in Christ, who lowing address. welcomed our humanity in his divine person, becoming, as the liturgy says, “a guest and 1. I am pleased to welcome you, dear Ital- pilgrim among us” (Roman Missal, Common ian volunteers who are members of the “Hos- Preface VI). 10 pitalité Notre Dame de Lourdes.” I greet you with affection, together with the members of 3. Dear brothers and sisters, as your activity the Committee of the Archconfraternity, who also testifies, hospitality acquires special im- wished to accompany you. I also extend my portance with regard to the pilgrimage expe- greeting to the members of the Boston Col- rience, especially when the pilgrims are the lege Chorale, who have come from the Unit- ill or very elderly, who need special attention. ed Sates of America. How many saints have achieved the perfec- This meeting offers me a fitting occasion to tion of charity precisely by assisting the sick underscore the value of hospitality, an essen- with that love which only Christ, received in tial and distinctive dimension of Christian the Eucharist and served in one’s brother, is charity, the work of mercy that the disciples able to communicate! One of the important of Christ—as individuals, as families and as aspects in the preparation for the Great Ju- communities—are called to perform in joyful bilee of the Year 2000 is that of deepening our obedience to the Lord’s command. spirit of hospitality. Every ecclesial community is called to develop this dimension, by 2. Because of modern conditions of life, the opening its heart and making room in it for all values of acceptance and hospitality, present those who knock on its doors. Thus, for every in every culture, risk being weakened and particular Church the holy Year is a providen- lost: they are actually delegated to organiza- tial opportunity for conversion to the Gospel, tions and structures that specifically provide for welcoming and serving the sick and suf- for them. Even if this responds to appropriate fering. organizational demands, it must not be reflected in a lessening of our sensitivity and at- 4. Welcoming our brothers and sisters with tention to our neighbour in need. Professional care and willingness must not be limited to an hospitality is certainly valuable, but it should extraordinary occasion, but must become for not be at the cost of that culture of hospitality all believers a habit of service in their daily which draws its deepest motivation from the lives. In this regard, dear brothers and sisters, word of God and as such remains the patri- your active involvement in the pastoral care mony of the entire People of God. of the sick, as carried out in your Dioceses, is truly commendable. It expresses your desire to prolong the experience of the pilgrimage to Lourdes in the every-day life of the Church. I therefore encourage you to continue gen- erously in your commitment, always in active communion with the Bishops. With the wish that your service may be a source of holiness for you and of real comfort to the people you assist, I invoke the special intercession of your patroness, Our Lady of Lourdes. The Cross Shines with Extraordinary Power

On the evening of Good Friday 1997, thou- many men and women associated through sands of the faithful took part in the tradi- martyrdom with Jesus’ death. We contem- tional Via Crucis, presided over by the Holy plate the mystery of the Lord’s agony and Father at the Coliseum. death, which in our own day, too, continues At the end of the Via Crucis, from the sum- in the pain and suffering of individuals and mit of the Palatine Hill, the Holy Father peoples severely tried by violence and war. spoke as follows to those assembled. Wherever a person is struck and killed, it is Christ himself who is hurt and crucified. The “Christus factus est pro nobis oboediens mystery of suffering, the mystery of limitless usque ad mortem—mortem autem Crucis” love! (Phl 2:8). We remain in silent recollection before this unfathomable mystery. 11 1. “For us Christ become obedient unto death, even death on a Cross” (cf. Phil 2:8). 3. “Ecce lignum Crucis...,” “Behold the These words of St Paul sum up the message wood of the Cross, on which hung Christ, the which Good Friday proclaims to us. Today Saviour of the world. Come, let us adore!” the Church does not celebrate the Eucharist, This evening the Cross shines with extra- as though she wished to emphasize that it is ordinary power at the end of the “Way of the impossible, on the day when the bloody Sac- Cross,” here at the Coliseum. This monu- rifice of Christ on the Cross was consummat- ment of ancient Rome is linked in popular ed, to make that Sacrifice present in an un- memory to the martyrdom of the first Chris- bloody manner in the Sacrament. tians. It is therefore a place particularly suit- Today the Eucharistic liturgy is replaced able for re-enacting, year after year, Christ’s by the impressive rite of the adoration of the Passion and Death. “Ecce lignum Crucis!” Cross, at which I presided a little earlier in St. How many of our brothers and sisters in the Peter’s Basilica. The hearts of those who faith came to share in the Cross of Christ dur- took part in that rite are still full of the emo- ing the Roman persecutions! tions which they experienced during the The text of the meditations which have reading of the liturgical texts about the guided us along this “Way of the Cross” was Lord’s Passion. prepared by my Venerable Brother Karekin I How can we fail to be touched by Isaiah’s Sarkissian, Supreme Patriarch and Catholi- detailed description of the “man of sorrows,” cos of All Armenians. I thank him cordially, despised and rejected by men, who bore the and, expressing once more my gratitude for weight of our suffering, and was smitten for the recent visit which he paid me, I greet him our transgression (cf. Is 53:3-5)? together with all the Christians of Armenia. I And how can we fail to be moved by also extend my greeting to Archbishop Ners- Christ's “loud cries and tears,” evoked by the es Bozabalian, who has joined us in the Way author of the Letter to the Hebrews (cf 5:7)? of the Cross as the representative of the Catholicos of Armenia. Many brothers and 2. Following the stations of the Way of the sisters of that Church and nation have shared Cross, we have just contemplated the tragic in the Cross of Christ by the sacrifice of their moments of the Passion: Christ carrying his Cross, falling under its weight, hanging on it in agony and, in the final phase of his suffering, praying: “Father, into your hands I commit my spirit” (Lk 23:46), expressing his total and trustful self-offering. Today our gaze is closely concentrated on the Cross. We meditate on the mystery of the Cross, perpetuated down the centuries in the sacrifice of innumerable believers, of so lives! Today, in union with them and with all rounds our existence, we cry to you, Cross of those who in every corner of the world, on our salvation, our faith! every continent and in the different countries O Lord, a ray of light shines from your of the globe, share through their suffering Cross. In your Death our death is conquered, and death in the Cross of Christ, we wish to and we are offered the hope of resurrection. repeat: “Ecce lignum Crucis...,” “Behold Clinging to your Cross, we wait in joyful the wood of the Cross, on which hung Christ, hope for your return, Lord Jesus, our Re- the Saviour of the world. Come, let us deemer! adore!” “Dying, you destroyed our death; rising, you restored our life, Lord Jesus, come in 4. As the shades of night envelop us, an glory.” eloquent image of the mystery which sur- Amen.

Mary United Herself to Jesus’ Offering

THE FOLLOWING PASSAGE CONTAINS THE HOLY FATHER’S CATECHETICAL 12 INSTRUCTION FOR THE FAITHFUL AT ST. PETER’S SQUARE, ON APRIL 2, 1997.

1. Regina caeli laetare, alleluia! timate participation in Jesus’ entire life. So the Church sings in this Easter season, In accepting with complete availability the inviting the faithful to join in the spiritual joy words of the Angel Gabriel, who announced of Mary, Mother of the Redeemer. The to her that she would become the Mother of Blessed Virgin’s gladness at Christ’s Resur- the Messiah, Mary began her participation in rection is even greater if one considers her in- the drama of Redemption. Her involvement in her Son’s sacrifice, revealed by Simeon during the presentation in the Temple, continues not only in the episode of the losing and finding of the 12-year-old Jesus, but also throughout his public life. However, the Blessed Virgin’s association with Christ’s mission reaches its culmination in Jerusalem, at the time of the Redeemer’s Passion and Death. As the Fourth Gospel testifies, she was in the Holy City at the time, probably for the celebration of the Jewish feast of Passover.

2. The Council stresses the profound dimension of the Blessed Virgin’s presence on Calvary, recalling that she “faithfully persevered in her union with her Son unto the Cross” (Lumen gentium, no. 58), and points out that this union “in the work of salvation is made manifest from the time of Christ’s vir- ginal conception up to his death” (ibid., no. 57). With our gaze illumined by the radiance of the Resurrection, we pause to reflect on the Mother’s involvement in her Son’s redeeming Passion, which was completed by her sharing in his suffering. Let us return again, but now in the perspective of the Resurrec- tion, to the foot of the Cross where the Moth- er endured “with her only-begotten Son the intensity of his suffering, associated herself with his sacrifice in her mother’s heart, and must suffer many things, and be rejected by lovingly consented to the immolation of this the elders and the chief priests and the victim who was born of her” (ibid., no. 58). scribes, and be killed, and after three days With these words, the Council reminds us rise again” re-echo in her heart at the dramat- of “Mary’s compassion”; in her heart rever- ic hour of Calvary, awakening expectation of berates all that Jesus suffers in body and soul, and yearning for the Resurrection. emphasizing her willingness to share in her Mary’s hope at the foot of the Cross con- Son’s redeeming sacrifice and to join her tains a light stronger than the darkness that own maternal suffering to his priestly offer- reigns in many hearts: in the presence of the ing. redeeming sacrifice, the hope of the Church The Council text also stresses that her con- and of humanity is born in Mary. sent to Jesus’ immolation is not passive ac- To the English-speaking pilgrims and visi- ceptance but a genuine act of love, by which tors the Holy Father said: she offers her Son as a “victim” of expiation I offer greetings and prayerful good wishes for the sins of all humanity. to the Bishops, priests and laity taking part in Lastly, Lumen Gentium relates the Blessed the International Theological Symposium on Virgin to Christ, who has the lead role in Re- the Alliance of the Two Hearts of Jesus and demption, making it clear that in associating Mary. My cordial greeting goes also to the herself “with his sacrifice” she remains sub- ecumenical delegation led by the Moderator ordinate to her divine Son. of the Presbyterian Church, USA. I likewise welcome the representatives of the Korean 13 3. In the Fourth Gospel, St. John says that Broadcasting System preparing a television “standing by the Cross of Jesus were his programme on the Vatican. mother, and his mother’s sister Mary, the Upon all the English-speaking visitors, es- wife of Clopas, and Mary Magdalene” pecially the pilgrim groups from England, (19:25). By using the verb “to stand,” which Ireland, Australia, Norway, Korea, Japan, the literally means “to be on one’s feet,” “to Philippines and the United States, I cordially stand erect,” perhaps the Evangelist intends invoke the joy and peace of Christ our risen to present the dignity and strength shown in Saviour. their sorrow by Mary and the other women. The Blessed Virgin’s “standing erect” at the foot of the Cross recalls her unfailing constancy and extraordinary courage in facing suffering. In the tragic events of Calvary, Mary is sustained by faith, strengthened during the events of her life and especially during Jesus’s public life. The Council recalls that “the Blessed Virgin advanced in her pilgrimage of faith and faithfully persevered in her union with her Son unto the Cross” (Lu- men Gentium, no. 58). Sharing his deepest feelings, she counters the arrogant insults addressed to the crucified Messiah with forbearance and pardon, associating herself with his prayer to the Father: “Forgive them, for they know not what they do” (Lk 23:34). By sharing in the feeling of abandonment to the Father’s will expressed in Jesus’ last words on the Cross: “Father, in- to your hands I commend my spirit!” (ibid., 23:46), she thus offers, as the Council notes, loving consent “to the immolation of this victim who was born of her” (Lumen Gentium, no. 58).

4. Mary’s supreme “yes” is radiant with trusting hope in the mysterious future, begun with the death of her crucified Son. The words in which Jesus taught the disciples on his way to Jerusalem “that the Son of man The Church Will Be Concerned As Long As Men and Women Are Afflicted by Wars, Die of Hunger, and Are Unable to Obtain Food and Medical Care

EXCERPTS FROM THE HOLY FATHER’S ADDRESS TO THE PLENARY ASSEMBLY OF THE PONTIFICAL COUNCIL COR UNUM ON APRIL 18, 1997

It is important to kindle unceasingly in the reign in our world presupposes that we are faithful the desire to manifest the love of the concerned about sharing resources. Charity Lord, who makes no distinction among peo- contributes to this, for it creates bonds of ple and who desires, above all, the good of mutual esteem and friendship among per- others (cf. Veritatis Splendor, no. 82). “By sons and peoples. It prompts generosity way of the works of charity we become a among men, who become aware of the need neighbor to those to whom good is done” for greater international solidarity. It is fit- (Origin, Commentary on the Canticle, I) and ting to recall that this cannot be achieved 14 reach out to our brothers and sisters; the without a true service of charity, which im- Church thus witnesses to the fact that each plies not only being able to share surplus person is worth more than all the gold in the goods, but also agreeing to be deprived of world; she will be concerned as long as men what is necessary. As St. Ambrose of Milan and women have to face catastrophes or demonstrated very well, to distinguish be- conflicts, die of hunger, lack what they need tween what is necessary and what is indis- to eat, dress, look after their health, and keep pensable enables each of us to be more alive those entrusted to them. open to our brothers and sisters in need by way of greater generosity, purify our own 5. Through the witness of fraternal chari- relation to money, and moderate our attach- ty, the disciples of Christ also contribute to ment to the goods of this world (cf. De the justice, peace, and development of peo- Nabuthe). ples. “Charity represents the greatest social commandment. It respects others and their 6. The Jubilee ought to foster greater defects. It demands the practice of justice, awareness among all the members of the and it alone makes us capable thereof. It in- Church and all men of good will concerning spires a life which becomes self-donation” the cooperation needed to accept the chal- (Catechism of the Catholic Church, no. lenge of sharing, of the equitable distribu- 1889). The wish to make justice and peace tion of goods, and of joining forces. In this way everyone will contribute to building a juster, more fraternal society—the premises for the Kingdom—since love is a witness to the Kingdom which is to come, and it alone can transform the world radically. Charity gives hope back to the poor, who discover they are really loved by God; each has his or her place in the upbuilding of society and the right to possess what is useful for suste- nance. Love for the poor manifests the need for social justice, as recalled by the document published last year by your office, Hunger in the World. At the same time, however, it is appropriate to affirm that charity goes beyond justice, for it is an invitation to move from the level of mere equity to that of love and self-giving, so that the bonds created among persons will be grounded on respect for others and the recognition of brotherhood, essential foundations of social life. 7. Those practicing charity carry out a goods. They can also question themselves in profound work of evangelization. “The spirit truth to determine whether they possess of poverty and love is indeed the glory and goods or are possessed by them, whether testimony of the Church of Christ” (Gaudi- they are obsessed by wealth or their hearts um et Spes, no. 88). Sometimes action in are open to their brothers and sisters. communion is more eloquent than all teachings: gestures joined to words are a particu- 8. At the end of this encounter, dear broth- larly effective witness. The Lord’s disciples ers and sisters, I entrust the activity of the are to remember that to serve the poor and Pontifical Council Cor Unum to the inter- those suffering means to serve Christ, who cession of the Virgin Mary, asking Her to is the light of the world. By way of their dai- support you as She supported the Apostles ly life in the love coming from Him, the in the Cenacle, while waiting for the Spirit faithful contribute to spreading light in the of Pentecost. I wholeheartedly impart the world. Charity is also the maximum “flow- Apostolic Blessing upon all of you, on those ering” of men; it conforms them to the Lord collaborating with you in charitable works, and renders them free as regards earthly and upon all who are dear to you.

The Lord Wants You to Be Pillars in His Spiritual Temple for the New Evangelization WE INCLUDE EXCERPTS FROM JOHN PAUL II’S ADDRESS TO THE SICK AND RELIGIOUS AT THE BASILICA OF THE MONASTERY OF BREVNOS IN PRAGUE, ON APRIL 26, 1997.

3. I now turn to you, dear brothers and sis- preparation for the Great Jubilee of the Year ters who are sick. Through pain you are be- 2000 and is consecrated to Christ, the one ing configured to that “Servant of the Lord” Saviour of the world, yesterday, today and who, in the words of Isaiah, “was wounded forever, I entrust to you my intentions for the for our transgressions, bruised for our iniqui- ties” (Is 53:5; cf. Mt 8:17, Col 1:24). You are a hidden force contributing power- fully to the life of the Church: by your sufferings you have a share in the redemption of the world. You, too, like St. Adalbert, have been placed by God as a pillar in the temple of the Church so as to become one of its most powerful supports. Dear friends who are sick, the Church is grateful to you for the patience, the Christian resignation and indeed for the generosity and dedication with which you carry, at times even heroically, the cross which Jesus has placed upon your shoulders. You are close to his heart! He is with you, and you bear him a precious witness in this world, which often mistakes pleasure for love and considers sacrifice as something meaningless. In this millenary year of the martyrdom of St. Adalbert, which is also the first year of universal Church and for the Church in your 4. I would now like to speak to you, dear country. Offer up your sufferings for the men and women religious of the whole na- needs of the new evangelization, for the tion! St. Adalbert has shown each of you how Church in mission lands, where the Lord to- it is possible to combine the contemplative day, too, is raising up his martyrs, like Adal- and the apostolic life, and he makes clear bert, and for those who are distant or who how providential consecrated life is for the have lost the faith. I also ask you to pray for Church and the world. You are a living and the work being done by the Church in this indispensable source of strength for the country, for your Bishops and priests, for an Christian community. increase in vocations to the priesthood and I remember my meeting with you seven the religious life, and for the cause of ecu- years ago in St. Vitus’ Cathedral. At that time menism. May St. Adalbert, son of the Czech you were emerging from a long and difficult nation and fearless witness to Christ, fill you period of repression which had forced believ- with a lively desire for full unity among ers, and religious in particular, to remain Christians. silent. But even in the dark years you were Into your hands and your hearts I place all able to bear a great witness of fidelity to the these hopes, dear brothers and sisters who are Church. The oldest among you experienced suffering. May Our Lady of Sorrows, who great humiliations and sufferings during the was acquainted with suffering and who un- two terrible dictatorships, Nazi and Commu- derstands you, be close to you as a loving nist. Many consecrated persons were in- 16 Mother. terned in concentration camps, imprisoned, And while I think of you that are sorely sent to the mines and to forced labour. But tried in body and spirit, I would like to ad- even in those situations they were able to dress a pressing appeal to the nation’s leaders give an example of great dignity in the exer- to be constantly sensitive to the situations of cise of the Christian virtues, as was true of suffering present in today’s society. The civil the Jesuit Fr. Adolf Kaipr, the Dominican Fr authorities and all citizens need to be con- Silvestr Braito, the Borromean Sr. Vojtecha cerned about the needs of the sick and should Hasmandová, and many others with them. promote effective and constant solidarity This treasury of acts of love, sacrifice and within society. Let respect for every human self-offering, fully known only to God, cer- being and respect for life from its beginning tainly prepared the flowering of vocations in to its natural end be the great treasure of the these new times of refound religious free- civilization of this land! dom. Topics

Our Conflict with Pain and Death: In Search of Meaning

The Health Apostolate In Lebanon on the Way to the Jubilee of the Year 2000

What Should Be Done About AIDS? Our Conflict with Pain and Death: In Search of Meaning

I. The Faces of Year 2000, Geneva, 1981). ardous, unhealthy, or unau- Human Suffering There are ten million thorized dwellings. epileptics, fifteen million lep- 3,500,000 are refugees. 1. I have seen many pained, ers, thirty-two million deaf- (Source: L’Etat du Monde 1991) suffering faces mutes, and fifty million para- lytics in the world. 12% of the North versus South seems The faces of hunger, pover- population suffers from some to be an opposition without ty, unemployment, and people kind of mental disturbance. any solution. 75% of the pop- at war. We must also bear in mind ulation lives in the southern Terrorized faces. AIDS, drug addiction, alco- hemisphere, over against 25% Unidentified, anonymous holism, the elderly, and un- in the north. Official data con- faces. firm the following. The faces of desolate moth- * The North is six times 18 ers, marginalized women. richer than the South. The The faces of exploited chil- North consumes 75% of the dren. earth’s resources and controls The faces of the sick (with 80% of commerce, 93% of in- cancer, AIDS, etc.). dustry, and nearly all re- The faces of the dying. search. Pope John Paul II says the * A billion people live on following. an income of less than $370 a year. A fifth of mankind lives “Today as well—perhaps on less than a dollar a day. today, above all—the tears of * Billions of dollars (the multitudes stricken by illness United States alone spends rise up from mankind. Whole $300 billion) are used for the populations are destroyed by demential arms race.2 the cruelty of war. The weak, above all, are the victims of 3. A Pilgrimage ongoing conflicts—mothers, Through Suffering children, and the elderly. How many human beings, pushed As may be observed, this is to the limit by hunger and dis- employment. a long trip, a major pilgrim- ease, have no access to even One out of every three in- age of all mankind through the most elementary forms of fants dies before age five. the world of suffering. Hence care.”1 700,000,000 will die before the universality linking to- age sixty. gether individuals and peo- 2. The Shameful Figures 5,000,000 die annually of ples, poor and rich, the igno- infectious diseases. rant and men of science, be- The following figures 450,000,000 suffer from lievers and nonbelievers: suf- speak for themselves. malnutrition. ferings of the heart, inner * Almost a billion people 720,000,000 lack potable wounds, experiences of lone- are in a state of poverty, mal- water. liness; sufferings of the spirit, nutrition, and disease. 517,000,000 lack adequate connected with an inner void, * Forty-six million people lodging. an alienation from God, one’s die of hunger each year. 604,000,000 have no access neighbor, and oneself; and * About 850 million people to decent medical care. sufferings of the body, numer- live in areas exposed to 600,000,000 children of ous illnesses—a never-ending malaria. school age lack schools. list, and the same may be said * In many countries life ex- 170,000,000 need special of suffering of the mind— pectancy is under fifty, al- education or rehabilitation multiplied today because of a though elsewhere normal life services. mistaken way of living.3 expectancy is now seventy- 695,000,000 live in coun- Interconnected sufferings five. tries where average per capita produced by injustice, pride, * The level of infant mor- income is under $100 a year. power, and human oppres- tality in many countries is 100 68,000,000 are nomads or sion—these are the shameful per 1000 (cf. WHO, World semi-nomads. figures we referred to above. Strategy: Health for All in the 200,000,000 live in haz- In his Message for the Third World Day of the Sick, but also, and above all, reaf- goods, the loss of bonds of af- Pope John Paul II said, “How firm our commitment to the fection, the loss of personal can we fail to recognize that solidarity enabling others to identity, and the loss of health. our civilization ‘should real- live, in concrete economic ize that, from different stand- and political circumstances, 2. Man Over Against Death points, it is a sick civilization and to the creativity which is generating deep alterations in a characteristic distinguishing Death is an event which man’?” (A Letter to Families, the human person and making man would like to annul and no. 20). possible the wealth of na- which places so much of his It is sick because of its ster- tions.”6 security in a state of crisis. ile selfishness, its individual- Suffering is a “universe” in istic utilitarianism—which is our universe; it is the realm a) Statement by the frequently proposed as a life of questioning. Second Vatican Council model—the denial or indiffer- But current man is under- “The greatest enigma in hu- ence often manifested before going the illusion that he can man life is death. Man suffers man’s transcendent destiny, correct everything: “The fat with pain and with the pro- and the crisis in spiritual and get treatment to become slim; gressive dissolution of his moral values causing the shy are trained to become body. But his greatest torment mankind such concern. The independent; students with is fear over permanent disap- “pathology” of the spirit is no problems are trained to con- pearance. He judges with a less dangerous than physical centrate…”7 sure instinct when he resists “pathology,” and they influ- accepting the perspective of ence each other (no. 1). complete ruin and a definitive farewell. The seed of eternity 19 4. What Can We Do? he bears in himself rises up against death because it may In the face of this whole not be reduced to matter panorama, we ask, What can alone…” (GS 18) we do? Shall we leave things as they are? Shall we resign b) Social Rejection of Death ourselves to impotence? Elizabeth Kübler Ross says, Man’s history is a constant “If you base your life on fear, experience of struggle against you will end it with fear.” pain. All philosophies and all We may speak of the social religions have done every- rejection of death, of social ig- thing possible and have been norance. Today death is ac- unable to eliminate it. The companied by silence, deceit, scientific knowledge ob- concealment, and solitude. tained has permitted greater Death is set aside. People do control and softened its im- not want to talk about it. It is pact, but man will never be taboo—”pornographic.” able to flee from suffering. Death is in certain places to- “The history of pain began II. The Faces of Death day. There is no room for it at with man.”4 home, in the family. Death is “…We can all do some- “It is not possible to conduct in the street, at the hospital, or thing. Each can make a con- a reflection on the conditions the hospice. Death is also ex- tribution. This certainly re- of suffering and pain unless pressed in new terms; it is not quires acts of renunciation we extend it at the same time called “death,” but “disappear- presupposing deep inner con- to death, to which they are ance,” “ceasing to exist,” or version. It is no doubt neces- closely tied.” W.H. Braun “absence of a loved one.” The sary to examine our behavior says, “Pain is the universal word “death” is pushed aside; as consumers, to combat he- companion of man and fol- it is in bad taste, an uncom- donism, and to oppose indif- lows man at all stages of his fortable presence. ference, without shirking our development until death.”8 We are living in a society responsibility.”5 which has lost the sense of A gesture of personal and 1. Death Is a Process death and creates new ways to community solidarity is in- die. We marginalize, deny, and volved. The Holy Father also Death is a process. It is the modify ritual.9 recalled this in his address to final loss. We do not arrive at Death goes against the sta- the United Nations. death without previously pass- bility and happiness of soci- “When millions of people ing through other small and ety; it is therefore scandalous, suffer the poverty represented large losses which are like the unjust, and anti-aesthetic for a by hunger, malnutrition, ill- different faces of death; to society admiring beauty and ness, illiteracy, and degrada- some extent, death itself is physical perfection. We do not tion, we must not only remind represented in them. These are want it to remind us of our ourselves that no one has a some of the faces, or losses, end; that is why we push it right to exploit another in showing us the possibility of aside, isolate it, and do not seeking his own advantage, death: the loss of material want it to be on familiar terms with us, recalling our own fillment of destiny. The rela- suffering, mystery, and re- death to us. tionship with death has per- sponse. “The inability to take to the haps never been so poor as in a) “The subject of suffer- dying the aid and attention these times of spiritual aridity, ing… is a universal subject they particularly need at the where, in haste to live, they accompanying man in every moment of death… arises pre- seem to avoid mystery, with- corner of the world” (SD, 2). cisely because in the death of out realizing that they are dry- “It is multidimensional. Man others we discover something ing up a essential source of the suffers in different ways… of our own. The sight of a dy- pleasure of living…”12 Even though, to some extent, ing person clashes with a de- the words ‘suffering’ and fense activated by imagining c) Death Belongs to Life ‘pain’ may be used as syn- an immortality we erect like a onyms, physical suffering wall to shield ourselves “Death, like birth, is part of takes place when ‘the body against the thought of death.”10 life. To walk means to lift up hurts’ in some way, whereas In the past the person close one’s foot as well as to rest it moral suffering is a ‘pain of to death presided over a ritual: on the ground” (Tagore, Mi- the soul’… (SD, 5). he called his loved ones to his gratory Birds). b) The second statement by side, gave his final advice, and The most important thing is the Pope is that suffering conveyed his last wishes— life. We are born to die. Death “should be accepted as a mys- everything was natural and in- is only a bridge between two tery which man cannot com- timate. shores. It thus belongs to our prehend in depth with his in- Today death has lost intima- telligence” (SD, 11). The cy and a sense of others. There world of suffering “at the 20 is barely any feeling for anoth- same time contains in itself a er. Mourning has been re- singular challenge for commu- duced—it is an offense to the nion and solidarity” (SD, 8). living. c) “But in order to be able to Today there have arisen perceive the true answer to the new—funeral—professionals question about suffering, we of death who, with a new ritu- must turn our gaze to the reve- al (the place of death, make- lation of divine love, ultimate up, conveyance of the body), source of the meaning of all separate death from the family that exists. Love is also the environment and try to make it richest source as regards the less terrible. It is a negated meaning of suffering… Simi- death whereby people seek to larly, love is the fullest source mitigate fear. for the answer to the question Relatives and health profes- concerning the meaning of sionals, who surrounded death suffering. This answer has and the dying in the past with been given by God to man on gestures of intimacy, close- the cross of Jesus Christ” (SD, ness, and meaning, are called 13). today to pretend, silence, con- way, our life. Only one who ceal, and deceive. experiences life knows what 2. Can We Free Ourselves And yet, in spite of all this death is. Only one who lives to from Suffering new comedy, whether we like the full can undergo a death and Death? Do They it or not, death is always pre- full of life. Really Have a Meaning? sent. To live is like a continual “We hide death as if it were birth. Consequently, if death We do not live in an ideal something shameful and dirty. belongs to life, it will be the fi- world, but, rather, in a real, In death we see only horror, nal birth, the final stage, the concrete one, wherein suffer- absurdity, useless and painful “final option,” and the final ing exists and exists for some suffering, unbearable scan- opportunity in life. reason. dal…”11 Man must know why he suf- In the preface to the book fers, why he dies, and what all Friendly Death, Françoise III. In Search of a Meaning of this means. Mitterand asks, “How should * It is necessary to free pain one die?” And he replies as 1. The Apostolic Letter and death from a sense of ab- follows. Salvifici Doloris surdity and lack of transcen- “We are living in a world dence. which is afraid of this question On February 11, 1984 John * It is necessary to free pain and therefore avoids it. Other Paul II published the Apos- from the alienation produced civilizations, before us, looked tolic Letter Salvifici Doloris, by suffering and death with no death in the face: they marked on the Christian meaning of horizon. out for the individual and the human suffering. I shall stress * It is necessary for man to community the road to pass three basic ideas which the give a meaning to suffering over. They sought to give rich- Pope brings out in this Apos- and be able to die in a fullness ness and meaning to the ful- tolic Letter: the universality of of life—that is, life must be in- fused into suffering and death. They both lived through a time they spent in the chapel, This is the road followed by negative experience in the wavering between hope and Jesus. He accepted pain and hospital because of the treat- despair! lived out its meaning of libera- ment the sick received. That * And how affectionately tion and salvation. experience moved them to and zealously Jordi’s mother He dedicated Himself com- found their respective reli- took care of him! pletely, to the point of death, gious institutes as an expres- * How many families wait- and death on a cross. But He is sion of a more humane and ed for us to come and visit the Risen Christ, the Christ of charitable dedication to the them! They frequently said to hope, the Christ of Life. Death sick. us, “We were waiting for has also been overcome by you.” Life. From that point on hu- b) My Experience * And that father, Paco, dis- man suffering has had a mean- as a Chaplain illusioned and despairing over ing and has become salvation at a Children’s Hospital his son, with a bifid spine; he (Jn 12:24): “In truth, in truth I The most surprising and did not believe in anything, tell you: If the grain of wheat richest thing in the experience saying he had lost the faith… does not fall to the ground and of evangelization is life, the We encouraged him to emerge die, it remains alone, but if it surprise of being challenged from that darkness and sad- dies, it yields abundant fruit.” each day by the lives of these ness, and after a few days we Suffering is a key time, an children, who, instead of be- saw more light and tranquillity appropriate time, a kairos: for ginning to live, are threatened in that room and in that couple the sick, who pause and begin alongside their son. to reflect and evaluate and * And what can we say live, observing life’s meaning about Alicia, twelve years old; 21 precisely in the time of illness; Juan, eight; Gemma, nine, a for God, in the sense that God victim of leukemia; José has his moments, designs, and Manuel, six; and Maria, three? means. God is always passing * Miguel Angel was a sev- through man’s life, but we are en-year-old with a cancerous sometimes distracted; in the tumor. It was a desperate case. time of illness, however, we The child cried, was ill, and can listen to Him without felt this. And, between sobs, many fears.13 with the awareness of an older person, he repeated rather fre- 3. Witness14 quently, “Mommy, kill me, kill me!” We spoke to his par- Pain, illness, and suffering ents, seeking to be very close are an observatory, a school, a and to provide encourage- university, an occasion for a ment. But there was no time new approach to life, and for prolonged conversation. It sometimes even for an authen- was always sporadic. It was so tic conversion and apostolate. hard, with such anguish! To demonstrate this affirma- by suffering and illness. The * This was the reflection of tion, I shall present two types surprise is to see many moth- a father: “At work I feel dis- of testimony: the first group is ers, many families, at the foot tant and do not trust my com- formed by saints who changed of the cross of their children in panions… I have always their lives on getting in touch pain. How much tenacity, re- thought there was a lot of mal- with pain; the second is sistance, and sorrow! How ice in people, but after so formed by people of every much questioning and mys- many days in the hospital I condition. tery! have discovered this human Our Religious Service is not value in healthcare personnel, a) The Saints an organization or a cold, cal- volunteers, and the religious Some of them have lived culated presence; rather, it is a service. I am happy, though through the experience of ill- life, a sign. We observe this in my son remains ill. The hospi- ness in their own flesh; the ex- many manifestations by fami- tal is a surprise.” Another fa- perience of suffering has ly members. Allow me to ther said, “We parents, lacking served others, the majority, to point out a few of them to you morale and frightened by the focus their lives again—they by way of example. incurable illness of our daugh- have lived out their vocation * “Thank you so much, ter, were consoled only by the at the side of suffering people. Elvira; you have helped me a words of the priest who at- Among the former we find great deal.” These were the tended to us for the Baptism St. Ignatius of Loyola, who, words of a mother to a visitor and death of our daughter.” while convalescing from a after the burial of her daugh- Allow me to tell you about wound, found God and offered ter. an eight-year-old girl who had Him his life. Among the latter * I remember the anguish of an accident along with her it is right to mention two great a young couple over the ill- cousin; we visited the two of champions of Charity, John of ness of their son, who died af- them rather frequently. After God and Camillus De Lellis. ter three months. How much being discharged, she came to the hospital one day to visit us “Did you think of God?” states, “in insults…, in perse- and brought several things, in- “How could one live with- cutions…” (2 Co 12:10). cluding the following letter. out thinking of Him?” Why suffering? What good Dear St. John of God, On another occasion, the is it? Can suffering be a call, a My grandmother is sending same Barcelona newspaper al- vocation? you this bouquet in gratitude so published statements by the “Suffering is present in the for your having cured me and tenor José Carreras. world to provoke love, to my cousin. Cure all the chil- “As a result of my illness, I cause works of love for one’s dren in this hospital. Help learned to value the religious neighbor to arise, to transform Yolanda and Gustavo and aspect, a certain mysticism, a all of human civilization into Rafa and the others to get certain type of reflection, and the ‘civilization of love’” (SD, cured as you helped us. My that has been one of the posi- 30). grandmother is sending you tive experiences remaining in In this love the meaning of this bouquet so that you will me from that situation. I have suffering is totally fulfilled, cure other children. I want you matured more as a man be- and it attains its definitive di- to give a lesson to those cooks, cause of this episode in my mension. who prepare very bad meals life and see things a bit more Human suffering is a call to which the children at the hos- profoundly.” love. “It is a vocation,” as pital don’t like. I am leaving Pope John Paul II states in the you my crutches because I c) Why Suffering? Apostolic Letter Salvifici Do- don’t need them any more, In Salvifici Doloris Pope loris, no. 26. A mysterious call since you have cured me. I am to love more, to share in the giving them to you so that an- infinite love of God for 22 other child can use them if he mankind. needs to, but I ask that no one There is a Jewish story that may have to use them in this a disciple asked his master, world. Because I don’t think “Why do the good suffer more people need to die or suffer, than the wicked?” since, if such horrible things The master replied, “Listen, did not exist, everyone would a man had two cows, one live happily. strong and the other weak. Affectionately yours, Which of them did he put the Isabel María.” yoke onto?” We shall now look at two The disciple answered, significant experiences associ- “Obviously, onto the strong ated with contemporary repre- one.” sentatives of the world of art The master concluded, “The who have been faced with merciful one does the same: in pain. We are referring to the order for the world to go for- renowned film director Fed- ward, he places the yoke on erico Fellini and to the tenor the good.” José Carreras. Some time ago I read a We shall first transcribe the John Paul II gives an answer. book and was struck by one of statements by Federico Fellini Suffering is a trial (SD, 11). its chapters, entitled “To Edu- to the Barcelona newspaper Suffering is a call to conver- cate for Suffering.”15 It con- La Vanguardia (August 29, sion (SD, 12). tains the following direct 1993) while he was hospital- Sacred Scripture recom- quote: ized in Rimini. mends joy as an excellent “Whoever is unable to suffer “I have discovered that the remedy: “The joyful heart im- a great deal cannot aspire to hospital is a wonderful place proves health; the downfallen doing great deeds. to meditate on one’s projects spirit dries one’s bones”(Pr —Burke” and one’s life.” 17:22). The interview continued. “Man’s soul supports him in “It seems contradictory for “What are you afraid of illness, but if he loses heart, me to open this article with the now?” who will lift him up?” (Pr heading ‘To Educate for Hap- “Above all, I’ll say that I 18:14) piness.’ Is it perhaps contra- won’t conceal the fact that I St. Paul found joy in suffer- diction or incongruity on the was afraid.” ing and discovered its value part of someone writing illogi- “Did you pray during those (SD, 1). cally and inconsistently? days?” “Now I am joyful over the “Let us state at the outset “Yes, I did.” sufferings I endure for your that happiness and suffering “What is prayer?” sake and make up in my flesh are not contradictory, but com- “An extraordinarily rational what is lacking to the tribula- plementary concepts. No one and intelligent way to place tions of Christ, in favor of his achieves high levels of happi- life’s heaviest burdens on the Body, which is the Church” ness if he has not first taken on ground and entrust the weight (Col 1:24). the dynamic of suffering. Suf- of anguish and doubt to some- “…I take delight in my fering must not be sought as one.” weaknesses,” St. Paul also an end, but accepted when it comes in a spirit of joy, soli- nate suffering, or even to ex- nology; I was in “good hands.” darity, and good cheer. plain it. He has come to fill it I felt the company of many * Suffering has forged great with his presence,” says Paul people, to the point that the ar- men. Claudel. And he continues, ticle on my experience was en- * Suffering puts selfish “Pain is a presence; it thus de- titled “I Never Felt So Well hearts to the test. mands our presence—a hand Accompanied.” My illness * Suffering takes us to high- has joined ours and holds us in was a good opportunity for a er levels. its clasp.” new relationship with God. As * Suffering makes us more And Mounier, when his a religious and a priest, I can understanding. daughter Françoise was ill, say that I have seen God more * Suffering draws us close wrote to his wife, “We must closely through numberless to our brothers and sisters. not think of this illness as if it small realities. * Suffering enables us to in- were something we are offer- Illness helped me to value teriorize. ing, so that we will not lose health more—both my own * Suffering gives us pa- the merit—the grace—of this and others’. I think I have be- tience. ‘little Christ’ in our midst… I come more sensitive, trust * Suffering brings us to seek don’t want us to lose these God more, and see the relativi- God. days by forgetting that they ty of many things previously “The educator, whether a are days full of an unknown regarded as important which parent or master, must teach grace.” are not. I have seen that prayer that suffering is a blessing I myself could narrate my is not easy—especially when when we live it out in a spirit illness is most acute—ritual of good cheer and harmony. prayer in particular, the com- We constantly complain about mon daily prayer, which I did 23 our bad luck or about the in- not identify with in the time I evitable sorrows life brings was living through. with it, whose intensity we are My prayer in bed and then unable to alleviate. They seem in the little chapel of the com- to make life unbearable. munity was mainly comprised “Difficulties should be ac- of short phrases: “Lord, thy cepted joyfully—heat or cold, will be done, but give me the solitude or company, igno- strength to follow it.” I fre- rance or the effort to learn, quently turned to the Lord weariness and boredom, dis- with this cry. appointment and doubt, laugh- I remember that one day, after and tears. ter a new relapse, I prayed to “The contours of pain rise the Lord in the words of Psalm up each day like the sun, the 136: “How can a song be sung air, or life itself. A life without to the Lord in a foreign land?” pain would be an advance And I said to myself, “It is death, since pain fortifies our true. It is hard.” And I applied will for the daily struggle. In it to myself, since in that time the school of pain we are in experience of illness, lived out my illness and my doubts the best position to verify the in the month of June 1995.17 were a foreign land for me. A quality of love. In learning to I had never before in my life foreign land was not to be able suffer, we learn to love. How had an experience of illness (I to continue with normal life. A clearly mothers understand was 59)—just minor prob- foreign land was so many this after the pains of birth! lems. But I suddenly felt that medical tests, so many analy- How they accept any suffering my body was telling me that ses, and so many injections. because of the love they feel something was wrong. It was I also identified with the for the child of their womb! true. Then came the tests, and psalmist’s cry: “Lord, my “I am accustomed to feeling the diagnosis was clear: “ul- God, I cried out to you and the clawing of pain quite fre- cerotomy, in addition to selec- you healed me” (Ps 29). quently. And my song of tive vagotomy.” And every- Another intense moment of thanksgiving rises to heaven, thing was “urgent”— prayer was the feast of St. Pe- since I can share the wonder- hospitalization and an opera- ter and St. Paul. I intimately ful experience of a God who tion. My via crucis began, not felt the joy, courage, and became flesh to impart to us, from bodily pain, which I did strength of the apostle: “I from the teaching chair of not feel, but from the “nui- know the one I have put my pain, the most sublime and en- sance” caused by so many trust in. I have fought the good during lesson of love. Suffer- medical probes, which were fight. I have run the race. I ing and happiness may just be never over. I asked myself have kept faith... The grace of two sides of the same coin.” many questions in the face of God always works with me...” Paul Claudel and Em- two realities, illness and work. (Antiphons of Lauds). manuel Mounier have left us a Accustomed to a very active “My strength and my power beautiful witness to suffer- way of life, I got the impres- is the Lord. He was my salva- ing.16 sion that I was really wasting tion” (2nd ant., Lauds, first “God has not come to elimi- time. I felt the support of tech- week). “Bend under the powerful true answer to the ‘reason for’ me, Lord, to contemplate your hand of God... Unburden all suffering, we must turn our immense face. For me death your distress upon Him, for gaze to the revelation of di- will always be a greater He cares for you” (1 P 5:6-7). vine love, the ultimate source birth.” In the end, this is what re- of the meaning of all that ex- In a poll conducted among mains; this is the substance of ists. Love is also the richest health professionals on the life. In those days the source on the meaning of suf- theme of “Death as the brochure with the Office for fering, which is always a mys- Teacher Chair of Life,”21 I reading on the seventy-one tery.” gathered together many ideas. blessed members of the Order, Cardinal Angelini explains Death provides instruction on martyrs of hospital service it with a metaphor, referring to life during the Spanish Civil War. the “planet of pain.” The plan- * because it teaches us to And I felt a kind of chill while et is a star shining with a light value things in their true mea- reading those texts; in those which does not belong to it, sure; martyrs I saw generosity, love the light of the sun. From a * because it places us in for the sick, faith in God, and Christian standpoint, pain touch with the hope of a tran- valor in times of distress, and may be compared to the plan- scendent life; I said to myself, “Courage! et receiving light, purification, * because it makes us sensi- And I saw that it was true: hu- and value from the mystery of tive to human and spiritual man and Christian life ma- Christ the Redeemer.19 values. tures in suffering. The arguments in favor of I would not like to conclude the positive meaning of suf- without manifesting another fering and death are numer- 24 experience which accompa- ous, as there are numerous nied me during my illness: as thinkers and experiences con- never before, I felt the prayer nected with this subject. We of others to be very near. All have touched upon only a few. said they were praying for me, Readers will find abundant and I really felt that “push,” material in our bibliography, that strength, and I thought, but we wish to facilitate re- “If men are close to you, how flection and, above all, read- can God fail to be?” ing of certain keys to under- Let us now pose this ques- going suffering and death in a tion for ourselves: Does suf- positive way, and to this end fering have meaning? supply data on books and Let us start from an evident journals devoted to these top- fact: suffering is not good in ics in particular.22 itself; rather, it is an evil. That In the future, death must re- is why an instinctive tendency cover its meaning, and it will exists to reject it, even in be- do so only when man finds the lievers. A woman religious, meaning of the dignity of who, after an operation, was 4. Death: The Teaching life... To give life meaning asked, “How are you, Sister?” Chair of Life again—to “rehumanize” it. replied, “Doing the will of That is the price which society God, but not so happy about If we must “learn to suf- must pay as soon as possible it.” fer”—that is, integrate death to avoid the dangerous ex- But that does not mean that into life and be able to die in cesses of an ethics which has it lacks meaning. “Suffering is the fullness of life—from lost its moorings to such a always bad, but it is an un- death we must learn to live; point that it recognizes the pleasant experience in which death is the “teaching chair of right to die as the justification something positive may be life.”20 for a policy of active euthana- lived through. Suffering pre- A Spanish poet, Pemán, sia.23 sents itself to us as a possibili- says the following: “One who We shall point out some ef- ty. It is I who must say what I is unable to die while he lives forts to recover the meaning will be in this experience of is empty and deranged; the of death. They are efforts pain. Suffering that is not way to live is to die a little which, when multiplied, can lived through inwardly re- each day. To live is to prepare change our language and our mains as an unpleasant fact the soul to attain life, dead to gestures. which will not contribute to pleasure and the world, so * Hospices and residences shaping my life; rather, it can that, when death comes, there are attempts to humanize the destroy it.”18 will be very little left for it to care of the dying. The mystery of pain is re- do.” * Palliative care, a new phi- vealed in the light of faith: Another Spanish poet, the losophy in accompanying the pain in the eyes of God has an Catalonian Joan Margall, in dying, is a search leading to a explanation. The Pope so his spiritual canticle says, meaning. states in the Apostolic Letter “And when the time comes for * The life testament is also Salvifici Doloris, no. 13. these human eyes to close, an attempt to humanize and “In order to perceive the open other, bigger eyes for recover control over death, since it is a question of pre- fillment of our resurrection. Notes serving human dignity until And if Christ rose, hope and the end of life. forgiveness are possible; with 1 Message for the Fourth World Day * Campaigns in favor of the Christ’s resurrection, pain and of the Sick, no. 4 (February 11, 1996). 2 JOSÉ L. REDRADO, El rostro de assistance of the dying at death are not accursed or Jesús y el sufrimiento humano, in El home. alien, but the companions for Padre, apóstol del Santo Rostro (Gorle: * Action plans aimed at a our journey, our pilgrimage, Velar, 1995). change in mentality at differ- our history, redeemed and 3 Cf. ARNALDO PANGRAZZI, Perché proprio a me? [Why Me?] (Milan: Pao- ent levels: social, ethical, po- saved in Christ Jesus. line, 1995), pp. 9-11. litical, medical, and eccle- Let us acclaim Christ, who 4 Cf. FELICE D’ONOFRIO, Il dolore sial.24 overcomes death in himself (Milan: Paoline, 1992). and in all of us. After Easter, 5 JOHN PAUL II, Message for Lent 1996. 5. Death Has Been death is no longer death, but 6 JOHN PAUL II, Address to the Unit- Overcome by Life life, a falling asleep in the ed Nations, October 5, 1995. Lord, light and resurrection. A 7 JOHN PAUL II, Message for Lent Death is the “instant in light never before seen is 1996. 8 FELICE D’ONOFRIO, op. cit., p. 9. which pure, naked, certain shining. The night is receding, 9 JEAN-LOUIS BAUDONIN DANIELLE truth penetrates into the soul” and the sun is rising—He is BLONDEAU, La ética ante la muerte y el (S. Weil), and we must look at the Risen One. It is Easter, a derecho a morir (Barcelona: Herder, it with our faces uplifted, as day of light, a song of hope. 1995). 10 N. ELIAS, La solitudine del morente did Jesus, “who, in appearing (Bologna: Il Mulino, 1985), p. 28. with a human demeanor, hum- 11 MARIE DE HENNEZEL, La morte am- bled himself, obeying unto ica (Milan: Rizzoli, 1996). death, and death on a cross. 12 Op. cit., p. 7. 25 13 JOSÉ L. REDRADO, El Rostro de For this reason God exalted Jesús… him and gave him the Name 14 JOSÉ L. REDRADO, “Evangelization which is above every other and the World of Health: A Challenge name” (Ph 2:5-9). From that for Religious in Health Care,” in Curate Infirmos and Consecrated Life (Vatican moment pain, taken on by the City: The Pontifical Council for Pas- Crucified and Risen Christ, toral Assistance to Health Care Work- has disappeared, and death is ers, 1994). no longer death, but life. 15 GREGORIO MATEN, La aventura de ser Joven, Ed. Atenas, Madrid 1993. As St. Ambrose says, 16 Cartas sobre el dolor, in Labor “Death is the universal pas- Hospitalaria, no. 235/1995, 52-56. sage. It is necessary for it to 17 JOSÉ L. REDRADO, I Never Felt So pass with value. The passage, Well Accompanied, in Dolentium in addition, is from corruption Hominum, no. 32/1996. 18 MIGUEL ANGEL MONGE, Suffering to incorruptibility, from death in Illness, Dolentium Hominum, to immortality, from restless- 32/1996. ness to tranquillity. Let the 19 Cf. Quel Soffio sulla Creta (Vati- name death not cause you can 1990), p. 147. 20 JOSÉ L. REDRADO, article in Dolen- fear, but, rather, rejoice over 7. I Am Making tium Hominum, 28/1995. the benefits of this beautiful a New World 21 JOSÉ L. REDRADO, Dolentium landscape” (De Bono Mortis, Hominum, no. 28/1995, 62-67. 4,15). A new world is arising— 22 * Apostolic Letter Salvifici Doloris. * Spanish Bishops’ Conference, When man looks at his ulti- must arise. A world without Vivir sanamente el sufrimiento mate destiny with faith, death suffering, laments, or death. (Madrid, 1994). is transformed for him into It is the Heavenly Jerusalem * VICO PEINADO, Profetas en el do- hope. St. Teresa of Avila sung in the Book of Revela- lor (Madrid: Paulinas, 1981). * A. ALAIZ, Vivere la vita (Paoline, writes, “Come, death, so hid- tion (21:1-4). 1993). denly that I won’t hear you “I saw a new heaven and a * C. JOMAIN, Vivere l’ultimo istante coming, so that the pleasure new earth... And I heard a loud (Roma: Paoline, 1986). of dying will not carry me off voice saying from the throne: * NOUWEN, Al di là dello specchio (Brescia: Queriniana, 1992). to life.” ‘This is the dwelling of God * Dolentium Hominum: For Paul, “to die is a gain” with men. He will place his no. 28, Redrado, “Death as a (Ph 2:21). dwelling among them and they Teaching Chair for Life” shall be his people, and He, no. 32, Monge, “Suffering in Ill- ness” 6. Christ Has Risen God-with-them. And he will * Labor Hospitalaria: dry every tear from their eyes, nos. 225-226 (special issue on life Pain—that is, illnesses, and there shall no longer be and death) wars, hunger, tribulations, death or weeping or outcry or no. 235 (special issue on suffering and a positive approach to it) marginalization, violations, weariness, for the old world 23 JEAN LOUIS BANDOUIN-DANIELLE and death itself—is the result has passed away.’ The one BLONDEAU, La ética ante la muerte y el of a mankind on its way to- seated on the throne then said, derecho a morir (Barcelona: Herder, wards a conclusion: the resur- ‘Behold. I make all things 1995). 24 Cf. “Action Plan of the Spanish rection, Easter, and triumph new.’” Bishops’ Conference on Euthanasia and for us, too, since Christ rose— Care for a Dignified Death,” Dolentium He is the prelude, advance ful- Rev. JOSÉ L. REDRADO, OH Hominum, no. 14/1990, 58-60. Ed. Desclée. espressione, Ed. 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Introduction health apostolate as it ap- ture with a fresh gaze. At the peared in 1992. We made same time we shall have occa- In recent decades in constructive proposals in the sion to explain what we mean Lebanon there has been no- hope they would be submitted by pastoral care in health, re- table development in the hos- to the General Assembly of call its Christological founda- pital field, especially on ac- Catholic Patriarchs and Bish- tions and canonical underpin- count of the war. To deal with ops in Lebanon so as to give nings, and convey the impor- growing needs, facilities in rise to a Bishops’ Commis- tance of health workers’ mis- the capital have had to multi- sion for Pastoral Care in sion and what suffering repre- ply capacities and equipment; sents for the sick. in the province as well, in the wake of the division of the country, numerous buildings The Pastoral Ministry have been constructed, in- and the Ministry of Healing 27 cluding some endowed with advanced apparatuses and After his resurrection, when services—scanner and IRM, appearing alongside the Lake renal dialysis, heart surgery, of Tiberius, Jesus entrusted a and radiotherapy. pastoral ministry to Peter, In the face of such techno- saying, “Feed my lambs” and logical progress, in spite of “Feed my sheep.”5 And the the collapse in values affect- same ministry was entrusted ing various areas, we must by Jesus Himself to the other ask ourselves if there has Apostles, when He appeared been analogous moral and to them while they were eat- spiritual progress, whereas ing and said, “Go throughout the ethical problems related to the world and preach the handicaps, euthanasia, and Gospel to every creature.”6 abortion, assisted procreation, But at the same time, precise- and so many other difficult ly to stress his great love for questions always regarded as those suffering, Jesus also en- exclusive prerogatives of the trusted to his Apostles a sec- West are more and more ex- ond ministry by telling them cruciating and pressing. to work miracles in his name: In November 1995, in “They shall lay their hands on Beirut, at the initiative of the Health. Only eight years later the sick, and these shall be UN Association in Lebanon the Great Jubilee of the Year healed.”7 and the International Union 2000 was to be held, with the These ministries later be- for Peace and Human Rights, invitation for Christian re- came the task of the Church, a seminar was organized on newal of apostolic commit- described by the Second Vati- Medical Bioethics and Hu- ment. We are thus in the heart can Council as the “Universal man Rights,1 in collaboration of preparation for the Third Sacrament of Salvation.”8 The with the Medical Association, Christian Millennium. The Church acts, then, “by bear- WHO, and the National Church looks with confidence ing witness to and at the same Council for Scientific Re- at the events of our time and time putting into practice the search. Numerous local and among “the signs of hope at mystery of God’s love for international personalities this close of the century,”3 man,” as affirmed by the Pas- took part in this meeting, sen- recognizes the progress “of toral Constitution on the sitizing health workers, ju- science and technology, and Church in the Modern World.9 rists, and public opinion to the especially medicine, in the To carry forward her pastoral bioethical problems which the service of human life.”4 and healing ministries, the healthcare ministry sought to It would thus be timely, Church has received charis- clarify during this Christian now that peace has returned to matic gifts from the Holy encounter. Lebanon, to draw up a bal- Spirit to convey to each of the In a prior commentary,2 in ance sheet on the road trav- faithful: “Jews or Greeks, the light of research on eled so as to discuss the cur- slaves or free men, and we thirty-eight hospitals, we re- rent state of the health min- have all drunk from a single constructed the picture of the istry and look towards the fu- Spirit” and form “the Mysti- cal Body of Christ.”10 St. Paul opening address at the First spect for human dignity (cc. teaches us, “Now you are the National Medical and Hospi- 96 and 618), which must be body of Christ and his mem- tal Congress in Beirut, “the safeguarded in man’s basic bers, each in his own role. story of hospital care in rights (c. 747-2), freedom (c. God has thus established Lebanon has always drawn 768-2), and need for integral some in the Church as apos- inspiration from the spirit of training (cc. 795 and 807). tles, first of all, then as missionaries.”14 The Church The safeguarding of human prophets, and thirdly as teach- is present not only in her own life and the physical integrity ers; afterwards there come institutions, but, thanks to the of the person are stressed in miracles, then the gifts of dedication of her religious, canonical penal law, which healing, assistance, and gov- she is also active at most of punishes abortion (c. 1398), erning.”11 the public and private hospi- homicide (1397), and serious Accordingly, in addition to tals connected with the Min- wounding and physical muti- the initial mission of working istry of Health. lations of the individual (cc. for the salvation of souls, a With this involvement, and 1397 and 1336). Special pre- second ministry is entrusted thanks to major efforts to dis- rogatives are granted to hos- to the Church of preserving seminate information, the pital chaplains and priests to bodily health, and therein lies Church is at the forefront in aid the sick, especially those the Christological foundation the health field, in both quan- threatened by death. C. 529-1 for pastoral care in health. establishes the care of the sick and, above all, of the dying as a special duty of parish The Church priests, with the obligation to 28 and Health Care act with great care, showing affectionate, singular charity In his message for the for the dying. Fourth World Day of the Sick In addition, as regards the (February 11, 1996), the Holy elderly, the sick, and those Father states, “Today pastoral caring for them, canonical care in health occupies a lead- legislation is less rigid, but ing place in the Church’s those enjoying good health apostolic work: it has numer- must respect the rules, as re- ous facilities for first aid and called by canons 539, 555-2, hospitalization and takes care 919-3, 167-2, and 930-1/2. of the neediest with attention which is recognized and highly appreciated in the world of The Universal health, thanks to the generous Canonical Structure commitment of many of our brothers in the Episcopate, A year after the Encyclical priests, men and women reli- Salvifici Doloris,16 devoted to gious, and numerous lay peo- the value of suffering for sal- ple who have developed a no- vation, Pope John Paul II ad- table sensitivity to those suf- dressed the Motu Proprio Do- fering.”12 lentium Hominum17 to the The importance of this as- titative and qualitative terms, Christian world, creating a pect of the Church’s mission and precisely for this reason new institution in the Roman is clearly brought out in the she has the right and the duty Curia: the Pontifical Commis- volume13 published by the to speak out for those suffer- sion for Pastoral Assistance to Pontifical Council for Pas- ing, but especially to give im- Health Care Workers, which toral Assistance to Health petus to a policy of education, in 1987 was to become the Care Workers. This volume of prevention, and care to main- Pontifical Council, with the about 1000 pages provides in- tain and recover health, in the Constitution Pastor Bonus,18 formation on 21,757 health name of defense of life and which establishes its aims. facilities located in 12,596 lo- human dignity. These objec- Article 152 calities in 135 countries on tives form part of a series of The Council manifests the five continents where the well-defined rules and canon- Church’s concern for the sick Church is working. They are ical structures. and the help given those de- mainly hospitals (about voted to the sick and the suf- 7000)—that is, 34% of health fering so that the apostolate of facilities belong to the Canonical Rules mercy they bear witness to Church. For the disabled the will respond better to the de- Church has about 1000 reha- In current canonical legisla- mands of the moment. bilitation centers. tion15 we find general rules re- Article 153 In our country, as brought flecting pastoral practice. Ac- 1. The Council is responsi- out by the President of cordingly, human salvation is ble for disseminating the Unions at Private Hospitals, found in the supreme Law Church’s doctrine on the spir- Dr. Faouzi Adaimé, in his (canon 1752), along with re- itual and moral aspects connected with illness and the to these outstanding prelates be sought for and discovered. meaning of human suffering. and the need to situate it with- Pope John Paul II—Cardinal 2. It works with the local in an appropriate canonical Angelini recalled—has stated Churches to provide health structure by devoting a spe- more than once that Lebanon workers with spiritual assis- cial Bishops’ Commission to in this trial is more than a tance in understanding their it. country—it is a Mission and task in the light of Christian Shortly thereafter, Divine Vocation involving dialogue doctrine and enable those Providence inspired Cardinal and human brotherhood. Ser- stimulating pastoral work in Fiorenzo Angelini, President vice provided the sick at hos- this field to have all they need of the Pontifical Council for pitals can also take on a na- to carry out this mission. Pastoral Assistance to Health tional character, then, for it is 3. In different ways it fos- Care Workers, to visit service offered to a whole ters practical and theoretical Lebanon, which he himself people by the Church, with no activities in this area by inter- described as a “martyred land discrimination based on reli- national Catholic organiza- comparable to a patient who gion or nationality. It is a gen- tions, in union with other or- is in the process of being uine apostolate of the Church, ganisms. healed.”21 This visit witnessed of a new evangelization. 4. The Council pays close to the Church’s closeness to Echoing Cardinal Angeli- attention to both legislative and love for her suffering ni’s exhortations, the General and scientific developments Assembly of Catholic Patri- related to health care for the archs and Bishops in Lebanon specific purpose of taking in December 1992 created a them into account in the Pastoral Commission for Church’s pastoral work. Health Care Workers in 29 Lebanon to coordinate the pastoral activities connected The Lebanese with hospitalization and care. Canonical Structure The Most Rev. Emile-Paul Saadé was elected President.22 The first local initiative re- The Pastoral Commission lated to the healthcare min- inaugurated its activity with istry is run by the Lebanese an official Mass on February Assembly of General Superi- 11, 1993, on the occasion of ors of Women’s Religious In- the First World Day of the stitutes, which in September Sick, instituted by Pope John 1992 instituted “a Health Paul II. Minister of Health Commission to study pastoral Marwan Hamadé was in the care at our hospitals,”19 com- front row during the celebra- posed of religious belonging tion, attended by numerous to the main women’s orders in official representatives, both the country: Sr. Lamia Ziadé, religious and lay. of the Maronite Holy Family; The Bishops’ Commission Sr. Wafta Farés, of the Con- immediately set to work by gregation of St. Theresa (later getting in touch with the Di- replaced by Sr. David Bassil); rectors of Catholic hospitals, Sr. Celestine Abou Jaoudé, of children, whether they are in- inviting them to devote atten- the Sisters of the Cross; Sr. valids, disabled, or dimin- tion to the health apostolate at Nouhad Nassar, of the Sacred ished. For Cardinal Angelini, their facilities. The results Hearts; Sr. Mona Nassar; and the sufferings endured by the have been decidedly positive; Rev. Georges Kerbaj, of the Lebanese must serve as an oc- for example, “by putting into Lebanese Maronite Order. casion to regain conscious- practice the recommendations Long before, when a poll ness and reflect on the pro- of the Bishops’ Health Apos- was conducted on the health found meaning of life and tolate Commission, St. apostolate to prepare our the- death, a kind of road they can Joseph’s Hospital of the Sis- ses, we had the honor of inter- set out on to become recon- ters of the Cross arose as a viewing the Most Rev. ciled with God and their service of pastoral care at Roland Abou Jaoudé, Vicar brothers and sisters. Cardinal hospitals. The service consists General of His Beatitude, Angelini on several occasions of direct attention to the sick Maronite Patriarch Habib insisted on the concept that it and their relatives and the Bacha; the Greek Catholic is in suffering that people training of personnel.”23 Metropolitan of Beirut, the learn to know themselves. In Since then it is traditional Most Rev. Paul Matar, then his view, the Lebanese who for the World Day of the Sick President of Lebanese Cari- suffer can discover a point of to be celebrated on February tas; and, finally, Monsignor union, since the suffering 11, coinciding with the feast Antoine Gemayel, Director of Moslems is the same as that of Our Lady of Lourdes (with the Catholic Information Cen- of Christians. And it is pre- Masses and fliers at hospitals, ter.20 We explained the impor- cisely by starting from that articles in the press, and a tance of the health apostolate point that existential unity can booklet published in French and Arabic containing the The Life Ministry which, to defend life, opens Holy Father’s Message for men’s arms and hearts to take this celebration). The sick and In 1995 the Holy See, Christ’s message to every- their relatives are thus guar- through the initiative of the one.”28 anteed spiritual assistance in Pontifical Council for Pas- In addition to providing their human setting and other toral Assistance to Health day-by-day care with the help services, such as liturgical Care Workers,25 published a of sophisticated technological celebrations. The medical Charter for Health Care instruments, medical action corps organizes spiritual re- Workers, a long-awaited text truly possesses inestimable treats every year to sensitize prepared on a multidiscipli- value as service to life. In a administrative and nursing nary basis. This document of- tangible way it manifests personnel and all other pro- fers an organic, exhaustive man’s commitment to his fel- fessionals to pastoral care. It summary of the Church’s po- lows, whether ill or disabled, is in fact necessary to pro- sition on the primary, ab- and represents a form of mote the flowering of volun- solute value of life in general Christian witness. This as- teer lay vocations to this ser- and the life of each human suming responsibility for vice, both inside and outside being. Along the ethical lines physical and moral health re- the medical profession, to of the “ancient Hippocratic quires the active, attentive in- make up for a lack of reli- Oath, which is always applic- volvement of the sick and is gious vocations, for “the har- based on a special interper- vest is abundant, and the sonal relationship. It is the workers, scarce.” meeting place for conscience and trust. 30 The health worker not only The Lay Mission must be competent scientifi- cally, but must contribute Like Christ, the Church abundant generosity, atten- wants to show she is attentive, tion, understanding, involve- respectful, and understanding ment, benevolence, patience, towards those enduring the and dialogue—in short, trial of illness—thanks to the Christian charity. dedication of hospital chap- A patient is not just a clini- lains and the men and women cal case, and providing care is religious present at health fa- not just a matter of safeguard- cilities, but also to the devoting health or healing sick or- ed assistance of the lay people gans, but means total service working within the health to life. “No one may be satis- ministry groups. fied with just attending to an In his Apostolic Letter for organ or an apparatus, but we the Jubilee of the Year 2000, must take responsibility for Pope John Paul II invites us to the whole person,”29 for “the value and “to listen more human being, with his dignity closely to the voice of the and his rights, does not stop Spirit to receive charisms and there—he is radically consti- help lay people.”24 Lay peo- tuted by an ontological identi- ple, both professionals and able,”26 it groups together all ty which is both spiritual and volunteers, display a commit- the complex problems posed physical,” wherein “believers ment to take part in this ser- by the indissoluble link be- recognize the image of vice of the Church by caring tween medicine and Christian God.”30 for their suffering brothers morality and sets forth the For their part, faithful to and sisters. For this purpose characteristics of health pro- their mission, which repre- they must receive specific fessionals and their essential sents a real vocation, health training—theological, pas- duties. In the Encyclical workers, as Good Samaritans, toral, and ecclesial. They Evangelium Vitae, the Holy must devote themselves in must be sustained and guided Father states, “Health person- body and soul to their task, in their mission by the group, nel—doctors, pharmacists, which “requires all their hu- which provides orientation nurses, chaplains, men and manity and for which com- and reflection and to which women religious, administra- plete dedication is demand- they make an original contri- tors, and volunteers—have a ed.”31 In this sense their activ- bution. Following the exam- very specific responsibility. ity constitutes a following of ple of the priests to whom the Their task is to safeguard and the therapeutic charity of health ministry is entrusted— serve human life.”27 Christ, “who went about do- and making the necessary dis- For us this Charter is a tool ing good and healing every- tinctions—they take part in for work and an integral part one,”32 and is addressed to the Life Ministry by virtue of of the initial and final training Christ Himself, present under a special charity. of health workers, “so that the appearance of the sick: “I their witness will be a mani- was sick, and you took care festation of the Church, of me.”33 The pastoral ministry does hospitals reflects the pastoral sign of the love of God—Fa- not, however, end with the involvement of every church ther, Son, and Holy Spirit— sick, but necessarily extends in the diocese. Made up, ide- for the sick and those close to to their families, undergoing a ally, of a chaplain, a religious them; time of constriction, oppres- coordinator, and professional * someone seeking to es- sion, and sorrow during seri- and volunteer lay people, it is tablish a dialogue which may ous operations and under dif- sent by the hierarchy on a become prayer; ficult conditions. Pastoral mission to the sick. It forms * someone concerned about workers must be comforting, part of the Church. creating bonds among the attentive, and a source of sick, health workers, families, hope. and parishes (health workers, A third aspect of the health The Experience for their part, must also com- ministry regards the medical of the Pastoral Team mit themselves to being a link profession and administrative in the chain); and nursing personnel, who It is possible for people to * someone who, if need be, need to be reminded that find their way to salvation accompanies the dying to the everyone must serve the sick, with the help of the members threshold of the new life. not only as a professional du- of the Pastoral Team, who ty, but also out of Christian represent the visage of the charity. We have to find the Requirements for the occasions to set forth for Professional Staff them—in special sessions in the course of annual retreats 1. Certain human qualities and with the help of compe- are needed. 31 tent speakers, as required— * Different levels of bal- the doctrine of the Church on ance are required: physical bioethics in general and on (good health), psychological thorny questions often emerg- (maturity, capacity to control ing in hospital practice—for one’s emotions, and steadi- example, when a therapeutic ness in the face of sickness abortion is not reprehensible; and death), and spiritual (the when cornea, kidney, and ability to nourish one’s faith heart transplants are licit; constantly). when it is proper, with an up- * Other qualities are an right conscience and full ability to listen, spiritual knowledge of the situation, to openness, sensitivity, good disconnect ventilators in cas- sense, discernment, discre- es of irreversible coma; and, tion, generosity, and respect finally, when and how the pa- for all, whoever they may be. tient may licitly be declared * One must be a witness to to be dead. Christ, with a capacity for Profession, vocation, and speaking words of authentic mission are joined in a Christ- faith. ian vision of life. Health 2. It is vital to be able to workers carry out an authen- work in a group, convey the tic therapeutic ministry—they Church through their life, experience of one’s ministry, are “Ministers of Life”34—for mode of being, words, and act as a stimulating influence, to serve life is to serve God gestures. and move from teamwork at through one’s neighbor. In Every team member seeks the hospital to external con- their work they do not act to be texts, such as parishes. alone, but in ecclesial com- * a representative of the 3. One must be familiar munion within the pastoral Church, in keeping with the with the cultural environ- team and in a sanctified place, task of each, as a witness to ments one is sent into—the such as a church or hospital, hope and a sign of the full- world of medical care—and, which is the house of God, as ness of God’s gift, with the without trauma, manage to forcefully and relevantly indi- constant desire to respect the situate oneself in institutions cated by its former name: path, expectations, and needs (hospitals or other health fa- “Shelter of God.” of every patient; cilities). * a listening presence, pa- 4. One must be an envoy of tiently agreeing to give every the Church, feel called to this The Health suffering person a hearing; pastoral service, and speak Ministry Team * someone who lends a and act on behalf of the hand to the sick, going out to Church, in the spirit of the As part of the health min- meet them with gestures of Second Vatican Council. istry, under the authority of friendship and restoring hope 5. One must accept initial the diocesan delegate and and the will to live, if neces- and thorough training in guided by the Bishops’ Com- sary; terms of human, theological, mission, the Pastoral Team at * an amiable presence, the and spiritual aspects. Prospects for the Jubilee should be easily reached, It is essentially the responsi- of the Year 2000 preferably near the hospital bility of the Bishops’ Com- entrance, and staff should be mission, in collaboration with To start the Third Christian available for any request, in- the proper academic authori- Millennium on the right foot, cluding emergencies or calls ties, to organize two groups the Bishops’ Commission has outside office hours. But in- of training supervisors: first- wished to take advantage of dependence does not mean ly, the professors who deal the three preparatory years isolation. This office must in with theoretical subjects such for the Great Jubilee of the fact act at all times in close as theology, liturgy, and psy- Year 2000, just as described collaboration with other hos- chology in terms of the health in the Encyclical Tertio Mil- pital departments, and that re- ministry (in Lebanon there lennio Adveniente, to pro- quires mutual esteem for the are sufficient people with this mote the healthcare ministry role of each to build a com- competence); secondly, the in Lebanon. For 1997 it has munity giving top priority to group leaders who must con- established an agenda includ- integral care of man. duct meetings and in the end ing the organization of a Na- As regards personnel, the grant certification. It is in the tional Congress, the celebra- office must be animated by a latter category that we en- tion of the World Day of the team spirit in pastoral care; counter deficiencies, and Sick, a push to create pastoral ideally, it should be made up there is undoubtedly a need care at hospitals, and the en- for future skilled group lead- couragement of lay participa- ers to get training elsewhere, tion in this service. As for us, particularly in France; when in an Appendix we present a they return, they themselves 32 projected organization chart will select the members of the for the health ministry,35 with pastoral teams according to a specific proposal for orga- clearly defined criteria and nizing the hospital aposto- principles. They will then late.36 have to establish personalized training programs for each group in order to initiate local The Creation of a work in this area. Pastoral Care Department

By their very essence and Training Hospital because of their vocation, Chaplains Catholic hospitals have a special obligation to remind An exemplary training pro- those working at them of gram which Lebanon ought their duty to provide not only to imitate is the one existing excellent medical care for pain the Diocese of Lyon.37 It is tients, but also indispensable adapted to each candidate, al- spiritual care, in recognizing lowing for part-time profes- man’s unitary composition as sional activity. It is sponsored body and soul. academically by the Pastoral Hence the concept of pro- Institute for Religious Studies viding care with a view to- of a chaplain, a religious co- at the Catholic University of wards all of man’s physical, ordinator, a full-time lay as- Lyon, which, in addition to a social, emotional, and spiritu- sistant, and one or more lay University Diploma in Reli- al needs. To give concrete volunteers. The personnel gious Studies, offers a Uni- shape to this ideal, it is neces- should be highly qualified, versity Diploma in Pastoral sary to create a pastoral care since effectiveness cannot be Training. There are similar department at every hospital improvised overnight. Atten- institutes in Paris, Lille, and and ensure that all its aspects tion must also be devoted to Toulouse. In Lebanon acade- are properly considered, as choosing personnel, the req- mic sponsorship will be pro- with all other hospital ser- uisites for pastoral workers, vided by the Liturgy Institute vices, in terms of resources the curriculum for their theo- of the Pontifical Theological and personnel. retical studies, and practical Faculty at the University of Materially, the pastoral care orientation for teamwork, un- the Holy Spirit in Kaslik. department needs indepen- der the guidance of training Studies last two years and dent space for at least two of- supervisors. lead to a University Diploma fices, one for the chaplain and in Pastoral Training. A doc- the other for the remaining toral program could also be personnel. It should be an ap- Training Supervisors created. propriately equipped office, for the Hospital Apostolate Preparatory stage. Candi- especially as regards informa- dates must first of all com- tion systems so as to follow In all training programs the plete a mandatory initial stage up patients and keep records first thing to do is seek out or consisting of a two-month on cases. The office space prepare training supervisors. -long discernment course with eight meetings at a pastoral companied by written re- in the name of Jesus thanks to service. This provides the op- ports. the care given the sick, orien- portunity for both sides to * Supporting volunteer tations on educational aspects evaluate abilities, difficulties, workers and other students. and services in the pastoral and reserves. If results are * Knowledge of the legal ministry. positive, candidates may start conditions applying to chap- 1.1. To expand the efforts the first year of study. lains—their rights and duties of the local Church to develop The first year includes sev- in relation to health facilities. the pastoral ministry. eral fields. * Handling emergency cas- 1.2. To confirm the concept 1. Theoretical studies: dog- es. of medical care for the body matic theology (the Church 4. Personal courses to re- and soul, insisting on the spir- and the Sacraments), moral view training with a view to- itual dimension. theology (human life and wards a position and to ana- 1.3. To encourage the mani- Christian ethics), pastoral lyze the responsibilities of a festation of Christian attitudes training and the educational professional. The purpose is and values at health facilities relationship (psychological to understand the duties of a so as to provide spiritual care. and historical approach), the ministry and to evaluate 1.4. To promote the role of catechetical act, cultures and prospects for working with a religious, involving them di- Christianity. pastoral team at a hospital. rectly in the activities of the 2. Practice in communica- pastoral ministry. tions sciences: techniques for 1.5. To promote the role of working with groups and au- lay people in both the Church diovisual and information and her pastoral ministry. training. 1.6. To encourage profes- 33 3. Practical courses at a sional exchanges among the general hospital (two different religious Congrega- four-month courses) to actions. quire a certain mastery in 2. To develop and apply a dealing with patients. program in pastoral education 4. Theoretical training in at health facilities sponsored the healthcare ministry. or administered by religious. 5. A personal course with 2.1. To furnish those con- the training supervisors to fa- cerned with appropriate infor- cilitate adaptation, observe mation on the proposed pro- progress or problems, and gram. avoid mishaps. 2.1.1. To set forth a concep- 6. Approval of candidates tion of pastoral care based on and a final examination are theoretical principles and required for admission to the clinical practice which in- second year. cludes philosophical and the- The second-year program ological premises oriented to- includes similar subjects con- wards the following. sidered more deeply. * Representatives of the as- 1. More detailed theologi- semblies of General Superiors cal and liturgical studies. involved. 2. Practical courses and in- Training Religious Who * The administrations of the clusion in a pastoral team, Work in the health facilities concerned. with participation in general Health Ministry * The hierarchy. and health ministry meetings 2.1.2. To list the profession- and the activities of the Bish- Through their constant ded- al and personal qualities re- ops’ Commission for the ication to the sick, the reli- quired for those who are to Health Apostolate in gious working at Catholic become ministers of pastoral Lebanon. hospitals have carried out the care. 3. Adaptation to pastoral health apostolate for a long 2.1.3. To clarify the essen- models. time. However, for the sake of tial points for action by the * Pastoral commitment un- renewal, and particularly with pastoral education program. der all aspects, including cat- a view towards training 2.2. To explain the concep- echetical instruction. novices, a special program in tion of the pastoral care min- * Taking part in the sacra- pastoral education is neces- istry to the professionals in- mental ministry. sary for them. volved through briefings and * Taking part in Church visits to health facilities. celebrations. 2.2.1. To work out the con- * Solid relations with hos- Pastoral Education ception of ministry and the pital personnel. Program38 role of health professionals. * Discussion of complex 2.2.2. To deepen the vision cases for ethics. 1. To offer congregations of of ministry for pastoral care. * Preparation and leader- women religious, witnesses to 2.2.3. To discover the de- ship of group sessions, ac- healings which have occurred gree of interest of the persons inclined towards pastoral edu- dure, to constitute an ad- Requirements and Training cation and identify potential vanced group. of Lay People candidates for the training 2.4.4.1. To offer three on Pastoral Teams program. two-hour theoretical classes 2.2.4. To encourage the par- each week. Staff Members ticipation of lay people in the 2.4.4.2. To follow up on 1. Varied human qualities program. participants once a week for are required. 2.3. To create a pilot project about an hour. * Different levels of bal- for initial training. 2.4.4.3. The program ance are required: physical 2.3.1. To select promising should last twelve weeks. (good health), psychological candidates through personal 3. To offer quality pastoral (maturity, capacity to control interviews and consultation service to the sick and their one’s emotions, and steadi- with supervisors and/or reli- relatives and friends through ness in the face of sickness gious superiors. the personnel available at fa- and death), and spiritual (the 2.3.2. To choose personnel cilities sponsored and/or ad- ability to nourish one’s faith destined for meetings in ministered by religious. constantly). places of prayer. 3.1. To help train profes- * Other qualities are an 2.3.2.1. To limit the maxi- sional health ministry depart- ability to listen, spiritual mum number of participants ments at institutions. openness, sensitivity, good to six people. sense, discernment, discre- 2.3.2.2. To select buildings tion, generosity, and respect which are close to each other for all, whoever they may be. training, shifting among them * One must be a witness to 34 on a rotational basis. Christ, with a capacity for 2.3.3. To conduct prelimi- speaking words of authentic nary exercises to test basic faith suited to every circum- theoretical concepts and clini- stance. cal competence. 2. It is vital to be able to 2.3.3.1. To offer hour-long work in a group, convey the theoretical classes twice a experience of one’s ministry, week. act as a stimulating influence, 2.3.3.2. To follow up on and move from teamwork at each participant for at least 45 the hospital to external con- minutes once a week. texts, such as parishes. 2.3.3.3. The program 3. One must be familiar should last eight weeks. with the cultural environ- 2.3.4. To evaluate the pilot ments one is sent into—the program as it evolves. world of medical care—and, 2.4. To begin a broad, on- without trauma, manage to going process of autonomous situate oneself in institutions training. (hospitals or other health fa- 2.4.1. To select capable cilities). candidates through personal 4. One must be an envoy of interviews and consultation the Church, feel called to this with religious superiors, eval- pastoral service, and speak uating participation in the pi- 3.1.1. To ensure the same and act on behalf of the lot project, if possible. financial, personnel, and of- Church, in the spirit of the 2.4.2. To select those des- fice support that other divi- Second Vatican Council. tined for courses in the meet- sions of the facility receive. 5. One must accept initial ing places and limit partici- 3.2. To guarantee a continu- and thorough training in pants to eight people. ous education program in terms of human, theological, 2.4.3. To conduct interme- three stages for those being and spiritual aspects. diate-level exercises on theo- trained—initial, intermediate, This training takes place ry and practice. and advanced. through the aforementioned 2.4.3.1. To offer 90-minute 3.3. To offer individual su- program for religious. theoretical classes twice a pervision and the chance to week. take part in seminars with Volunteers 2.4.3.2. To follow up on those who have completed the 1. Volunteers ensure visits participants once a week for advanced level and do pas- to the sick and, according to at least an hour. toral work. chaplains’ needs, help with 2.4.3.3. To carry out super- 3.4. To encourage gifted celebrations. In whatever ac- vision of the group being students to continue more ad- tivity they perform, constancy trained once a week for at vanced studies in other coun- is vital for both the group and least an hour. tries. the people who meet. A 2.4.3.4. The training pro- 3.4.1. To guarantee compe- half-day once or twice a week gram should last twelve tence and professional stabili- seems sufficient to consoli- weeks. ty in the future, as regards ed- date their involvement and 2.4.4. With the same proce- ucation and practice. avoid their taking on roles which are excessively impor- Christ in the essence of his tium Millennium Adveniente, 46. 4 Ibid. tant. life. 5 Jn 21:15-16. 2. Volunteers must neces- * A challenge to become 6 Mk 16:15. sarily attend group meetings. reconciled with others. 7 Mk 16:18. 8 Dogmatic Constitution Lumen A staff member should over- * A challenge to bear wit- Gentium, 48. see them and establish the ness to faith serenely, even in 9 Gaudium et Spes, 45,1. time to be devoted to meet- difficult moments. 10 1 Co 12:13. 11 1 Co 12:27-28. ings. * A challenge to identify 12 John Paul II’s Message for the 3. The health ministry ac- oneself increasingly with Je- Fourth World Day of the Sick (February tivities should be explained to sus Christ, in redeeming ac- 11, 1996), published by the Bishops’ Commission for the Health Ministry in volunteers and staff to the ex- tion for the coming of a new Lebanon, p. 5. tent that they are affected. humanity. 13 INDEX—Ecclesiae Instituta Vale- This participation should be tudini Fovendae Toto Orbe Terrarum, second edition (Vatican City, 1994). stressed to supersede the 14 JOSEPH PARES, Hospitalization in group concept and enter into a Conclusions Lebanon: Current Situation and broader perspective concern- Prospects (Lebanese University Publi- cations, 1987), p. 11. ing the Church. Finally, thanks to the 15 Apostolic Constitution Sacrae Dis- 4. Volunteers visit patients healthcare ministry in ciplina (January 25, 1983). who may present difficulties. Lebanon, in this period pre- 16 L’Osservatore Romano, February 14, 1984, 5-11. Good will is not enough. It is ceding the Jubilee, and to the 17 L’Osservatore Romano, February thus indispensable for staff stimulus of the Bishops’ 19, 1985. members to give volunteers Commission, the sick can 18 Dolentium Hominum, no. 8 (1988), 5. basic training which provides take on their sufferings and 19 Circular of September 22, 1996 of necessary insights. offer them, together with the Lebanese Assembly of General Su- 35 Training should be com- Christ’s, for the redemption periors of Women’s Religious Insti- tutes. pleted before work is begun. of the world, knowing that 20 Sr. Celestine Abou Jaoude, op. cit., Different kinds of training suffering, like the Cross, must pp. 371-377. may be offered according to never be a sign of defeat, but 21 Ibid., pp. 399-405. 22 Final Statement of the 1992 Ses- personal needs (liturgy and of victory. It recalls man’s sion of the Assembly of Catholic Patri- other courses). fragility and opens horizons archs and Bishops in Lebanon. If financial considerations embracing the infinite and the 23 Circular no. 95/152 of Mother Arzé Gemayel, Superior General of the Sis- should arise, they must be dis- transcendent; it spiritualizes, ters of the Cross and Mother Jannette cussed with the group and the forcing people to deal with Abou Abdallah, Superior of St. Bishops’ Commission. everyday reality to arrive at Joseph’s Hospital, August 31, 1995. 24 JOHN PAUL II, Apostolic Letter Ter- More specific training the eternal. It must become tio Millennio Adveniente, 46. should form part of general, the beacon of a new confi- 25 The Pontifical Council for Pastoral Assistance to Health Care Workers, ongoing training and emerges dence enabling everything to Charter for Health Care Workers (Vat- from the ordinary group be seen in a new light, the ican City, 1996). meetings and special study light of hope and the Resur- 26 JOHN PAUL II, Encyclical Evangeli- um Vitae, no. 28. days. rection. 27 Ibid. 28 CARDINAL FIORENZO ANGELINI, In- Sr. CELESTINE ABOU troduction to The Charter for Health Care Workers. Suffering and the JAOUDÉ 29 Liturgy Institute of the John Paul II’s Message to the Meaning of Life World Congress of Catholic Pontifical Theological Faculty Physicians, in Insegnamenti, V/3, p. at Holy Spirit University 673, no. 4. In conclusion, we ought to in Kaslik, Lebanon 30 John Paul II’s Address for the insist on the query recurring Blessing of the First Brick at the Bio- in dialogue between patients medical Center of the University of the Sacred Heart in Campobasso, Dolen- and the healthcare minister: tium Hominum, no. 30, 10/1995, 18. Why does God, who is infi- 31 John Paul II’s Message to Partici- nite love, allow suffering and pants in the Medical Congress on the Care of Tumors, in Insegnamenti, V/1, death? In the face of this p. 698. question, Camus replied that 32 Ac 10:38. the world is absurd and that 33 Mt 25:31. 34 John Paul II’s Message to the Per- suicide is the most logical so- sonnel at the St. John of God Brothers’ lution. Hospital, in Insegnamenti, I, p. 437. Christian patients, on the 35 Appendix I, Proposed Organization Chart for the Healthcare Ministry in other hand, ask about the Lebanon. challenge posed by pain, as Notes 36 Appendix II, Proposed Organiza- Vitor Pinto explains.39 tion Chart for the Hospital Apostolate. 1 R. SACY, “Why a Seminar on Med- 37 Rev. Souchon-Champagne, Train- * A challenge to reconsider ical Bioethics and Human Rights?” ing Hospital Chaplains, A Circular of life in the light of a new Lebanese Medical Journal, vol. 8, no. 1 the Diocese of Lyon (February 1992) Gospel reality. (January 1996), 1. and Diary of Studies of the Catholic 2 SISTER CELESTINE ABOU JAOUDE, University of Lyon 1994-1995. * A challenge to change “The Health Ministry and Its Prospects: 38 We have adopted the pastoral edu- one’s attitude towards earthly The Case of Lebanon,” Doctoral Thesis cation program begun by Sr. Maureen material goods and other peo- in Liturgy, Pontifical Theological Fac- Grady. ulty, University of the Holy Spirit 39 Rev. VITOR PINTO, “Suffering and ple. (Kaslik, 1993), 500 pages. the Meaning of Life,” Dolentium * A challenge to rediscover 3 JOHN PAUL II, Apostolic Letter Ter- Hominum, no. 28 (1995), 116-121. What Should Be Done About AIDS?

Introduction AIDS victims, have the right While awaiting the appear- to be treated with love and ance of an effective cure for AIDS is an infectious dis- mercy. Jesus, the Good this disease, we must concen- ease with a 100% mortality Samaritan of Mankind, trate our efforts on educating rate, caused by a virus which would have received and and informing the population attacks the human immune cared for them with the same on prevention. It is necessary system (HIV) and provokes love He showed for the lepers for information to be dissemi- the progressive destruction of who came to Him (Mt 8:1-4). nated prudently and responsi- T4 lymphocytes, which are AIDS patients must not be bly to avoid ungrounded cer- only one variety of the nu- the victims of prejudice, tainties or fears. The sick, merous white globules whose wrath, recrimination, rejec- too, will be asked to do task is to defend the human tion, isolation, injustice, or everything possible to avoid body from infections (bacte- condemnation. The challenge the spread of the disease by 36 ria, other viruses, mycoses, adopting a responsible atti- parasites, etc.). tude. Thanks to education WHO estimates that the in- and accurate information, dividuals infected with HIV men will change their sexual number between eight and behavior. To insist on the use ten million and there will be of condoms is pure illusion. between fifteen and twenty Indeed, by limiting ourselves million in the year 2000. to this measure or insisting on HIV has been isolated in it more than is proper, we most biological fluids. In our shall arrive at the mistaken countries, however, the most conviction that by virtue of frequent routes of infection the condom the risks of infec- are the following. tion are eliminated and that it 1. Sexual relations, in is thus unnecessary to modify 80-85% of the cases. one’s sexual behavior, the 2. Blood and its deriva- primary cause of infection. tives. This way of acting could 3. Mother-child vertical instill into people—the transmission. young, above all—negative 4. Organ transplants. behavior leading to social de- structiveness. Out of their el- posed today for those of us ement and generally disori- What Does who are disciples of Christ is ented, at the mercy of all the the Church Say? to imitate the Risen Lord to easy pleasures offered by the deal with and uncover the city, the young people of our Fear of infection is normal, deep meaning of contempo- country find themselves with- if we consider the number of rary events, whether they be out a reference point, spurred the sick and of the seroposi- joyful or painful. towards unhealthy dreams tive, above all. It is extremely The presence of AIDS in and pleasures, for the addi- important to know how the the world and in our country tional reason that in most cas- disease is transmitted to is an event we should all ask es parents have forgotten avoid panic reactions and ourselves about which ought their role as educators. The keep the sick from being mar- to lead us towards human sol- street has taken their place. ginalized. To take precautions idarity. We must all fight un- The socioeconomic and is legitimate to avoid an un- reservedly against AIDS, not cultural crises have only necessary risk of contracting against its victims. Our faith made things worse. Unem- the virus, just as it is our duty leads us to believe that in ployment has hit all sectors. to avoid its propagation. But God’s design men, thanks to The poor have become poor- we must always act with their commitment and intelli- er, and indigence has spread awareness of human dignity gence, when moved by a sen- into the most vulnerable ar- and the needs of the sick to timent of human solidarity eas. Some parents have prevent the creation of humil- and assisted by divine grace, pushed children and adoles- iating situations for them. will overcome this malady, as cents to beg in the streets to From a Christian stand- they have overcome many meet the families’ daily point, all the sick, including others in the course of history. needs. Some girls have had no choice but to abandon Church only teaches us to be ganized talks and debates on themselves to prostitution in more human. But this does AIDS at all the parishes in the order to go on studying. Sex- not mean that it is easy to put Archdiocese of Brazzaville, ual relations are increasingly this teaching into practice, working in close collabora- frequent and early among the since we have our instinct tion with PNLS and other young. and are pushed by obscure NGOs. We have always in- Individualism is on the forces we are unable to mas- sisted on focusing greater at- rampage, and charity is less ter spurring us to make ges- tention on the Congolese and less visible. Community tures needed for our lives. Church, but without results. responses to social needs are The true and only effective Accordingly, after the first rare. Poverty has given rise to form of care remains educa- stage, we felt the need to cre- notable changes in Congolese tion which helps human be- ate authentic pastoral care for society, changes with an im- ings to grow towards emo- the sick, a collective aware- pact on the conscience of tional and sexual maturity. ness which is arising in our men whose conduct was ap- The Catholic Church, Church. Few families can say parently normal. The Congo thanks to a religious tradition they have not lost a relative, has not managed to consoli- and a philosophy of the hu- friend, or acquaintance on ac- date a clear moral model ca- man person which are consis- count of this terrible illness. pable of edifying its people, tent with one another, be- But to believe in Jesus especially the young, victims lieves that the best prevention without adopting adequate of the influence of the street for individuals and society measures does not protect and the media. can come only from authen- people from HIV. Nowadays in our society tic, complete knowledge of Caring for AIDS victims is individual efforts aimed at not a simple matter, in view 37 good conduct, morality, in- of the peculiarities of this tegrity, faithfulness, chastity, malady. There are no vac- decorum, and virginity until cines. The medicines which marriage are the object of de- relief sufferings are not with- rision, and those who still in reach of the Congolese. practice them are thus regard- Moreover, the illness contin- ed as mentally retarded and ues for a long time, and about eccentric. Parents who live 90% of the cases have arisen according to the Gospel or a in intimate relations. moral code and who truly We must be Good Samari- want to educate their children tans in the image of Christ. feel threatened by the reality Jesus received lepers, regard- of life in the streets and ed by the people as accursed, quashed by groups and the punished by God for sins media. committed. We, too, have to The Congolese Church was receive and comfort all bear- the first to mobilize with ing the burden of disease. GES, organizing sessions for We must thus console fam- AIDS education and informa- ilies by supporting them with tion in all the parishes of the our love so that they can help Archdiocese of Brazzaville in the human being and sexuali- their sick relatives. March and April 1986. ty. Finally, efforts should be In the face of this pandemic included to discover and eliminate the causes of the affecting good, talented, and Aims productive young people and contamination of blood and its derivatives. putting our development and 1. Each of us must take his The Church firmly believes health skills to the test, the or her place in the fight that to curb the disease it is Church has always proposed against AIDS. All our pastors necessary to educate and a healthy lifestyle for men as are called to be familiar with modify human behavior. All a positive ideal. The aim of AIDS to combat it decisively other paths would prove to be Church teaching is thus not to and talk about it with preci- only uncertain and, in the place us in chains, “but, on sion and security, without end, ineffective, thereby trivi- the contrary, to free us.” shame. The teaching of the Church alizing the form of sexuality is comparable to the railings which already prevails in our 2. The Church must create of a bridge intended to keep country. occasions for dialogue, ex- us from falling into a river. At change, sensitivity, relief, and heart nothing which is truly spiritual support where the human can be against faith What Should seropositive can meet and at- and nothing which is Christ- the Church Do? tend educational sessions, ian can be against man. God with professional and artistic cannot contradict Himself In March and April 1986 training and, hopefully, the and give man principles con- the Church first mobilized on chance for recreational activi- trary to the divine design. The this issue. The GES in fact or- ties. 3. At every parish small capacity. All Catholic health Conclusions care units, managed by ES facilities do not belong to the and not the parish GES, must GES, but they bear witness to Suffering remains a mys- be created. the teachings of the Church. tery, but gives us a major les- Everything is entrusted to son on life. AIDS is certainly 4. There must be estab- health facilities, as if reli- giving us a lesson today and lished centers for attention gious centers did not exist. obliges each individual to re- and day care staffed by social There are so few that they are flect and examine his or her and health workers, with free unable to modify the course heart; and every community service for the poorest and of the social and medical fa- is asked to become aware and minimum fees for other pa- cilities and have no influence review its culture. tients. At the same time it is on organization or choices in AIDS enables us to evalu- necessary to organize the do- care. Their commitment to ate both the strength and the nation and distribution of witnessing to Christ and man- weakness of man. food, pharmaceutical prod- ifesting their compassion of- It is a great lesson on life, ucts, clothing, and other con- ten goes unnoticed, discredit- for, in any event, at the root tributions. ed by the general indiffer- of all human sufferings there 5. Reflection is needed to ence. It is thus urgent for is a ray of hope, a breath of implement a recruitment GES members, helped by all life which will be amplified strategy to find parents for their pastors, to start up a new at all levels by the spirit of AIDS orphans who are left campaign for Catholic social solidarity. alone so as to prevent their and medical workers to ex- * Solidarity among AIDS plain to them that an authen- 38 entry into groups that, for dif- victims and self-confidence. ferent reasons, are living in * Solidarity between the the streets, where they, in community and the organiza- turn, would be marginalized. tion providing hospital and Above all, we must keep home care. them from being stuck away in orphanages. * Solidarity between national and international pro- 6. We must help with prop- jects by publishing ethical er information to take the dra- statements. ma out of AIDS. These experiences of au- The Church, a moral body thentic solidarity will help in- which is respected and lis- dividuals and our community tened to by our society, must to rediscover the true moral create an organization to deal values of traditional Con- with the sexual education of golese society and, therefore, the young and youngest, the way of God and to contin- since for most of our sec- ue to listen to the voice of ondary school students it may God Himself, who says, already be too late. “See. Today I am placing be- Let us seek to protect the fore you life and good, death very young so that in a few and evil, for today I com- years the epidemic will halt. tic health apostolate by the mand you to love the Lord 7. We should train lay Church cannot exist without your God, to walk in his Catholics in the Congo so involvement by all in reflec- ways, and to observe his they will be stronger in faith tion and meditation on the commandments, his laws, and spiritually solid to be- Magisterium. They are not and his norms, so that you come the salt of the earth and asked to abandon the groups may live…” (Dt 30:15-20). It the light of the world and so they belong to, but to take might seem like a hard road that their lives will be a con- part in reflection as Catholic to set out on, for it is not easy tinuous witness. To change professionals. to change our life habits, behavior and transform men- 9. There is need for an or- abandon certain forms of be- talities is fundamental; the ganization to suggest the best havior, and bow our heads. longer we wait to act, the mode of action which em- And just as Noah and his greater the risk is that it will braces all the aspects the sons did in agreeing to board be too late. Church seeks to deal with in the boat before the universal Parents must again become this fight against AIDS. flood, those who have ears to educators—that is, models, hear the voice of the Church living examples for society. 10. Home care should also and face the challenge repre- be promoted to provide a sented by AIDS today will 8. We have no Catholic concrete, immediate response board the boat of St. Peter for hospital that can serve as a on a par with activity by the survival of humanity and hub to take on moral and spir- health workers. the glory of God. itual responsibility for the sick. The GES have often im- Dr. NTARI BENOIT provised according to their National President of the GES Testimony

Religious Assistance Agreement Between the Venezuelan Bishops’ Conference and Public Hospitals

The Course of the Healthcare Ministry in Peru, 1988-1996

Congo: Bases for Creating a Bishop’s Commission for the Health Ministry Religious Assistance Agreement Between the Venezuelan Bishops’ Conference and Public Hospitals

The Venezuelan Govern- Religious Assistance Service beds: two full-time chaplains. ment, represented on this oc- and Its Coordination with Hospitals with 500 to 800 casion by the Minister of Other Hospital Services. The beds: three full-time chap- Health and Social Welfare, administration of the hospi- lains. Dr. Pedro Rincón Gutiérrez, tals included in this agree- and the Catholic Church in ment may determine along 5. On the Cessation of Ac- Venezuela, represented on with the proper Catholic ec- tivity by Priests Named as this occasion by the President clesiastical authorities the Chaplains at Hospitals. The of the Bishops’ Conference, forms and terms of detailed priests appointed as chaplains the Most Rev. Tulio Manuel regulations for the Catholic may cease in their functions Chirivella, Archbishop of religious assistance service, by their own decision, by the Barquisimeto, have decided which in any event shall be decision of the corresponding to draw up this Religious As- conducted in thoroughgoing ecclesiastical authority, or by 40 sistance Agreement, based on coordination with other hos- unilateral termination of the the provision contained in pital services. To this end, the work contract through the de- Article 65 of the Constitution hospital administration shall cision of the institution gov- of the Republic which guar- provide the Catholic religious erning the hospital at which antees freedom of worship assistance service with the Catholic religious assistance and consisting of the follow- necessary means to carry out is being provided. In the latter ing clauses. its mission and shall collabo- two cases, before cessation rate with appropriate infor- takes place, the parties in- 1. On the Purpose of the mation on patients in particu- volved shall be duly notified Agreement. The purpose of lar. so as to provide for a replace- this agreement is to guarantee ment and adopt the necessary religious assistance for 4. On Naming Priests work-related measures in ac- Catholic citizens hospitalized Chaplains of the Religious cordance with law and ap- at public health facilities in Assistance Service and Their plicable norms. Venezuela, for Catholic per- Compensation. The priests sonnel working at them, and responsible for Catholic reli- 6. On Financing the Reli- for the members of their fam- gious assistance at the afore- gious Assistance Service. The ilies. mentioned hospitals shall be Venezuelan Government, by designated by the local Ordi- way of necessary budget al- 2. On the Religious Assis- naries and appointed chap- lotments, shall be responsible tance Service. In order to en- lains at the hospitals to which for financing Catholic reli- sure religious assistance at this agreement refers. The gious assistance at the hospi- the aforementioned hospitals, hospital administration in tals included in this agree- there shall be a Catholic reli- question shall take the neces- ment. To this end, the Gov- gious assistance service at sary steps to include the ernment shall transfer the each of them directed by a chaplain on its staff for the necessary funds to the corre- priest in collaboration with purposes of remuneration, in sponding Health Administra- Catholic volunteers who keeping with the time he de- tion to ensure the functioning complete this service in a votes to this work, and ac- of the Catholic religious as- suitable way. The Catholic re- cording to the same terms and sistance service in the terms ligious assistance service conditions applying to other specified in the second clause shall have adequate space hospital employees. of this agreement and adopt available, including a chapel, The minimum number of the work-related measures an office, a bedroom where chaplains responsible for pro- mentioned in the fourth the chaplain can rest or spend viding Catholic religious as- clause. the night, and a bathroom. sistance at public hospitals The opening or closing of shall be determined by the 7. On the Regulation of public hospitals shall entail number of beds they have Cases of Transfer of the Na- the establishment or suppres- available, according to the tional Public Health Service. sion, as the case may be, of following criteria. Given the nature of the ser- the Catholic religious assis- Hospitals with up to 100 vice referred to in this agree- tance service, with its person- beds: one part-time chaplain. ment and its necessary con- nel, resources, and rooms. Hospitals with 100 to 250 nection with the public health beds: one full-time chaplain. service, in the context of the 3. On the Regulation of the Hospitals with 250 to 500 concurrent responsibilities established by the Constitu- The provisions of this In order to guarantee the uni- tion of the Republic and in agreement shall serve as stan- ty of regulations and the effi- accordance with the proce- dard norms for other agree- cient functioning of Venezue- dures indicated by the Organ- ments with other levels of the lan public hospitals, the pro- ic Law for Decentralization, Venezuelan Public Adminis- visions in this agreement Delimitation, and Transfer of tration in cases of already-im- shall be incorporated into the Public Responsibilities, in plemented transfer of the statutes and norms governing cases of transfer of the public public health service to other such hospitals. health service which affect governmental jurisdictions or this agreement, the regula- transfer to a municipal level, [There follows a specifica- tions stipulated by the afore- when legally possible. tion on when the agreement is mentioned Organic Law for to be put into effect.] such cases shall be applied 8. On the Unity of Provi- according to the terms of Ar- sions Regulating the Func- General Secretariat ticle 6 in the latter. tioning of Public Hospitals. Venezuelan Bishops’ Conference

41 The Course of the Healthcare Ministry in Peru, 1988-1996

THE CHURCH AT THE fessionals, technicians, and structuring and strengthening SERVICE OF LIFE many volunteers in Peru’s the different efforts already in cities and rural areas. Ex- existence. The health apostolate in Pe- changing experiences has per- Those working at DEPAS ru is becoming consolidated. mitted their mutual enrich- see such efforts as a move- It was in 1980 that the Bish- ment. DEPAS, in addition to ment to endow their health ops’ Commission for Social promoting exchanges, con- work with Gospel meaning. Action (CEAS) took the first tributes to disseminating ma- There are common orienta- steps to shape health activities terial and all kinds of tions for activity which are nationally. In 1988, encour- health-related information. progressively arising and be- aged by the Motu Proprio Do- One favorable aspect here is coming consolidated. There is lentium Hominum, the Peru- the communication existing then reflection on the integral vian Bishops created the De- between the Lima office and vision of health—that is, con- 42 partment for Pastoral Care in other church jurisdictions, es- cerning healthy living condi- Health (DEPAS). pecially on a regional level. tions, love for the excluded, health as the responsibility of everyone, solidarity and the To Evangelize Peru on the Move defense of life, the mystical the World Of Health dimension of the health apos- At present the health min- tolate, the varied aspects of Today, more than in the istry is active in almost the this ministry, and health in re- past, the healthcare ministry in whole country and has visited lation to Christian commit- Peru is encouraging reflection 78% of the Dioceses. A good ment. based on faith by pastoral many local health teams func- workers in this field so as to tion autonomously. Among deepen their Gospel commit- forty-one church jurisdictions, To Care for Life Together ment and also promote ex- twenty-six have their own changes, coordination, and leaders and functioning dioce- When we speak of institu- structuring of the health apos- san teams, which always take tional advances, it must be tolate as part of overall pas- part in official events. There stressed that there is now toral care. Its presence is thus are twelve other dioceses greater knowledge and recog- growing in the different Dio- which are not always present nition of the health ministry, ceses in the country. It seeks to and are not in frequent com- not only in Church institu- stimulate, advise, and accom- munication, though they are tions, but also in others, such pany health work and fortify known to have significant as the Ministry of Health local, regional, and national health activities. In only four (MINSA), the Peruvian Social organization. In this way there dioceses is communication Security Institute (IPSS), and is a gradual creation or renew- with DEPAS almost complete- NGOs. The coordination of al of areas and action attempt- ly lacking. this activity in relation to the ing to foster insight into the At this time there is an inte- government is reflected in cer- task of evangelizing and hu- gral vision of pastoral care in tain agreements—for instance, manizing the world of health. health nourished by CELAM those signed by MINSA and In recent years there have documents and the reflections several dioceses to strengthen been significant advances in and texts prepared by those local work. In addition, in dif- organization. The structuring working at DEPAS, particular- ferent areas of the Church and strengthening of the ly as regards three substantive there is now greater attention health ministry almost every- dimensions: 1) solidarity and to and desire for familiarity where in the country have mercy (the accompaniment of with the health ministry. In been achieved. Acceptance the sick), 2) transformation of some dioceses those responsi- and participation by pastoral the community, and 3) policy ble for this ministry are also workers at meetings or train- and institutions. The action, invited to take part in the ing sessions held in Peru have services, and initiatives of the diocesan meetings called by been very positive. There is al- Church in health care are situ- the Bishop. ways generosity, good humor, ated in one or another of these With this positive wish to and involvement among those dimensions, without becom- humanize health care, in re- who make possible the fur- ing isolated, but seeking to be cent years significant channels therance of this apostolate: part of a whole, while respect- for training health profession- women religious, priests, pro- ing their peculiarities and als—nurses, doctors, social workers, and administrative sume responsibility. There are small percentage of Peruvians personnel—have been creat- also cases in which a lack of (10-15%) live in opulent con- ed. They have considered top- financing has frustrated the re- ditions, the rest struggle to ics relating to bioethics, or alization of planned activities. survive in extreme poverty. “the ethics of life,” emphasiz- In spite of reverses, we must Even official statistics show ing that human values and re- go on strengthening and ex- that 50% of Peruvians are in a lations are at the service of panding the health apostolate state of poverty and about six life, health, and the sick. There on a local, diocesan, regional, million Peruvians live in ex- has also been a notable de- and national level and also co- treme poverty. Obviously, in mand for material, talks, and ordinating some activities these population groups basic lectures on these subjects, for with seminaries and institutes needs are not met. events organized by the public for religious formation to Historically, then, there is a health authorities as well. make the health ministry bet- social, economic, and political In 1996, the health ministry ter known—what it consists deprivation which has given entered more decisively into of, along with its scope, di- rise to a “health debt” as re- the area of bioethics in a Latin mensions, and contributions. gards large sectors of the Peru- American perspective, consid- It would be good to promote a vian population which has not ering the challenges posed for day for hospital chaplains so yet been paid and has tended countries like Peru and bear- they can share their pastoral to grow in recent years as a re- ing in mind not only the ethi- experience and enrich their sult of the neoliberal policy cal problems in technological lives. It is imperative to re- pervading the sphere of our advances, but also the con- mind public opinion of the Latin American countries, crete situation of poverty in persons or patients who, as a with adverse effects on the which millions of our brothers result of their condition or sit- majority of people. 43 and sisters live, and the ongo- uation, are excluded by soci- ing deterioration of the envi- ety: the elderly, the psychiatri- The Social ronment, the Creation. cally disturbed, tuberculosis and Medical Situation We observe, then, the con- patients, and AIDS and UTA solidation of a national health victims, etc. Love and mercy “Health promoters” have ministry network whose mem- towards them must be promot- arisen as a response by the bers support one another. It is ed. people to the country’s health a network mainly composed As we see, the health min- problems, mainly because of of lay pastoral workers with istry has a lot to do with the the difficulties of the rural great dedication and commit- poverty afflicting our Peru. poor, who lack access to pub- ment who take on new respon- The precarious living condi- lic medical services. sibilities and seek to build up tions characterizing most Pe- Church identity through health ruvians make this ministry Epidemiological Picture care. seem three times as challeng- In cities and rural areas in- ing. But those working in it fectious diseases persist which have faith and take on these have defied urban “modern- Challenged to Grow in a challenges with great security. ization.” The significance of Worthy and Healthy Way They know they must be alert tuberculosis in morbidity and to any eventuality which may mortality cannot be over- Though there have been affect the health of those who looked, in spite of efforts to some results in this trajectory, have least, such as privatiza- maintain an efficient National there is still a long way to go. tion, health reform, develop- Control Program, since the so- For example, there must be in- ments in social security, or in- cial causes of this illness— sistence on the need to main- human sterilization cam- particularly poverty—exceed tain a registry with complete, paigns. The Church is and will the possibilities of health man- updated information on the always remain at the service agement. Church’s contribution to the of human life and dignity. The reappearance of health of our people. Doing so pathologies which seemed to will require dedicating more Lima, January 1997 have been overcome—the first time and human and economic signs of malaria, constantly on resource. the increase in recent years, We must recognize that in with the additional difficulty the ecclesiastical jurisdictions of the spreading of malignant there are different levels of de- HEALTH PROMOTERS malaria, caused by plasmodi- velopment of the health min- SERVING um falciparum; an increased istry. We need to encourage THE COMMUNITY: incidence of breakbone fever; one another to grow. Some ju- THE PERUVIAN periodic outbreaks of bubonic risdictions have more stable EXPERIENCE plague, yellow fever, hepatitis, teams than others, and some and other diseases; and an in- have more support than others. 1. Introduction creased incidence of leishma- There are a certain number of niasis (UTA). jurisdictions where until the It is not exaggerated to say The 1991 cholera epidemic present there has been no one that the history of our country was a warning regarding the named by the Bishop to as- is full of inequities. Whereas a epidemiological retrogression fostered by the economic, so- ist in its infrastructure and hu- health service in the commu- cial, and health crisis. This man and economic re- nities in which they live. damage has not disappeared sources—with a very low bud- They are chosen by the and is a constant threat, given get constantly imposing choic- community. They say they the deficiencies in basic sani- es among different needs and must be “affectionate, human- tation we still have to deal fostering priorities based on itarian, called to service, un- with. investment criteria and pro- selfish, endowed with imagi- Infant mortality and malnu- ductivity in care while exclud- nation and creativity, and able trition are still worrisome, in ing the weakest, who are un- to work hopefully and joyful- spite of a 50% reduction in in- able to pay for services not in- ly” (cf. Health Promoter Pro- fant mortality over the last cluded in the “basic package” gram in the Diocese of twenty years—estimated to offered free by MINSA (cov- Chachapoyas). average 58.3 per 1000 live ering diarrheas, acute respira- They work unselfishly as births in 1993 and not only tory infections, tuberculosis, volunteers, with generous ser- still high, but unequal (102 per malaria, and vaccines). vice, stimulating involvement 1000 in Apurimac and 24 per In rural areas and low-in- and fostering people’s own re- 1000 in the Province of Lima). come urban districts, poverty sponsibility for health. They The national average for blocks access to care for most. encourage others to improve chronic malnutrition among To this factor there are added living conditions with the help children between six and nine the problem of distance, a lack of the community’s human re- years of age is 49%, according of roads and means of com- sources and institutions. De- to the Talla National Census fending the rights of all, they of Schoolchildren (Ministry of have a critical (and self-criti- 44 Education) in 1993; however, cal) spirit. They deal with hu- malnutrition was 23% for Tac- man realities and draw inspi- na and 71% for Apurimac. ration from the Gospel: “In Acute respiratory infections truth I tell you that whatever are still the main cause of ill- you did to the least of these ness and death in children un- brothers of mine you did to der five. They usually present me” (Mt 25:45). between six and twelve Their service, training, and episodes a year of this kind. dedication are earning them Maternal mortality is still credibility among their neigh- high, at 261 per 100,000 live bors, and on remaining within births, as a result of complica- the community they are be- tions during pregnancy, birth, coming more aware of the fact and confinement (L.P. Salud that it is not just a question of 1995-2000, p. 12). This is re- curing illnesses and are begin- lated to the fact that half of the ning to take on new commit- births are at home and 47% ments and roles to work with take place without profession- community development and al care (Summary of the families. 1991-1992 Demographic and munication, and the popula- The promoter has a Family Health Survey). tion’s customs and beliefs, first-hand grasp of community The first AIDS case was which sometimes conflict with problems because he or she identified in 1983, and there the culture of institutions and experiences them and is also has been a rapid increase. In health workers. aware of the assets and poten- 1993 MINSA estimated there The 1994 National Survey tials that can provide support: were 5000 symptomatic cases on Living Standards found medicinal plants, natural re- and between 30,000 and that about 30% of the popula- sources, customs and aspira- 60,000 bearers, most of them tion was ill and that 67% of tions, people, organizations, young people (Francisco the sick poor had not sought and so on. Sánchez Moreno, Encuesta di- medical assistance; 40.9% of They become community agnóstica, vol. 34, no. 2 the sick who were not poor leaders who, in addition to [March-April 1995], p. 36). had not sought care, either. promoting and caring for The July 1996 bulletin of the health, seek to achieve ad- AIDS and ETS Control Pro- vances for their people and gram reported 4,450 cases 2. Profile of the thus struggle against all forms since 1983. The cases appear- “Health Promoters” of conformity. ing in the interior of the country are increasing, and the These are ordinary men and problem is thus growing. women who, on the basis of 3. Historical Precedents their experience, deep com- Health Services System munity commitment, and Before WHO, in 1978 in This is a heterogeneous sys- Christian faith, seek to defend Alma Ata, urged governments tem (IPSS, FFAA, MINSA, life where it is threatened. and the world community to and the private sector) which They receive general training adopt the strategy of Primary is poorly distributed—central- to prepare and update them for Care to protect and promote people’s health, there were al- have been active since 1971, all: “I have come in order for ready community agencies in and today there is a promoter them to have life and have it in Peru dealing with health prob- network organized into associ- abundance” (Jn 10:10). lems. ations. The presence of the 5.2. Specific Aims Catholic Church in health care a) To provide basic care to has a long history in our coun- 4. The Location those excluded from the offi- try. There are several religious of Experience cial system, by way of health congregations that have been promoters. working for over fifty years in The promoters arose in dif- b) To create awareness of this field, especially with the ferent parts of the country as a the right to health and foster neediest population groups in response to the lack of health active participation in pursu- the most remote parts of the services in many places and ing health. mountain and jungle regions, the material poverty of people. c) To create community where the government health Today, as the conditions origi- health organizations to enable services were lacking—and nating them have continued, the voice of the people to be still are in many cases. the experience has grown and heard and to channel contribu- We do not yet have a sys- become stronger, with suc- tions and requests for help. tematic grasp of the full scope cesses and hindrances, for- d) To foster the integral de- of the health promoter experi- ward and backward move- velopment of communities. ence nationally. There are in- ment. but without ceasing. e) To announce the King- dications that in Puno, in the dom of God through concrete Altiplano region, the Ministry gestures of solidarity with the of Health took the first initia- poor. 45 tives in the 1950s through Dr. Manuel Núñez Buitrón. The training and follow-up 6. Training of promoters as an experience and Follow-Up in our Church has been going for Promoters on for over four decades. For more than forty years the Sis- 6.1. Training ters of the Missionary Compa- Training is integral, perma- ny of Jesus have been working nent, participatory, reality-fo- in the Amazon region, where cused, experiential, practical they began in Santa Marça del from the promoter’s stand- Nieva; they later spread to San point, and progressive. Lorenzo and Santa Rita de It includes the following. Castilla, serving the native * Skills for certain aspects, communities and settlers (De- prevention and cure of dis- partments of Loreto and Yuri- eases frequent in an area, and magnas). The Ursulines have promotion of healthy habits been in the Vicariato de San and living conditions and first José del Amazonas (Depart- At present there are over aid. ment of Loreto) since 1961. 6,700 trained promoters fol- * Knowledge and analysis The Servants of St. Joseph lowed up by pastoral workers of socioeconomic, political, have been in Chiriaco (Ama- in the Catholic Church. They and cultural reality on a local zonas) since 1968, working are in almost the whole na- and national level. with the Aguaruna population. tional territory—in rural areas * Human, Christian, and And many other congrega- and poor city neighborhoods. spiritual training as basic sup- tions have joined them. They 33 out of 41 ecclesiastical ju- port for evangelization soon realized the immensity of risdictions have incorporated through health. the task and, recognizing the the promoter experience into This acquisition of skills is people’s potential, started to their work in health. (The map effected in programmed seek out and train local resi- showing where they are to be courses with advisors and pro- dents to provide basic health found is included in an appen- moters at different levels. services in the community. dix.) Some courses are for training They have thus built up and new promoters, and others, for consolidated their experience updating and reinforcing in training and following-up 5. Objectives them. promoters, other community workers for children’s health, 5.1. General Objective 6.2. Advice, Stimulation, and traditional midwives. To manifest the Lord’s mer- and Follow-Up In the mountains the most ciful love in the midst of the * Visits to villages where ancient experiences are those neediest through action by there are promoters to share of the North Andean region. health promoters to attend to with them and evaluate the The Diocesis of Cajamarca is and advance the health of the work they do. There is instruc- the pioneer. In the Province of poorest, in addition to seeking tion and correction as needed. Bambamarca the promoters worthy living conditions for They are listened to, and doubts are resolved in the * Alertness to health ques- openness to others, and soli- field, with mutual enrichment tions in the community. darity. in the light of experience, sci- * Promotion, management, ence, and communion. and implementation with the 7.4. Management, Training, * Meetings with promoters community of small sanitation and Leadership in villages near the one visit- projects and encouraging the * To mobilize the commu- ed. creation of latrines. nity for shared efforts to ob- * Meetings with all the pro- * Activities to improve nu- tain clean water, campaigns moters in the area or diocese trition and the family econo- against epidemics, days de- to convey experiences, en- my—family and town veg- voted to vaccination, etc., as courage, refresh knowledge, etable gardens, consumption an aid to fomenting solidarity. update, and examine new of local agricultural products, * Teaching and advising tasks. apiculture, picigranjas, and new promoters in training * Regional and national raising small animals. courses and visits. meetings to permit an ex- * To help care for and con- * Implementation and ad- change of experiences, train- serve nature by providing ministration of first aid. ing, strengthening of faith, training in sanitary environ- * Coordination with differ- broadening people’s vision of mental conditions and atten- ent institutions. reality, and dialogue with pro- tion to water, the earth, the air, moters from other places, pro- and forests. 7.5. Evaluation fessionals, and pastoral work- and Follow-Up ers. Work is evaluated, contri- * Visits to converse with butions are made, and orienta- people and promoters on the 46 tions are agreed on for future results of work. activity. * Periodic promoter-evalua- These regional meetings are tion meetings involving com- generally annual; national mittees at different levels. meetings are usually once every two years. 8. Persons Involved

7. Activities * The rural and urban poor. of the Health Promoter * Pastoral workers: religious and lay. 7.1. Attention to the Sick * Promoters and health pro- * First aid and treatment of fessionals. the problems common to the area for which promoters have been trained—e.g., acute res- 9. Resources piratory infections, acute diarrhea, parasitosis, and malaria. 9.1. Human. * Visits to the homes of the Promoters from among the sick and orientation of the 7.3. Promotion rural and urban poor, pastoral family as to care. of Community workers, health professionals, * Identifying people with Development and other skilled persons. TB, UTA, malaria, etc. and * Training local health seeing to it that they get atten- committees. Organizing 9.2. Institutional. tion in the public health ser- health promoter committees Town government, local au- vice. for the area, the department, thorities, religious congrega- and the region. tions, NGOs with a Christian 7.2. Preventing Disease * Holding town assemblies orientation, and others. and Promoting Health to coordinate work with agri- in the Community culture, other government 9.3. Economic. * Taking part in the normal bodies, and NGOs to adminis- Contributions by communi- vaccination program of the ter funds or other benefits for ties (the promoter’s time, Ministry of Health and in Na- the community. lodging for traveling promot- tional Meetings. * To coordinate with town ers, and sometimes trans- * Verifying children’s leaders, other authorities, the portation). NGOs and weight to identify malnutri- parish, the health center or UNICEF, with other interna- tion and orient mothers in care hospital, and others to achieve tional bodies. Contributions of the young. goals. by religious congregations. * Health education in the * To promote local harmo- community: talks and expla- ny and balance, seeking to nations in the language proper start from one’s own family 10. Evaluation and to a given locality. experience, and to develop Follow-Up * Involvement in the health new relations with spouses of Experience campaigns organized by the and children based on dia- Ministry. logue, respect, sharing tasks, Work is reported on at town assemblies and is subject to contributed to lowering high 10.2. Difficulties approval or criticism. There is infant mortality rates, though a) The country’s health evaluation in the field through we cannot measure their ef- problems persist and are visits to communities. There fect precisely. worsening, particularly access is local, regional, and national c) They handle basic sanita- to care by the poor, because of evaluation at meetings. tion in many places: canals for the perverse effect of econom- It is important to point out water, constructions of la- ic policy and the neoliberal that the degree of develop- trines, and community educa- model. ment is variable, depending tion. b) The persistence in some on the length of service and d) Progress in coordination cases of authoritarianism in the kind of advising and sup- with MINSA through agree- health personnel dealing with port that has been available. ments and support in some lo- the public and promoters, The oldest projects are more calities. with little recognition of peo- consolidated, have more ex- e) Organizing communities ple’s real value, which im- perience, and have shaped a and forming networks: associ- pedes genuine participation. local or regional network. ations, health committees, c) Easy-to-use instruments Others are more recent. Some promoters’ committees with must be created so that the have achieved greater autono- legal personnel (regional or promoter can gather data on my and close relations with broader areas). the work done which will sup- MINSA; others are in the f) Developing projects to port dialogue with MINSA. process of doing so. improve the quality of life: d) Distances and a scarcity of means of communication 10.1. Achievements and roads in rural areas. a) More than 6,700 Church e) A fight between values 47 health promoters in coastal, and antivalues as a result of mountain, and jungle areas the economic model—soli- and some local or regional darity vs. individualism— networks. which threatens to weaken or- b) A concrete contribution ganizations. to community health, recog- f) Financial insufficiency nized by the community, local for support of promoters’ authorities, and international work. Some desert because bodies such as UNICEF. they have to work more to survive and lack time. Examples * Significant action during the 1991 cholera epidemic. 11. Challenges and Many lives were saved, with Perspectives only 1.8% mortality in 300,000 cases, with about * To achieve a more hori- 100,000 in rural areas. People zontal relation with MINSA already knew how to practice and enable promoters to feel prevention and care regarding biogardens, picigranjas, and surer about their contribution, acute diarrheas when the epi- raising small animals. with a critical and self-critical demic broke out, and that was g) As regards the environ- approach to guarantee the at- vital; in addition, people ment, a concern for reforesta- tention that people need. quickly acquired skills pro- tion, education, involvement * To fortify, disseminate, vided for the emergency. on town committees to defend and broaden this experience * Their contribution to im- woods and land. of solidarity with others— proving vaccination coverage h) Personal development of promoters trained by MINSA, is undeniable: 18% on the av- those involved, with greater the NGOs, and other church- erage in 1982, and 84% in self-confidence, more open- es—and join efforts towards 1993. The promoters persuad- ness to other sectors and shared goals. ed the population to vaccinate broadening of scope, with * To consolidate local and children (formerly, they used greater capacity for analyzing regional networks (help form to hide children when teams health policies. them where they do not exist), arrived). i) There are promoters ca- with a view towards a nation- * About 3,800 local pable of training others. al organization which will first-aid posts administered by j) Work is seen as a context speak out for them and enable them which make basic medi- in which to manifest faith and them to be heard. cines available to the poor. Christian commitment, with a * To write the history of the * They alert others to epi- lay contribution to building road traveled and the contri- demics as health watchmen. the Church in health care. bution made. * They take health care to k) In 1995 the first National * To work out a proposal 25% of the Peruvian popula- Health Promoter Day was for the health system which tion that is not reached by the held, recognized by the Min- will include the community government. istry of Health by way of a experience of the health pro- * We are sure they have Vice Ministerial Resolution. moters. Bases for Creating a Bishops’ Commission for the Health Ministry

THE BISHOPS’ CONFERENCE OF THE CONGO

Introduction ment, of the enduring inspira- the way of the Church, and this tion of the Gospel, and of the way is one of the leading The world of health is an signs of our time so that cur- paths. area which the Church may rent difficulties will become a We all know that health is not neglect and to which she “challenge” for our growth no longer regarded as the ab- gives preference in the mission and help us to perform a ser- sence of disease, but as physi- joining together all the mem- vice better suited to Congolese cal, moral, social, and spiritual bers of the People of God, people today and more faithful well-being. Consequently, our inasmuch as service to the sick to the Gospel spirit. health system’s objective must and those suffering is an inte- By its very nature, work in be not only to heal people of gral part of her function. the health field deeply in- illness, but also to promote Faithful to the teaching and volves Christians, for whom health for a higher quality of command of the Master life. Under this aspect, the 48 throughout history, countless health of the community is men and women have wit- considered in close relation to nessed to the charity of Christ all that serves as a basis for the towards the sick, the elderly, complete well-being of the the disabled, and those aban- person, such as education in doned by society in every peri- freedom, the elimination of od. personal, familial, and social Christian health and social imbalances, health education, workers and the GES (Gospel ecology, and the removal of and Health Groups) in particu- the causes of many diseases— lar have become aware of per- malnutrition, a lack of hy- forming their function in an in- giene, an inadequate environ- creasingly complex world ment, unemployment, and im- which has undergone deep prisonment. transformations. Encouraged The fight for health is be- by Jesus’ permanent com- coming a primary duty of all mand, they pose the following society, which must guarantee questions. not only well-being, but the * What is their specific mis- very survival of man. Society sion? the sick constitute a permanent must thus commit its best ef- * What is the meaning of call to self-examination and forts in a collective endeavor their presence in environments existential verification of their to serve man as a whole and all where care is mainly provided human and psychological men. Indeed, to approach the by the “non-GES”—that is, by qualities, their identity, and the suffering, as with all health-re- government? spiritual motivations for their lated problems, represents the * How can they manifest work. In their relationship with best common denominator their commitment today— the suffering, Christian social among men, regardless of ide- even more than in the past—as and health workers give con- ology, culture, social status, Christians and social or health crete expression to and live out and political and economic workers? their relationship with God, conditions. * How can they respond ad- their commitment, and, there- After twelve years of in- equately to new demands in fore, the profound, ultimate tense work sustained by re- health care? meaning of their lives and mis- flection, exchanges, and expe- * How can they prompt new sion in the world. In fact, every rience, the Gospel and Health forms of support and involve- place where men suffer is a Groups (GES), in spite of their ment in keeping with the spirit special place for revealing good will, see that their action and most urgent needs of Con- God and displaying the has not yielded the results golese society? Church’s pastoral action. “The hoped for. The social and In this search we feel called Church, which arises from the medical situation of the Con- to overcome situations of mystery of Redemption in golese people is continuing to malaise, discouragement, and Christ’s Cross,” is duty-bound deteriorate, and the profes- even bewilderment and gain to seek an encounter with man sional awareness of Catholic greater insight into our identity in a special way along the road health workers is, on the through renewed interpretation of man’s suffering. It is in this whole, no better than it was of the objectives of our move- encounter that man becomes twelve years ago, even though some in various places have to the health apostolate in take to heart visits to the sick, truly become more conscious. many parishes. the organization of groups to In spite of the efforts applied It is limited to a sacramental provide care, and attention to and the sacrifices made, the ministry focusing on Reconcil- the poorest patients and their GES feel their labors have not iation and the Eucharist, visit- families. The parish will then been supported by all the pas- ing the sick without specific make the neighborhood’s tors during congresses. We objectives, and helping in the health problems its own and recognize, however, that their final moments of their lives. foster the integration of the participation in our major Many parish communities sick into society and the Chris- meetings is a grace for our show a certain paternalism to- tian community as rightful movement and for the Church wards the sick in their manner members. in the Congo. of contacting and assisting We observe that in our them, instead of recognizing Church each works on his own the role entrusted to them by 2. The Parish Community’s without sharing experiences Christ as active members at all Assistance to the Sick with others. Much is being levels and especially in evan- and Their Families done in the health field, but in gelizing the community they a dispersed manner. In the end, belong to. The parish community evan- one gets the impression that There is a lack of responsi- gelizes the sick and their fami- the Catholic Church is not or- bility on the part of the com- lies by accepting and respect- ganized, and this is a pity munity as regards true educa- ing them and, without false when we look at the efforts tion on the meaning of life in compassion, considering them made, the good will, and the to be responsible, adult per- seriousness of all. The Gospel sons. It takes care of them so- 49 and Health Groups think the licitously, shows an interest in time has come to put an end to their problems, accompanies this way of acting. them in their solitude, fights to Health is no longer a prob- make their rights prevail, prays lem concerning only social for them, and helps them to and medical workers, but, live in faith, taking them the rather, it is the whole ecclesial Word of Christ and the sacra- community, made up of dioce- ments and serving them un- ses and parishes, that must selfishly. This is a visible, tan- take part in the health aposto- gible sign for our world, which late. is so forgetful of the sick and We in the GES think it is tends to marginalize them. necessary to put a real health ministry into practice to make service to the sick more effec- 3. The Contribution tive. of the Sick To this end, a Bishops’ to the Parish Community Commission for the Health Ministry must be established, health, illness, suffering, phys- The sick, when evangelized in addition to diocesan, parish, ical decline, and the final stage by the parish community, be- and group commissions. of death. come, in turn, evangelizers of We shall propose a reflec- A good many parishes are this same community, which is tion taking the parish as the ba- completely unaware of the enriched by the grace of their sis for everything and then health problems and situations illness. some orientations and a pro- in their area and of health care The sick give the communi- posal for a program. legislation. For this reason, ty real awareness of human be- most of the time the advance- ings in their fragility, limits, ment of health, the prevention and enormous resources of THE PARISH of illness, and the improve- available energy. AS AN EVANGELIZING ment of care are mere phrases. They remind the community COMMUNITY Parishes sometimes neglect if the Gospel values which are AND THE HEALTHCARE care of the sick, who are left to forgotten today: the free gift of MINISTRY their circle of friends and rela- life, complete poverty, aban- tives, and overlook the needi- donment of useless things, the est and most abandoned, along power of love, and integrity 1. The Health Apostolate with their families, as with the during trials. in Our Parishes at Present elderly, the chronically or psy- They are the poor who invite chiatrically ill, terminal pa- their neighbors to be generous, On analyzing the situation, tients, the disabled, alcoholics, affectionate, willing to serve, we observe major successes AIDS victims, and others. unselfish, and ready to act so which are a source of hope, but It is hoped that every parish, that their rights will be recog- also a certain number of no- in discerning the deeply hu- nized. table gaps. man and Gospel-oriented di- By their presence alone, There is a lack of sensitivity mension of this ministry, will they raise questions about life, suffering, and death. They pre- help and accompany them dur- health situation and the sick. sent a purified image of God— ing their illness. The must accept responsibil- the suffering God who has It must integrate the sick in- ity for educating the young come out of love to share in to the community as active and children on life problems man’s suffering to the point of members in all respects, recog- (health, illness, suffering, touching him in the deepest nizing their irreplaceable mis- physical decline, and death), abyss in order to save him. The sion, valuable contribution, with all the means at their dis- sick are witnesses to the and role as evangelizers of the posal. Paschal mystery of death and community itself. They must be a source of resurrection. It must ensure complete re- comfort for their sick, break- The sick who are able to newal of the sacramental min- ing with them the Bread of the give meaning to their lives be- istry to the sick. Word of God, loving them, re- come reliable witnesses It must organize groups for lieving their sufferings as far through their fight against ill- the pastoral care of the sick as possible, and having them ness and suffering, which they with adequate training and suf- understand that they are not accept with love—an accep- ficient knowledge. alone, isolated, or useless and tance which sometimes attains It must pay special attention are not a burden on society. to serenity and joy in human to the problems and difficulties They must sensitize all their and spiritual maturation. of the families of living pa- members to individual respon- tients and of those who have sibility in promoting health died through concrete help and and caring for the sick. 4. Attitudes to Value moral support. They must visit the elderly in Order to Help Parishes and accompany them during 50 to Act and Let illness with respectful, un- Themselves Be selfish service. Evangelized by the Sick They must renew the celebration of the sacraments ad- In order for this to occur, the ministered to the sick, particu- parish community must con- larly the Anointing of the Sick, tact and accompany the sick which ought to be proposed at with proper respect for them, the right moment, sometimes with joy, solicitude, authentici- in a community celebration ty, and unselfishness—with (for instance, on the World actions more than with words. Day of the Sick). It shares hope with them, The sick must be members makes their expectations its of the community in full stand- own as a community and not ing. They are also responsible just as mere individuals, find- for the evangelizing mission ing support in prayer and spiri- entrusted to them. Their com- tual strength. plete participation in the life of the community must thus be facilitated in every way. 5. Initiatives to Be Promoted 6. Structures and Cooperation must be ex- for the Best Service Means to Be Created tended to all other fields to fos- to the Sick ter the integration of the sick and Their Families All structures and means in into society. by the Parish existence should be used—the The community must extend GES, Christian groups in the care to all its most disadvan- The parish community must Legion of Mary, EPV, confra- taged members—drug addicts, be familiar with the field of ternities, and others. alcoholics, and AIDS victims. health and the conditions of There should be coordina- They must be concerned the sick, especially of the dis- tion of action with other pas- about the families of the sick inherited. toral groups devoted to the and also assist them after the It must sensitize all of its sick in an area or diocese. death of relatives. members to the health ministry There should be contact and The following points ought and the responsibilities of each collaboration with other organ- to be observed regarding the in this area. isms in the health apostolate. care groups. It must educate children, * Ensure that, in addition to young people, and adults on good will, they are endowed the problems of health, illness, 7. Conclusions with needed skills. suffering, physical decline, * Give them a sense of be- and death. The parish community and longing to the Church as those It must promote assistance all other communities with a sent by the community to care to and care of the sick by its Christian inspiration must for the sick. members. identify their evangelizing ac- * Provide adequate training It must know and identify tion in the health field. on doctrine and health care to the most serious illnesses and They must direct their ef- give them the necessary exper- the neediest of the sick so as to forts towards knowledge of the tise. * Create pastoral groups for live well, giving meaning to cific and effective steps at least health care dedicated to the health, to illness, when it pre- to lighten their burdens when a sick and able to sensitize dif- sents itself, and to death, when solution cannot be found. ferent sectors of the parish for the time comes. 5. All Christians are respon- coordination of the varied Pastoral care must not be sible for acting in the name of apostolates. based on sacraments without the Lord and of the Church. Communities shall include taking into account the an- We must thus go beyond a Christian social and medical nouncement of Jesus of clerical, individualized min- workers, whether or not they Nazareth so as to enable peo- istry to arrive at an ecclesial are GES members, in the ac- ple to live through existential and community ministry. To tivities of the parish ministry situations in their full signifi- this end, it is necessary to sen- for better knowledge of prob- cance. This change in perspec- sitize the Christian community lems and their practical solu- tive and orientation in pastoral and its members, promote tion. care involves a new style of committed Christian lay action They shall organize the accompaniment of the sick and in health care, and coordinate World Day of the Sick in close must give rise to initiatives all health workers. collaboration with the sick, the such as the creation of church GES, Catholic Charities, hos- contexts which are more hu- pital chaplains, EPV, and other mane and help men live in a The Organization movements. healthier way. of This Ministry The Bishops’ Commission 2. The sick are persons, not for the Health Ministry (to be things. We must, therefore, The pastoral care of the sick established) shall offer general must be practiced wherever guidelines for this ministry on the sick are found—that is, at 51 a diocesan level. home, at the hospital, in the The national and diocesan parish, and elsewhere. executive offices shall be re- In view of the real situation, sponsible for working out the we feel it is necessary to orga- training program for pastoral nize the following commis- workers. sions. * Commission for Christian Health Workers (GES). ORIENTATIONS * Charity Commission. FOR THE HEALTH * Commission for Pastoral MINISTRY Care at Hospitals and at Social and Medical Centers (chap- Introduction lains). * Commission to Coordi- Daily experience in the Con- nate Movements and Groups golese Church and in society Caring for the Sick (Legion of enables us today to propose Mary, EPV, confraternities, some guidelines which should etc.). characterize the health min- move from pastoral care mak- * Training Commission. istry in its varied practical di- ing the sick into an object to - National Plan for Health mensions in our country—the care which regards them as a Development parish, the hospital, the dio- person, as Jesus Himself, and - Bioethics cese, the interdiocesan level, integrates them fully into the - Natural Methods to Regu- the nation, and so on. community, which they evan- late Births gelize with their way of liv- - Accompaniment of the ing.3. The family is also im- Dying Orientations portant. We must thus go from pastoral care addressed to the 1. As servants of life, we sick alone to care taking the Pastoral Activities must go beyond pastoral care family into account. helping people towards a Indeed, illness deeply af- 1. Sensitizing the Church hi- “good death” (the sacramental fects the family. The role of erarchy. or occasional ministry) to ar- the family is basic and even ir- 2. Celebrating the World rive at a ministry which en- replaceable alongside the sick. Day of the Sick (February 11) courages them to experience Authentic, intelligent, and and the feast of St. John of health, illness, accompani- prudent pastoral involvement God (March 8). ment, and death in a positive with the family is indispens- 3. Renewing care at hospi- and Christian way and is thus a able. tals and social and medical ministry of evangelization and 4. We must be close to the centers through varied steps. care. neediest and least favored, * Sensitizing and permanent Indeed, human beings not with their concrete problems, education for all Catholic only need to be accompanied to become their neighbor, dis- health workers, whether or not towards a “good death,” but al- covering them in the parish or they belong to the GES. so, and above all, they need to at the hospital and taking spe- * Permanent training of hospital chaplains through month- situations and their pastoral problems and participation in ly meetings. implications by way of solving them. * Training of workers for * development of theologi- hospital care (two or three cal and pastoral reflection on 7. To encourage communion times a year). health, suffering, and death by and collaboration among chap- * Diocesan and interdioce- involving social and medical lains, men and women reli- san congresses. workers, writers, theologians, gious, social and medical * Publishing documents. catechists, hospital chaplains, workers, and parishes by pre- 4. Sensitizing Christian and others; cisely defining the role of communities and parish * promoting interdiscipli- each, along with their training, groups. nary reflection on ethical prob- duties, and rights. 5. Promoting and creating lems, health care, and the re- social and medical facilities in sponsibility of the health 8. To promote lay commit- the Church. worker so as to offer clarifica- ment to health care. 6. Promoting lay commit- tion; ment in health care. * attention to conflict situa- 9. To encourage the specific 7. An action plan for tions in the world of health. and ongoing training of Christ- bioethics and home care of the ian health workers by defining sick and dying. 2. To intensify the Church’s training programs and includ- 8. Training for all sectors. and society’s solidarity to- ing the study of bioethics. 9. Mobilization of resources. wards the sick and most disinherited—the terminally ill, the 10. To initiate and promote elderly, and the psychological- the training of seminarians in 52 Proposal for a ly disturbed. the health ministry at schools National Action Program and universities. in Two or Three Years 3. To renew the celebration of the sacraments for the 11. To create and promote The basic objective is to sick—that is, to rediscover the Church-sponsored health facil- stimulate or strengthen reflec- curative dimension of all the ities which will help men live tion in the Church through sacraments, particularly those in a healthier way. much broader participation in celebrated in the period of ill- health care, with a view to- ness. 12. To foster relations and wards delineating the major cooperation with civil and lines of force of the Church’s 4. To know the spiritual Catholic health organisms, presence therein on the basis needs of the sick. both nationally and interna- of the Gospel. The three priori- tionally. ty axes are the following. 5. To reinforce Church com- a) Health today in the Con- munion among health workers 13. To support and reinforce go. and within health apostolate currently existing resources b) Health and faith. movements. and channels for training in the c) Orientations and priorities health ministry. for the Church’s presence in 6. To give a new thrust to health care. evangelizing action by parish- 14. To use the mass media The major specific objec- es in health care by reawaken- more effectively to dissemi- tives are as follows. ing Christian conscience, cre- nate the health apostolate. ating a new dynamic of parish 1. To contribute to promot- involvement in serving the Dr. NTARI BENOIT ing a new health culture by sick, and promoting parish National President of the studying social and medical awareness of basic health Gospel and Health Groups Activity of the Pontifical Council

Fatima: Fifth World Day of the Sick John Paul II’s Letter to Cardinal Fiorenzo Angelini

THE DESIGNATION OF A SPECIAL ENVOY FOR THE CELEBRATION OF THE WORLD DAY OF THE SICK IN FATIMA

The Pontifical Mission es- celebration to take place in a Church, and confirm our pres- tablished to accompany the more fitting and appropriate ence in spirit. You shall speak Cardinal was made up of Rev. way, we have decided to send of the filial affection due the José L. Redrado, O.H., Secre- a person to represent Us and heavenly Mother, recalling tary of the Pontifical Council manifest our benevolence. that the message of the for Pastoral Assistance to Precisely you, our Venerable Blessed Virgin Mary in Fati- Health Care Workers; Rev. Brother, who have served as ma is nothing but a call to con- Felice Ruffini, Undersecretary President of the Pontifical version and penance; you shall of the Council; Monsignor Gi- Council for Pastoral Assis- also take care to explain the acomo Giampietruzzi, Secre- tance to Health Care Workers salvific value of pain; to those tary of the Apostolic Nuncia- with wisdom and diligence, participating in the celebra- ture in Portugal; Professor seem to Us fully prepared and tions, especially those afflict- Walter Osswald, President of qualified to carry out this mis- ed by illness, you shall express 54 the International Federation sion in a suitable manner. our benevolence, that it may of Catholic Medical Associa- Therefore, through this Letter, reach and console all. tions; and Professor Daniel by our authority we name you Finally, to all present you Serrao, Member of the Pontifi- our Special Envoy to preside shall convey the Apostolic cal Academy for Life. at the sacred celebrations at Blessing as an announcement that Marian shrine on our be- of heavenly aid and a pledge half so that you may manifest of blessed salvation. To Our Venerable Brother our sentiments as a Pastor to From the Vatican, Decem- the clergy and people, and to ber 30, 1996, the nineteenth Fiorenzo Angelini, Cardinal all present. year of our Pontificate. of the Holy Roman Church You shall bear our greeting, declare our love for that JOHN PAUL II The Christian people is accustomed to invoking the Vir- gin Mother of God as the salvation of the sick and consola- tion of the afflicted. For her part, She never abandons any- one who beseeches her almost omnipotent aid and asks for her intercession. Our thought now turns particularly to the city in Portugal which since the beginning of this century has enjoyed singular protection on the part of the Blessed Virgin Mary. Very appropriately, the Por- tuguese people will celebrate the World Day of the Sick at the Sanctuary of the Blessed Virgin Mary in Fatima on Feb- ruary 11, 1997. This sacred event gives us all the opportunity and the occasion to contemplate Mary beneath the cross of Jesus taking upon Herself the spiritual care of the whole human race and at the same time to spur our hearts towards a stronger, more se- cure faith. For this reason, to confirm our love for the sick more forcefully and in order for this Note by the Permanent Council of the Portuguese Bishops’ Conference on The World Day of the Sick 1997

1. In 1992 Pope John Paul in the Fatima ministry: 3. During his life, Christ II established the World Day “Come to me, all of you that addressed the weakest and of the Sick, to be celebrated are weary and oppressed, and the poorest with special atten- each year at a Marian Shrine. I will comfort you.” All of the tion, among them the sick He indicated February 11, the suffering feel attracted by the and the marginalized: “They liturgical commemoration of Divine Physician. In the suf- brought him all those suffer- Our Lady of Lourdes, as the fering Christ, as John Paul II ing from an illness, and He day consecrated to this cele- reminds us, each of us finds cured them all” (Mt 4:24). bration by the whole Church. the meaning of his own suf- Like Jesus Christ, all who Major Marian shrines in the fering. He is Love, and only assist the sick—health work- following years were thus at in Love can we understand ers and volunteers—are the center of this event of human suffering. called to a grandiose mission. worldwide scope. Lourdes This year, 1997, is the first They may not be able to cure, and Czestochowa in Europe, of the triennium preparatory but their first duty is always 55 Our Lady, Queen of the to the Jubilee of the Year to assist diligently all who World in the Ivory Coast, 2000. It is important to have suffer. Particularly, their duty Africa, and Our Lady of better knowledge of the One is to help them to overcome Guadalupe in Latin America we call Jesus Christ. For this the loneliness and hopeless- have been the sites previously reason the Fifth World Day of ness which so often mark chosen. For this year, 1997, the Sick, held at Fatima, has their hard road. the Pope has chosen Fatima, the theme “In health and in On this day we cannot fail a Sanctuary to which he is sickness Jesus Christ gives to ask the sick, as examples closely bound, for the cele- meaning to life.” He is the of life and intercession for the bration of the Fifth World same—yesterday, today, and major intentions of the Day of the Sick. always. It is He who gives Church and the world, to be- The importance of Fatima meaning to all things and all come apostles, both among in the life of the Church is be- moments in human life. He other sick people and in their yond question. The Pope re- describes Himself as “the own Christian community. calls this in his Message for Way, the Truth, and the Life” the World Day of the Sick: “It (Jn 14:6), “the life-giving 4. In Fatima, with the is an occasion for each of us Bread” (Jn 6:35), “the living whole Church we are cele- to listen to the message of Bread that has come down brating the World Day of the Our Lady, whose basic core is from heaven” (Jn 6:51), “the Sick. We ask Our Lady to an appeal for conversion and living water gushing forth for help all who suffer, who feel penance, as the Gospel re- eternal life” (Jn 4:14), and excluded from society, who quests.” “the Resurrection and the because of age or for any oth- We are familiar with the Life” (Jn 11:25), who has er reason have been margin- story of the seers at Fatima, come “for all to give life and alized. the way they asked for the give it abundantly” (Jn We deeply hope that all conversion of Russia while 10:10). Jesus Christ is the ref- Christian communities— observing the world of their erence point for our whole parishes, movements, reli- time, a manifestation which life as Christians. gious institutions, and oth- pointed to a renewal of soci- ers—will be present during ety, a victory over wars and the two leading moments of violence, and a transforma- the World Day of the Sick: tion of social structures on February 10, the Day of Re- the basis of justice and free- flection for health profession- dom. als and volunteers, and Feb- ruary 11, the significant 2. The World Day of the World Day of the Sick, for all Sick invites us to reflect on who suffer from any illness illness and physical, psycho- and for those who can accom- logical, and moral suffering pany them at the celebration in a new light. of the Eucharist, presided In his Message for this over by the Pope’s Special Day, the Pope reminds us of Envoy. Christ’s invitation, which, May Mary guide us during moreover, is always present this day of prayer and hope. At Fatima Mary Has Dried So Many Tears:

AN ACCOUNT OF THE FIFTH WORLD DAY OF THE SICK

The last World Day of the their role in the health min- time for insight into the prob- Sick was celebrated at Fatima, istry. lems of greatest concern to- Portugal, February 9-11, 1997. The areas of pastoral action day for the leaders of Por- After Lourdes, Czesto- which, beginning at that mo- tuguese society. chowa, the Ivory Coast, and ment, took shape, organizing In addition to the Pontifical Guadalupe, it was the Fatima and working together, were Council for Pastoral Assis- Shrine’s turn to welcome this the health professionals (with tance to Health Care Workers, celebration. The eyes of the the Associations of Catholic preparations for the now im- whole Church, focusing on Workers), the chaplains (with minent celebration involved the theme “In health and ill- their diocesan coordination the Bishops’ Conference, the ness, Jesus Christ gives life centers), volunteers (already Bishops’ Commission for So- meaning,” were set upon the present in fifty-eight hospi- cial and Charitable Action, Altar of the World. During tals), and parishes (organized the Ministry of Health, the 56 this first year of the triennium into parish groups for the National Commission for the preparatory to the Jubilee of health apostolate). Health Apostolate, the the Year 2000, the World Day Towards the end of 1996 Catholic Medical Association of the Sick centered on the the Tenth Health Ministry of Portugal, the Catholic As- Person of Jesus Christ. He is Meeting was held. sociation of Nurses and Other the Way, the Truth, and the In analyzing the topic “Re- Health Workers, the Diocesan Life, the Bread of Life, the sponsibility in Serving Life,” Secretaries for the Health Living Water issuing forth for the different groups deepened Ministry, and different move- eternal life; He is the Resur- their awareness and made ments, congregations, and rection and the Life. For all of very specific commitments civil organizations wishing to these reasons, in moments of for the celebration of the take part in the health aposto- hardship all turn to Christ World Day of the Sick, at late. In three months of very with trust, abandoning them- which a Health Ministry Pro- intense work, the whole coun- selves and identifying them- gram would be enunciated. try was activated and even selves with Him in suffering, On account of later difficul- some dioceses in other Euro- putting hope in Him to over- ties affecting all areas of pas- pean nations became income it, and accepting the Fa- toral action in regard to im- volved. ther’s will with Him. plementing this measure, joint These were the deeply-ex- work was limited to approval perienced sentiments which of a “pastoral action plan for 2. The Celebration of spurred health workers, vol- chaplains at hospitals and the World Day of the Sick unteers, pastoral workers, health facilities,” the central and, above all, the sick to core and moving force for all This pastoral event took travel to the Fatima Shrine for organized activities to be car- place in three stages: the ar- the Fifth World Day of the ried out in dioceses. rival of the Pope’s Special Sick, in communion with all Health workers and volun- Envoy, Cardinal Fiorenzo the sick in the world who, in teers also made a solemn Angelini, the Day of Reflec- accepting Jesus Christ, coop- commitment, stressing certain tion with health workers and erate with Him in the work of elements in the prayer John volunteers, and the Day of the redemption. Paul II offered in Fatima at celebration and solemn Com- the feet of Our Lady on May mitment. 13, 1982. On February 9, at 11:30, 1. Preparation Another preparatory mo- Cardinal Fiorenzo Angelini ment was certainly the arrived at the Lisbon airport, The first indication that this Bioethics Meeting held in where he was received by the Day would be held at Fatima Porto with health workers, Apostolic Nuncio, the Bish- appeared during the First Na- February 4-7, 1997—a mo- op, the President of the Bish- tional Congress for the Health ment of intense reflection on ops’ Commission for Social Ministry. In December 1995 the service to life which is the and Charitable Action, the the possibility of celebrating responsibility of all working Minister of Health, the repre- the Fifth World Day of the in the world of health. Orga- sentative of the Cardinal Pa- Sick at Fatima galvanized all nized by the Catholic physi- triarch of Lisbon, and the the Congress participants, cians and the National Ethics members of the National who immediately formed four Commission for Human Sci- Commission for the Health teams to deepen awareness of ences, it was undoubtedly a Ministry. Cardinal Angelini was ac- Conference at the Vatican, an wheelchair, and by the direc- companied by Cardinal invitation that had immediate- tor of programs at Radio Re- Deskur, the Most Rev. Javier ly been accepted. He then birth, who had overcome a se- Lozano, President of the Pon- manifested his best wishes for rious illness. tifical Council, and Fathers the success of the World Day At the close, the profession Redrado and Ruffini, Secre- of the Sick, which was about by health workers, read be- tary and Undersecretary, re- to be held. fore the whole assembly, pre- spectively, of the Council, On February 10, a major pared those attending for the and the members of the Pon- Day of Reflection was held celebration of the Eucharist. tifical Mission. for all health workers, volun- The approach to the During the press confer- teers, and parish workers. Shrine’s Altar was along the ence, Cardinal Angelini Over 2000 people attended Holy Way, with the six most stressed the importance of the and showed notable interest significant stations: the con- World Day of the Sick, its not in the talks presented, which demnation to suffering, the exclusively religious charac- were as follows. first fall, the meeting with ter, the meaning of suffering * “The Health Ministry on Mary, the help of Simon the in human life, the scope of the the Threshold of the Third Cyrenean, and Christ’s death Fatima message, and the love Millennium” - the Most Rev. and resurrection. of John Paul II for Portugal Javier Lozano. In the presence thousands and Fatima. When asked * “The Health Ministry and of people, including the sick about the Church’s position the Pope’s Message” - Cardi- and those accompanying on the problem of abortion, nal Fiorenzo Angelini. them, twenty bishops, and now being discussed in Portu- * “Jesus Christ and the about two hundred priests, the gal, the Cardinal replied that Sick: A Biblical Vision” - central Mass began; it was 57 it was not only a religious Professor Isidro Alves. televised throughout Portugal problem, but, rather, a human * “The Sick in the Message and in some other countries. and ethical one, and an indi- of Fatima” - the Most Rev. cation had already appeared Luciano Guerra. in Hippocrates and in his * “The Health Ministry as 3. The Mass during Oath that medicine is always an Innovating Experience” - the World Day of the Sick at the service of life and that the Most Rev. Javier Osés. life, for the Church, is always * “Challenges of the Health There are events which inviolable. The more life is Ministry” - Rev. Vitor Feytor leave a lasting impression. defenseless and fragile, the Pinto. This happened on February more it should be protected This Day of Reflection be- 11. The Mass celebrated at by society. gan with a concert by the the Fatima Shrine included John Paul II’s Special En- Coimbra University Choir very intense moments of great voy, accompanied by the Pon- and ended after the Eucharist spiritual power. tifical Mission, was then re- with a magnificent organ con- In the penitential rite, Car- ceived by the Apostolic Nun- cert by Rev. Giuseppe di dinal Angelini knelt before cio at the headquarters of the Mare: “Jesus: From Hope to ten seriously ill patients and Apostolic Nunciature in Lis- Glory.” washed and kissed their bon. As we were in Fatima, in weary, wounded feet. After celebrating Mass at the evening we could not fail The word of the Lord, com- the Church of St. Anthony, in to recite the Rosary, and the mented on by the Special En- the presence of a hundred vigil procession was com- voy, was followed by the Italian pilgrims who were pletely filled with the hope message of the Pope, who, in traveling to Fatima specifical- coming from Jesus and mani- Rome the preceding Sunday, ly for the World Day, Cardi- fested in gestures of solidari- had spoken about the mean- nal Angelini was received at ty. ing of illness and suffering the Belem Palace by the Pres- It was an extremely intense and the importance of the re- ident of the Republic, to moment on the eve of a great demption achieved by Christ. whom, after the official state- day. All the pilgrims at Fatima ments, he presented a silver The celebration and the could see the Pope on a giant medal commemorating the solemn promise decisively screen as he spoke from the nineteenth year of Pope John marked February 11, the window at St. Peter’s Square. Paul II’s Pontificate. World Day of the Sick. At the Offertory the gifts The President of the Re- During the morning, the included donated blood, med- public stressed the close Plan for Pastoral Action was icines, clothing, and varied bonds between Portugal and presented, followed by varied articles for Timor, Angola, the Holy See and the manner testimonies by sick and suf- and Mozambique, for the in which the Church is vitally fering people and those caring neediest hospitals, and also a important in the existence of for them. wheelchair and other symbols the Portuguese. The testimony by Cardinal of the challenge to improve In addition, he expressed Deskur was noteworthy, as health care, in the context of a gratitude for the invitation his were statements by the Bish- message of generosity to- wife had received to take part op of Leiria-Fatima, by a wards others to serve them, in the Tenth International woman doctor confined to a relieve their sufferings, and offer them a more humane ap- ful moments in my life; it was where there are a children’s proach. In addition to the worth the trouble.” center and neonatology and bread and wine, offerings The Health Campus was an maternity departments, they were made of the seeds for a extraordinary experience. In were received by the adminis- new harvest and the candle some tents made available by tration and all the medical the Pope had sent specifically the Portuguese Red Cross a and paramedical personnel for this celebration. center for taking blood sam- working there. In the chapel a Another moment of intense ples was set up, along with an memorial tablet was un- spirituality was the Anointing area for preventing heart dis- veiled, and from the auditori- of the Sick. Twenty seriously ease, a service to collect med- um it was possible to sent a ill people were anointed by icines to be sent to the Dio- closed-circuit television mes- Cardinal Angelini and Arch- cese of Timor and clinical in- sage to all the patients. bishop Lozano. The power of struments and clothing for In the case of the House of the sacrament seemed to be hospitals in Angola and St. Francis, Cardinal Angelini transmitted to the whole Mozambique. had occasion to visit a center throng while the words pro- In addition, there were also for the elderly. During both nounced by the two ministers two tents to discuss the prob- visits the Cardinal was ac- were being heard: “Through lems of drug addiction and companied by the Minister of this holy anointing, may the AIDS, areas where the Health and the Bishop re- Lord in his love and mercy Church wishes to act. sponsible for the Health Min- help you…” To make this Campus pos- istry. The hymn of thanksgiving was a cry of joy in the face of 58 so much human pain: “Mirac- 5. Fatima, Coimbra, ulous Queen of Heaven, un- Batalha, and Alcobaça der your mantle woven of light, make war grow still on On the evening of the 11th earth and the peace of Christ and on February 12, the Spe- be achieved among men.” As cial Envoy’s entourage visit- the hymn was being recited ed Coimbra, where Mass was and children greeted the Car- celebrated at the Carmel dinal sent by the Pope, white where the ninety-year-old Lu- doves ascended into the sky cia, the Fatima seer, lives. and balloons rose into the There were also visits to blue of the firmament. the two great Monasteries of The blessing of the sick and Batalha and Alcobaça, which the closing procession, bear the signs and traces of though common at celebra- the history of Portugal in its tions in Fatima, took on a Christian and spiritual dimen- new meaning, since so many sion. sick people, health profes- At the end of this account sionals, and volunteers asso- we must not overlook John ciated with the health min- Paul II’s special relation to istry had never before gath- sible there was collaboration the Fatima Shrine. Here, in ered at Fatima. from the Portuguese Institute 1982, he came to give thanks for Transfusions, the Por- for having survived the assas- tuguese Institute for Preven- sination attempt the year be- 4. Significant Signs tive Cardiology, the Commis- fore. Here he returned in during this Fifth World sion for the Fight against 1991 on the tenth anniversary Day of the Sick AIDS, the Life Project, the of that tragic event. He al- Institute for Emergency Med- ways turns to Our Lady of Fa- It is small gestures that icine, and the Movement to tima when he is suffering, and make a difference. At this cel- Defend Life, in addition to it was the image of Fatima ebration there were so many the Red Cross. Close cooper- which recalled the fiftieth an- that we cannot mention them. ation with the Ministry of niversary of his ordination to The presence of Cardinal Health and the National the priesthood. Therefore, Deskur, a personal friend of Commission for the Health throughout the time spent in the Pope, though he was Apostolate should also be the Shrine there was a photo- physically limited by confine- stressed. graph of the Pope kneeling at ment to a wheelchair, accom- the feet of Our Lady. panied this great pilgrimage. The Visit to His Holiness Pope John His testimony in the Auditori- St. Andrew’s Hospital and Paul II was a living, continu- um and prayer at the shrine St. Francis’ Hospice ous presence accompanying were certainly very incisive. the unfolding of this celebra- At the end of the vigil proces- Cardinal Angelini and the tion in Fatima of the Fifth sion, he stated with simplicity Pontifical Mission had the World Day of the Sick. and emotion, “I have experi- chance to visit two health fa- enced one of the most beauti- cilities. At Leiria Hospital, Rev. VITOR FEYTOR PINTO At This Sanctuary Many Have Found Liberation and Comfort THE HOMILY BY CARDINAL FIORENZO ANGELINI AT THE FATIMA SHRINE DURING THE MASS CELEBRATED FOR THE WORLD DAY OF THE SICK ON FEBRUARY 11, 1997

Dear Brothers and Sisters! which eighty years ago illumi- Founder and on serving those The readings from the Bible nated this unknown strip of suffering seeks to serve we have heard invite us to earth, was and remains an im- Christ.1 meditate on the deepest mean- age of the victory of light over Dear brothers and sisters! ing of the celebration in Fati- darkness, of goodness over By the express mandate of the ma of the World Day of the evil, of joy over suffering. Holy Father, John Paul II, I am Sick. This miracle of liberation here today to remind you of The episode of the liberation and salvation, expected by the the message of Our Lady of of the People of Israel by way whole universe, which, togeth- Fatima, a message which is of their miraculous passage er with man, awaits our adop- call to conversion and penance through the Red Sea and the tion as children of God and the through giving value to pain. Gospel episode of the storm May our minds and our which is calmed remind us that hearts, in this time in which we liberation and salvation require renew the memory of the sac- 59 suffering. But, above all, they rifice of the death on the cross remind us that pain, trials, and of the Son of God and partici- tribulations form part of the pate in the sacrament of our human condition and that only salvation, be transformed into from God can liberation and a shared awareness of the pain the strength to deal with them afflicting so many of our come. brothers and sisters. However, to obtain this in- Our thoughts go out to the ward and outward liberation, sick present here and those in- both physical and spiritual, habiting the places of suffering hope is needed, nourished by and care all over the world, to faith in the goodness and mer- the children, young people, cy of God. and the elderly who experi- For the Israelites who, guid- ence abandonment, and to ed by Moses, nourished this those who, bent down by suf- hope and this faith, the cloud fering, are unable to transform was dark for their enemies, but it into an instrument for re- cast light which guided them demption and liberation. in the night, while the sea wa- Believe me! No lesson in ter raising an insurmountable redemption of our bodies (Rm life is as credible and powerful wall for the Egyptians opened 8:23), requires the acceptance as the lesson we receive from for them into a way of salva- and offering of suffering, as in those suffering and from our tion (Ex 14:19-22). the example of Christ. commitment to serve them. To the apostles, who, when The Lord Jesus, though With all the suffering and threatened by the storm, cry God, stripped Himself, took on the sick and for their sake we out, “We are lost!” Jesus the condition of a slave and invoke here, at her Sanctuary, replies, “Where is your faith?” “humbled Himself, becoming Our Lady, the Health of the (Lk 8:25). And St. Paul re- obedient until death, and death Sick, so that, by her interces- minds us that precisely in pain on a cross.” “That is why God sion, there may be ignited in “we are saved in hope” (Rm has exalted Him and has given our hearts and in those of all 8:24). Him a name which is above our brothers and sisters the Faith and hope in liberation every other name” (Ph 2:6-9). light of faith and the support of from the evil and pain afflict- The way of the cross is the hope. ing our spirit and our body way of our liberation. This is The Day of the Sick is truly have gathered us together to- the mystery we are celebrating the Day of man in the truth of day in this sacred place to cele- today. It is the mystery of his most universal condition: brate the World Day of the Christ and the mystery of the the condition of pain. Sick. Church. As Christ, indeed, was Fatima, like all other Marian So many suffering in body sent by the Father to announce shrines in the world, is a wit- and spirit have in fact come to the good news to the poor and ness to the numberless crosses this sanctuary and, through to heal those with a contrite brought to the feet of the their faith and their hope, heart, so the Church recog- Mother of Jesus. But it is, found liberation and comfort. nizes in the poor and the suf- above all, a witness to the The prodigy of the sun, fering the image of her prayer rising from the heart of whoever has been able to offer Lenten period and which, on piercing prunings, and the al- to God the burden of personal recalling the fragility of our ternating vicissitudes of the tribulation. condition, also exalts the sub- seasons, then becomes laden Let us ask the Lord, through lime greatness of our libera- with wonderful fruit, suffering the mediation of Our Lady, for tion. is a haven of joy and grace if the gift of liberating hope and Tomorrow the Church will accepted and lived out in com- of faith which heals our suffer- celebrate the feast of the Holy munion with Christ, with one’s ing. Face of Our Lord Jesus Christ. gaze turned towards his Face Our gift will be transformed On November 5, 1986, the dripping blood—a revelation into a power for reparation and Congregation for Divine Wor- of the Father’s love and the re- redemption. ship—in a document sent si- demption of the world. Fifteen years ago, on the an- multaneously to the President In communion with the Pas- niversary of the assassination of the Pontifical Council for tor of the universal Church and attempt at St. Peter’s Square, Pastoral Assistance to Health with our hearts supported by the Holy Father, John Paul II, Care Workers and the Bene- the faith and hope of which wished to come to Fatima to dictine Congregation of Sisters Our Lady is the loftiest exam- thank Our Lady for her mater- for Reparation to the Holy ple, let us repeat with the Lord nal protection and to offer God Face of Our Lord Jesus Christ, tested by pain the words He his suffering through her represented here today by their pronounced in Gethsemane: hands. Superior General—approved “Father, if you wish, remove From the Holy Father, then, the text of the Mass and the this chalice from me! But let we receive an example of how Liturgy of the Hours of the not my, but your will be done” to live out and celebrate the Most Holy Face of Jesus. (Lk 22:42). In his will, indeed, 60 World Day of the Sick. His There is a very close tie be- is our peace and our joy! lofty magisterium and ministry tween the health ministry and have been imparted from the devotion to the Holy Face of FIORENZO Cardinal ANGELINI teaching chair of suffering, the Christ, which is the highest chair chosen by Christ for the and most sublime expression salvation of the world. of healing, reparatory, and We shall be reminded of this sanctified suffering. lesson of life in the coming Almost like a plant which, Notes days by the rite of anointing after having endured the risks with ashes which initiates the of growth, inclement weather, 1 Cf. Lumen Gentium, 8. The Sick Need Our Human Warmth

THE POPE REMINDS THE FAITHFUL OF THE FIFTH WORLD DAY OF THE SICK

At the Marian prayer recit- deep sharing that he asks of pay the price. Thus it can hap- ed with the faithful at St. Pe- his disciples, when he entrusts pen that the elderly who are ter’s Square on Sunday, Feb- to them the task of “healing no longer self-sufficient, de- ruary 9, 1997. the sick” (cf. Mt 10:8). fenceless children, the dis- If we pray with faith, the abled, the severely handi- Dear Brothers and Sisters: Lord will not fail to work mir- capped and the terminally ill acles of healing even today. are sometimes seen as a bur- 1. The Gospel often speaks His Providence, however, den and even an obstacle to of the cures worked by Jesus. usually works through our re- be removed. On the other The sick crowded round him sponsible efforts and requires hand, walking at their side, and sought to touch him “for us to combat illness with all dear brothers and sisters, power came forth from him the resources of intellect, sci- helps build a society with a and healed them all” (Lk ence and appropriate medical human face, enlivened by a 6:19). I like to remember this and social assistance. deep sense of solidarity, 61 shortly before the fifth World where there is room and re- Day of the Sick, which will be 2. Jesus’ love for the sick spect for all, especially the celebrated this coming Febru- encourages us especially to weakest. ary 11, the feast of Our Lady put the resources of our heart of Lourdes. into action. We know from 3. Looking to Christ, physi- By healing the sick, Jesus experience that, when we are cian of souls and bodies, we shows that his gift of salva- ill, we not only need adequate also meet the caring gaze of tion is offered to the whole treatment, but human warmth. Mary, invoked by Christians person, since he is the physi- Unfortunately in contempo- as “Health of the sick,” Salus cian of soul and body. His rary society we often risk los- infirmorum. May the Blessed compassion for those who are ing geuine contact with oth- Virgin help us touch the heal- suffering spurs him to identify ers. The pace of work, stress ing hand of her divine Son, with them, as we read in the or family crisis makes it in- welcome the saving power of passage on the last judge- creasingly difficult for us to the Gospel and become our- ment: “I was sick and you vis- give one another fraternal selves a concrete witness to ited me” (Mt 25:36). It is this support. It is the weakest who all who need us.

Human Sickness Is a Call to Conversion

The Message of Fatima is become “the poles of a univer- to the grotto of Massabielle, to an appeal for conversion and sal pilgrimage of peace.” pause in prayer and to com- penance, the Holy Father said The Holy Father’s words mend to the Blessed Virgin, at a Mass for Sick are published below. Salus infirmorum, all the sick, “Illness represents a call to especially those who are the Your Eminences, conversion for the human per- most sorely tried in body and Venerable Brothers in the son,” John Paul II stressed spirit. Episcopate and in the Priest- while addressing thousands of The official celebration is hood, the infirm who had gathered at taking place today at the Dear Brothers and Sisters: St. Peter’s Basilica on Febru- Shrine of Our Lady of ary 11, 1997 to take part in a 1. I am pleased to extend to Fatima, particularly dear to concelebrated Mass marking you all a cordial greeting at me and highly significant in the Firth World Day of the the end of the Mass celebrat- the present phase of prepara- Sick, at which Cardinal Vicar ing the Fifth World Day of the tion for the Jubilee of the Year Camillo Ruini presided, repre- Sick, during the liturgical 2000. The Blessed Virgin’s senting the Pope. The Holy commemoration of Our Lady message at Fatima—as at Father expressed the hope that of Lourdes. Lourdes—is a call to conver- Rome and Jerusalem would This Day takes us in spirit sion and penance, without which there can be no authen- them for the valuable apos- I pray that this initiative, in tic Jubilee. tolic work they are doing for the name of our common fa- For the human person sick- the sick in escorting them to ther Abraham, may be the be- ness is also a call to conver- various Marian shrines. ginning of a new flowering of sion, to entrust one-self entire- I likewise thank the Mon- reconciliation pilgrimages for ly to Christ, the one source of teverdi Choir and the Philhar- the Great Jubilee of the Year Salvation for every man and monic Society of Crespano 2000. for the whole man. The theme del Grappa for enlivening the May Rome and Jerusalem of the convention sponsored liturgy today and for their in- become the poles of a univer- by the Roman Pilgrimage In- spiring performances. I am al- sal pilgrimage of peace, sus- stitute, which re-echoes the so grateful for the gift of a tained by faith in the one, universal call of the first year precious reproduction of the good and merciful God. For of preparation for the Jubilee, statue of Our Lady of Monte this intention, I invite you, invites us to do this. Grappa, who watches over the dear sick people, to raise to monumental cemetery where the Lord fervent prayers en- 2. My affectionate thoughts thousands of soldiers who riched by the offering of your are especially addressed to the died in the First World War suffering. many sick people present; I are laid to rest. Let us pray for cordially extend them to all them on this occasion. 4. Let us now, spiritually the sick who have joined us united with the pilgrims gath- by radio and television. May 3. Every year, the Roman ered at the shrine of Lourdes Our Lady, dear brothers and Pilgrimage Institute suggests a and those who are in Fatima sisters, obtain for each one of prophetic gesture of peace: to celebrate the World Day of 62 you comfort of soul and body. this year it plans a pilgrimage the Sick, turn to Mary with I also willingly bless those to Hebron to the tomb of the trust, invoking her motherly who have accompanied the Patriarchs, a holy place for the protection. sick, the volunteers, and the three great monotheistic reli- I cordially bless you in the members of the UNITALSI gions, as a harbinger of peace name of the Father and of the gathered here, and I thank in the Holy Land. Son and of the Holy Spirit.

Cardinal Angelini’s Words to the President of the Republic

ACCOMPANIED BY THE PONTIFICAL MISSION AND BY THE PRESIDENT OF THE PONTIFICAL COUNCIL FOR PASTORAL ASSISTANCE TO HEALTH CARE WORKERS, ARCHBISHOP LOZANO, CARDINAL ANGELINI PAID AN OFFICIAL VISIT TO THE PRESIDENT OF THE PORTUGUESE REPUBLIC, DR. JORGE SAMPAIO.

Mr President, while thank- to Health Care Workers and his them and those who, in keeping you for the opportunity to closest associates. ing with their own responsibili- visit you, I convey my most re- The most solemn and em- ties, work to assist the sick and spectful greeting, which I cor- blematic celebration of the through this assistance pro- dially extend to all the authori- World Day of the Sick is taking mote the supreme good of life ties and leaders present. As the place this year in the most no- and the dignity of the human Special Envoy of the Supreme ble nation of Portugal. Eighty person. The World Day of the Pontiff to preside at the cele- years ago, in this land, in Fati- Sick aims, above all, in accor- brations of the World Day of ma, events took place which dance with the reson for which the Sick, I bear the Holy Fa- have transformed the Shrine it was established, to shake the ther’s greeting to you, Mr. bearing this name, dedicated to consciences of all people of President, and to the whole Our Lady, Mother of Fod, and god will so that dedication to Portuguese people, which, over the goal of a growing number those suffering will grow, on the course of the centuries, has of pilgrims visiting the Fatima the part of public institutions as written glorious pages in the Shrine and daily experiencing well, in collaboration with the Church’s history as well. The this land’s traditional spirit of Church. members of the Pontifical Del- hospitality witness to both hu- In this spirit, Mr. President, I egation join me in greeting man pain and a commitment to reiterate my personal esteem you, and, first among them, the cope with it with courageous for you and that of the Pontifi- President of the Pontifical people. cal Delegation accompa,nying Council for Pastoral Assistance The Church is alongside me. CULTURAL ENCOUNTER (FEBRUARY 10, 1997) “In Health and Illness Jesus Christ Gives Life Meaning.”

With this core idea, the Day of Reflection aimed at health and pastoral workers began at the Paul VI Pastoral Center in Fatima. We offer readers some of the topics presented.

The Meaning and Value of the World Day of the Sick WORLD DAY OF THE SICK, FATIMA, FEBRUARY 11, 1997

63 I am pleased, first of all, to * to convey the Supreme She revealed eighty years ago extend my most cordial greet- Pontiff’s love for the Por- at Fatima, over the sin of the ing to all those present: Bish- tuguese Church; world which blocks and ops, authorities, and those re- * to confirm his spiritual checks the establishment of sponsible for public and pri- presence among us; but, the Kingdom of God on earth. vate health facilities, priests, above all, No offering of love, expia- men and women religious, * to recall the salvific value tion, reparation, and salvation and especially all the health of pain, along with the mes- is so necessary and effective professionals. sage of Our Lady of Fatima. as the offering, in communion My grateful salutation is In addition, the Pope invites with Christ, of the pain ac- shared in by the members of me particularly to express to companying our life. the Pontifical Delegation— those afflicted by illness his On the other hand, refusal firstly, by the new President of personal and consoling benev- of incurable pain, rebellion the Pontifical Council for Pas- olence and blessing.2 against trials, and the desper- toral Assistance to Health These are the thoughts and ate attempt to blot sacrifice Care Workers and his closest feelings also filling my mind out of our existence lead to and most distinguished asso- and my heart today. selfishness, self-enclosure, ciates. My experience in head- The World Day of the Sick loss of the meaning of life, ing this Council for the first this year is situated at the be- and nonrecognition of the true twelve years of its existence ginning of the first year of the scale of values. has enabled me to verify on a triduum preparatory to the The deepest meaning of the daily basis how much this great Jubilee of the Year 2000. Day of the Sick is the invita- body can do for the sick and It is to be a year entirely de- tion to share with the sick health workers and how much voted to reflection on their condition of suffering, to both the Church and civil so- Christ—a reflection, however, implement in service to those ciety expect from it. as the Pope specifies, which suffering the supreme com- In his Message for the must not be separated from mandment of love, and to dis- World Day of the Sick, the the role played by his Most cover in human pain the se- Holy Father, John Paul II, Holy Mother, who is proposed cret of victory over evil and states that this celebration of- to all believers as a model of of hope in the triumph of fers each of us the opportunity lived faith.3 good. to listen once again to Our La- Mary is a model of lived From the world of suffering dy’s invitation, expressed faith especially because She and illness there rises up a eighty years ago in this was a supreme model in ac- very intense cry of help. No blessed land. cepting and valuing pain. human beings—and Chris- The basic core of this invi- Sharing in the sufferings of tians even less than others— tation—as in the Gospel—is Christ, the Mother of Jesus may say they are neighbors to the call to conversion and experienced pain along this others if they do not approach penance.1 arduous road, alongside her the pain of others. In the personal letter by Incarnate Son, as a defense- This sensitivity is the first which the Holy Father desig- less witness to incomprehen- manifestation of service to nated me as his Special Envoy sion, persecutions, and Jesus’ those suffering, a service to preside at tomorrow’s litur- passion and death. She partic- spurring us not only to under- gical celebrations, I am asked ularly suffered, however, as stand our neighbor, but to discover the deepest meaning of mension of wisdom. Christ, who, on becoming in- pain. This mysterious truth is illu- carnate, wished to take on the Pain, if accepted in the minated only if every sick per- condition of pain. name of Christ, is a healing son—indeed, every human be- The prayer ascending to power, for it rallies man’s ing, for no one is free from God each day at Fatima, with most valuable resources, pain—finds the meaning of the mediation of Our Lady, is draws man closer to others, his or her sufferings in those prayer dictated by the pain of and transforms us into Good of Christ Himself. The mys- the spirit and the body; it is a Samaritans in a period in our tery of Christ’s passion ex- redeeming offer of suffering, history so painfully marked by plains the mystery of human according to the requests the divisions, wars, lack of com- pain. This is the truest mean- Mother of Jesus addressed to munication, loneliness, and ing of the celebration of the the little shepherds of Cova da despair. World Day of the Sick. Iria. Men, in terms of both indi- However, it must not be The apparitions in 1917 and viduals and organized society, limited to the religious initia- the later manifestations deriv- are certainly engaged, and tives for this occasion, timely ing from them once again em- rightly so, in the fight against as they are. It is a powerful phasized that the way to true, pain. However, without a call whose echo must resound most effective evangelization deep, pre-eminent love of life, throughout the year. depends on a valuing of suf- no fight is possible for authen- In fact, the recovery of the fering—that is, the cross, the tic liberation from the trials of salvific meaning of suffering symbol and guarantee of our existence. is at the same time a recovery salvation. And it is precisely this of a cultural dimension which This solemn World Day 64 love—which is love for all life is both human and Christian. must be an intense moment for and for the life of each human All true, real, and lasting becoming aware of these being—which makes it possi- civil progress has always truths, which are the richest ble to do good with suffering flowed from the ability to deal source of hope for the human and to do good to those suffer- with main constructively, with race on the threshold of the ing.4 In this sense, St. Paul the unity of purpose, and over- third millennium. Apostle speaks of a pain come it insofar as it has been which provokes death and of a granted to man to overcome FIORENZO Cardinal ANGELINI pain which provokes life.5 its negative effects. It is pain as the cause of Pastoral care in health finds death that is continually intro- its source in this truth, ex- duced into the world by self- plained to us concretely by 1 Cf. John Paul II, Message for the World Day of the Sick, Oct. 18, 1996, ishness, the pursuit of the un- Christ, who in his ministry no. 1. bridled well-being of an indi- gave preference to contact 2 Cf. L’Osservatore Romano, Dec. vidual or a class, achieve- with the suffering and sick. 31, 1996. 3 Cf. Apostolic Letter Tertio Millen- ments which do not benefit all, And in this ministry the nio Adveniente, 43. but are at the expense of de- Church over the centuries has 4 JOHN PAUL II, Apostolic Letter Salv- priving others, and by serious written her noblest and most ifici Doloris, 30. 5 “…For pain according to God pro- sins of omission, both individ- heroic pages, in the awareness duces irrevocable repentance leading to ual and social, which are at the that, in encountering those salvation, whereas pain according to the root of so many calamities, of- suffering, we encounter world produces death” (2 Co 7:10). ten improperly termed “natural.” It is pain that can generate life—that is, salvation—which derives from sharing the suffering of our neighbor, the capacity to place the great lesson learned from our own suffering at the service of others, just as to value pain is to recognize our limits, whereby we are spurred to kneel before God and, like Job in the Bible, adore the mystery of his in- scrutable designs. “Blessed are those who suffer, for they shall be consoled” (Mt 5:7) is not a paradox, nor does it display a utopian view of the world. Even less is it a celebration of pain for its own sake, but, rather, it is an indication transcending the limits of science to place us in the di- The Healthcare Ministry on the Threshold of the Third Millennium

When the healthcare min- In the fundamental area of Council until the present and istry is spoken of on the eve of accompanying and assisting by the different Bishops’ Con- the third millennium, there is the sick, we can point to em- ferences in the Catholic world, talk of realities, but also of phasis on attaching value to it may be helpful to begin by lines of action to be developed the suffering of the sick, pa- delineating this apostolate’s in the future. These lines are tients’ offering pain to God, current objective, on the basis suggested by Tertio Millenni- vocational work in this field, of the rich and profound mes- um Adveniente and by the cir- messages for the sick from sage from Pope John Paul II cumstances this ministry is different Bishops, the sensitiz- for the Fifth World Day of the now passing through. The two ing of families, religious and Sick. The Pope emphasizes elements point towards a com- medical attention, especially suffering as the way of salva- mon objective and provide to patients who are least pro- tion and our duty to play the clues to foresee where the tected, sick people who are role of the Good Samaritan. main thrust of this ministry missionaries, and the parish In this light, it will not be 65 will be heading in the future. I census of the ill. difficult to discern our objec- shall specify this subject mat- In terms of fruitful coordi- tive in terms of Tertio Millen- ter in terms of the pastoral ori- nation and cooperation with nio Adveniente, the Apostolic entations of this Council. other institutions, I shall men- Letter in which the Pope offers There have been many ini- tion the associations of doc- us goals for this milestone fo- tiatives on the part of the Pon- tors, pharmacists, nurses, and cusing on the Incarnation of tifical Council for Pastoral As- social workers; the social vol- the Word. We might say that sistance to Health Care Work- unteers devoted to this min- the objective of the health ers, and many have yielded istry; and the involvement of apostolate at this time is “to excellent results. Others, how- Dioceses, religious communi- commemorate the Incarnation ever, are still at a developmen- ties, and lay communities, etc. of the Word in keeping with tal stage. Among the major ar- Particularly important are con- the Apostolic Letter Tertio eas, I would like to mention tacts with international bodies: Millennio Adveniente, to in- the following. the proclamation of a right to troduce the Gospel into cul- In the domain of publica- health for all mankind, support ture, sanctify this time, and tions, Dolentium Hominum, for the United Nations Char- achieve unity in the healthcare now in its twelfth year, stands ter on the basic right to health, ministry throughout the out, including the Proceedings included among the funda- world.” This general goal of the International Confer- mental human rights, and sup- could be divided into partial ences, published in the leading port for WHO’s Health for All objectives for each of the three languages, as well as the SE- in the Year 2000 program. years, in accordance with the LARE collection, which in Finally, to conclude this themes assigned to each of 1992 already included rich, though incomplete, them: Jesus Christ (1997), the forty-two works, and the Index overview, I wish to mention Holy Spirit (1998), and the Fa- of Catholic Healthcare Institu- the Plenary Assemblies, Inter- ther (1999). tions worldwide, The Charter national Conferences, We could also attempt to for Health Care Workers, high-level dialogues, encour- formulate the partial objective translated into many lan- agement of kindred organiza- for 1997, centering on Jesus guages, and other texts. tions, ongoing relations with Christ, as “to contemplate, In the sphere of evangeliza- the Episcopate and the Nun- celebrate, and live out the tion and public opinion, we ciatures, medical aid, and ecu- mystery of Christ in his Incar- can note information on the menical dialogue, among oth- nation through the Sacrament healthcare ministry in the me- er aspects. of Baptism and the Divine dia, catechetical instruction Motherhood of Mary, to fortify for adults and general training faith, holiness, and unity in the on the health apostolate, a Objective of the Healthcare healthcare ministry through- video on the Christian mean- Ministry on the Threshold of out the world.” ing of suffering, a book of the Third Millennium prayers for the sick, etc. Par- ticularly effective has been the If we wish to get an idea of Basic Channels World Day of the Sick, along the health apostolate on the with Hospital Day, and efforts eve of the third millennium, As we know, in the health by students to promote the while bearing in mind the im- apostolate, as in the Church’s World Day of Pain. mense efforts made by the entire ministry, there are three basic channels: the Word, Life must be understood in pain—but there is one single Sanctification, and Guidance. its totality: health is life, but, side, the positiveness of life, The health apostolate has because of sin, suffering and which arises from a clean, moved through these channels pain also accompany life. We pure fount; this fount is the in the achievements men- cannot understand life as death of Christ, his cross. It is tioned at the outset. If now, in health alone or as suffering Calvary together with the gar- 1997, we were to ask our- alone, but in its totality it is den of the resurrection (cf. Rm selves where the health min- health and suffering. Accord- 6:4; Col 2:2). istry should head, in accor- ing to the Apostolic Letter And in this orientation of dance with its objective, by Salvifici Doloris, the paradigm the ministry of the Word, way of these three specific for life is exclusively Christ which exalts the preaching of channels—that is, what the our Lord in his Paschal reality. the Paschal message as ap- concrete goals of the ministry Life is the Incarnation of the plied to health, we fully con- for this year are—we might Word (Jn 1:4), and life is the form to this first year of cele- answer as follows. hidden and public existence of brating and preparing for the In the area of the Word, “to our Lord; life is the passion third millennium, in which we contemplate the Incarnation and death of Jesus Christ, and commemorate the Incarnation of the Word in Christian suf- life, his glorious resurrection of the Son of God. It is only fering and in the culture of and ascension into heaven. through the year of Jesus life, to increase faith and The whole is life. Paradoxical- Christ that we can reach un- prompt admiration and grati- ly, death itself is life on being derstanding and comprehend tude in the sick and health contemplated in the glorious ourselves in the concreteness workers in the face of this perspective of the resurrec- of our existence, so that 66 mystery.” tion—not just with a merely through the cross the “valley In the area of Sanctification, theoretical retrospective gaze, of tears” will already be seen “to celebrate the mystery of but, by virtue of the hypostatic as paradise with the resurrec- the Incarnation of the Word in union, in a simultaneity mak- tion (cf. 2 Co 7:4; 1 Th 1:6; Ph the prayer of the sick and ing the cross glorious in itself 1:21; 3:10-11; Col 1:24). health workers to live it out and causing it, when filled more intensely in Baptism and with the resurrection, to be ac- Technology and the the Anointing of the Sick.” cepted as an exaltation (cf. Jn Meaning of Nature In the area of Guidance, “to 3:14, 14:16; Col 1:24). live out the Incarnation of the Life is thus sacred, but not Another point I regard as es- whole Christ in the sphere of only in a deistic perspective pecially important on the the health apostolate through deriving from a bare affirma- threshold of the year 2000 and cooperation with all the pro- tion that life comes from God the third millennium relates to fessionals involved, to intensi- as its first efficient principle— medical technology in differ- fy their communion.” rather, in a concrete vision ac- ent forms of research, particu- I shall now sketch out some cording to which this efficient larly in the field of biogenet- orientations for work, or poli- principle, which is at once ex- ics, though not exclusively cies for action, which might emplary and final, is the dead therein. It is the very concep- help us in a special manner to and risen Christ (cf. Ga 2:20).1 tion of nature as an object of reach the goals foreseen. Health and suffering are, then, investigation. I think the basic Many of these orientations essential to life, but suffering problem is the attitude with have already been pro- is not the negative side of life which nature is approached grammed by the Council and and health—it is the very for research. Is it the re- other pastoral bodies; others cause of health. Death in searcher who imposes an end could be further intensified. Christ is the cause of life in on nature, or does he strive to Christ, and this life in Christ in investigate what the end of na- not just one of many lives, a ture itself is, aiming his work ORIENTATIONS “spiritual” life in the Cartesian in that direction? FOR WORK sense, but it is the only possi- There are two kinds of ble life and the only psychoso- knowledge—modifying or 1. The Word matic life existing. transforming and observation- In the future of the health- al. Both are correct in their Life and Suffering care ministry, in the area of the proper measure. Observational Word, understanding pain in knowledge should precede the In terms of the Word, I think health and health in pain modifying kind—observation the health ministry must pre- should come to be stressed as which, in the case of finding sent itself particularly as the essential. The basic thing is to oneself before a human being, culture of life contending grasp and experience how suf- becomes a respectful attitude against the culture of death, fering, pain, and affliction are before the mystery of the di- since the human suffering of not something negative, but vine/human being we spoke the Word of God changes each positive, from which health about in the previous point. To man’s illness and death as a and life flow. It is not that we feel admiration at the mystery result of sin into a source of are faced with two sides of the of the Incarnation of the Word salvation and a measure of same coin—one positive, is the path for knowledge of glory. health, and the other negative, the human person. It is religious knowledge that imposes person: to understand that medicine then intervenes and itself. The ministry of the Christ suffers in each of us and strives to restore the strength Word in this field brings with that his sufferings are our suf- to fulfill that mission. When it a sense of adoration. We ferings, which He mysterious- death comes, it comes as the have access to clarifying the ly suffers in each, it is neces- final stage of life—no matter mystery of man only through sary for us to have an intimate when it arrives—and medicine the mystery of the Incarnate union with Him. This union is has performed its task without Word.2 brought about in us by the any frustration. It is this knowledge that will sacrament of Baptism. On tak- The sacrament of Anoint- provide the measure for au- ing seriously our incorpora- ing, which is joined to medi- thentic modification in any tion into Christ through Bap- cine, comes fully into play kind of therapeutic action on tism, we are taking seriously here. One of its major effects the human being, whether it be his death and resurrection in is to re-establish health when at a prenatal stage, during de- each of us, with such effec- God so decides—that is, when velopment, or in a terminal tiveness that every one of our the person has not yet finished phase; whether the person is sufferings and pains are a carrying out his mission on healthy and needs preventive source of good in Him and earth and must complete an- medicine or is ill and requires through Him—that is, they are other stage, or several more, to diagnosis and adequate treat- themselves goods, for they are perform his task. When the ment. This is the texture of a source of life. But this para- sacrament does not restore ideal culture, where homo dox is possible only if, instead health, it then acts to make faber and homo sapiens fuse of learning it as a theory, we death itself a triumph, with the in action. Under this aspect of live it out in Christ in such ability to hand over one’s spir- reference to the Incarnation of fashion that, through the it as Christ did, with the love 67 the Word, we find ourselves in Paschal experience of resur- of the Holy Spirit which is re- the suitable context to prepare rection, we can say with St. ceived in the Viaticum togeth- for the third millennium by Paul that, by way of Baptism, er with this sacrament, as a celebrating Jesus Christ, the it is not us, but Christ who union in total faith and in the paradigm for all that is human, lives in us (cf. Col 2:2). abandonment of Christ on the in any field.3 Baptism, which, moreover, cross, with the absolute cer- To sum up, medical technol- takes on special significance tainty of the future resurrec- ogy must take into account the in the celebrations of this first tion.4 fact that nature has an end in year of preparation for the itself which must be respect- third millennium, thus appears ed—even more when the hu- as one of the pastoral orienta- 3. Guidance man person is involved—and tions to be stressed in the fu- that the researcher or modifier ture for a ministry of sanctifi- In the sphere of guidance, a cannot on his own establish an cation in the domain of health great family is molded in the end other than the one God professionals. It thus acquires Church; unity is constructed Himself has established, and its full therapeutic and psy- as the convergence of those he must submit to that end. chosomatic meaning of eras- who are different. In this field ing sin and overcoming suffer- I shall indicate the ongoing ing and pain. creation of the great family of 2. Sanctification health professionals as a key The Anointing of the Sick point. In regard to sanctification, I This family spirit has three now wish to mention two The other sacrament I shall dimensions: the health sacraments closely linked to emphasize is, as I said, the worker-patient relationship, the health ministry: Baptism Anointing of the Sick. It is the interrelatedness of health and the Anointing of the Sick. closely linked to the concep- professionals, and relations tion of medicine and its fight among the sick themselves. Baptism against illness and pain. If we see medicine and the health Health Professionals We shall speak of Baptism professional as mere fighters and Patients not only in the sense that we against death, we shall be re- are increasingly seeing the ur- paid with frustration, for all The health worker-patient gency of its being adminis- medicine and therapeutic skill relationship is becoming more tered by health personnel in will always end in failure be- pressing every day, since the special cases, but under anoth- fore the inescapable reality of growing socialization and er aspect, being incorporated death. But there is another technification of medicine are into the Body of Christ, into way of looking at life: life as a drifting away from the proper Christ as Head of the Mystical vocation, as a mission which treatment due patients from Body. the Lord has given us to carry health professionals. The sick What we said in the previ- out; in this manner, each stage are increasingly reified and ous point about life should not of life has its own mission to treated as mere numbers in merely sound like a nice theo- be fulfilled, and when illness records, as mere occupants of ry, but it is a reality to be inti- steps in the way and does not hospital beds, or, even worse, mately experienced by each allow us to carry out our duty, just as money coming into the hands of health workers. of all the Bishops responsible elementary ones, to be avail- It is appropriate to insist for the health ministry in the able simply because one is a more and more on creating the different Bishops’ Confer- human being. We might term most humane relations be- ences around the world. this elementary care the mini- tween the two groups, on the The World Days of the Sick, mum common good in inter- respect patients are due from like the one we are celebrating national health, a right to health professionals, on the now, are very important for which all countries would ad- trust the professional should the Church and on the thresh- here in solidarity—rich coun- prompt in the sick, and on the old of the third millennium tries, by providing appropriate true friendship—indeed, take on special significance so facilities and medicines, and brotherhood—which ought to that our world, by way of the poor ones, by making a com- exist between them. health ministry, may receive mitment to give their popula- There must be increasing in- the grace of experiencing in tions the education needed for sistence on a Christian sharing all its intensity the commemo- them to be able to enjoy that of goods in the field of medi- ration of the Incarnation of the minimum of health for all. It is cine and health, in such fash- Word which we shall celebrate to be hoped that the Health for ion that criteria for medical ac- in the year 2000. All program will be a welcome tion will be reached in keeping accomplishment and that with a communication of The Sick when the third millennium is goods; patients communicate inaugurated, it will joyfully to doctors their economic re- In speaking of the sick, in greet the new century. sources, and doctors, their re- the context of offering guid- These eleven areas—life sources in science and the art and suffering, technology and 68 of medicine, in accordance the meaning of nature, Bap- with the real possibilities of tism and Anointing of the both. The criterion would not Sick, the health worker-patient be economic, but the commu- relationship, the interrelated- nication of goods. ness of health professionals, the union of Catholic health- Health Professionals care institutions, the union of their chaplains, the union of As for health workers Bishops responsible for the among themselves, let us not health ministry, the union of forget that modern life has set Orders and Congregations de- about commercializing the voted to this apostolate, and medical profession to such an health for all—offer some of extent that the latter finds it- the directions for action which self immersed in competition I suggest could stand out as and often falls into characteristics of the health out-and-out rivalry. One pas- apostolate on the eve of the toral orientation is to increase third millennium. unity among health professionals. The different profes- + JAVIER LOZANO sional associations are quite President of the Pontifical Council deserving of praise—the asso- for Pastoral Assistance ciations of Catholic physi- to Health Care Workers cians, Catholic nurses, and other health workers. It is to be hoped that we can have such associations in every country and then create world- Notes wide coordination of all of ance, I think that, following them. the example of the Good 1 As stated in Salvifici Doloris, no. The other pressing point is Samaritan, we should pause 21: “The cross of Christ casts salvific light on man’s life and on his suffering to intensify the union of before all the world’s sick, act in particular, for through faith it comes Catholic hospitals (AISAC) effectively, and, as our main to him together with the resurrection; the already existing on the level of assistance, give them our love, mystery of the passion is contained in the Paschal mystery.” the Holy See. which entails personal dedica- 2 In effect, Christ¼, in revealing the In this field the possibility tion. mystery of the Father and his Love, also of consolidating a union of As a practical aspect of this manifests man to man fully and enables him to know his sublime vocation” (Vat- chaplains at hospitals and oth- dedication, I would like to ican II, Gaudium et Spes, 22). er health facilities and stress WHO’s initiative re- 3 Let us not forget that, as John Paul Catholic institutions is also garding what I would call the II says in Tertio Millennio Adveniente (no. 7), “In Jesus Christ, God not only very important, along with the international common good, speaks to man, but seeks him.” union of religious Orders and the right to health care—that 4 “The Anointing of the Sick takes Congregations engaged in the is, it would be very significant our being conformed to the death and resurrection of Christ to its fulfillment, apostolate for the sick, and a for the minimum resources begun with Baptism” (Catechism of the special union must be charted needed for health, at least the Catholic Church, no. 1523). Innovating Experiences in the Health Ministry

Observations Some Changes the needs of all and the eco- Prompting These nomic factor threatens to hold 1. I shall present this sub- New Experiences sway over the human one, ject on the basis of my expe- and the strong, over the weak. rience, especially what I have There is a new way of deal- Finally, let us point to the lived through for twenty-two ing with health today, of un- crisis in or lack of spiritual years as the person responsi- derstanding it, and of situat- and moral values in a society ble for the health apostolate ing oneself before health, ill- wherein citizens increasingly in the Spanish Bishops’ Con- ness, and death. want to live more and better, ference. The value of physical and but in many cases without It remains a limited experi- mental health is exalted, and knowing why, since they ence. Many of you have other immense efforts are devoted have lost the meaning of life. experiences. It is worthwhile to preventing, combating, and The body and health are to value all of them for mutu- investigating diseases. Yet, at mistreated on being subjected 69 al enrichment. the same time, society itself to the frenetic pace of con- There are innovating expe- in many ways induces citi- temporary life. The artificial riences when the health min- zens to turn their backs on procreation and prolongation istry is alive within us. such human realities as pain, of human life is fostered, and illness, and death. Further- at the same time its deteriora- 2. A second point is that I more, the project of building tion or destruction is facilitat- regard innovating experi- a healthier society is in prac- ed by preventing human be- ences largely as an exigency tice resulting in the creation ings from being born after of the renewed conception of of a society of the healthy and conception, marginalizing the Church and her mission in strong for the healthy and certain groups of sick peo- the world deriving from the strong, marginalizing the ple—the elderly, the chroni- Second Vatican Council and weak, diminished, and sick. cally ill, the psychically dis- of the admirable efforts made Never has the value of turbed, or AIDS victims—or by our Christian communities health been so esteemed, but artificially accelerating the after the Council. never has human life been so death of those not regarded as In addition, this effort by threatened by pollution, the socially useful. our churches is a response to nuclear risk, abortion, eu- This is a series of profound the challenge of the first mag- thanasia, and so on. changes involving serious nitude posed for us—a New Medical technology has contradictions, in keeping Evangelization in a different, progressed in extraordinary with the observations con- pluralistic, secularized, and fashion, overcoming many tained in the Pastoral Consti- often secularistic, society. illnesses and increasing the tution Gaudium et Spes, nos. This means that the “inno- average lifespan, but psycho- 5-11. vating experiences” we shall logical, social, and spiritual And the Church experi- discuss, as well as others, al- weakness in the face of suf- ences these changes as a call so reflect changes in society fering is also increasing. to face them and renew her- and changes in the Church. Health care and assistance self. Starting from such profound to the sick have finally man- The healthcare ministry is changes in the world of ill- aged to become a basic hu- also aware of these very deep ness and health policy and man right, but attempts to changes in the world of care, the Church is commit- make this right a reality are in health, illness, suffering, and ted and spurred to renew this practice reaching the point of death and is responding to ministry simultaneously in overcrowding and bureaucra- them with what we call “in- terms of various demands: tization. novating experiences.” the Word of God, the current As the right to health care Magisterium of the Church— has been applied to all citi- so abundant in the field of zens, growing demand for Changes in the Hospital, health, life, illness, and suf- services and the high cost of Emblematic of Illness fering—theological-moral re- technical and human re- and Healing flection, and the dedication of sources have tremendously many Christians engaged in increased health budgets, The hospital has changed announcing the Gospel in the thereby making moral deci- in its functions, structure, and area of health and renewing sions complex and difficult, distinguishing features. health facilities. since it is not possible to meet Today it belongs to the same society which is secu- ways in this field of the each Christian’s action, for larized. health ministry, we Christians the health ministry, and for Health, illness, and care must always maintain a the orientation of every inno- largely depend on public ad- supreme and ultimate refer- vating experience. ministration, especially the ence to Jesus and his action major hospital, and are ceas- and message regarding the ing to be a matter of charity sick, health care, and life. Where We Perceive alone, becoming a right It is precisely Jesus and his These Innovating which society must ensure for message that lead and en- Experiences Today each citizen, regardless of courage us to make deep in- age, cultural background, fi- novations, for He is thSavior I shall point out experi- nancial situation, or religious of all men in all times. We ences. Many of them, thank faith. must embody his attitudes in God, are found in all our It is a complex institution the past in our present, and churches. I shall limit myself with diverse functions: care the power of his message en- to citing them and making a of the sick, promotion of lightens and spurs us to re- brief description, without go- health, research, and teaching. spond to, illuminate, and ing into details on their gene- It has become a large-scale modify our Christian modes sis. I shall do so because health enterprise governed by of commitment amidst the space does not permit me to the norms and control proper new health models and struc- engage in a detailed account to every enterprise and, in tures so that they will always and many of them are well terms of personnel, subject to and in all respects contribute known to everyone; more- the laws of the current sys- to people’s welfare. over, any specific experience 70 tem: efficiency, professional- Jesus, who lived out the can be shared with others on ism, organization, competi- joyful experience of the Fa- a different occasion. tion, and overwork. ther and of the Kingdom in- It is the house most sick tensely, also approached hu- people pass through in search man suffering, experienced it New Relations with the Sick of healing, relief, or the pre- in his own flesh and was vention of illness. deeply moved by the pain of Awareness is growing that With these characteristics, others (Mt 9:36; 14:14; attention to the sick is the re- the hospital has consequences 15:32). sponsibility of the whole to which we must not be in- He did not love or seek suf- Christian community, and not different: overcrowding and fering, but He found it in his just priests. In parishes reducing the patient to a case life, like any of us, and took it groups of Christian volun- or a number. on to show his faithfulness to teers are flourishing—lay Many people die in hospi- the Father and to his human people, religious, and priests. tals, which have not been condition, like ours, and his And the same is occurring conceived for a dignified love and unconditional soli- at hospitals with the new way death; nor is personnel pre- darity in regard to men. of understanding religious pared for this critical juncture Suffering continues with service. in the existence of patients. Christ, but is transformed and In my judgment, the novel- At the same time, however, overcome by love (Apostolic ty lies, above all, in the fact the hospital today offers sig- Letter Salvifici Doloris, that these groups represent nificant human and pastoral 14-18). the whole community and act opportunities. It is a chal- The experience of suffering in its name, and the sick are lenge for our faithfulness to made Him sensitive to the not regarded only as the ben- the Gospel and makes it pos- pain of others and led Him to eficiaries of this pastoral ac- sible to conduct a dialogue identify Himself with those tion, but as active members of between faith and culture and suffering (Mt 25:35-40). the community who are unit- shed light on the major sub- Attention to the sick was a ed to the parish or diocese, jects related to life—the special field for Jesus’ Mes- pray with it, and are aware of meaning of the person, foster- sianic action, the sign and belonging to it, realizing that ing humanity, and morally model of his liberating, sav- their illness and prayer bene- clarifying the ethical prob- ing work (Mt 11:5). fit the whole Church and the lems posed there. He approached them, world. To sum up, the new experi- looked after them with love, In its celebrations, the com- ences we shall refer to which freed them, counted on them, munity remembers them and take place at the hospital are and cured and saved the intercedes for them, and there motivated mainly by these whole person. is growth in Church commu- changes. And, through his Spirit, Je- nion through sacramental sus remains present today in Communion or taking part in every patient and wants his the Eucharist at patients’ Every Innovating Church to be the Sacrament homes or in the hospital. Experience Refers Us of Salvation for this world of It is a rich experience, with to Jesus the ill, of illness, and of enormous pastoral possibili- health care. ties. In acting in ever-renewed This is the foundation for * The encounter with the sick has also extended in- A new mentality is observ- are seldom appreciated. At- creasingly to encounters with able regarding this sacrament, tention to health workers is a their families through dia- largely fostered by the doctri- pastoral duty and a practical logue with those responsible nal and pastoral orientations way of assisting the sick as for the health ministry, ac- provided by the official texts well. companiment, and shared for the Rite of Anointing. Health personnel must be celebrations. There is progress, though helped to discover and es- * The celebration of the slow, in offering assistance so teem the ethical values in this sacraments with the sick is that this sacrament will be re- work, to share with others the progressing in significant ex- ceived at the right time, with- tough questions which arise periences for patients, rela- out risking undue delays or in the practice of their profes- tives, and the parish or hospi- leaving it, as often happens, sion, and to foster solid rela- tal community. for the moment when the pa- tionships with one another. There is a gradual super- tient has lost consciousness. These experiences reflect seding of a health apostolate The ecclesial meaning of the conviction that personnel almost exclusively based on the sacrament is being in- need training beyond a strict- celebrating the sacraments of creasingly furthered, with ly professional level, to the the sick, among other reasons participation by members of point of discovering the joy because there are many fewer the Christian community, and of service and doing good, who request these sacraments community celebrations are and they must be capable of today. supported, with prior cate- interdisciplinary collabora- Vatican II’s liturgical re- chetical instruction in which tion. form has also provided better those who are to receive the understanding of the sacra- sacrament are diligently pre- 71 ments and has promoted a pared. Other members of the Experiences more diligent search for mod- community join in the cele- with Ethical Counseling els for celebration better suit- bration at both hospitals and, ed to the secularized and plu- above all, parishes. We must start from the fact ralistic context of our society. Some churches are also that every day ethical prob- Celebration of the sacra- dealing with assistance to lems are posed in hospitals ments is increasingly viewed health workers so they may which affect patients, rela- not as something isolated, but discover and consider the tives, professionals, and dif- as forming part of a context spiritual needs of the sick and ferent departments and ser- and process of faith which are the right time to receive the vices, such as questions relat- the culmination of a personal sacraments. ed to the beginning and end relationship with the sick— of life (abortion and euthana- that is, the sacraments are sia), the provision of care, ceasing to be mere isolated Pastoral Attention professional practice, or the rites and are being situated in to Patients’ Families organization of health facili- a framework of fraternal ac- and Health Workers ties. companiment including per- Let us bear in mind that sonal relations and affection Families, in some special these problems are frequently for the sick, listening and circumstances, need a great silenced or produce inhibi- paying attention to their deal of help, as in the case of tion; or emotion-packed deci- needs, signs of service, and a patients who must be isolated sions may be made without willingness to fight against or who remain in a deep co- ethical reflection or the nec- illness. ma for prolonged periods, or essary interdisciplinary dia- These are gestures and atti- as occurs with children or the logue. tudes with a quasi-sacramen- incurably ill who are dying or There are pastoral groups tal value, in terms of a have just died. at some hospitals which have Church which is the Sacra- There is an effort to be posed this problem and seek a ment of Salvation for the close to these families and solution by offering ethical world. help them to cope with the counseling to the patients, We are assimilating respect situation. families, personnel, and ser- for the sick and a good under- Health workers also de- vices at their facilities that so standing of the meaning of serve special attention—care request. religious freedom—insepara- must be given those caring These experiences are not ble from pastoral zeal—with for health. There are some ex- easy because the task is itself gradual action involving periences which involve con- delicate and complex—every stages and avoidance of crete aims and forms of ac- moral judgment presents dif- whatever may cause un- tion. ficulties, and even more so in founded rejection. There is assistance so that the face of problems which in New experiences with cele- personnel will know patients many cases are new, and we bration of the sacrament of better, with their problems are in a secularized and plu- the Anointing of the Sick are and needs. ralistic world in which a pre- also proving to be a rich con- Those who provide care sentation of Christian morali- tribution to the health min- engage in work which is ty alone is not accepted; istry. hard, tiring, and draining and Christians values are unknown, debated, or rejected. faced with this problem, ted to humaneness a convic- In this context, there are gradually discover the hu- tion also prevails that positive undeniable difficulties in eth- manizing power of the relations with personnel must ically counseling people who, Gospel and, by way of semi- be maintained to the maxi- in such a fragmented culture nars and training programs, mum degree, including pa- as ours, adhere to very differ- take an interest in enriching tients and families. ent value systems. the Christian vision of the Part of fostering humane- And yet, in spite of the person, health, suffering, ness is preferential attention complications, there is expe- healing, and death. to the most abandoned and rience on how to act. The cri- They progressively discov- diminished of the sick, those terion is that, though value er that fostering humaneness who suffer most. And pa- systems differ, there are means regarding the sick as tients’ rights must be defend- grounds for convergence persons suffering in body and ed. which make dialogue possi- in spirit who must be cared ble. for integrally and not just in What is certainly clear is terms of disease. Religious Service that, in certain instances, the at Hospitals people involved must know, value, and appreciate the This experience is yielding teachings of the Magisterium. excellent results. Not all ethical values are We start from the assump- linked to the same degree to tion that the Church has al- the Gospel vision of man, nor ways provided religious ser- 72 do they have the same value vice at hospitals. Chaplains in safeguarding the dignity of have carried it out most fully, man. especially by administering Concrete experience is be- the sacraments of the sick. ing gained with the ethics The work of Christian reli- committees established at gious and lay people who on quite a few hospitals. These their own initiative have committees represent a borne witness to their faith shared forum for dialogue on and provided spiritual assis- the values of the person. They tance also deserves special are a valuable aid for doctors mention. and other health professionals At present a new institution who feel abandoned in the exists—the religious ser- face of some serious ethical vice—prompted particularly problems. by the complexity of the hospital; its aim is to organize various activities to meet the Fostering Humaneness hospital’s needs. in Hospital Care In these new circumstances the religious service cannot Humaneness is one of the act on its own, independently major concerns because hos- of other services, but must be pitals are ceasing to be hos- part of the health facility’s pitable for the sick and those general organization and working in them. structure its own religious On occasion, the sick are The conviction prevails in aims and efforts, like any oth- reduced to a mere object of those committed to this oper service. care, to a number, on account tion for humaneness that the The experience of the reli- of overcrowding and bureau- sick are persons who particu- gious service is developing cratization, due, in many cas- larly need to be recognized, and becoming more consoli- es, to political and economic loved, listened to, under- dated. interests, where criteria of ef- stood, and helped to feel use- This service is provided by ficiency prevail, with a ne- ful. the Church through the chap- glect of relations between There is a tendency to have lain, by virtue of his irre- health professionals and pa- patients feel themselves to be placeable sacramental min- tients. main actors in their health, istry, and those religious or I think this is one of the subject to rights and obliga- lay people who have been major concerns, for both tions. suitably trained for it. Christians working in this Attitudes change when it is It represents a change or in- field and those who, though felt that hospitals ought to be novating experience because not Christians, are aware of at the service of the sick, it is a task which must be car- the serious situation as re- without falling into the trap ried out by a team. A shared gards a lack of humaneness. of political or ideological in- plan for action must be drawn There are some Christian terests. up, and it must form part of health workers who, when In those who are commit- the pastoral care of the sick in the parish and diocese. The training experiences experience of Christian This team is a basic instru- which are appearing aim to health professionals whose ment for religious assistance, help people to grow in human organization and statutes especially at large hospitals. and Christian terms and behave been approved by the The foregoing means that come better pastoral workers Spanish Bishops’ Confer- the team must be formed, not through preparation. ence. only for practical reasons—in In programs and practice, It is grounded in applying order for the service to func- priority is given to growing in the mission of Christian lay tion properly—but also for relation to God, for the main people, as traced out by the ecclesiological reasons, since thing is and will be Christian Second Vatican Council and it is a way—perhaps the main witness. CFL, to the field of health. one—for the Church to be- Respect for others, gen- These are groups of profes- come visible at the hospital. erosity, and a willingness to sionals who are also Chris- The team involves fraterni- cooperate and work in a team tians willing to commit them- ty, cooperation, and commit- also deserve special attention selves in the health field. ment. in training. They are made up of Chris- It must be very familiar tian lay people who work in with the facility in all respects this area. They are differenti- and, on this basis, point out ated from some associations pastoral priorities. of physicians and pharma- It must correctly reconcile cists. faithfulness to the Gospel Their field of action is the with the Church’s current ori- hospital, above all, though entations and the main prob- they work with parishes and 73 lems and needs of the facility dioceses on the basis of crite- and the sick. ria of faith and the Gospel. It must formulate aims to Their aim is to transform be reached, action to achieve health care environments in them, and the specific means all their dimensions, struc- to be used, clearly delineating tures, and problems. stages and dates, and also The goal is to foster hu- name those responsible for maneness, under its varied as- different activities and evalu- pects, attention to the margin- ate—this point is supremely alized, membership on ethics important—the work of the committees, schools for the team and its results. health ministry, seminars on It is a service provided by bioethics, care of AIDS vic- the facility reflecting the citi- tims and the chronically ill, zens’ right to religious free- and patients’ rights. dom and must therefore be They are growing in included in the facility’s orga- self-awareness and spirituali- nization chart. ty. It must maintain relations with other services and take part, if possible and appropri- The Day of the Sick ate, in the commission on humaneness and the ethics com- We have been celebrating mittee at the facilities where this Day for many years. It is they exist. Another dimension of this a very advantageous celebra- And it is praiseworthy for preparation is assistance in tion to sensitize the Church them to maintain contact with gaining familiarity with the and society to the sick and the parishes from which pa- sick—their experiences, reac- health problems. Vital topics tients come and to which, tions, forms of behavior, and are the families of the sick when cured, they return. needs, especially spiritual and the Christian community needs. in relation to the sick. One must turn to the abun- The Day is prepared by Experiences dant material on specific top- choosing a topic and provid- in Training ics which is becoming avail- ing instruction. Pastoral Workers able in the different churches The Congress on Church in order to continue in this di- and Health helped us to en- Pastoral workers in health rection. counter orientations for the need training—specific train- future. ing. This is one of the most An Experience with Most Rev. JAVIER OSÉS manifest aspirations because Christian Lay People Bishop of Huesca, Spain there are new situations con- in the Field of Health Responsible for the Health Ministry tinually arising and they must within the Spanish Bishops’ be faced competently. I shall conclude with the Conference Challenges for the Portuguese Health Apostolate

After intensely experienc- human existence, such as in- claim emphatically “health for ing the Fifth World Day of the terpersonal, spiritual, and su- all by the year 2000,” with Sick in Fatima, we feel the ex- pernatural relations (cf. EV, very effective slogans: to give igency of new calls and major 23); we must therefore remain more years to life, to give commitments in our pastoral at people’s side, particularly more life to the years, and to action in health care. The when they are sick and dis- ensure health for all. That was health situation, the rights of abled, giving them the best in 1977. Twenty years have the sick, the responsibilities of quality of life we can and now passed, and we are still health workers inspired by helping to meet their specific very far from this goal. Christian values, the dynamic To accept this challenge of religious communities con- thus presupposes the follow- secrated to helping and caring ing. for the sick, and the sensitivity * To possess a new ethical 74 of parishes to those who suf- sensibility. The foundation for fer and are marginalized—all ethics is the human person, of this poses “challenges” for and no one respects ethical the health ministry which values unless human rights must be urgently examined in are borne in mind, accepting order to respond in terms of and promoting them in differ- pastoral programs and plans ent situations. Rights regard- for the coming year. ing life, care, truthful informa- What are these “chal- tion, informed consent, and lenges”? I shall list six of choice belong to the ethical them which I feel are basic for dimension of the practice of all pastoral action: life, health, medicine and related sciences. solidarity, prophecy, evange- * In addition, we must pro- lization, and, finally, organiza- mote humanity in health care tion. at all hospitals, clinics, and other facilities, as well as in home care. When we speak of 1. The Challenge of Life humanity and paying attention to the human person in his Society at the close of this concreteness, we must bear in millennium is dominated by mind “humaneness” in care, the death culture, as Pope relations, spaces, equipment, John Paul II has rightly stated. needs so they will always feel and institutions. Only global We must set the life culture the joy of living. humanization can serve the against it with the following * Competently practicing person in the wholeness of his approaches. the art of medicine and nurs- being. * Respect for human life, ing, always at the service of * A primary need is to carry under all aspects, defending, life; we thus seek to prevent on health education programs. promoting, and serving it illnesses with primary care, The exigency is for all citi- from the moment of concep- treat patients with secondary, zens—but particularly boys tion until natural death. For differentiated care, relieve and girls, teenagers, and this reason, and because the pain with palliative care, and young adults—to be oriented right to life is inviolable, we remain close to those suffer- towards healthier lifestyles. do not accept abortion, eu- ing with the care of compas- This education for health thanasia, or the abandonment sion and constant presence. hinges on three points: sup- of the disabled or terminally port for healthy growth in ill. We want to celebrate life ecologically pure environ- in all instances. 2. The Challenge of Health ments and through balanced * Promoting the quality of nourishment, guidance to- life, not only from an eco- We are living in a century wards risk-free behavior in nomic standpoint, with unbri- of great progress in medicine, emotional and sexual life and dled consumption or the beau- science, and technology. in social and professional ac- ty and pleasure of physical Nowadays people pay more tivities, and reference to the life, but especially by champi- attention to their own health. spiritual and supernatural val- oning deeper dimensions of WHO went so far as to pro- ues which are helpful for the mental wholeness required for way can we counteract the Christ during his earthly pil- quality of life. currents in social thought grimage is its capacity to de- which see in these people only nounce all that can threaten a burden to be eliminated the life of the human person. 3. The Challenge from our community life. We In taking Christ as our exam- of Solidarity ask for and seek a life of qual- ple—yesterday, today, and al- ity for all these people. ways—we must accept our The contemporary world is * To accept and care for prophetic mission. dominated by the idea of suc- those excluded from society, * By denouncing injustices, cess, prestige, and power. Not too, when they are marked by inequalities, and inhuman sit- everyone manages to reach suffering, is still another task uations oppressing our fellow these goals, possess money, or for the health apostolate. In citizens. Every day we receive live in a sea of pleasures. our country, with numerous protests and reports on mis- There are many people who ethnic minorities from Africa, treatment and abandonment, suffer, frustrated in their Latin America, and Eastern denunciations of diagnostic ideals and unable to attain the Europe, there are many peo- errors or negligence at our objectives they have set for ple who, for varied reasons, health services. In spite of the themselves. It is this kind of find access to health care to be notable efforts made at these world that people deeply difficult. In the name of uni- facilities, such situations may marked by a lack of fulfill- not be silenced. This is the ment and hope live in. The prophetic denunciation every- Church has been able to pro- one has a right to hope for. claim her preferential option * We also exercise prophe- for the poorest. Such is the cy by proposing alternatives 75 case in the world of health which may respond to the care, where the challenge of aforementioned problems. solidarity entails the follow- Such alternatives must be a ing aspects for the Church. clear, evident sign of toler- * To pay attention to the ance, community life, and dia- poorest of the poor, who, to- logue, but also of effective- day, are certainly drug addicts ness in seeking solutions to and AIDS victims, because of the problems of those who the nature of their illnesses, feel most abandoned or dis- and all who are marginalized dained. Medical care and its in abandonment. There is nev- scientific, technical, and hu- er too much insistence on ac- man quality must not be the tion to prevent these diseases, exclusive privilege of just though it is quite difficult. It is some, who may be the richest vital to encounter all who, on or highest-ranking socially, account of their problem, are but must be a right for all. regarded as social refuse. It is * Prophecy is also carried part of the Church’s vocation out by offering clear witness to receive and understand at hospitals and religious clin- drug addicts and AIDS vic- ics, parish social and commu- tims in such a way that they nity centers, and services for feel helped as persons, sup- versal solidarity, we must support of children and the el- ported in their problem, and stand at their side, and as a derly. The Church’s institu- reincorporated into society as Church construct channels for tions must be prophetic and normal people with the right approaching health services bearers of a new time which it to receive the strength to fight so that these people will be is urgent to establish. from others. helped at birth, during mater- * But it is also the Church’s nity, after accidents, in times mission to accept the physi- of crisis and need, in old age, 5. The Challenge cally, psychically, and mental- and in all other instances. of Evangelization ly disabled to give them a dig- Their status as immigrants— nified place to live within so- sometimes illegal ones—must The Pope never wearies of ciety. The advancement of not be an obstacle to medical speaking of a new evangeliza- these people, in terms of the and health care they are enti- tion with new methods and quality of life they are capable tled to. For them as well, the new expressions. This evan- of, would allow them to feel Church must be a solicitous gelization, the announcement and truly be extraordinarily mother and intercede. of the Gospel with renewed useful. Disability of any kind commitment, becomes an ex- must not be a reason for extraordinary challenge in the clusion. The Church has al- 4. The Prophetic Challenge area of health. ways given priority to the * Through a life witness mentally disturbed, inviting us Perhaps the most incisive whereby we accept and under- to see the suffering face of aspect of the Gospel as the ad- stand human beings, patients Christ in them. Only in this venture lived out by Jesus or health workers, at the hospital or at home, we are united Church is aware of this and is ers, is indispensable. to those who suffer most and thus concerned about devel- * In Christian communities, we live in a communion of oping organized action in the parishes, and home support life and destiny with the hu- health ministry as well so as groups devoted to the sick. man community we belong to. to be more effective. This Here action may be either so- This life witness enables us challenge is not easy. On read- cial, to deal with the loneli- always to behave with human- ing the Gospel we might get ness and fears appearing dur- ity in relations with the sick the feeling that everything is ing illness and suffering, or and health workers. spontaneous and left to pastoral, in terms of announc- * We evangelize through chance. ing Jesus and celebrating faith the explicit announcement of But that is not the case. in prayers and sacraments. Jesus Christ, an announce- Christ twelve apostles with a * In dioceses, through ment adapted and gauged to well-defined project. He in- health ministry commissions the faith of those we en- structed and trained them for including hospital chaplains counter, related to the expec- four years by way of talks, and parish health apostolate tations of those who, though events, and experiences which groups which will create plans not believers, wish for better later endowed them with a and projects to make the knowledge of Him in whom personal dynamic. He then Church present alongside the we believe and who gives expanded the group of disci- sick and suffering. meaning to our lives. ples to seventy-two followers. * In nations, through health * Finally, we evangelize But on the mountain at the ministry commissions, whose through organized catechesis, Ascension there were already pastoral dynamic may be ap- which takes place with a pro- five hundred. proved by the Pontifical 76 gressive initiation into Christ- He sent them in pairs for a Council for Pastoral Assis- ian life, with all its conse- trial period which was estab- tance to Health Care Workers. quences in a dynamic of faith lished, as Luke tells us in his This is organized activity at and life. Faith is not just trust- Gospel. He suffered through different levels which reflects ing Jesus Christ or possessing each moment of hesitation on a global approach seeking to deeper knowledge of his truth their part, asking them to encounter the human person or his person. Faith tends to- overcome their doubts. Final- in the mystery of man’s sick- wards unconditional adher- ly, He granted them the Holy ness and suffering. Suffering ence to Jesus Christ in all the Spirit, who encouraged them is not a punishment or trial or situations which life proposes, and their action in the world at fortuitous occurrence. Suffer- which is possible only that time. ing and illness are human lim- through explicit initiation and The healthcare ministry its which the Church helps commitment. must accept the challenge of people overcome through organization. Christ, with Christ, and in * In centers for health edu- Christ. 6. The Challenge cation and patient care which In health and sickness, for of Organization are also the workplace of us Christians only Christ health professionals. There an gives life meaning. Contemporary life does not organization of Christians, es- permit improvisation. The pecially among health work- Rev. VITOR FYTOR PINTO Fatima: A Moving Experience

Fatima was the scene of the Fifth World Day of the Sick in 1997. Fatima touches people because of its austerity, its message, the simplicity of its people, and all its pilgrims. Fatima always leaves stirring memories. On this occasion we have included three testimonies, three experiences of pilgrims who accompanied us and shared this celebration with us in Fatima: a mother, a doctor, and a nurse. Their impressions follow.

As a Mother with the Mother

I had long known that Fati- which I had also experienced a mind, I arrived in Fatima. At ma was a famous Marian form of spirituality, but luke- home in Rome I had left my sanctuary exerting a powerful warm, light as a cloud, often three children—well cared for attraction for the Catholic imperceptible and sometimes and at peace—and my hus- world, and the idea of making mechanical and routine, in a band, moved by a strange cu- 77 a journey or pilgrimage there vaguely predisposed state of riosity and an intense desire to had fascinated me from the be alone at last with myself for outset, but I would never have a while. imagined the whirlwind of The encounter at the Sanc- emotions and feelings this trip tuary, in the Little Chapel of would stir up within me. the Apparitions, was over- The opportunity to attend whelming, unique, unrepeat- the celebration of the Fifth able—an appointment for World Day of the Sick was of- which I grasped I had been fered me by the Pontifical awaited, quite patiently, for a Council for Pastoral Assis- long time. There I found a tance to Health Care Workers, wonderful friend, and as one where I work. I took part in woman to another, as a mother both the liturgy and other with the Mother, I spoke to events with great interest. Her extensively. I reviewed The attractiveness of the site my life, my affections, and my for tourism, with its natural existence here below in the beauty, immediately struck me world and gradually discov- as secondary in comparison to ered an indissoluble, very the atmosphere of deep peace powerful bond which time had encountered there. only attenuated, but never bro- An arrival in Fatima— ken. In this tranquil and beau- largely by chance, in my tiful atmosphere, in these case—after a long trajectory long, lively exchanges in si- lasting many years during lence, I let myself be carried which I had led a very intense off, and the passage from life full of numerous joys and words to prayer was quite some sorrows, studying, brief. working a lot, forming a fami- To rediscover prayer and its ly, having children and think- immense value was a second, ing always and only of them even more overwhelming and their untroubled growing breakthrough for me. That up, surrounding them with White Lady, holding in her care, attention, and total love. . hand the most precious jewel, . . In such a frenetic and busy the Rosary, in those distant life, where there is no room to days had told three simple pause and one collapses at shepherds to pray a great deal night just to get a bit of rest and recite the Holy Rosary as and then start all over the fol- often as possible to make lowing morning with break- reparation for the world’s sins. fast, school, the office, and I, too, very simply attempt- traffic… ed to obey those unpretentious Well, after all those years exhortations, for, while pray- spent in that way, during ing and remaining for long periods before Our Lady, I felt must not lose the opportunity ple, and courage in adversity. such a deep, intense peace to entrust oneself completely Certainly, not everything is arising within me that it made to Her so that She will assist or will be easy. Now that I me turn pale and canceled out and protect us. have come back home, appar- my stress, concern, and an- I entrusted my family—the ently nothing has changed. I guish, bringing me a state of greatest good I possess—to have resumed life as usual and calm which I had not experi- Our Lady, particularly my everyday events have gotten enced for a long time. children. I am sure She will the upper hand. And yet I feel And this unfamiliar state look after them and remain at different and am different. spurred me to go increasingly their side forever; and their And I bear with me a great to the Chapel of the Appari- earthly mother will accompa- longing to convey my peace to tions or the Chapel of Perpetu- ny them with love, care, and others, especially by my ex- al Adoration to pray more and all they need as their young ample. For me, the message of not lose those sensations—to lives burst open. Fatima has been at once sim- recharge my batteries, a bit But I grasped one important ple and grandiose. As St. worn out and excessively oc- thing to do from now on: never Bonaventure wrote, “Whoever cupied by contemporary life. to fail to pray—at any time of thinks of Her in the serenity of The power of prayer is im- day, wherever I am—to pray the mind will find the sweet- mense—oceanic. It is an an- incessantly for all, since only ness and quietude of peace.” chor of salvation. And in the from prayer do we draw the presence of Our Lady one strength which is life, exam- ALESSANDRA CIATTINI

78 My Experience of Fatima

I am a nurse and a believer, therein encounter the message newed our promises—perhaps and about five years ago I be- of Christ and his work. On the the part of our commitment gan to travel with the Spanish opening day I was particularly which the whirlwind of daily Federation of Religious in impressed by what Cardinal work, with its ration of afflic- Health Care in Catalonia. Angelini said to us—examples tions and ambitions, had si- Freely embracing faith as a like that of the Pope himself or lenced. foundation, I accepted a com- Cardinal Descourt, who of- Today, in the perspective of mitment to service in the con- fered their pain to Christ, are a faith in Christ, scientific crete perspective of my daily living witness to God’s love. progress presents itself to us as work. I had the chance to at- In recalling the Pope’s oper- one more gift of love for hu- tend the World Day of the ation, he also said that fre- man beings, but we cannot fail Sick in Fatima in February. I quently healing science is in- to reflect in the light of the in- would like to share my experi- spired by the breath of the formation appearing every day ences with you and suggest Holy Spirit, and professionals in the media that there may be 79 that we reflect together in the are the simple, beautiful in- a dark side to it, something light of our faith. Christ visit- strument of Christ’s love for neither pure nor clean which ed those in pain and showed us. At that moment the anes- ends up brutalizing the human special love for them, as He thetist who took part in the op- being and depriving him of did with children and the sim- eration and Cardinal Descourt freedom. Through faith we ple, and in that act of sublime shed tears of faith and joy. I can endow science with its love which the care of the sick was present there. maximum splendor, its true di- ought to be, we health profes- We spoke about all of this mension of achievement. The sionals should approach God and much more in Fatima and health sciences must draw us with humility and a will to prayed that Mary, our help and near God, not separate us from serve others, bringing Christ’s refuge, blessed balm of love, the human being. We must get Gospel message into daily would hear our entreaties. back on the path of bioethics events and turning the parable I came away with so many with renewed effort, fleeing of the Good Samaritan—heard experiences in my heart that I from subservience to the eco- so often—into a supreme real- find it hard to recount them, nomic interests of powerful ity. but there is one which I espe- lobbies—or to the most in- To feel the suffering of cially remember—the torch- significant, unbridled desires those in pain, attend to their light procession. There we be- of men. Our work day by day needs, console their affliction, came aware of—and the senti- must be offered—sanctified— and relieve their loneliness— ment was infectious among to others, serving only our this is love rendered concrete us—the fervor and spirituality brothers and sisters suffering in sanctified work at health fa- of the Portuguese people in re- in their illness. These are my cilities around the world, gard to Mary. We also saw thoughts on coming back whether they are built of cost- penitents walking on their home from a beautiful place ly stone or poor canvas in knees as far as the cave, mur- called Fatima, Portugal. refugee camps. For some the muring prayers of gratitude time comes to feel pain and for the graces received, and at GLORIA TARIN illness in their own flesh and that moment we inwardly re- Nurse Encounter and Prayer

Here I am, Mary. I did not haps I am incapable of doing assassination attempt. think I would come back so so. How many of us, I won- People go to Fatima pre- soon to see You. I have been der, are able to express our cisely for this reason: to pray. to so many places in recent faith through prayer? Our La- Fatima is the place of prayer years, the different localities dy looks at me, the women for one’s sufferings, to make where the World Day of the pray, and I am silent, a sinner reparation for oneself, for oth- Sick has been celebrated: before the beauty of the light ers, and for those who never Lourdes, Czestochowa, Ya- of Mary’s face and the faces pray, in the interior rediscov- moussoukro, and Guadalupe. of the praying women. Per- ery of dialogue with the Lord Meaningful, singular, and un- haps they are mothers. They our God. forgettable experiences, al- are not young, but, like all On the Face of Our Lady I ways surrounded by an im- mothers, they pray—first of glimpsed a smile, like that of a mense throng of the faithful of all, for their children, then for mother taking pleasure in ob- 80 every race and age, but all of their husbands, relatives, serving her children who are them with one great joy in friends, and loved ones. And growing properly, in keeping their hearts—the encounter all of us pray most of the time with her attentions and wish- with Her, the Mother of Jesus. for something belonging to es. To me, as a man and doc- And now, after about twen- us, for a gift received—Love. tor dealing with suffering, that ty months, I am again before With Love I saw the Face of smile represents Mary’s hap- You. It is the day before the Mary, who is weeping at the piness over the regained chil- Fifth World Day of the Sick. foot of the cross and praying, dren who entrust themselves My friends are elsewhere. It is and the Face of Jesus, who, to Her, certain of her help and late in the evening. There is a though suffering, is praying protection. bit of cold wind. Around me and beseeching with serenity The seated woman has now is a vast open space—it is a and courage because He gotten up and is going off, and square in front of the church knows the Father’s will has now I, too, can head back to in Fatima. I am facing the lit- been done. The women pray my pilgrim friends. Tomorrow tle chapel with the illuminated with intense, firm faith, and is the Fifth World Day of the statue of Our Lady. There are now I, too, am praying with Sick—a feast day. Today a few lights around it. All is si- them, in my silence, but with sick person is healed. Tomor- lence. It is cold, and I realize my heart full of joy over those row both he and others will be that only three of us have re- moments of radical, deep ill again, but certain that, on mained before You—two communion with Him. seeing again the smiling Face women and I. On entrusting to the Lord of Our Lady, their sufferings One woman is sitting and the persons dear to me and all will mean many healings for praying, holding a rosary. The the sick suffering in body, many other sick people whom other is completing her mind, and spirit, bearing them only She knows and for whom umpteenth turn around the with me and within me, I the time has now come, for Chapel—on her knees. The again see the image of our “God dwells in them as Love.” rosary is in her hands, too— Holy Father, John Paul II, at what faith! the foot of the statue of Our ANTONINO BAGNATO, M.D. I observe them, and my Lady of Fatima, absorbed in Vice President of the mind stops to reflect. I have prayer, giving thanks for the Catholic Medical Association never prayed that way. Per- recovery of his health after the in Rome