Santa Clara University Scholar Commons Jesuit School of Theology Dissertations Student Scholarship 9-2018 “The eF male Face” of Hiv/Aids as an Ethical Challenge to the Catholic Church in Uganda: Lessons of Catholic Social Teaching Athanasius Kikoba Follow this and additional works at: https://scholarcommons.scu.edu/jst_dissertations Part of the Religion Commons “THE FEMALE FACE” OF HIV/AIDS AS AN ETHICAL CHALLENGE TO THE CATHOLIC CHURCH IN UGANDA: LESSONS OF CATHOLIC SOCIAL TEACHING A dissertation by Athanasius Kikoba Presented to The Faculty of the Jesuit School of Theology of Santa Clara University In partial fulfillment of the Requirements for the degree of Doctorate in Sacred Theology Berkeley, California September 2018 Committee Signatures ____________________________________________ Dr. William O’Neill, S.J. (Director) Date ____________________________________________ Dr. Marianne Farina, C.S.C. (Reader) Date ____________________________________________ Dr. Teresia Hinga (Reader) Date To my parents who led me into the Church and whose love has nurtured me. CONTENTS ACKNOWLEDGEMENTS VI ABRREVIATIONS VIII ABSTRACT XI GENERAL INTRODUCTION 1 CHAPTER ONE: GENDERED VULNERABILITY OF WOMEN AND GIRLS TO HIV/AIDS IN UGANDA 13 Introduction 13 A Personal and Ministerial Encounter with Persons with HIV/AIDS 13 Gendered Vulnerability of Women and Girls to HIV/AIDS on the Global Level 18 Gendered Vulnerability to Women and Girls to HIV/AIDS on Continental Level: Sub-Saharan Africa 26 Historical Implications of the HIV/AIDS Pandemic in Uganda 29 Gendered Vulnerability of Women and Girls to HIV/AIDS in Uganda Today 37 CHAPTER TWO: FACTORS RESPONSIBLE FOR GENDERED VULNERABILITY OF WOMEN AND GIRLS TO THE HIV/AIDS PANDEMIC IN UGANDA 43 Economic and Political Factors 43 Poverty 43 Corruption 57 Limited Domestic Funding 62 Social and Cultural Factors 64 Stigmatization and Discrimination 64 Excessive Alcohol Consumption 69 I Gendered Sexual Violence 71 Rape in Conflict Areas 71 Domestic Violence 76 The Objectification of Women: Media and Language 78 Cultural and Traditional Factors 82 Dowry, Widow Inheritance and Female Genital Mutilation 82 Patriarchal Biases: Denial of Full Opportunity in Education, Access to Health Care, Participation in Politics and Public Life and Right to Land Ownership 88 Progress Made So Far and Remaining Challenges for the Future in the Fight Against HIV/AIDS 93 International Community 93 The Ugandan Government 97 The Catholic Church in Uganda and Other Faith-Based Organizations 101 The Non-Governmental Organizations (NGOs) 109 The AIDS Support Organization (TASO) 109 National Community of Women Living with HIV/AIDS (NACWOLA) 111 KITOVU Mobile Home-Based Care 113 CHAPTER THREE: CATHOLIC SOCIAL TEACHING AS AN ETHICAL FRAMEWORK FOR ADDRESSING HIV/AIDS IN UGANDA 116 Human Dignity 121 Human Rights 124 A Historical Survey of Human Rights in the Catholic Tradition 127 Pope Leo XIII and Human Rights 128 Pope Pius XI and Human Rights 133 Pope Pius XII and Human Rights 138 Pope John XXIII and Human Rights 141 II The Second Vatican Council and Human Rights 150 Pope John Paul II and Human Rights 154 Pope Benedict XVI and Human Rights 160 Pope Francis and Human Rights 164 The Common Good 167 Solidarity 175 An Option for the Poor 190 CHAPTER FOUR: PROPOSALS/POLICIES FOR A LIFE-AFFIRMING AND LIFE-ENHANCING THEOLOGY FOR WOMEN AND GIRLS WITH HIV/AIDS IN UGANDA 198 The Catholic Church in Uganda 199 Short-Term Goals 200 A Pastoral Letter Written in Collaboration with Women and Girls with HIV/AIDS 200 Tackling Stigmatization and Discrimination Against Women and Girls with HIV/AIDS 208 Mid-Term Goals 213 Advocacy and Education 213 Counseling 217 The Ministry of Reconciliation 217 Anointing of the Sick 220 Preparing the Sick for Death: The Need for Compassion, Patience and Hope 223 Long -Term Goals 226 Proclaiming the Gospel of Life 226 Working for a More Inclusive Church 227 Marriage Preparation in the Age of HIV/AIDS 232 The Church and the Condom Debate, A Case of Discordant Couples 236 The Responsibility of Women and Girls with HIV/AIDS in Uganda 238 III Short-Term Goal 238 Responsible Lifestyle 238 Mid-Term Goal 240 Seeking Treatment and Care 240 Long-Term Goal 240 Ongoing Self Care by and for AIDS Patients 240 The Responsibility of Men in the Time of HIV/AIDS 242 Short-Term Goal 242 Living Responsibly 242 Mid-Term and Long-Term Goals 242 Ongoing Dialogue with Men Regarding Culture 242 Long-Term Goal 245 A New Paradigm: Understanding Masculinity from a Feminine Perspective 245 Physicians’ Responsibilities in the Time of HIV/AIDS 247 Short-Term Goal 247 Truthfulness with and to Patients 247 Mid-Term Goal 247 Observation of Confidentiality 247 Long-Term Goals 248 Focus on People, Not Money 248 The Government of Uganda 253 Short-Term Goals 253 Provision of Safe Bathrooms and Sanitary Pads for Girls in Public Schools and Prioritization of Education for Girls 253 Mid-Term and Long-Term Goals 254 Prioritize Spending on Health Care, Provision of Medications, and Timely Remuneration of Health Care Workers Over Purchase of Military Hardware 254 More Than Words: Enforce Human Rights 256 Tackling Corruption 260 IV International Community 262 Short-Term Goals 263 Commitment to Funding HIV/AIDS Programs 263 Poverty Reduction 265 Debt Relief 268 Ensuring the Ethical Norms Guide Research and Trial Vaccines 270 Non-Government Organizations (NGOs) 272 Short-Term Goal 272 Forming Support Networks 272 Mid-Term and Long-Term Goals 273 Universal Access to Antiretroviral Therapies and Mobilization of Funds to Finance HIV/AIDS Programs 273 Collaboration with Churches to Eliminate Harmful Practices such as Domestic and Sexual Violence and Female Genital Mutilation 273 CONCLUSION 276 BIBLIOGRAPHY 280 V Acknowledgements A piece of work like this dissertation is the fruit of many interlocutors collaborating and working together. And so, I would like to express my deepest gratitude to the many people who have worked with me and prayed for me. First and foremost, I would like to thank Professor William O’Neill, S.J., my director for his wisdom, great intellectual capabilities, patience and humility. Studying under you and working on this academic project under your guidance has truly been the greatest honor of my life. You manifested the grace and love of God to me. I thank you greatly. I am equally grateful to Professor Marianne Farina, C.S.C., and Professor Teresia Hinga, my two readers. I appreciate your insights. In the same vein, I am very grateful to Archbishop Denis Lote Kiwanuka, the Emeritus Archbishop of Tororo, who gave me the opportunity to pursue further studies in theology. Your fatherly care made a difference in my life. I am equally indebted to Archbishop James Odongo, the Emeritus Archbishop of Tororo, who first gave me the chance to study in the U.S.A. and ordained me to the priesthood. To my new Archbishop Emmanuel Obbo, A.J., thank you. To Fr. Hans Smeets, M.H.M., my former Pastor, I thank you for inspiring me to join the priesthood. May God grant you eternal life. To Bishop Patrick McGrath, the Bishop of San Jose, I will forever be indebted to you. You provided me with the opportunity to exercise my priestly ministry in your diocese and I thank you. Your cards and assurances of prayer on my ordination anniversary helped me to love my vocation. Your humility and pastoral concern for the priests is inspirational. Thank you and God bless you. To my Pastor, Fr. Gregory Kimm, thank you for your support, fraternity and friendship. You made a great difference. To the VI parishioners of St. Joseph of Cupertino, thank you for your prayers and support. May God bless every one of you. To the parishioners of St. Athanasius who first received and welcomed me to California, I am very grateful to you all. Lastly, I thank the Jesuit communities at Santa Clara University and the Jesuit School of Theology for the scholarships, friendships and prayers. Your generosity and magnanimity of hearts will stay with me for the rest of my life. Thank you. My gratitude also goes to all the students I have met and studied with. May God bless our future journeys. VII Abbreviations ABCs Abstinence, Being faithful, and Condom Use Acfode Action for Development Organization AfD Associates for Development AIDS Acquired Immunodeficiency Syndrome ANERELA + African Network for Religious Leaders Living with or Affected by HIV and AIDS ARTS Antiretroviral Therapies ARVs Antiretroviral Drugs AUD Alcohol Use Disorder CA Centessimus Annus CEDAW Convention on the Elimination of All Discrimination Against Women COR Letter of Saint Paul to the Corinthians CST Catholic Social Teaching DCE Deus Caritas Est DH Dignitatis Humanae DRC Democratic Republic of Congo EPH Letter of Saint Paul to the Ephesians FMG Female Genital Mutilation GDP Gross Domestic Product GFATM Global Fund in the Fight Against AIDS, Tuberculosis and Malaria GS Book of Genesis HIV Human Immunodeficiency Virus HSRC Human Sciences Research Council ICRW International Center for Research on Women IGA Income Generating Activities JN Gospel of John VIII LE Laborem Exercens MT Gospel of Matthew MTCT Mother-to-Child Transmission MUWRP Military HIV Research Program NACWOLA National Community of Women Living with AIDS NAFOPHANU National Forum of People Living with HIV/AIDS NGOs Non-Governmental Organizations NIAAA National Institute on Alcohol Abuse and Alcoholism NRM National Resistance Movement NSP National Strategic Plan PERFAR President’s Emergency Plan for AIDS Relief PLHIV Persons Living with HIV PLWA Persons Living with