Pontifical Council for the Pastoral Care of Migrants and Itinerant People People on the MoveN° 101, August 2006
HIV/AIDS and its effectson refugee situations in a Christian Perspective
Archbishop Agostino MARCHETTO Secretary of the Pontifical Council for the Pastoral Care of Migrants and Itinerant People
1. Introduction She is lying on a mat outside her house, gasping for breath. Her daughter, Monique, 12 years old, looks on helplessly. The oldest son, a boy of 15 years, is out searching for food. He dropped out of school to look after their parents who were sick for months with AIDS. In the meantime the father has died. It is two days since the family has eaten anything. The 12-years-old daughter relies on a daily free school meal. She sometimes has to miss school as her mother's condition rapidly deteriorates. Some days I can't attend classes because I have to take care of my mother, says Monique. She is now too ill to walk to the hospital. This is just one story of how HIV/aids is influencing the daily lives of so many people. Indeed, AIDS1can be seen on a daily base around us. The victims are from different countries and backgrounds. They are ordinary people, relatives and friends, colleagues and neighbours. 2. The problem Sub-Sahara Africa is the subcontinent most heavily affected by HIV/AIDS. Of the 39 million people suffering because of AIDS worldwide, 25 million live in sub-Saharan Africa2. At present 13 million Africans have died of it and 12 million children have lost at least one parent as its consequence3. In 2004 around 3 million Africans got infected and sixty percent of the people infected with HIV/AIDS globally are living in Africa. Among young people aged 1524 years, an estimated 6.9% [6.38.3%] of women and 2.2% [2.02.7%] of men were living with HIV at the end of 20044. There is still not a true cure for the disease. However, certain medicines exist which slow down the disease. Many times however, these are not available to people because of poverty - they do not have the means to buy them - or infrastructure for medical treatment are lacking. HIV/AIDS has enormous social and economic consequences on society, and affects many aspects of daily life, which especially touch the poorest. I just want to mention, in a nutshell, some of them. The most productive age group in society is especially affected, and gradually this becomes visible in countries. Professionals as well as illiterates fall sick. Schools are losing their teachers, hospitals and clinics their medical staff, governments their civil servants, and the productives sectors their labourers. This has an impact on the wider society and increases the poverty of people. Life expectancy has decreased, in some countries dramatically, by ten to fifteen years. Changes in roles is also taking place. Thus we find older people obliged to return to work on the land since they cannot rely anymore on the support of their children. Moreover, there are parents who have to care for their sick children, seeing them die, and then take in their grandchildren - orphans - to care for them. It is an economic burden and an emotional one too, to see your child dying when you are old. Children, and especially girls, will no longer go to school, but stop their education and stay home to take care for their younger brothers and sisters, doing odd jobs to earn some money to contribute to the family and, many times, ending up heading the family. The number of orphans has dramatically risen, and they are vulnerable to different forms of abuse and exploitation. Once they become street children, they face special risks being involved in prostitution, sniffing of glue and moreover, in times of civil war, also being recruited as child soldiers. (See the proceedings of our 1st International Congress of pastoral care for children of the street, one year ago, published on our Review People on the Move and in Internet: www.vatican.va/roman_curia/pontifical_ councils/migrants/documents/rc_pc_migrants_doc_20251004_ strada_finaldoc_en.html ). Rural development, food security and agricultural policies are negatively affected. The death of millions of African farmers leads to lower food production, while family earnings are reduced. Sick people work less, and tedious heavy work can no longer be done. That also leads sometimes to the loss of the necessary know-how and skills to do agricultural work. Discrimination - exclusion Many times persons suffering from AIDS are turned away from the family, the community and perhaps even the parish. It still happens that people lose their jobs once it gets known that they suffer from aids. They are discriminated against because they have contracted an illness, and this leads to isolation. Different reasons can be at the origin of this behaviour. The main one is not being sufficiently informed about the nature of the disease and how it is transmitted. People still lack knowledge and sufficiently understanding about HIV. Out of fear people avoid casual daily contacts, do not buy foodstuffs from people who are infected, or are no longer invited to eat together. Another reason can be economically motivated: to take care of a sick person requires time and costs money. Poorer families faced with making a decision how to use available means for the whole family, may tend to neglect the sick person, who, according to them, who will soon die anyway. The mobility of people The rates of the infection and consequences for the different groups of people on the move are different. Transport It is a well-known fact that HIV/AIDS has spread along the transport routes. This is due to the attitudes of lorry and taxi drivers. Some have fixed places where they spend the night, sometimes with a woman in different towns. This could be with professional prostitutes or with women who, as a survival strategy, sell their bodies to earn their living. Migrants We have to make a distinction between the policy that has to be followed by migrants whether they are staying with their family or remaining alone. Thus a policy that groups men together staying in all male hostels, and returning home once a year to see their families, will create a special social cultural environment. When isolated from traditional socio-cultural norms and values of their home society, their behaviour is no longer regulated by social and moral constraints. This anonymous situation, particularly when there is easy access to different partners, multiplies the possibilities of infection. Returning home, they bring the disease along and spread over great distances. In South Africa for example, with its hundred of thousands of contract migrant labourers, miners are a clear example of such a policy and the spread of AIDS. War crimes - systematic rape The correlation between AIDS and war cannot be automatically made. However, the risk factor during war becomes higher, especially in cases where systematic rape is used as a weapon of war. This has happened, for example in Liberia, the Democratic Republic of Congo and Rwanda, resulting thousands of women being infected. One Rwandese widow stated: After killing our husbands, they turned to us. They knew very well that they were infected with the virus and wanted us to experience the same agony. She has now been living with HIV for nine years. Her skin is scared and eyes sunken by the disease. The genocide did not only kill; it left in its wake lasting psychological scars on thousands of survivors5. Refugees and Internally Displaced Persons Many times they are blamed for having introduced HIV/AIDS into a region. However, research indicates otherwise. The percentage of HIV/AIDS infected refugees is normally not higher than the one of the surrounding population. Often it is even lower. Evermore over the years, by attending awareness campaigns in camps, refugees are better prepared for prevention, which also leads to a reduction of HIV/AIDS infection rates. Between 2001 and 2003, the UN High Commissioner for Refugees (UNHCR) and its partners measured HIV prevalence among pregnant women in more than 20 camps housing some 800,000 refugees in Kenya, Rwanda, Sudan and Tanzania. The results: refugee populations in three of the four countries had significantly lower HIV prevalence than the surrounding host communities. For example, in northwestern Kenya, 5% of refugees were HIV-positive, compared with a 18% HIV prevalence in the surrounding ... population. In the fourth country, Sudan, the refugee camps and host community had comparable infection rates6. However a certain risk for spreading HIV/aids exists when refugees return. Then their percentage of infections may be higher than those of the remaining population in the country of origin, especially in isolated regions. More research is still needed to get to know the situation of urban refugees, which is most probably worse than the situation of refugees in camps, since they have to struggle to survive. After all they do not receive material support and rely on government services that may discriminate against them when they are undocumented. This all may lead to a more risky behaviour. The same is most probably also true for Internally Displaced Persons who hardly can rely on the services of their government7. 3. The Answer of the Catholic Church The dignity of the individual plays a central role in the social doctrine of the Church. In fact that is the basis also of its vision for society: ...individual human beings are the foundation, the cause and the end of every social institution8. This means every man has the right to life, to bodily integrity, and to the means which are suitable for the proper development of life; these are primarily food, clothing, shelter, rest, medical care, and finally the necessary social services9. In the same line The joys and the hopes, the griefs and the anxieties of the men of this age, especially those who are poor or in any way afflicted, those too are the joys and hopes, the griefs and anxieties of the followers of Christ10. This motivates the involvement of the Church, with those who suffer, regardless their ideology and religion. Thus when the Church speaks out about poverty or life, human rights or death penalty, this is done from the same point of view; each human person has an essential and priceless value, a dignity which should not be threatened. This is true also when new problems challenge the human being. Nowadays this includes the persons living with HIV/AIDS, so that this caring presence of the Church is incarnated into many different forms and covers a whole range of activities addressing the different aspects of the needs and the problems of the society. 3.1. In the hospitals On various occasions, Pope John Paul II has affirmed that those suffering from HIV/AIDS must be provided with loving care and shown full respect, giving every possible medical and spiritual assistance, and indeed treated in a way worthy of Christ himself. So, as a consequence, the merciful love of God needs to be shown especially towards the orphans of parents who have died of AIDS11. To be concrete the Catholic Church takes the care also for one in four patients who are HIV positive worldwide. 12% of care providers for HIV/AIDS patients are agencies of the Catholic Church and 13% of the global relief for those affected by the epidemic comes from Catholic non-governmental organizations. The Holy See, thanks to its institutions worldwide, provides 25% of the total care given to HIV/AIDS victims, placing itself among the leading advocates in the field, in particular among the most ubiquitous and best providers of care for the victims12. A breakdown of activities in 2005 shows that at present 45% of actions is undertaken by governments, 27% by the Catholic Church, 16% by other religious communities and 12% by Non Governmental Organisations13. The Episcopal Conferences of Africa and Madagascar (SECAM) fully support this task and commit themselves to making available our Churchs resources be they our educational and healthcare institutions or social services and to identify focal points in parishes, dioceses, and national Episcopal Conferences in order to assist with gathering information and development of programme strategies14. Further developments have led to the establishment of the Good Samaritan Foundation, created by Pope John Paul II, on 12th September 2004, for the purpose of showing the concern of the whole Church for the poorest and most deprived among the sick, the people affected by AIDS, and the focus of the Foundation is Africa15. 3.2. Access to medicines Access to life-saving antidrugs (ARVs) is difficult in many countries, with the result that millions of people cannot use them because these medicines are not sufficiently available, or their cost is too expensive for a large part of the population. Partly, this is a consequence of the intellectual property rights or the patents on the medicines. In this regard it is appropriate to recall what the Second Vatican Council emphasized regarding the common destination of the world's goods16 and what is taught by the Encyclical Centesimus Annus, that is: "Of its nature private property also has a social function which is based on the law of the common purpose of goods17. This has immediate consequences in dealing with hunger, poverty and disease. As far as sicknesses are concerned, it means that the right of every individual to health care should be promoted and that property rights are subordinated to the common good18. The Holy See has promoted this and proposed it in UN meetings, asking the rich countries to respond to the needs of HIV/AIDS patients in poorer countries with all available means, so that those men and women afflicted in body and soul will be able to have access to the medicines they need to treat themselves19. The same approach could be taken by local Churches in relation to their respective governments to obtain the necessary resources for the treatment of HIV/AIDS patients. Therefore the Church supports the view of UNHCR20 that refugees should be treated in the same way as citizens of the country concerning aids and access to medicines, whereby mandatory testing of asylum-seekers should be forbidden, since it does not prevent the spread of the virus and is not in accordance with human rights standards. 3.3. Against discrimination and stigmatisation Persons suffering from HIV/AIDS are also vulnerable, because many times they face discrimination or are stigmatised by their immediate surroundings or by the society at large. In fact, the relation between the sick and the healthy, a relation between human beings, is threathened by intolerance and one should not blame people suffering from AIDS. In this context Pope John Paul II spoke several times against the discriminatory treatment of people suffering from it. As stated already in 1989 with these patients: God loves you all without distinction, without limit. He loves those of you who are sick, those suffering from AIDS. He loves the friends and relatives of the sick and those who care for them. He loves all with unconditional and everlasting love21. The Bishops of Southern Africa put it in this way: AIDS must never be considered as a punishment from God. He wants us to be healthy and not to die from AIDS. It is for us a sign of the times challenging all people to inner transformation and to the following of Christ in his ministry of healing, mercy and love22. These convictions are embedded in the vision that all men possess a rational soul and are created in God's likeness, since they have the same nature and origin, have been redeemed by Christ and enjoy the same divine calling and destiny, the basic equality of all must receive increasingly greater recognition. .... with respect to the fundamental rights of the person, every type of discrimination, whether social or cultural, whether based on sex, race, color, social condition, language or religion, is to be overcome and eradicated as contrary to God's intent23. This is a common teaching of the Church, and every Christian Community is asked to join in and promote a relation of trust, acceptance and caring, and so become a place of healing where all are welcome and feel at home. 3.4. The question of reproductive health in refugee situations Some years ago several UN Agencies published a field manual concerning reproductive health in refugee situations24. It promotes reproductive health as a right, taking its lead from the Cairo Conference25. After various discussions with the UNHCR, an answer26, indicating the concerns for the Holy See, was developed by three dicasteries of the Roman Curia. Differences concerning the concept of reproductive health, as is evident in the positions of the Holy See and the UN, result in taking sometimes opposite actions. In fact Regarding the terms sexual health and sexual rights, and reproductive health and reproductive rights, the Holy See considers these terms as applying to a holistic concept of health, which embrace, each in their own way, the person in the entirety of his or her personality, mind and body, and which foster the achievement of personal maturity in sexuality and in the mutual love and decision-making that characterize the conjugal relationship in accordance with moral norms27 Furthermore the Church holds that human life starts at the moment of fertilisation. So we must say thath the Field Manual proposes an utilitarian and narrow approach of sexuality. This results in the use of condoms on a massive scale and the morning-after pill, when forced sexual relations have been realized (and this pill is considered by it as an emergency contraceptive), with sterilisation also regarded as a simple contraceptive. The Note for the Bishops Conferences,in any case, states that pastors have the duty to ensure respect for refugees as persons and for their rights. This involves knowing the refugees and the health care workers who are looking after them, winning their trust, listening to their appeals, and paying attention to everything said in confidence. In any case by a presence that is not limited to Catholic charitable organisations, pastors must be very vigilant to ensure that practices proposed by the Field Manual and considered to be immoral do not gain a foothold28. 3.5. Prevention Marriage is a permanent, loving, faithful, mutual relationship between a man and a woman. It involves partnership and mutual respect and is committed to the bearing and rearing of children and the guidance of adolescents. It involves, rejecting artificial contraception29, the use of natural methods for regulating birth means. In this perspective abstinence and chastity before and outside the marriage and faithfulness to each other within the marriage are virtues. Moreover, they are the best and most effective prevention against the sexual transmission of HIV/AIDS. This requires training in the authentic values of life, love and sexuality. A proper appreciation of these values will inform today's men and women about how to attain full personal fulfilment through affective maturity and the proper use of sexuality, whereby couples remain faithful to each other and behave in a way that prevents them from becoming infected by HIV/AIDS. No one can deny that sexual licence increases the danger of contracting the disease. It is in this context that the values of matrimonial fidelity and of chastity and abstinence can be better understood. Prevention, and the education which fosters it, are realized in respecting human dignity and the person's transcendent destiny, and in excluding campaigns associated with models of behaviour which destroy life and promote the spread of the evil in question30. Every educational programme, whether Christian or secular, must therefore emphasize that true love is chaste love, and that chastity provides us with a founded hope for overcoming the forces threatening the institution of the family and at the same time for freeing humanity from the devastation wrought by scourges such as HIV/AIDS. The companionship, joy, happiness and peace which Christian marriage and fidelity provide, and the safeguard which chastity gives, must be continuously presented to the faithful, particularly the young (Ecclesia in Africa, 116). This task not only includes encouraging and educating young people but also requires the Church to be the leader in the sustained effort to promote programmes which foster authentic respect for the dignity and rights of women31 and in this fields concrete work is done and associations are existing. Nevertheless, in todays modern world such attitudes seem to be at odds with ongoing developments. Pope John Paul II addressed it in this way: Do not be deceived by the empty words of those who ridicule chastity or your capacity for self-control. The strength of your future married love depends on the strength of your present commitment to learning true love, a chastity which includes refraining from all sexual relations outside of marriage. The sexual restraint of chastity is the only safe and virtuous way to put an end to the tragic plague of AIDS which has claimed so many young victims32. 3.6. HIV/AIDS infection among married couples In this theme to be objective, I have here to say that a few cardinals33, very recently, have discussed this matter. They seem to leave the option open for married couples to decide for themselves how to defend against the disease when one of them is already infected by AIDS. Also the Southern Africa Bishops Conference intervened in the discussion with these words: There are couples where one of the parties is living with HIV/AIDS. In these cases there is the real danger that the healthy partner may contract this killer disease. The Church accepts that everyone has the right to defend ones s life against mortal danger. This would include using the appropriate means and course of action. Similarly where one spouse is infected with HIV/AIDS they must listen to their consciences. They are the only ones who can choose the appropriate means, in order to defend themselves against the infection. Decisions of such an intimate nature should be made by both husband and wife as equal and loving partners34. However, one has to recognize that there is a considerable difference of opinion among Catholic moralists on this topic. Moreover, even for those following this new point of view in the mentioned specific case, the moral law does not change as far as condoms and contraceptives are concerned as a matter of principle. In any case, I think there will be a clarification about this specific point of HIV/AIDS married couples from the part of the Holy See. 3.7. Education Information, legitimate and moral prevention, counselling, respectful taking care for, considering the person as ... a person have to be integrated in Church structures also for education, i.e., formation programmes in the seminaries and religious houses, and at diocesan, deanery or parish level in accordance with the circumstances, and should include refugee communities. The necessary knowledge, combined with Christian and african wisdom, as far as life and human sexuality is concerned, taking here into consideration our african meeting. For the UN may I add that the battle regarding AIDS must go together with the one against malaria and tuberculosis, two diseases which kill the same number of people, together, that AIDS does. It will be a sign that in the battle against AIDS there are not contraceptive motivations, in the line of reproductive health, which finds the Catholic Church in a very convinced opposition. 4. Conclusion As Pope John Paul II wrote: The battle against AIDS ought to be everyone's battle. Echoing the voice of the Synod Fathers, I too ask pastoral workers to bring to their brothers and sisters affected by AIDS all possible material, moral and spiritual comfort. I urgently ask the world's scientists and political leaders, moved by the love and respect due to every human person, to use every means available in order to put an end to this scourge35. This is a programme of action which invites us to integrate the AIDS ministry into the normal life and work of the Church, respecting our own catholic ethical convictions, to strengthen it and to make sure that it reaches those in need. **********
L'HIV/SIDA ET SES EFFETS SUR LA SITUATION DES REFUGIES : UNE PERSPECTIVE CHRETIENNE
L'Afrique sub-saharienne est le sous-continent le plus lourdement affecté par l'HIV/SIDA, où les personnes, très souvent, n'ont pas les moyens d'assumer le coût des remèdes ARV. Les conséquences sociales et économiques de la maladie sont immenses pour la société. Le développement, la sécurité alimentaire et les politiques agricoles sont affectés de façon négative. L'espérance de vie diminue, les rôles-types changent de sorte que les personnes âges sont obligées de retourner travailler la terre et de prendre soin de leurs petits-enfants, tandis que les enfants ne vont plus à l'école. L'infection HIV/SIDA s'est aussi diffusée à travers différentes formes de mobilité. Un des modes de propagation est la diffusion le long des routes, à travers les attitudes des camionneurs et des chauffeurs de taxi ; un autre, par l'intermédiaire de certains groupes de migrants résidant dans les auberges réservées aux hommes, et un troisième réside dans le viol systématique appliqué en tant qu'arme de guerre. L'Eglise place la dignité de la personne humaine au centre de sa doctrine sociale. La conséquence immédiate réside dans les soins à donner aux patients atteints du HIV/SIDA et dans le respect à leur égard. Les Institutions catholiques assurent environ 25 % des soins au niveau mondial. En outre, l'Eglise encourage l'accès aux remèdes pour tous. Il est demandé à toutes les communautés chrétiennes de s'unir et de promouvoir un rapport de confiance, d'acceptation et d'assistance, et de devenir des lieux de soins où tous soient accueillis et se sentent comme chez eux. La proximité et le respect se démontrent dans l'abstinence, la chasteté et l'emploi des méthodes naturelles des moyens de régulation des naissances. L'Eglise n'accepte pas certains éléments du concept de "santé reproductive" mis en avant par les agences des Nations Unies, éléments qu'elle considère comme immoraux. Il faut faire bien plus dans le domaine de l'éducation, en promouvant les programmes de formation au niveau des paroisses, des diaconats et des diocèses. Comme le Saint-Père Jean-Paul II l'a déclaré : "La bataille contre le SIDA doit devenir la bataille de chacun de nous". ********** HIV/AIDS E I SUOI EFFETTI SULLE SITUAZIONI DEI rifugiati: UNA PROSPETTIVA CRISTIANA
LAfrica sub-sahariana è il sub-continente più duramente interessato dall' HIV/AIDS e dove le persone, il più delle volte, non hanno i mezzi per sostenere il costo dei farmaci antiretro virali. Le conseguenze economico sociali della malattia sono enormi per la società. Lo sviluppo, la sicurezza del cibo e le politiche agrarie ne sono influenzate negativamente. Laspettativa di vita diminuisce, i ruoli stanno cambiando, cosicché le persone anziane sono costrette a tornare a lavorare la terra ed a prendersi cura dei nipotini, mentre i bambini lasciano la scuola. Linfezione HIV/AIDS si è inoltre diffusa attraverso differenti forme di mobilità. Una ha luogo lungo le strade attraverso i comportamenti dei conducenti dei camion e dei taxi. Unaltra è legata ad alcuni gruppi di migranti che sostano negli ostelli maschili, ed infine una terza si ha laddove lo stupro sistematico è praticato come arma di guerra. La Chiesa pone al centro della sua dottrina sociale la dignità della persona umana. E questo ha come immediata conseguenza il prendersi cura di pazienti affetti da HIV/AIDS e mostrare loro rispetto. Le Istituzioni cattoliche forniscono ormai il 25% delle complessive cure nel mondo. Oltre a ciò la Chiesa promuove laccesso alle medicine per tutti. Ad ogni comunità cristiana si richiede di essere unita, e di incoraggiare un rapporto di fiducia, accoglienza e cura, diventando un luogo di guarigione, dove tutti siano i benvenuti e si sentano a casa. La collaborazione ed il rispetto si dimostrano con lastinenza, la castità e luso dei metodi naturali di regolazione delle nascite. La Chiesa non accetta determinati elementi del concetto di salute riproduttiva delle agenzie delle N.U., considerandole immorali. Di più deve essere fatto nel campo delleducazione, favorendo programmi di formazione, a livello diocesano, di decanato e parrocchiale. Come Papa Giovanni Paolo II aveva già affermato La battaglia contro lAIDS dovrebbe essere la battaglia di ciascuno di noi.
*Global Overview of the Churchs Involvement in mitigating the underlying root causes of
HIV/AIDS and its effects on refugee situations in a Christian Perspective,Annual Imbisa Regional Refugee Conference, Windhoek, Namibia 15 21 May 2005
1Human Immunodeficiency Virus / Acquired Immunodeficiency Disease Syndrome.
2Economic and Social Council. Commission on Population and Development. Thirty-eighth session 4-8 April 2005. Item 3 of the provisional agenda. Follow-up actions to the recommendations of the International Conference on Population and Development.
3AIDS in Africa:Three scenarios to 2025, UNAIDS January 2005, p.28.
4AIDS epidemic update, December 2004, UNAIDS / WHO, p. 19.
5Integrated Regional Information Network News, 8 October 2003.
62004 Report on the Global HIV/AIDS Epidemic: 4th global report, UNAIDS, 2004, p. 179.
7Paul B. Spiegel.HIV/AIDS among Conflict-affected and Displaced Popula-tions: Dispelling Myths and Taking Action in Disasters, 2004, 28(3), p. 329.
8
Mater et Magistra N. 219.
9
Pacem in Terris N. 11.
10
Gaudium et Spes N. 1.
11Intervention by the Holy See at the 26th Special Session of the General Assembly, 27 June 2001.
12Intervention by the Holy See at the Plenary Session of the United Nations on "Implementation of the Declaration of Commitment on HIV/AIDS", New York, 22 September 2003.
13Card. Javier Lozano Barragán, Metabioetica e biomedicina, Roma 2005, p. 45.
14The Church in Africa in face of the HIV/AIDS Pandemic, Our Prayer is always full of hope Pastoral Message, SECAM 1 December 2003, p. 2 and 4.
15Press Conference launching the The Good Samaritan Foundation, 17 December 2004.
16
Gaudium et Spes N. 71: By its very nature private property has a social quality which is based on the law of the common destination of earthly goods. If this social quality is overlooked, property often becomes an occasion of passionate desires for wealth and serious disturbances, so that a pretext is given to the attackers for calling the right itself into question.
17
Centesimus Annus N. 30.
18Intervention by the Holy See at the 61st Session of the Commission of the United Nations on Human Rights on Access to Medication in the Context of Pandemics, such as HIV/AIDS, Tuberculosis and Malaria, Geneva, 29 March 2005: The protection of intellectual property rights, while legitimate in itself, is seen within the wider perspective of promoting the common good, building global solidarity, and prioritizing the life and dignity of the worlds most vulnerable people, many of whom can be counted among those struggling the illness and deep socio-economic impact of HIV and AIDS.
19Intervention the Holy See at the 59th Session of the United Nations Commission on the Question of Extreme Poverty within the Context of Globalization, Geneve, 7 April 2003.
20HIV/AIDS and Refugees. UNHCRs Strategic plan, 2002 - 2004, p. 3.
21Pope John Paul II, Address given at Mission Dolores, 1989.
22Southern African Bishops Conference, A Message of Hope, Pretoria 2001, p. 4.
23
Gaudium et Spes N. 29.
24Reproductive Health in Refugee Situations. An Interagency Field Manual, Geneva 1999.
25International Conference on Population and Development, Cairo, Egypt, September 1994.
26Pontifical Council for Health Pastoral Care, Pontifical Council for Pastoral Care of Migrants and Itinerant People, Pontifical Council for the Family
, TheReproductive Health of Refugees. A note for the Bishops Conferences,Vatican City 2001.
27Holy See, Reservations to the Programme of Action of the International Conference on Population and Development, Cairo, September 13, 1994.
28 Pontifical Council for Health Pastoral Care, Pontifical Council for Pastoral Care of Migrants and Itinerant People, Pontifical Council for the Family
, The Reproductive Health of Refugees. A note for the BishopsConferences, Vatican City 2001, p. 44.
29See Encyclical Letter
Humanae Vitae N. 14: Therefore We base Our Wordson the first principles of a human and Christian doctrine of marriage when We areobliged oncemore to declare that the direct interruption of the generative process already begun and, above all, all direct abortion, even for therapeutic reasons, are to be absolutely excluded as lawful means of regulating the number of children ... Similarly excluded is any action which either before, at the moment of, or after sexual intercourse, is specifically intended to prevent procreation - whether as an end or as a means.
30Intervention of the Holy See Delegation at the 26th Special Session of the General Assembly, 27 June 2001.
31Pope John Paul II, address to the Bishops of Gambia, Liberia and Sierra Leone on their "
Ad Limina" Visit, 15
th February 2003.
32Pope John Paul II, address during the meeting with the new generations in Nakivubo stadium, Commit yourselves to this spiritual revolution of purity of body and heart, Kampala, 6 February 1993: LOsservatore Romano, 10 February 1993, N. 33. As far as Uganda is concerned we must note that it is a country in which the percentage of the patients suffering of AIDS have diminished during the last years, very considerably. The local Catholic Church has done a very good contribution to this achievement, without renouncing to its specific moral approach..
33See the statements of the Cardinals Javier Lozano Barragán, National Catholic Reporter 25 February 2005; Murphy-OConnor, The Tablet 2 April 2005; Georges Cottier, Interview released to the agency
Apcom on 30 January, and The Guardian 2 February 2005; Godfried Danneels, Kruispunt programme of Dutch Catholic broadcaster RKK, 9 January 2005.
34Southern African Bishops Conference, A Message of Hope, Pretoria 2001, p. 3.
35Post-synodal Apostolic Exhortation
Ecclesia in Africa of Pope John Paul II to the Bishops, Priests and Deacons, Men and Women Religious and All the Lay Faithful on the Church in Africa and its Evangelizing Mission Towards the Year 2000, N. 116.
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