De Standaard, the most respected Flemish newspaper in Belgium, has an interesting report of an interview
with medical doctor Anne-Françoise Gennotte and psychologist Marcella Ares.
“In the conflict between medical science and religion, there are three types of patients,” says Anne-Françoise Gennotte. She is responsible for the treatment of HIV and aids patients in the Brussels university medical centre Saint-Pierre. She is mainly talking about Africans, who are a large percentage of the patients.
“A first group are the believers who do not have any problems with the medical treatments in our hospital, sometimes in spite of the teachings of their religion. Sometimes, they say that they are tired because they have had to stand for many long hours. Sometimes during Lent, they haven’t been drinking for an entire day, or they have skipped their medication. When they tell us that, we don’t make problems. On the contrary, we encourage them to find support in their faith. The most important part is that they continue to come to the hospital. Some of these patients even give us a role in their religious views. For example, they see us as God’s hands.”
A second category are people who ‘get lost’ between the diagnosis and the treatment proper. “This is always a difficult time. Nobody finds it easy to learn that they are HIV positive. People have very different reactions. Most of our African HIV patients have strong religious convictions, and they are often a member of one of the dozens of larger and greater churches in our neighbourhood. Some pastors tell them that it is bad to be treated in a hospital. Sometimes, the community rejects them because the virus is a sign of Satan, and they get lost.”
“Finally, there is a category of people who start their treatment, but suddenly stop it. In the past two years, we have had a dozen or so cases like this. We are never given an official reason, but there are every time very strong suspicions that their religion has something to do with it, that their pastor no longer allows them to take the treatments.”
Gennotte and Ares have experienced this quite recently with a young girl. “She was HIV positive and at one point she abruptly terminated the treatment,” says Marcella Ares. “We no longer saw her, until two months later when she came back with her parents. Her parents were furious. Their pastor had told them that praying and fasting are much better remedies against the aids virus than the hospital treatment. However, they didn’t work at all. After two months, the virus was still there and these people no longer believed the pastor.”
All the churches, about which the two women are talking, are a part of the Pentecostal movement, a very diverse movement with only one common element: a strong faith in the Holy Ghost. The Charismatic movement of which several people at the Belgian royal court are fervent adherents as well as these “foreign churches” in the vicinity of the Brussels South railroad station.
These Pentecostal churches have their roots mainly in black Africa –there are also South American churches– and they are mainly established in Antwerp and Brussels. Some of them are recognized. Many others, often obscure, congregations are not. These churches are located in small rooms, garages or living rooms. God and Satan are put up against each other. Spiritual leaders practice exorcism. Other rituals are severe fasting and long sessions of standing upright.
The moment at which African immigrants are most susceptible to come under the influence of these churches is the time of their arrival in our country. “They are often very vulnerable at that time,” says Anne-Françoise Gennotte. “They do not know the language, the customs, the rules. Oftentimes, they have no food, no roof over their heads. Those churches exploit this vulnerability. They offer a social safety net, the warmth of a community.”
These churches do not only recruit members among disoriented newcomers. Gennotte and Ares have also seen church representatives coming to the hospital. “It is always difficult to be 100% certain that they represent a church,” says Ares. “In any case, one can sometimes see people around a hospital bed who say that they are family members but who sometimes aren’t. We suspect that this is the way the first contact is made with one of the churches.”
“We can see that something is wrong, but we do not confront the patients,” says Marcella Ares. “We must avoid that the fragile trust is not damaged, no matter the cost. The last thing we want, is that all contact would be stopped. Because of that, we never look for conflict. When patients announce the end of their treatment, we obviously try to convince them otherwise. We discuss it, but we must avoid a break. Because, if we lose them, what will happen to them? They risk being ostracized by their community. In that case, they may return to their country of origin. All while they are HIV positive.”
It is often a delicate balancing act, but the gentle-hand approach still seems the best solution. “But if that doesn’t work, if there is no other way, then we go to the courts,” says Gennotte. “We already did that in the case of an HIV-infected pregnant woman. She refused the treatment, also for her baby. What do you do in such a case, when the life of a third person is in danger? The problem is that the first days of the life of such a child are of crucial importance, in order to avoid contaminating the child. However, the mother did not want to part with the child and wanted to go home immediately after giving birth. In that case, the juvenile court has allowed us to keep the baby in the hospital for a few days in order to give it the treatment it required.”
The doctors of the university medical centre Saint-Pierre would prefer to avoid such a situation in the future and they certainly want to avoid an increase of the phenomenon. “Because of that, we want to have a good communication with the representatives of these churches,” says Gennotte. “They can convince the people that their virus is not a sign of Satan. These religious leaders can do much more. They can educate their people about condoms, because even those are not yet accepted by a large part of the African community.”