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FEATURE: Laying Stepping Stones Estonian Church Has Become a New Support Group for People Affected by HIV
TALLINN, Estonia/GENEVA, 30 November 2007 (LWI) - Jekaterina Manko comes from a well-to-do family in Estonia's northeastern city of Narva. At 25, she divides her professional time between two organizations in the capital Tallinn, where she heads projects aimed at fighting the spread of HIV.
But this is a complete turn-around for Manko, an injecting drug user in her teens, who tested positive for HIV when she was 18.
Thanks to follow-up meetings with specialists from the nearby AIDS center, and rehabilitation with a narcotics' anonymous group, Manko came out of her drug and alcohol dependency, has access to medication and considers her health situation as quite good.
Discrimination
Talking openly about her HIV positive status was initially difficult as she feared discrimination and losing her close friends. Those fears are in the past now - most of her close friends know she lives with HIV and she enjoys their circle of friendship.
But it is not easy for a person living with HIV to make new friends especially from the opposite sex. "It was hard for me to generally talk with men," says Manko. She was afraid that "after developing a good friendship it would not be easy to eventually add, 'I am also HIV positive'." Two years ago she met the man who is now her husband. He is HIV negative, and the couple dreams of having their own children in the future. Manko considers herself lucky, especially knowing that she can get medication that enables women like her to give birth to healthy babies.
Hers is a positive struggle with drug addiction and HIV, unlike the case of thousands of people in a country whose HIV prevalence is mainly attributed to young people under the age of 30.
Injecting Drug Use
The first HIV case in Estonia was reported in 1988, with only about 10 new infections recorded annually during the next 12 years. Before 2000, HIV and AIDS were almost unknown in this country of 1.3 million people.
According to the December 2007 "AIDS Epidemic Update" by UNAIDS, injecting drug use is the most-reported mode of HIV transmission in the three Baltic States (Estonia, Latvia, and Lithuania) where the epidemics appear to have stabilized. But Estonia continues to have the highest rate of newly reported HIV diagnoses (504 per one million people) and the highest estimated adult national HIV prevalence, around 1.3 percent, in all of Europe.
Although injecting drug users mainly in the northeast were the initial drivers of Estoniaâs AIDS epidemic, the prevalence today is currently widespread and there are increasingly more infections through sexual relations.
"The AIDS epidemic here has a woman's face," say Tallinn-based medical doctor Irina Moroz, referring to the increasing number of infected young women.
But the attitude that HIV is a problem among drug users is still prevalent and seems to be strongest in Estonia's third largest city Narva, bordering Russia.
"It seems to me that the more the virus spreads the more the stigma spreads. It is especially relevant for Narva," says Dr Andrei Antonov, based there. He points out that three percent of the city's population of around 70,000 has tested positive. But he is concerned that many of them do not seek further support or treatment. "Are they careful not to infect others? We don't know. Why should they? They feel rejected, stigmatized, lonely and bitter," he remarks, adding that they dare not speak out about their status for fear of judgment and rejection. "Many don't see the point in getting tested, many don't think they could be positive," he says. The number of those infected could be three times higher than the official figures, he argues.
Church Leadership
Dealing with HIV-related issues in Estonia is a major challenge also for churches - called to be open and welcoming places for those infected and affected by HIV.
The Estonian Evangelical Lutheran Church (EELC) became engaged in HIV prevention work in 2002 after signing the requisite agreement with the Ministry of Social Affairs, says EELC Archbishop Andres Poder. But it was not until early 2007 that it started its own AIDS coordination project with support from the Lutheran World Federation (LWF) Department for Mission and Development (DMD).
The LWF-supported EELC HIV and AIDS awareness raising project incorporates an ecumenical approach, with the aim to fight the stigma associated with the disease. The church has translated into Estonian and Russian languages the LWF handbook for AIDS work titled "Grace, Care and Justice" and the video "What Can I Do?" about Ugandan Anglican church leader Canon Gideon Byamugisha, who upon disclosing his HIV-positive status also challenges fellow Christians to avoid judgmental attitudes toward HIV-positive people.
The video and booklet have been discussed at EELC's awareness-raising seminars organized for representatives of all Christian denominations in Tallinn, Narva, Parnu, Johvi and Tartu. Such workshops provide general information and statistics on HIV, about the epidemic globally and in Estonia, dependency on drugs and prevention, how to assist injecting drug users also living with HIV and the role of churches in fighting the epidemic. Each seminar includes a testimony from a young woman living with HIV to demonstrate the people mainly affected, and also show that it is possible to live a normal life with the virus, and overcome drug addiction.
Equipping Church Workers
But it takes time to get all church workers on board. While most of the pastors commend the EELC's AIDS work, some argue they do not need such seminars as they are neither HIV positive nor have congregation members living with HIV. In Kambja, a small village near the eastern city of Tartu, the EELC is implementing an HIV-prevention program titled "Stepping Stones" among adolescent boys and girls where topics such as alcohol abuse, drug use, sexuality and sexually transmitted infections, HIV and violence are discussed.
Archbishop Poder acknowledges that a lot of work lies ahead but at the same time commends the church for its leadership role in the AIDS project. "At first it was about organizing topical events every year during World AIDS Day [marked on 1 December globally]. With the current project we have made a big step forward. Not only are church members better prepared to communicate with those who are affected, we are also more informed about prevention work," he stresses.
"The church has become a new support group for those in need," says the EELC archbishop. "A seed has been sown."
The EELC AIDS coordination project is aimed at equipping church workers with the basic information about HIV and AIDS, provide theological resources, pastoral care and counseling. The long-term goal is to establish a network of Christians working in the field of AIDS in the country, and create an EELC working group of pastors, diaconal and youth workers to monitor the project and also strategize on support for people living with HIV.
The 163,500-member EELC has 215 pastors. It joined the LWF in 1963. (1,166 words)
Ms Eva-Liisa Luhamets, the EELC AIDS project coordinator contributed this article for LWI. Luhamets was a youth intern at LWF/DMD in 2006.
(*Photos available. Please contact hpu@lutheranworld.org)
The LWF handbook "Grace, Care and Justice" is available on the LWF Web site at: http://www.lutheranworld.org/LWF_Documents/HIV-Handbook-web.pdf
More information on ecumenical activities to commemorate World AIDS Day is available at: http://www.e-alliance.ch/resources/hivaids/WAD2007-flyer.pdf
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(The LWF is a global communion of Christian churches in the Lutheran tradition. Founded in 1947 in Lund, Sweden, the LWF currently has 140 member churc hes in 78 countries all over the world, with a total membership of nearly 66.7 million. The LWF acts on behalf of its member churches in areas of common interest such as ecumenical and interfaith relations, theology, humanitarian assistance, human rights, communication, and the various aspects of mission and development work. Its secretariat is located in Geneva, Switzerland.)
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