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Number 188 - December 2018
The month of December begins with World AIDS Day and this year is the 30th anniversary of the event. Tremendous progress has been made against HIV and the UNAIDS website states that there is a global commitment to end the epidemic by 2030. Still, it estimates that around 37 million people are living with the virus and that a quarter of those with HIV do not know that they are infected. Thus the theme for 2018 is ‘Know Your Status’.
In July UNAIDS issued a new report: Miles to go – closing gaps, breaking barriers, righting injustices. It calls for immediate action to reach 2020 targets. Michel Sidibé, UNAIDS Executive Director, said that ‘entire regions are falling behind; the huge gains we made for children are not being sustained; women are still most affected; [and] resources are still not matching political commitments.’
The report said that globally, new HIV infections have declined by just 18% in the past 7 years - to 1.8 million in 2017 - and new infections are rising in about 50 countries. Also of concern is that in 2017, in those over 15 years old about 58% of new infections were among women.
Because of antiretroviral therapy (ART) the number of AIDS-related deaths in 2017 was around 940,000, the lowest this century. Nevertheless, the current pace of decline is not fast enough to reach the 2020 target of fewer than 500,000. Sadly, around 110,000 children died of AIDS-related illnesses. While 80% of pregnant women with HIV had access to medicines to prevent viral transmission, about 180,000 children acquired HIV during birth or breastfeeding. A report by NAM-aidsmap on 28 November said that while HIV drugs greatly reduce the risk of transmission during breastfeeding, an undetectable viral load does not appear to reduce the risk to zero.
Unfortunately tuberculosis (TB) remains the biggest cause of death in people living with HIV. The report states that about 90% of people with TB who are diagnosed with HIV are on treatment. On the other hand, only about 40% of people starting ART are screened, tested or treated for TB.
While about US$20.6 billion was available for the AIDS response in 2017, there were no significant new commitments, so increased investments from both donor and domestic sources are needed.
International Day for the Abolition of Slavery occurs on 2 December. According to the United Nations (UN) website, its focus is on eradicating contemporary forms of slavery, such as trafficking in persons, sexual exploitation, the worst forms of child labour, forced marriage, and the forced recruitment of children for use in armed conflict. Essentially, it refers to situations of exploitation that a person cannot refuse or leave because of threats, violence, coercion, deception, and/or abuse of power.
The website says that about 40.3 million people are in modern slavery, including 24.9 in forced labour and 15.4 million in forced marriage.
Today forced labour affects migrant workers trafficked for economic exploitation of every kind: work in domestic servitude, the construction industry, the food and garment industry, the agricultural sector and in forced prostitution. Women and girls are disproportionately affected by forced labour, accounting for 99% of victims in the commercial sex industry, and 58% in other sectors. And while the Convention on the Rights of the Child recognizes the right of the child to be protected from economic exploitation, almost one in ten children around the world are subject to child labour.
UN human rights bodies have also documented the persistence of old forms of slavery in traditional beliefs and customs. These are the result of long-standing discrimination against the most vulnerable groups in societies, such as tribal minorities, indigenous peoples and those regarded as being of low caste.
Still, there are signs of progress in the struggle to end these abuses. A legally-binding Protocol entered into force in November 2016. Adopted by the International Labour Organisation, it is designed to strengthen global efforts to eliminate forced labour. The more governments that ratify it and ensure it is implemented, the closer will be the end of slavery for good.
International Day of Disabled Persons on 3 December reminds us of the estimated one billion people living with disabilities worldwide who face many barriers to inclusion in key aspects of society. As a result, they do not enjoy access to society on an equal basis with others, including in areas of transportation, employment, and education and in social and political activities. Exercising their right to participate in public life is part of creating democracies and reducing inequalities in society.
On 10 December we observe Human Rights Day. This year is the 70th anniversary of the Universal Declaration of Human Rights. This landmark document proclaimed the inalienable rights to which everyone is inherently entitled as a human being regardless of race, colour, religion, sex, language, political or other opinion, national or social origin, property, birth or other status.
The UN website calls attention to the fact that it was drafted by representatives of diverse backgrounds from around the world, including many women. While the best known was probably Eleanor Roosevelt, another was Minerva Bernardino from the Dominican Republic. She was instrumental in arguing for inclusion of ’the equality of men and women’ in the Declaration's preamble. With other Latin American women she played a crucial role in advocating for the inclusion of women’s rights and nondiscrimination based on sex in the United Nations Charter, the first international agreement to recognize the equal rights of men and women.
International Migrants Day occurs on 18 December. As UN Secretary-General António Guterres noted: ‘Migration has always been with us. Climate change, demographics, instability, growing inequalities, and aspirations for a better life, as well as unmet needs in labour markets, mean it is here to stay. The answer is effective international cooperation in managing migration to ensure that its benefits are most widely distributed, and that the human rights of all concerned are properly protected.’
It also requires a willingness on the part of governments to deal with the many causes of migration and displacement, including economic injustices and the many conflict situations around the world.
Shafi Musaddique, in a CNBC article on 2 May 2018, quoted the Stockholm International Peace Research Institute as saying that global military spending in 2017 was $1.7 trillion. This amounted to 2.2 percent of global gross domestic product, equivalent to $230 per person. The 29 member nations of NATO spent a total of $900 billion on arms in 2017. Perhaps the lure of such profits exceeds that of providing for worldwide healthcare, education and social services.
Most of all, we wish our readers peace and joy at Christmas. Many of us mark this feast celebrating the Incarnation on 25 December. We also remember our sisters and brothers of the Eastern tradition and elsewhere, who celebrate on 6 or 7 January.
As Medical Missionaries of Mary, we are committed to serve in areas where human need is greatest. Significantly, our Sisters and Associates are involved in all the issues of human need mentioned in this editorial. Thank you for all the ways in which you have worked with us this year, promoting justice and human dignity for all, signs that God is among us. Let us pray for each other daily.
In this newsletter, you can read: how people have transformed their lives in Kasina, Malawi; the stories of two MMMs who celebrated 50 years of commitment; and how a village in Tanzania used local resources to obtain a reliable source of water.
Sr. Carol Breslin, MMM
‘Love, according to [St.] Bonaventure and [Duns] Scotus, is the reason for the Incarnation, and it is the fullness of love that underscores the mystery of Christ. In an evolutionary universe, love knows no time or limits, it simply grows and attracts until all things are united in a common center, the center named Christ (Ilia Delio, OSF, Revisiting the Franciscan Doctrine of Christ, Theological Studies 64 (2003)).
Training for Transformation - True Human Development
In our 2013 Yearbook, Healing and Development, Sister Ukachi Ibeh described how the Training for Transformation (TFT) approach was introduced at Kasina Health Centre in Malawi. In 2017, Dr. Eamonn Brehony, of our MMM Resource Team, conducted a review of MMM ministries in the country. He found that a number of positive changes had occurred in Kasina and suggested that others might learn from that experience. Sister Stella Ovientaoba recently sent us the following report. Background In 2005, Archbishop Ste. Marie of Dedza Diocese invited MMM to take over the running of Kasina Health Centre (KHC). Located in mountainous Dedza District in central Malawi, the health centre needed a huge amount of maintenance.
There were no drugs. A shortage of medical assistants meant that attention to patients was poor. Many ‘under-five’ children had severe malnutrition. An inadequate annual harvest, poor crop management, and low prices for agricultural goods contributed to the situation. Food stores were depleted early because excessive amounts were used during festivities and initiation celebrations. There were high levels of dependency and illiteracy.
With funding from Misean Cara, in 2008 MMM introduced the Training for Transformation process in the villages in the KHC catchment area. Its goals were to enable the people to adopt a self-reliant attitude; to facilitate development; and to ensure food security and counteract malnutrition. With its sustainable approach, participants would be able to continue activities when MMMs were no longer present.
TFT was conducted in four phases in all the villages from 2009 to 2013. Participants were drawn from community stakeholders: women leaders, chiefs and group village headmen, religious leaders (churches and mosques), KHC staff, youth from schools, and health surveillance assistants.
A community-based approach In Phase One the people composed their own definition of development. They learned the basic principles of TFT, the concept of integral human development, and transformative leadership styles. They were encouraged to engage in small individual and group activities in a self-reliant way. In Phase Two the community experienced group dynamics. They identified group problems and ways of solving them. In Phase Three they analyzed the structures that were hindering development. The community was encouraged to work on these issues to accomplish structural change.
The chiefs decided to have a general meeting to address issues that had surfaced during the third phase. These included unfair trade practices, traditional activities like gule wamkulu masquerades, wastage of food at celebrations, early marriage, abortion, a low standard of education, and alcohol dependency. Afterwards, a committee was appointed to draw up a work plan. Kasina Health Centre was there to support them as needed. This was a momentous beginning.
In Phase Four the community learned how to begin development projects to bring about structural change.
The people also learned about health: prevention of conditions such as malaria and diarrhea; the Expanded Program of Immunization; and safe motherhood. They were encouraged to promote good sanitation, nutrition and shelter. They began demonstration gardens for food security and supported fair trade. Other activities were programmes for women and youth and education for orphans.
Trusting the people and the process The impacts of TFT in the health centre catchment area are very obvious. There is greater self-reliance, with people working hard to provide for their basic needs, including sufficient food all year round. They have embraced modern farming methods and are rearing domestic animals such as chickens, goats and cows. People are able to plan and to save money from the sale of farm produce to purchase building materials. There are many new houses with iron roofs. The chiefs mobilized the community to build a development centre for meetings and other community activities. Some villages use the centre for pre-school sessions (nursery school).
The community leaders have arranged to have regular meetings to discuss development issues. They organize yearly tree planting to boost reforestation and protect the environment. Every year they organize the World AIDS Day celebration as part of the ongoing fight against HIV, encouraging people to live positively. Through their persistent efforts and a petition to the District Council, last year the road leading to the health centre was graded for easier accessibility.
The women use local banking to provide school fees for their children and pay their medical bills. In the past the nutrition rehabilitation unit (NRU) was filled with severely malnourished children. Now the NRU is usually empty or has only one to three children. At the under-five immunization clinics the children are healthy and well nourished. This is the fruit of continuous nutrition training. Building on the foundation TFT has motivated the KHC staff to improve their education. Some attended part-time classes to obtain good points for admission to third level. As of July 2018, a medical assistant has just finished and a lab technician and two nursing students will be finishing soon. It was remarkable to see one of the TFT participants, a chief with only a primary school certificate, deciding to enroll in evening classes. He wanted to have his secondary education. He finished his final exams in July and hopes to move on to third level. He said that the training challenged him greatly and made him realized his potential. He did not mind that he is a chief and was the oldest in his class.
TFT has prepared fertile ground for other non-governmental organizations to implement their projects in the area. The people have been nurtured to participate meaningfully in developmental initiatives for the good of the community. This is not to say that everything is perfect, but there has been a shift and a change in mind-set. The people are more open to discuss issues, to dialogue and challenge themselves to be proactive. Breaking through ancient traditions and cultures is never easy, but the fact that people are able to identify which aspects of the culture are blocks to development and have started to address them is a great milestone.
We continue to work with the people of Kasina to foster sustainable growth and development and bring about a better quality of life.
A Time of Jubilee
Along with Sister Agnes Hinder, Sisters Rosemary Mohan and Catherine Fallon celebrated their Golden Jubilees of religious profession in 2018. From varied backgrounds, they have lived their ministry of healing and shared their gifts in many different ways.
1. A Life of Dedication
Sister Rosemary Mohan is from Scotstown, County Monaghan. Her journey over the past fifty years has involved training and ministry in several countries and continents. MMM certainly encourages adaptability!
Rosemary was born in 1944 and completed her secondary schooling at the Saint Louis Convent in Monaghan. Before joining MMM she taught in a secondary school in Alnwick in England as a locum. She later completed a commercial course in Dublin and trained in hospital administration. She worked in Saint Ultan’s Hospital, Charlemont Street, in Dublin as a clerk-typist.
Rosemary joined MMM in 1965. After profession she completed a B. Comm. at Cork University and worked in the laundry accounts office in Drogheda for two years.
She was assigned to Nigeria in 1975 and served first in Irele, where MMM had a clinic in a remote rural area. In 1976 she transferred to Saint Mary’s Hospital in Eleta, Ibadan, as hospital administrator. This was a busy general hospital in a sprawling overcrowded city. During that time she also served in local MMM leadership. In 1983 Sister Rosemary was assigned back to Ireland as Central Business Administrator, a post that she held for nine years.
In 1994, after a sabbatical at the Institute for Spiritual Leadership in Chicago, USA, she was appointed chaplain to international students at Chiswick International Hostel in London, England. In 1996 she was appointed to MMM leadership in Ireland. While in Ireland she trained as a reflexologist.
In 1998 Rosemary returned to London and worked for four years with a project for homeless people called Kairos Community Trust, based in Camberwell and Brixton. At that time she also trained as a psychosynthesis counsellor.
Rosemary was assigned to Rwanda/Uganda in 2002 to help with counselling at the University of Butare and to do workshops in reflexology and massage. She was MMM Area Leader in Uganda/Rwanda for three years. Returning to Ireland in 2010 she worked for some months in the accounts department of Aras Mhuire. She was then appointed to her current ministry as local business administrator in our Motherhouse in Beechgrove, Drogheda.
2. Fifty Years of Love and Service
Sister Catherine Fallon was born in Lanarkshire, Scotland in 1947. After profession in MMM she trained as a general nurse in Drogheda and as a midwife in Southern General Hospital in Glasgow.
In 1977 she was assigned to Tanzania and did nursing for about a year before attending language school for several months. In 1981 she was appointed to the formation team and was directress of vocations. She moved to Arusha and served in MMM leadership. In 1985 Catherine was assigned to Makiungu and served for three years as hospital matron.
She then spent over four years at Kabanga, in maternity nursing and in MMM leadership. In 1993, Catherine moved back to Arusha and was part of a team involved in maternity and child health in Arusha Region.
After helping with mission awareness work in the USA, Catherine returned to Tanzania in 1997. She spent four years in Nangwa in community-based health care (CBHC). She then spent a year in Ireland and helped in the nursing care of our MMM Sisters in Áras Mhuire. At the end of 2002 she was back in Nangwa, this time becoming project coordinator of the CBHC work, in which she served for almost eight years.
Assigned to the European Area in 2010, Catherine has been a member of the clinic team in Beechgrove, Drogheda, since 2011.
Looking back with thanks As Catherine recalled her last fifty years she said, ’I am full of gratitude to God for calling me to MMM and to Mother Mary for accepting me into the congregation. It allowed me to fulfill a youthful dream of living and working in Africa. I am grateful as well to the myriads of people who helped me along the way: my parents, family, and MMM family, and to the people of Tanzania who welcomed me into their lives and allowed me to share the talents God has given me.
‘I have many ''gold in the memories'' stories. The one that stands out is the day I arrived in Tanzania for the first time. Sister Ruth Percival and I set out from the Motherhouse in late September 1977. We arrived at Dar-es-Salaam airport about 10 a.m. As I stepped out of the plane, I had the most overpowering thought, ''I'm in the wrong place.'' I wondered if God was telling me: ''Ha ha! April Fool!'' - because I entered MMM on 1 April 1966. Even with the bustle of getting through security and the usual travel matters, the thought persisted. It continued for a while after I began my ministry in Makiungu Hospital in Singida Region.
‘A year after I arrived in our mission, I received a letter from our Congregational Leader, asking me to apply to take my final vows. With the mentoring of an elderly Missionary for Africa (White Fathers) I realized that my list of reasons for continuing as an MMM far outweighed the list with those for leaving. I have never regretted my decision. I was full of joy and happiness on 7 July 2018 when I celebrated all the gold in my memories with some family members, my MMM Sisters, and my companion Sister Agnes Hinder.
‘To all of you who joined with me that day, thank you again for the congratulations through cards and gifts - and above all for your presence. Mungu Awabariki Daima kwa ukarimu wetu (God bless you all always for your kindness).’
Celebrating 40 Years in Clinchco, VA
Our 1969 MMM General Chapter approved establishing a mission in a medically under-served area in the USA. It would return some service to the country, be a formative experience for young MMMs, and show our way of life to women interested in joining us. We chose Appalachia, a region of 395 counties in 13 states, extending from southern New York to Georgia, Alabama and Missouri.
A land of defeated and impoverished mountain people, up to 45% of those in Wise, Scott and Dickenson counties of southwestern Virginia were within federal government poverty lines. The water was contaminated with acids from strip mining. Aquatic life was killed in about 12,000 miles of once clear mountain streams. The mountains themselves were dying, as miners attacked them, leaving only scarred, unstable and barren land.
The people of Appalachia numbered 19 million. Since 1944 over 2 million had left in search of a better life; 75% of the land in Virginia, West Virginia, Kentucky and Tennessee was owned by outside corporations.
Still, precious traditions were held in a place of great scenic beauty. During an exploratory visit a medical service with a pastoral ministry was requested, with home nursing and visiting a big need.
In June 1978, three MMMs moved to Clinchco, Virginia, a former company town owned by the Clinchfield Coal Company, part of the multi-conglomerate Pittston Corporation. Located in Dickenson County, there was no hospital and only three day clinics for almost 19,000 people. There was no resident Catholic priest.
Newly-professed Sister Joan Grumbach, on her first mission assignment, remembered leaving Winchester, MA, with all their worldly goods stowed in the back of a pick-up truck. One of their stops was to see the bishop in Roanoke, VA, for permission to have the Blessed Sacrament in the house. When they arrived at No. 9 Coal Camp, a bunch of wildflowers, left by a welcoming neighbour, was on the pot-bellied stove. Unfortunately, the stove and many other things did not work. The roof leaked and windows were broken. The Lutheran pastor, Don Prange, and his wife came to their rescue, providing them with their first meal and helping them to get hot water. Rev. Prange later arranged for them to announce their arrival on the radio.
Holistic health care Sister Bernadette Kenny wrote, ‘When we first came we visited homes. People knew we were to help in self-care, so they would understand their illnesses and how to promote health for themselves and others, and understand their own resources to stay healthy. That might involve using traditional mountain remedies, or just taking better care of themselves in nutrition or exercise and reducing stress in traditional ways.’ With the nearest buses an hour and a half away, it also meant bringing people to hospitals, getting medicine, and sometimes just being present.
Clean water and sanitation were a great problem. Bernie said, ‘They had to carry the water. I even went to a woman who was having postpartum depression and tried to give her a permanent - and learned what it was to try and do that without running water.’ In nearby Tramell, where there were forty-five homes, no house had running water or an indoor bathroom, only a spigot outside behind the row of houses.
Infant mortality in the area was four times the national average, partly from lack of early prenatal care and support during delivery. There was poor nutrition because the people had moved away from their beans and cornbread. The MMMs worked in a food co-op to try to remedy the situation. By 1983, Bernie found that she was limited by how little she was able to do as a registered nurse. So she went to the Medical College of Virginia and became a family nurse practitioner. It enabled her to do a lot more in the treatment of illness and understanding how people can stay healthy. Clinchco has been her home ever since and many other MMMs have lived in Clinchco, receiving as well as giving.
In 1984 the Sisters got a health wagon, making the service much more visible and enabling them to do more - like blood sugar testing, pap smears, immunizations, etc. They plied the dangerous mountain roads, bringing basic care to remote locations. The Health Wagon now serves five main counties in southwestern Virginia. The Health Wagon newsletter says that in 2018 the average patient is 46 years old. Eighty-six percent of patients are uninsured. Despite working multiple jobs, 70% make too much money to qualify for Medicaid, but not enough to afford private insurance. So they can’t afford to go to the doctor but can’t afford not to.
In 1998 Bernie was invited to Mountain City, Tennessee, to see the work of Remote Area Medical (RAM) Volunteer Corps, founded by Stan Brock. Realizing its potential for Virginia, Bernie and her co-workers mobilized volunteers from across the state. The first RAM visit to Wise County, Virginia, was in 2000. It is now a yearly intensive three-day event that brings hundreds of volunteers together, including MMM Associates. Over 3,000 people were seen at RAM in 2018, availing of free dental, vision, health screening and other services. An ecumenical approach There have been opportunities to cooperate with members of other faiths and for social justice involvement. Initially the MMMs participated in the small Catholic group, drawn from a thirty-mile radius. They collaborated with the interdenominational Church of the People, working together on social issues and having health fairs. They prayed together to give thanks afterwards. Bernie said, ‘We would break bread together and reflect on the scriptures.’ The leaders helped each other to understand local situations.
The Sisters said that Clinchco is a mission where there is a 'real network that weaves in the church and outside the church and across denominations. The healing that bubbles out of all of this is quite person-oriented and network-oriented. It happens, not hierarchically, but by people relating to each other over time. …There's no other way to get credibility. You don't come here with a title or a label as something special...In the ministry of presence, you find that the crises are blessings in disguise. But you can't want to see results. You really have to value the process.’ Much to celebrate Reflecting on the past forty years, Sister Bernie said the main changes have been life-supporting. ‘In 1980, only 15% of families had sewage facilities and running water. Today only 15% don’t have these services. We didn’t have a hospital; now we have an emergency room. Still, specialty care is more than two hours away for most families. The Health Wagon and RAM provide free medical care to many thousands of families each year. ‘There have been major changes in Church development. Formerly there were up to fifty families enrolled in the parish. Now at weekly Eucharist, we may have nine or ten folks. There are many reasons for this, including economics, families moving for jobs, and educational opportunities. Counter-cultural influences lead to different choices, e.g. consumerism, sports, etc.
‘The greatest gift I have received is support from friends and family. They have looked after me and my home. They have healed me, teased me about being too serious about life and things that do not matter. They have fostered much personal growth. I have managed many challenges and difficulties through faith and love. I am deeply grateful, although at the time I would have wished to be somewhere else. Letting go of my opinions through non-judgmental acceptance of these people has been a blessing. I still have opinions, but am able to listen longer and wait to be asked for my thoughts, to share and invite further discussion.
‘The gifts that MMM has given are the wonderful Sisters who have lived here, receiving and giving generously of their talents. Their visits to families are a great treasure - valued for their advocacy for benefits for the sick and disabled. Other MMMs visited and offered support. Many MMM Associates have also visited and worked here. The lives of many have been enriched by these connections.'
As Bernie says, many MMMs have made important contributions in Clinchco. MMM Associates also continue to do so, helping very much with RAM. 'MMM can be proud of this coat of many colors!’
As Sister Bernie approaches her 80th birthday, the Health Wagon is preparing to celebrate a milestone as well. Another stationary clinic is now set to open in Dickenson County, VA – to be named the Sr. Bernie Kenny Clinic.
See the article in Irish America: https://irishamerica.com/2018/11/sr-bernie-kenny/
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