Essential Reading

As Jon O’Brien rightly notes in “In a Weak State,” religious groups have attempted to fill the gap in health services provision in Africa. In Zambia, for example, the Christian Health Association of Zambia (CHAZ) is only second to the Ministry of Health in improving access to health services among the populace, especially the marginalized and the hard to reach. For a long time in Kenya, some districts were almost exclusively served by church-based health facilities. A similar effort by the church hierarchy is almost wholly replicated in all sub-Saharan African countries.

The contribution of the church hierarchy in improving the health of the African people can therefore not be discounted, and therein lies the problem. With this wide reach with health services, do church-based health facilities promote access to the right to health as conventionally understood in medical circles?

To be able to answer this question, it is important first to note that medicine is a science and it only works when applied as such. The moment we moralize health services and use a religious yardstick to judge which health services should and which ones should not be made available to communities we end up denying many people their right to health, especially poor and marginalized people found in communities where the church often provides its services. This negates the very intention of the church to reach the unreached with services. A few examples of disputed services come to mind and lay bare this violation of the right to health.

When HIV first started, the sufferers were demonized by the church hierarchy. Condoms were demonized too. For a long time now, a big section of the church has refused to embrace modern family planning. Supporting modern family planning can lead to excommunication in some churches. Communities served by churches that do not embrace Family Planning are intentionally denied the services despite the many known benefits. More recently, the hierarchy has made a concerted assault on immunization. They do not want women to have tetanus vaccine. They have previously also opposed polio eradication campaigns. They use false evidence to justify their case. Then comes the contentious issue of abortion. Many church-based health facilities do not provide safe abortion. Others do not even provide post-abortion care. As much as the church has been great at providing a number of health services, history will judge them harshly when the story is told of how people died from preventable health conditions because the only available health facility in their village was run by a church that denied them essential services.

JOACHIM OSUR
Director of Regional Offices and Field Offices,
Amref Health Africa
Kenya