Introduction As in 2009, World AIDS Day 2010 will again focus on Universal Access and human rights. As Christians, World AIDS Day provides us with precious moments to reflect on HIV and our belief that all people are created in God’s image. While we work to promote and protect the human rights of people living with or affected by HIV, or those who are vulnerable to infection, we must also recognize and take action on the spiritual dimension that calls us to work for justice and treat all as our sisters and brothers. This year’s World AIDS Day worship service focuses specifically upon the importance of linking HIV and food issues as part of efforts to achieve Universal Access and human rights. While access to medicines is vital for all, so, too, is access to food, water and other basic rights. Indeed, as the worship service demonstrates, one right can not be fully achieved without the other, leading to a call for more comprehensive and integrated approaches to both addressing HIV and stemming hunger.
Preparing the Service
You are encouraged to use this order of worship on World AIDS Day – Wednesday, 1 December 2010. It may also be used at a service on the Saturday or Sunday before or after World AIDS Day, or indeed at any other time over the coming year. The only special items needed for this service are 4 candles, a recording of Bob Marley’s song ‘Could you be loved’ and copies of the EAA’s letter on HIV and Food (attached as an annex). You are also advised to read the EAA’s webpage that explores the links between HIV and Food and download any resources that your congregation may find useful. You can also order hard copies of the EAA’s factsheet on ‘HIV and the Right to Food’ as well as its advocacy one-pager by emailing rfoley@e-alliance.ch
This service can be downloaded from http://www.e-alliance.ch/en/s/hivaids/world-aids-day/ to make it easier for you to adapt it for your own context. It is also available through this link in English, French, Spanish and German, along with other resources for World AIDS Day. Credits: This liturgy was written by the Rev. Nicole Ashwood, unless otherwise indicated. Scripture quotations are from the New Revised Standard Version Bible, 1989 by the Division of Christian Education of the National Council of Churches of Christ in the USA and are used by permission. All rights reserved. Worship Service for World AIDS Day 2010
Universal Access and Human Rights: ‘Medicines alone are not enough’
Musical Preparation Greeting and Opening Hymn
Liturgist 1
My sister, my brother – you are welcome!
In need of food and provisions, healing and hope
‘Brother, sister, let me serve you’ (v. 1)
This day, God’s spirit rests upon those who
Are afflicted, who comfort the afflicted, the poor,
the needy . . . the hungry, the crying, the dying, those who thirst for
the nourishment of food and a space at the table
All God’s word is now fulfilled in our presence, and Jesus bids us -
one and all; sick and hearty, hungry and full - come! ‘Brother, sister, let me serve you’ (v. 2)
Today God’s spirit empowers us to break through the darkness
of apathy, ignorance, hopelessness and despair
to provide healing for the broken, comfort for the afflicted
hope for the forsaken and bread for the hungry
So come, all who are thirsty for justice, hungry for equity
All …whomever and whatever you are considered to be – You are welcome!
‘Brother, sister, let me serve you’ (v. 3-6)
Readingi: The linkages between HIV and Food
Food security, that is vital for all, has a particular significance for people living with HIV. An adequate diet can help them stay healthy and reduce their vulnerability to AIDS-related diseases. Without adequate food, an individual’s response to antiretrovirals (ARVs) can be undermined; the frequency of opportunistic infections increase; and the progression of AIDS-related illnesses hasten. Providing medicine alone, therefore, is not enough – adequate food and nutrition are essential elements of HIV prevention, treatment, care and support. HIV also has an impact on food security. At the household level, AIDS-related diseases can limit people’s energy levels and ability to work and earn money to buy food. Time and household resources, particularly those of women, are also consumed by caring for sick family members. At the community level, HIV and AIDS reduce the number of productive people in the labor force and limit agricultural output, further reducing food security. Social exclusion and discrimination also increases the vulnerability of people affected by HIV and AIDS to hunger. In turn, a lack of food or income may force people to prioritize buying food over ARVs, and thus reduce the effectiveness of HIV treatment further. Food insecurity, limited earning options or resources, and conflict or other emergencies can also increase people’s vulnerability to HIV as they can lead to higher-risk behaviors such as engaging in sex for food or money. These cyclical linkages call for comprehensive approaches to both ensuring food security for all and to achieving universal access to HIV prevention, treatment, care and support.
The reading is followed by the jingle of bells, finger cymbals or a hand gong and the dimming of lights to signify the devastating affect that AIDS has had on us all.
Song of Approach Suggestions: ‘Jyothi do’, ‘Let Us Break Bread Together’, Silence
Prayer of Confessionii
Leader All We know our excuses, we have rehearsed them well.
The world is complicated and the way not sure.
All We know our excuses, God.
We must be careful or we do more harm than good.
All We know our excuses, God.
Justice is a nice dream, but we also need to take care of ourselves.
All We know our excuses, God.
What can we do when a broken financial system rewards the rich and impoverishes the poor even further?
All We know our excuses, God.
We have become adept at turning away from the hungry.
All We know our excuses God.
We do not connect the abundance of our bread with their deprivation.
All Break through our excuses, God.
Transform and renew our lives so that we might become a living manifestation of your promises of a feast for all. Restore us to life for our sisters’ and brothers’ sakes dear Lord
Assurance of Pardon Leader
Sisters and brothers, Christ’s love sets us free from our sins and calls us into loving relationship with each other. Christ has forgiven us, and we are now at peace. Because Christ has set us free from our sins, we can share God’s marvellous light with others
Lord’s Prayer (Caribbean version) Old Testament Reading Isaiah 58:5-8
Is this the kind of fast I have chosen, only a day for a man to humble himself? Is it only for bowing one's head like a reed and for lying on sackcloth and ashes? Is that what you call a fast, a day acceptable to the LORD?
Is not this the kind of fasting I have chosen: to loose the chains of injustice and untie the cords of the yoke, to set the oppressed free and break every yoke?
Is it not to share your food with the hungry and to provide the poor wanderer with shelter— when you see the naked, to clothe him, and not to turn away from your own flesh and blood?
Then your light will break forth like the dawn, and your healing will quickly appear; then your righteousness will go before you, and the glory of the LORD will be your rear guard.
Fruit of Awareness: The Story of Jhupri B. K.iii During the representation of this story, a basket of bread/fruits may be passed around the room for all to partake, so that they may have ‘food for thought’ to accompany them.
Reader 1 The struggle to stay alive
Just two years ago, Jhupri B.K. was losing her battle with HIV. She had lived with her husband in Mumbai, India, for 15 years where her husband was working as a watchman. Shortly after they returned to their Nepali village in Siddheshwor, Accham, her husband died of an AIDS-related illness. Not long after her husband’s death, she too fell sick. When she underwent a blood test in Accham, she found out that she too was infected with HIV. That is when her real ordeal began. She fell so ill that she became bedridden. Her hair started falling off and she had skin problems. None of her neighbors came near her with the fear of contracting her disease. ‘HIV/AIDS almost took my life. I was losing my consciousness because of the disease and I was not aware of anything. I didn’t even know that my two-year-old son, who was also HIV positive, had died. To date, I do not remember the moment when he was taken for cremation. I had lost all hope of living’, Jhupri says. Jhupri B.K. struggled not only with her health but also with hunger and ostracism. Medicines brings change but challenges remain Luckily, the volunteer facilitators working with people living with HIV in the area came to her rescue and took her to Mangalsen, the Accham district headquarter for Anti-Retro Viral (ARV) treatment. She says the ARV worked magic on her and her health started improving. She has now been on medication for two years. Her medication includes Lamivudine and Efavirenz. However, her ordeal has not come to an end yet: She has a family of six including herself and her five children. Her second daughter is also HIV positive, which alone has been reason enough for her to be discriminated against at school. This comes in addition to the discrimination she daily faces for belonging to the Dalit community, the so-called impure and untouchable community. Without a source of income to feed the family of six, managing every meal is a real challenge for Jhupri. ‘The ARV treatment makes me very hungry and the doctor says I need to maintain a proper diet and have nutritious food. But how can I myself eat when I can’t even manage two meals a day for my children? Moreover, I have to walk to Mangalsen to fetch the medicine, because I can’t afford to travel in a vehicle. The walk takes about three days’, Jhupri explains. Jhupri B.K shares her story with the staff of Sansthagat Bikas Sanjal, an NGO in Nepal. Community support: received and given
After starting the ARV treatment, Jhupri recovered from her physical illness, but did not attain a state of wellbeing, as she felt very distressed. She had no one to share her suffering with. The support provided by Youths in Empowerment Sector (YES) Nepal, an affiliate of Sansthagat Bikas Sanjal, has become a shoulder for her to rest her head upon, when she feels exasperated. Jhupri speaks warmly of the support volunteer facilitator Khemraj Bhul has been giving her. The volunteer facilitator coordinates efforts with other organizations to provide all the support possible. ‘I feel very good, when I talk to Khem Raj. He treats me like an aunt and often visits me to check how I am doing. The support that YES Nepal has given me is invaluable. The information and facts about HIV the volunteers gave me have helped me lead a healthy lifestyle. I now know about HIV/ AIDS and talk to my neighbors about it’, Jhupri says. Jhupri is now well informed about the modes of transmission of HIV. She regularly interacts with women whose husbands are in India. She also gives advice to people who have returned from India to undergo voluntary counseling and testing (VCT) for HIV. The only dream that Jhupri B. K. now has is to see her children educated, so that they can earn a decent living for themselves and wouldn’t have to travel too far to look for work. Jhupri B.K. represents many of the women in the Accham district, who are facing the consequences of something that was not their fault. Having contracted HIV from husbands who worked in India and have since passed away, they now struggle everyday as the sole bread-winners in their family. Their only wish is to create a better future for their children. A group discussion with women affected by HIV. Text: Nisha Gurung / Sansthagat Bikas Sanjal Photographs: Sansthagat Bikas Sanjal Silence Gospel Reading Matthew 4:3-7
The tempter came to him and said, "If you are the Son of God, tell these stones to become bread." Jesus answered, "It is written: 'Man does not live on bread alone, but on every word that comes from the mouth of God."
Affirmation: A call to community action and advocacyiv Liturgist 1
Bread alone is not enough… Medicine alone is not enough… Food alone is not enough… Prayers alone are not enough….
All But together we can fight Together we are strong Together we can feed each other Together we come . .
Infection leads to powerlessness, We get sick, weak, cannot produce We can no longer feed ourselves or our children We cannot pass on our skills to them So the cycle of life is broken.
All But we are the restorers of the breach, And today we join hearts and hands with action that for the sake of those present and those to come, our action matches our passion!
We cannot love God unless we love each other. We know God in the breaking of bread, and we know each other in the breaking of bread
We are not alone anymore. Heaven is a banquet, and life is, too — even with a crust — as long as there is companionship. We have all known loneliness.
All We have learned that the only solution is love. And love comes with community.
Prayers of Intercessionv Preceded by the playing of Bob Marley’s ‘Could you be loved’
God of the desert places be with those who wait, Queuing for water and food Watching their little children Losing energy to play, Looking for rain, For work and health and harvest. In their time of waiting, be their heart’s courage and their souls’ hope; make their desert bloom.
A candle is lit as lights remain dimmed.
Christ our God, You too were born a child Not free into our world: Subject to poverty, harassment by foreign powers, And dangers to your health.
In your name Let us cry freedom for your children now, at this time, and through all generations.
God of beauty, Maker of all that grows, You did not create us to be separate from the earth, But planted us in a garden
To tend it and care for it. We thank you for the multitude of plants that nourish our bodies, Comfort our pain And give us pleasure
Give us, God, a meal At which no one is hungry and all are fed, At which no one is unwanted, and all are loved, At which the sick are healed and the broken restored, At which the grieving are comforted and the lost found. We pray in the name of Jesus Christ, our Sustainer.
The room is restored to its former brightness to illuminate the fundamental human rights and dignity that we all share. Offering Bob Marley’s ‘Could you be loved’ (or other similar song) is played again during the collection. Hymn (Suggestions: )
Benediction
Longing for food, many are hungry; Longing for water, many still thirst; Longing for health, many remain weakened; Make us your bread broken for others, Shared until all are fed.
As the congregation leaves, they can be invited to read and sign the EAA’s letter calling on world leaders to do more to link food and HIV as part of their efforts to meeting the Millennium Development Goads and the HIV Universal Access goals (see below). The letter should then be sent it to your head of state or other government officials responsible for HIV and/or food issues in your country.
Dear [Head of State], We are writing to urge you to ensure that international commitments to address both hunger and HIV are met. The number of people living with HIV is now an estimated 33.4 million globally. Although the epidemic is stabilizing, this is at an extremely high level. People living with HIV are among the most vulnerable in developing countries, many living in extreme poverty, lacking appropriate nutrition and livelihood options. Rising global food prices are further increasing the vulnerability of impoverished people and communities, and further reducing their ability to cope with and recover from external shocks such as environmental changes and armed conflict. In our global village, more than one billion people are denied their basic human right to adequate food. Good nutrition is required for all people, however, for people living with HIV, this is even more important. In the developing world in particular, diet can be poor and often malnutrition is already an issue. The presence of HIV can exacerbate this situation, reducing the capacity of people and communities to feed themselves. On the other hand, it is well established that access to adequate food and nutrition can substantially mitigate the impacts of HIV and AIDS. To date, however, limited progress has been made in integrating nutrition and food security interventions into HIV programs and policies. A key reason for this is the lack of political will. Governments committed themselves in the Millennium Declaration to end hunger and poverty (Millennium Development Goal 1) and to combat HIV and AIDS (MDG 6). By 2015, hunger should be halved and the spread of HIV should be halted. Yet these goals are far from being reached, as is the UN target of 0.7% of gross national income for official development assistance. The international community also recognized the importance of nutrition in HIV prevention and care when, in June 2006, the Declaration of Commitment by the United Nations General Assembly Special Session (UNGASS) on HIV/AIDS, stated that: “all people, at all times, will have access to sufficient, safe, and nutritious food to meet their dietary needs and food preferences for an active and healthy life, as part of a comprehensive response to HIV/AIDS” (Article 28). This commitment is an important component of governments’ pledge to achieve universal access to HIV prevention, treatment, care and support by 2010. But this target too is far from being reached. At the 2011 UNGASS review in June, governments will meet in New York to review the implementation of these commitments. Over the coming years, they will also continue to review progress towards meeting the MDGs by 2015. Ahead of these review meetings, it is vital that each state demonstrates real political will to the integration of nutrition and HIV by:
Delivering on Article 28 of the UNGASS Declaration of Commitment by incorporating nutrition and food
security issues into policies and programs aimed at scaling-up efforts to achieve universal access to HIV prevention, treatment, care and support, including those to prevent vertical or ‘mother-to-child’ transmission of HIV
Incorporating nutrition indicators into HIV monitoring and evaluation activities, including the monitoring
and evaluation of national AIDS strategies
Ensuring that agricultural policies and programs are HIV-responsive and target smallholder - mainly
Working across sectors, including with people living with HIV and wider civil society, to ensure that food
and nutrition assistance reaches the most vulnerable, is relevant and appropriate, and does not fuel stigma and discrimination
Thank you in advance for your life-saving action. Yours in faith,
i Extract from the EAA’s advocacy one-pager ‘HIV and Food: Medicines alone are not enough’, published online at www.e-alliance.ch/en/s/food/food-and-hiv/ and accessed on 13 October 2010 ii Taken from liturgy developed for and used at the LWF Stuttgart Assembly 2010 iii This case study was submitted to the EAA by the Finnish Evangelical Lutheran Mission on behalf of its partner organization in Nepal. Sansthagat Bikas Sanjal iv Adapted from a meditation by Dorothy Day, published online by the Christian Reformed World Relief Committee in ‘A Place at the Table’, and accessed on 13 October 2010 at: www.crwrc.org/site_uploads/uploads/crwrc/resources/crwrc_APlaceAtTheTable.pdf v Adapted from prayers published in ‘Dear Life, Praying through the year with Christian Aid’, by Janet Morley, Hannah Ward and Jennifer Wild (Christian Aid, 1998) and included in the liturgy developed for and used at the LWF Stuttgart Assembly 2010
This order of worship has been compiled, translated and published by the Ecumenical Advocacy Alliance.
This material may be photocopied or quoted as long as credit is given to the source.
This material may not be used for commercial purposes. 2010 EAA. www.e-alliance.ch
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Existing Chemical Substance ID: 21829–25–4 CAS No. 21829–25–4 EINECS Name nifedipine EINECS No. 244–598–3 Molecular Weight 346.32 Structural Formula O=C(OC)C2(C(C1(=C(N(=O)(=O))C=CC=C1))C(C(OC)=O)=C(C)NC=2C Molecular Formula C17H18N2O6 Dataset created by: EUROPEAN COMMISSION – European Chemicals Bureau This dossier is a compilation based on data reported by t