The Price of Poverty

The price of poverty is high for women and girls in East Africa.

In 2019, UNAIDS reported that AIDS-related illnesses were the leading cause of death for women between the age of 15 and 49. Globally, women and girls account for more than half of the number of people living with HIV and it’s estimated that each day, 50 adolescent girls die from AIDS-related illness, and 460 adolescent girls are newly infected with HIV.

At CARE for AIDS, we serve some of the most vulnerable people on the planet, and it’s no surprise that nearly 80% of our clients are women.

Today is World Menstrual Hygiene Day, and we are excited to join with other organizations around the world to facilitate conversations that begin to destigmatize women's health issues.

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Economic Poverty and Menstrual Health

The cost of menstrual hygiene products can be an insurmountable barrier for women and girls across East Africa. In 2004, Kenya was the first country to remove taxes on menstrual hygiene products, yet two-thirds of women in Kenya still report not being able to afford sanitary pads. In rural areas, even simple access to these products can be challenging. According to the Tanzania Bureau of Statistics, the average woman spends 5-10% of her monthly income on period products. In contrast, American women report spending about 0.15% of their monthly income on period products. 

This cost barrier leads to unhealthy and sometimes exploitative practices. Many girls make pads from old household rugs, which can lead to discomfort and even infection. Some girls feel forced to trade sex for sanitary pads, a devastatingly common practice in East Africa. Because of this, girls are more likely to experience gender-based violence and their risk of contracting HIV and other sexually transmitted diseases is greatly increased. 

 Lack of access to hygiene products means many women and girls feel homebound for the duration of their cycles, keeping them out of work and school. In Tanzania, 17% of adolescent girls report missing school because of their periods.

The COVID-19 pandemic recently highlighted the importance of school for young women in East Africa. During just three months of lockdown and school closings in Kenya in 2020, about 152,000 girls became pregnant, a 40% increase from the previous year. 

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How can you make a difference?

By investing in moms, you invest in girls.

Take Anne's story: Anne is a graduate of the CARE for AIDS center in Mwiki in Nairobi, Kenya. Anne has three children, and her 14-year-old daughter, Maryanne, is already benefiting from her mom's involvement in the program. 

Anne has taught her daughter the practical skills she learned in the program. During the empowerment seminars, Anne learned how to make woven mats, bags, and wall decorations. She taught her daughter these skills, and together they have started a thriving business. By empowering one mother, a whole family has been impacted, and now both Anne and Maryanne are bringing in an additional income, which means they now have access to the health and hygiene products they need to thrive. 

Former president of Malawi, Joyce Banda, said, "The seeds of success in every nation on Earth are best planted in women and children." 

At CARE for AIDS, we believe that to see a community thrive, you must invest in the lives of women and girls. CARE for AIDS staff in East Africa are trained and experienced in women's health issues and also have training in water, sanitation, and hygiene protocols. During home visits each month, CARE for AIDS health counselors address general hygiene and sanitation and, when necessary, train clients on topics of sexual and reproductive health. Thanks to our generous partners at Johnson Ferry Baptist Church in Marietta, GA, CARE for AIDS clients also receive free, reusable sanitary pads. Health counselors teach clients and their adolescent daughters how to use these pads, and some clients have even learned how to make them and have been equipped to train other community members in menstrual health and hygiene.

As women journey through the CARE for AIDS program, they are being equipped and empowered to keep themselves and their families healthy. Through women's health education and economic empowerment, a world without period poverty and stigma is possible!

To learn more about this topic, read the 2019 UNAIDS Report on Women and HIV.

Relational Poverty: Our Relationship with Creation

THIS IS PART FIVE OF A FIVE-PART SERIES IN WHICH WE WILL BE FURTHER UNPACKING THE CONCEPT OF RELATIONAL POVERTY. THIS IS THE FRAMEWORK WE USE AT CARE FOR AIDS TO DEFINE AND ADDRESS THE POVERTY THAT OUR CLIENTS EXPERIENCE AND THAT WE EXPERIENCE IN OUR OWN LIVES AS WELL.

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This week we get to dig into the last of the four key relationships- relationship with creation. 

We have seen all of these relationships shift in quick succession in the narrative of Genesis chapter 3, and our relationship with creation is no different. After Adam and Eve break their relationship with God, experience shame, cover themselves, and blame each other, we hear God's reaction. He solemnly reveals the consequences to the couple, saying: 

““Cursed is the ground because of you; through painful toil, you will eat food from it all the days of your life. It will produce thorns and thistles for you, and you will eat the plants of the field. By the sweat of your brow you will eat your food until you return to the ground, since from it you were taken; for dust you are and to dust you will return.””

It's here we see humankind's relationship with creation drastically shift. Adam and Eve will no longer thrive alongside creatures and crops in Eden- they are exiled from God's perfect garden. The curse over Adam here is not simply that farming would be hard from this point on- the shift in his relationship to creation is at its heart, a shift in humankind's relationship to work. 

Adam and Eve had work in Eden- they named and cared for animals, they tended to trees and harvested their food with delight. We were created to be stewards of creation and to learn what that meant by being in a close, intimate relationship with the Creator. When Adam and Eve were walking alongside God each evening, work was easy. Work was fulfilling and life-giving, it taught them about the character of God. But upon their exile, work became a struggle, and we all experience that struggle today.

When we think about our relationship to work, it's helpful to think of it on a spectrum. Imagine the middle of the spectrum being work as worship- work as it was designed to be in Eden. When work is worship, it is an instrument by which we can care for those under our stewardship and empower our neighbors and communities to thrive. 

But very few of us live the majority of our work lives in the middle of that spectrum. Often, we find ourselves living on one extreme end of the spectrum or the other. In one extreme, work is an idol. When work is an idol in our lives, it becomes an end in itself instead of being a means to an end. On the other end of the spectrum is sloth (as the Bible calls it). 

We were not created to idolize work, nor were we created to live completely off of the work of others- both extremes on the spectrum display brokenness. The problem is, in the Western world, we have made being a "workaholic" much more acceptable than being "lazy". We acknowledge verbally that it's not good to idolize our work, but we reward ourselves and others when work rules their lives. It has become a cultural badge of honor to be exhausted and busy. Because of this, we often look with disdain on the economically poor, thinking that if they just worked hard enough, they could fix their economic situation. When we think like that in international development (or local development), when we neglect to see our own broken relationship to work, we ask the economically poor to trade one sickness for another. We expect them to become like us- and that is never the goal! The goal is for both the economically wealthy and the economically poor to become like Jesus! 

At CARE for AIDS, work is often one of the last things to fall into place for our clients before they graduate from our program. The hard work of healing their own relationships with God, themselves, and others comes first, and when healing happens in those relationships, long-term economic empowerment is possible. 

The Lenten season is such a perfect season for us all to assess the areas in our lives where we experience poverty. I challenge you to place yourself in the story of Genesis 3 and reflect deeply on your relationships.

Here's the wonderful news: the last thing that happens in Genesis 3 before Adam and Eve's exile is this: 

““The Lord God made garments of skin for Adam and his wife and clothed them.””

God made the first sacrifice necessary in human history- he killed an animal and used its skins to cover Adam and Eve. As a beautiful bookend to this story in Genesis, God also made the last sacrifice necessary in human history. The Good News of Easter is that, through Jesus, we are covered. Our relational poverty can be healed. 

Relational Poverty: Our Relationship with Others

THIS IS PART FOUR OF A FIVE-PART SERIES IN WHICH WE WILL BE FURTHER UNPACKING THE CONCEPT OF RELATIONAL POVERTY. THIS IS THE FRAMEWORK WE USE AT CARE FOR AIDS TO DEFINE AND ADDRESS THE POVERTY THAT OUR CLIENTS EXPERIENCE AND THAT WE EXPERIENCE IN OUR OWN LIVES AS WELL. 

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This week, we are going to dive into what it means to have a healthy, balanced relationship with others. 

As we saw last week in Genesis 3, immediately after their relationship with God and with self shifted for Adam and Eve, their relationship with each other also broke. Blame shifting in Genesis 3 quickly devolves into jealousy and murder in Genesis 4 (Cain and Abel), and our relationships with each other continue to cause strife and injustice throughout the rest of the story of humanity. It's a bit more obvious how a broken relationship with others can manifest in economic poverty - work that allows for economic flourishing necessitates community, and community is simply a network of trusting, healthy relationships between individuals. 

At CARE for AIDS, our clients often experience a forced separation from others because of the stigma associated with HIV. This of course negatively impacts their ability to find fulfilling work, but it also over time impacts their view of themselves. Many of our clients experience devastating internalized stigma because of the years of community stigma and discrimination (see how all of these relationships are so intertwined!).

The way we address this in the CARE for AIDS program begins with group therapy. When clients enter the program, they see that they are not alone. Through participating in peer-led group therapy and savings groups, clients are reconnected to a community of peers who value each other and have reciprocal, mutually beneficial relationships. Healthy interpersonal relationships begin with the affirmation of everyone's inherent dignity- the affirmation that we are all made in the image of God. 

In addition to allowing for fulfilling work, community greatly enhances our relationship with God. The analogy of the Trinitarian God as light has always resonated with me throughout the Bible (1 John 1:5, Isaiah 51:4, Habakkuk 3:4), so I am going to run with that analogy for a bit.

Our family room is my favorite space in our house. At almost every hour throughout the day, it is flooded with sunlight. While I was recently on maternity leave, Dallas (my now six-month-old) and I would sit in the family room every morning and he would gaze at the light glittering on the walls. When he was a few weeks old, I bought these little prisms that I could hang in the windows - when the light hits them it explodes into tiny rainbows that fill the room and dance on the ceiling all morning. It makes the whole room feel suddenly magical. The most familiar room in our house is transformed by these little rainbows, and they often draw my attention to the corners and part of the ceiling I would otherwise never pay attention to- I see the room in a whole new way a few times a day and it's so delightful (Dallas loves it too as you can imagine). 

For those of us who have been Christians for years or decades, God can often feel as warm and familiar as sunlight. God brings comfort and beauty and we can settle into our knowledge of him like a cat napping in a warm sunspot. And that is lovely. I love this image of God because he feels so close and familiar. But this experience of God is a very individual experience- our personal relationship with him is of course extremely important, but as Westerners, we often only experience God in this hyper-personal way. What ancient Israel knew, and what many of our brothers and sisters in the Global South know, is that to truly experience God in community is to see new facets of His character and Glory. It's like shining light through a prism. Something so familiar becomes new and magical. 

When I am in relationship with a thriving community of believers- particularly a community of diverse believers of different nationalities, races, genders, and backgrounds- I see different facets and characteristics of God that I wouldn't get to experience in a homogenous or purely individual faith setting. My attention is drawn to new areas of faith, and the mystery of the Gospel is made new for me again and again. Being in right relationship with others is magic. It reveals new things about ourselves and about God.

Next week, we will dive deeper into the theology of work and how our right relationships with God, self, others, and creation can come together to ultimately alleviate economic poverty.

Relational Poverty: Our Relationship with Self

This is part three of a five-part series in which we will be further unpacking the concept of relational poverty. This is the framework we use at CARE for AIDS to define and address the poverty that our clients experience and that we experience in our own lives as well. 

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This week, we will dig into one of the most complex of the four key relationships: relationship with self. 

To understand the origin of our relational poverty in this area, we must go back to Genesis. As the story goes, Eve listens to the serpent and falls prey to his temptation. She and Adam eat the fruit and this sets in motion a series of events culminating in their exile from Eden. 

It's clear that as a result of this first sin, a relational shift happens between humankind and God. But if we pick apart the series of events, we see this: self-consciousness, shame, efforts to hide, blame-shifting, and finally, physical and relational separation from God.  

What we witness in Genesis chapter 3 is a massive shift in humankind's relationship with self. The first realization Adam and Eve have after sin enters the world is their nakedness - their consciousness shifts from admiration and enjoyment of God and creation to personal shame. Now, I find it important to note the difference between shame and guilt here. I believe that guilt is a useful emotion - a tool that leads us toward repentance and reconciliation. Shame, on the other hand, drives us deeper into ourselves. It's an emotion that causes fear and results in avoidance. I believe what Adam and Eve were experiencing upon seeing their nakedness was shame. They covered themselves and hid, and when God came to walk with them in the cool of the evening, they avoided him, trembling behind their fig leaves. When God confronts them, their shame drives them to blame-shifting-- “this woman you gave me!” “The serpent deceived me!” There is no effort toward reconciliation to God in this moment for Adam and Eve. Their view of themselves drove a wedge in their relationship with God and in their relationship with each other (as well will explore next week). 

Humankind's original sin was rooted in the desire to be like God (having too high a view of ourselves) and resulted in the desire to hide from God and each other (too low a view of ourselves). And today, this brokenness in our relationship to ourselves persists. 

This type of relational poverty manifests in different ways and can drastically impact how we think about economic poverty alleviation. If you have ever heard the term "white savior complex", you know what I mean. If we as Westerners approach economic poverty alleviation with too high a view of ourselves and our power, we often unintentionally compound the shame that the economically poor experience. When we approach poverty alleviation in this way, both parties are pushed farther away from each other-- Westerners feel even more God-like and the economically poor feel even more shameful and unworthy. 

At CARE for AIDS, we address this relational poverty in a few different ways. First of all, we constantly try to acknowledge and reconcile our own relationship to ourselves as staff members both in the US and in Africa. We meditate on what it means to be made in the image of God and we do our best effort to work from that knowledge. For many of our clients, the shame and desperation caused by extreme economic poverty is compounded by the social stigma they experience because of their HIV status. We address this through one on one counseling and group therapy. We also impress upon clients the Biblical truth that they are fearfully and wonderfully made in the image of God. 

Simply put, our ethos when it comes to serving the economically poor is this: "I am not okay, you are not okay, but Jesus can fix us both." 

The very good news from Genesis is that, even when Adam and Eve were hiding in their shame, separating themselves from God, God sacrificed an animal to make clothes for them to cover their nakedness and rid them of shame. Even as God knew we were separating from him, he foretold a sacrifice that would cover us -- a sacrifice that would reconcile us to him, to ourselves, to each other, and to creation.

Relational Poverty: Our Relationship with God

This is part two of a five-part series in which we will be further unpacking the concept of relational poverty. This is the framework we use at CARE for AIDS to define and then address the poverty that our clients experience, and that we experience in our own lives as well.

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The framework of relational poverty begins in the creation story. In Genesis, God establishes four key relationships when he creates mankind: human's relationship to God, human's relationship to self, human's relationship to others, and human's relationship to the rest of creation. In the beginning, these relationships were all perfectly balanced, which allowed for human flourishing.   

As Genesis describes, sin enters creation, and each of these relationships shifts off balance. Our goal at CARE for AIDS is to facilitate restoration in relationships in these areas so that clients can ultimately escape material poverty. 

This week, we will unpack what that looks like for the first key relationship: our relationship with God. This relationship is particularly important because when we aren't aligned and whole in how we relate to God, we often replace God's sovereignty in our lives with other things - work, self... all of the typical things we are prone to idolizing. As humans, we were designed to be part of God's kingdom, but when we don't seek God's rule in our lives (as the Lord's prayer guides us to seek “...Thy kingdom come, Thy will be done...”), we inevitably give something or someone else kingship. For many of us in the West right now, we may be experiencing relational poverty in this area because we can rely on ourselves for our "daily bread". Financial stability can lull us into the belief that we can be our own gods (more on this next week when we unpack relationship to self). 

Many of our clients and others living in the majority world have developed a spiritual wealth in their lives that we in the West have never experienced. There is a spiritual grit that is developed through trials that we have cushioned ourselves against in developed countries. In times of crisis, we would do well to learn from men and women who have richness in their relationship with God. Men and women like our clients.

One of the things that is particularly cruel about HIV/AIDS is that the stigma associated with the disease can often rob our clients of their confidence in their relationship with God. Many are told that God is punishing them by giving them HIV, or that the disease is a curse that separates them from God's love. These beliefs create a crack in this key relationship for our clients, and it robs them of their spiritual wealth.  

One of the ways we address this at CARE for AIDS is by partnering with local churches to host the program in the communities where we work. Spiritual counselors at each CARE for AIDS center help clients find their footing in their faith and help them see the truth - that their diagnosis is not a punishment from God and that nothing can separate them from his love. We work hard throughout the nine-month program to facilitate healing and restoration in each client’s relationship to God, and we on the American team have learned so much about spiritual wealth from our African colleagues and clients. 

Take some time this week to reflect on this key relationship in your life. Are you experiencing poverty in your relationship with God? Where do you need healing and restoration in this relationship? 

If our relationship with God remains broken, the other three key relationships will inevitably be off-balance, as we will explore in the weeks to come. 

To do a deep dive into this subject, you can read more from our friends at the Chalmers Center or read their book, When Helping Hurts.