Religion and Public Health: Strengthening the Response to Preventable Diseases through Education

The following keynote address was delivered at the National Conference on Religion and Public Health in Stellenbosch on 6 October 2010.

Ladies and Gentlemen, Honoured Guests, dear friends, it is good to be with you this morning, as joint patron of this Conference, along with Dr Aaron Motsoaledi, South Africa's Minister of Health. I am grateful for this opportunity to address the vital relationship between ‘Religion and Public Health’, and in particular to consider how those of us from the faith communities can play our part in ‘Strengthening the Response to Preventable Diseases through Education’. My perspective is particularly through the lens of Judeao-Christian tradition, though I hope what I shall say has wider application among the faith communities.

May I begin by expressing my thanks to the National Religious Association for Social Development; to Fr Richard Menatsi (Chairperson) and Sheik Ahmed Sedick (Vice Chairperson); to Dr Renier Koegelenberg (Executive Secretary), and Canon Desmond Lambrechts (Director of the Public Health Programme); and all who have worked with them, in their organising, and generous hosting, of our time together. We look forward to Dr Motsoaledi joining us later today, so that our conversations and debates around these vital topics can be further broadened and deepened.

From the perspective of Anglicans in Southern Africa, there could hardly be a more auspicious day to meet, for today in the Anglican calendar of saints and heroes of the faith, we remember Henrietta Stockdale – also known as Sister Henrietta, who laid the foundation of professional nursing and modern hospital organisation in Southern Africa. The daughter of an English clergyman, she came to South Africa in response to a plea for teachers and nurses, having first trained in London. In due course, she established Southern Africa’s first training school for nurses in Kimberley, and those she taught also went on to found other training schools across the region. Her conviction of the need for proper authentication of qualifications resulted in the Cape of Good Hope Medical and Pharmacy Act of 1891, which provided for the first state registration of nurses and midwives in the world. She died on this day in 1911.

As I address the specific topic of ‘The contribution of religious networks to primary health care: challenges and expectations’, Sister Henrietta is just one vivid example of how faith communities have been engaged in delivering health care of one sort or another, through the changing circumstances of the world over many centuries. Care and compassion towards those in need, including the sick and suffering, has been a touchstone of most faiths, since ancient times. In the Hebrew Scriptures we read of the prophets denouncing the leaders of the nations as shepherds who fail the flocks entrusted to their care, since they have not ‘strengthened the weak, healed the sick, and bound up the injured’ (cf Ezek 34:4). In the Bible, Jesus tells his followers that whoever tends those who are ill are effectively caring for him – and whoever fails to offer such help stands condemned (Matt 25). Historically, precursors to what we would recognise as hospitals were found in antiquity, but their emergence as we know them today was most strongly influenced by the care provided by the Christian churches, monasteries and religious orders in Europe.

Even now, when the ultimate responsibility for the health sector rests with governments, faith communities remain deeply involved in the delivery of primary care. It was recently estimated by the World Health Organisation that almost half of health services in sub-Saharan Africa are provided by churches. Other faith communities are similarly engaged across the world. And where governments take the major role, as Sister Henrietta’s example demonstrates, today’s health care systems are often historically influenced by the faith communities.

But we are here today to consider not the past, but the present and the future, and to focus our energies, our imaginations, on what can we can do here and now to help make a difference to the health of our country. In doing this, I want to suggest that we as the faith communities ask ourselves three questions: What is the Content that we need to address over the next two days? What are the Processes that we want to suggest for engagement of the faith communities with the Health Ministry? What are the Values that we can particularly bring to the table?

Content

When it comes to the Content of the challenges of the health sector, our starting point can only be that we are not doing as well as we ought, as a nation. Of course, we live with the distorted heritage of the past, when world-class care was provided to the few, while the many were left with far less than adequate provisions. But we are not prisoners of the past, and cannot use our legacy, dismal though it was, as an excuse for not doing better today.

As I prepared to come here, I was fascinated to read the timely piece by Anso Thom in the Cape Times on Monday, and further references to Minister Motsoaledi yesterday. These spoke about the disjunction between our relatively high spending per capita, and the levels of health our country enjoys – or, rather, fails to enjoy. Some of the problems we face are well known, certainly at the level of newspaper head-lines. We know about the high levels of HIV and AIDS, and of TB, in South and Southern Africa, and of the way the two are so often linked. We know of the problems of malaria. We also know of the problems of service delivery in hospitals and clinics. We know of the high level of maternal and infant mortality rates, and South Africa’s very poor record in pursuing the Millennium Development Goal to reduce this. Beyond our borders the challenges are often wider and greater – cholera in Mozambique, for example. My brother bishop in the southern part of Mozambique also commented that, tragically, traffic accidents ‘compete’ with disease when it comes to causing death and injury. Poverty also increases the ability of individuals to access care, and of governments to reach their people. This can be a significant problem in relation to family planning and the treatment of chronic conditions including epilepsy, as well as for ARV provision and TB medication.

But there are other ills of which we are perhaps less aware. I was shocked to learn recently that the Department of Water and Environmental Affairs acknowledges that in South Africa over 100 children may die daily from diarrhoeal diseases, largely a result of poor water and sewage provisions. Adequate sanitation can reduce the incidence of diarrhoeal diseases by up to 40%. Poverty can exacerbate health problems in so many other ways – not least in the lack of basic education about good health practices. We need to ask ourselves some hard questions: Why does HIV continue to spread at unacceptable levels? Why is TB, entirely treatable, so prevalent? Why are people so passive, defeatist, in the face of illness, often only going to clinics when they are seriously unwell? Why do so many of us follow life-style practices that increase the risk of us developing serious, even life-threatening, conditions including diabetes, heart disease, and cancer – when so many of these are largely unavoidable?

Monday’s Cape Times article was titled ‘Prevention is much better than cure’, and I am delighted that education for disease prevention is such a priority for the Health Minister. I hope I will have an opportunity to speak to him after his arrival to express appreciation for all he is doing to turn around the Health Department, and to focus energies and resources in areas that can make the biggest difference at the most basic levels of disease prevention and care. I also want to pay tribute to the excellent supporting work that was done, all too briefly, by his deputy, Dr Molefi Sefularo, who tragically died earlier this year. I hope that the Minister will urgently appoint a new deputy who can provide similar strong assistance in driving the work of the ministry forward.

But the health challenges of this country, and the other nations of Southern Africa are greater than any of us can face alone, and therefore we must all contribute what we can to alleviating the burden. Primary health care has to be the place to start ‘eating this elephant, bite by bite’. This means we must tackle disease prevention, health promotion, swift effective treatment, and longer term evaluation, rehabilitation, and, where necessary, palliative care, and support for the terminally ill and their families.

Process

In many of these areas, the church has much to offer. This brings me to my second theme of ‘Process’. When it comes to preventing disease and its spread, and promoting good health, one of the most important components is education. Here faith communities have remarkable potential. While we are generally no longer in the business of providing medical professionals, we nonetheless most certainly do have remarkable capacities for communication with a very high proportion of the population of our country. We have, so to speak, a ‘reach’ that governments and political parties might envy. We must be intentional in using it well.

For we need to recognise and acknowledge that we have not always been wise. For too long, churches and other faith communities have not played a positive role in relation to education on HIV and AIDS. For too long we fuelled stigma, and with it ignorance and denial, all of which contributed to the disease’s spread. But as we learn to speak more openly, more honestly, more constructively, about these diseases and the factors around them, so we can help society as a whole to deal with them in this way. Let’s face it, the faith communities are never comfortable talking about sex, but we have no option but to do so, realistically, and holistically, and help change wider attitudes about what is too often something of a taboo subject.

One good news story comes from Khayelitsha, where Anglicans set up church-based HIV and AIDS support groups. Initially, we found that those who came were choosing to attend a group far from their home – they didn’t want to be recognised and identified and become the subject of gossip and speculation within their own communities. But now attitudes have changed – not only because of changing church attitudes, (though this has certainly been significant); but also through such factors as almost all pregnant women knowing their status, and this being seen as ‘normal’. We now find that people are far more relaxed about attending a group in their own community, far more relaxed about testing and knowing their status.

Making this transition from being part of the problem to being part of the solution has required first of all a commitment to ensuring our clergy are well-educated in the facts. Educating clergy and church leaders can enable us to do more on other health issues, in everything from nutrition to basic hygiene. Problems of gender-based violence and abuse, and emotional and mental health support, are other areas where our formal teachings – on Fridays, Saturdays, Sundays – must be well-informed. And while others may joke that clergy only work one day a week, we all know that there is a vast range of other activities within our parishes and congregations and communities, through which we can help educate and influence society.

Our communities can also provide effective support for good treatment compliance – people holding one another accountable for taking their medicines on time, and keeping up with their courses to the end of treatment. The persuasion of people-power is an area where we have vast resources at minimal cost.

We can also, as appropriate, partner with the Ministry in their formal education campaigns. Beyond that, while it is not our task to fulfil the Ministry’s responsibilities for them, there are surely many other ways we can support them in their aim of putting people first, the ‘Batho Pele’ initiative. Through our networks, our volunteers, our commitment to compassionate caring – and also through our physical presence in practically every settlement and community across our country – we have considerable capacity to act in constructive and cooperative partnership with those who have the skills and financial resources that we lack. Where necessary, for example, we can provide physical space for health professionals when they visit far-flung communities. Another example I might mention is the Siyafundisa Programme of the Anglican Church, where, in agreement with the government, we delivered US-funded peer education and life skills training to young people. I am sure that there are other examples that we will be able to share today and tomorrow.

Values

I have already touched indirectly on my third theme – the perspective on value, and values, that the faith communities can contribute within the health sector. This is perhaps where we have most to offer, as values, ethics, and the philosophical or moral context of what it means to be a healthy individual within a healthy community, are our ‘core business’. While Governments must uphold the ethos of Constitutions and the rights they guarantee to citizens – and in South Africa we are certainly blessed with having one of the best Constitutions in the world, when it comes to the rights of citizens – my belief is that it is civil society in its various forms, and particularly the faith communities, who bear the greatest responsibility for putting flesh on the bones, and giving shape, to the moral dimension of our societies.

For example, it is our care and concern for the whole human person, and for each individual as someone who ‘lives in relationship’ with their nearest and dearest as well as wider circle, that provides the context for health and well-being. We are the ones who can, and must, shape and support a prevalent mindset within our nation, so that we all operate automatically on the basis that medical treatment of physical maladies cannot be separated out from a wider concern for the person’s emotional and spiritual well-being.

As Christians, we root this in the belief that God created all humanity in his image; and that the second person of the eternal Trinity further dignified human existence by becoming incarnate in the man Jesus Christ. All people are intrinsically valuable in the eyes of God, intrinsically worthy of dignity and respect, no matter what their circumstances. It is well-documented that people generally respond more positively when they feel that they are respected and cared for in the whole of their being, on every level, in the attitudes of everyone from hospital receptionists through to medical staff.

Valuing also applies in other ways. We know that public sector budgets do not stretch to generous salaries. Nonetheless, faith communities can support a greater degree of respect and appreciation within the wider community for all those who work in this field; and, through this, help health workers from top to bottom feel a greater sense of value in the work they do – rather than feeling their work is to be evaluated purely in terms of financial reward. It is our desire that doctors, nurses, health professionals and all their support staff should find a deep degree of satisfaction through the difference they make to people’s lives; and should know themselves highly valued and appreciated within the wider community.

Promoting true values has another dimension, one that I am saddened that I have to mention – which is the need for the highest ethical behaviour within health management. There are far too many stories of corruption of one sort or another, particularly in relation to procurement of goods and services. (Of course these are not confined to the health sector.) It is the responsibility of the faith communities to give a clear, strong, lead in promoting an atmosphere of complete intolerance of corruption and malpractice of every sort. We must also give moral support and encouragement to the many within the public sector who do strive to uphold best practice and the highest ethical standards, and who, often at risk of their own jobs, are prepared to stand up against abuses. They deserve our wholehearted backing. We must look to ourselves also.

Caring for the whole person has other dimensions where the faith communities can extend the reach of the health care sector beyond what governments can provide. When I was 12 years old, my mother had TB, and spent 6 months in Rietfontein Hospital in Johannesburg. It was a very traumatic time for us, her children. Being part of a wider caring community is so vital in such circumstances – this is why church-based support groups and home care networks are so essential, and have such a significant impact where we run them. We must make our congregations aware that they need to be Christ’s compassionate eyes and ears in our communities, to ensure none in need are overlooked. A growing priority concern must be the identification of child-headed households, bringing them into contact also with social services who can provide help and support (and we can act in other ways in support of the Child Act). Sometimes a church person just going along as moral support to a clinic or government office, can make all the difference to an individual’s confidence in accessing the care they need and deserve.

We can also help ‘translate’ – in words, in practices – from the language of the professionals to those of local communities. For example, my sister, who worked in primary health care for 40 years, told me about how they had to walk sensitively alongside Traditional Healers, finding culturally appropriate ways for them to avoid reusing needles and razor-blades. We need to promote upholding best possible legal and ethical health practices in ways that have positive synergy with the lives of communities.

Let me mention a couple of particular concerns. One is that, rightly, governments seek to ensure consistent standards of care across countries. But the down-side can be that local initiatives are stifled. Worse, in some places, health services run by independent bodies, including the faith communities, are actually being closed down when they are not part of the uniform but limited, provisions that the government can supply.

There are also questions we must put to the business sector – even if they are not really part of our deliberations. But they too must consider values. Those industries with large work forces, and especially those with migrant labour, bear a heavy responsibility to be pro-active in promoting good health among their employees. I am glad that this is, at long last, beginning to be seen as increasingly normative. And business can go beyond this, and dare to consider the wider community from whom their workers are drawn – for we know that the average number of people supported by every person in employment can be very high.

We also need to encourage one another to think outside traditional boxes. In this respect, I am very glad that the Revd Paul Holley, will be speaking to us this morning on behalf of the World Health Organisation. He is director of the Anglican Health Network based in Geneva Switzerland. With the threat of aid cuts looming, they are looking at new models of healthcare funding. I hope he will share this with us.

And finally, of course, I must mention the care of the dying. As societies become increasingly urbanised, westernised, individualised, this becomes more and more of a taboo subject. The faith communities also have an ancient history to draw on, in this most challenging of areas – and our teaching can help people deal with the reality of human mortality, and face with honesty the last journey of life.

Conclusions

As I come to a close, I am glad to report that last week, at the Anglican Church in Southern Africa’s Synod, which we hold once every three years, tackling the challenge of health was one of 8 priority areas to which we committed ourselves in the decade ahead. Some of you who are here today were part of that debate and will help take our decisions forward in practical ways. It is my prayer that we will both learn from, and contribute to, the discussions of the next two days.

Finally, let me end with God – well, I am an Archbishop! – and with a word of encouragement. Though the challenges before us are vast, we know that God is on our side. It is his longing that all his children will find compassion, care, healing, and wholeness on the difficult journey of life. We can therefore be sure, that whenever we commit ourselves to these goals, it will be his joy and delight to support and strengthen us, to guide and encourage us, and to bless our endeavours, so that we may also be a channel of his blessing to others. May it indeed be so. Amen

Archbishop Thabo Makgoba's Charge to the Provincial Synod of the Anglican Church of Southern Africa

‘Anchored in the Love of Christ, Committed to God’s Mission, Transformed by the Holy Spirit’

Habakkuk 2:1-4, ^*Gal 6:1-10, Luke 4:1-13

Introduction

May I speak in the name of God, Father, Son and Holy Spirit.

Dear brothers and sisters in Christ, members of Synod, distinguished guests

– I greet you in the precious name of our Lord and Saviour Jesus Christ, and welcome you to the thirty-second session of the Provincial Synod of the Anglican Church of Southern Africa.

I extend a particular welcome to our invited guests – and especially to you, my dear brother from Haiti, Bishop Jean-Zaché Duracin. May your time with us be a time of growing and deepening partnership in the gospel.

A special welcome also to you, who are at Synod for the first time. I hope you will quickly feel at home among our processes and procedures, and able to make a full contribution.

We also greet Dr Mamphela Ramphele, thanking God for her years of faithful service, for which it is our privilege to honour her today with the Order of St Simon of Cyrene.

On the Feast of St Michael and All Angels, we ask God to send his holy angels to watch over us, and keep us safe in the centre of his will, throughout our time together.

May he bless and guide us, may he strengthen and inspire us with his vision, so that we may be his faithful instruments in the building up of his Church, and in his mission to his world.

God’s Vision for God’s Church in God’s World

Let me begin by thanking all those who have helped in preparing this Charge – first, as always, Lungi and my children, who have put up with weeks of inattention!

I also thank the Bishopscourt staff, my brother Bishops, and everyone who has contributed reflections, reports and other input.

This Charge is a collegial effort intended to reflect the perspectives, concerns and activities, of our whole Province.

The theme of both Charge and Synod, is the Vision offered by Provincial Standing Committee: that we, as the Anglican community in Southern Africa, seek to be:

• Anchored – in the love of Christ
• Committed – to God’s mission
• Transformed – by the Holy Spirit.

The context for our response to God’s vision, is provided by the prophet Habakkuk:

‘I will stand at my watch-post, and station myself on the rampart; I will keep watch to see what he will say to me’.

Jesus similarly began his ministry with prayer and fasting in the wilderness.

Now we in turn come away together to seek the Lord, following our own forebears’ example.

Exactly 140 years ago, in 1870, our first Provincial Synod met, and laid the foundations of our Constitution and Canons, on which all subsequent generations have built.

Let me pay specific tribute to the legacy of my two immediate predecessors.

We wish ‘Arch Desmond’, and Ma Leah, many peaceful, joyful, restful, years ahead as he retires from public life.

We also thank God for Archbishop Njongo, for it was on his watch that the 2002 and 2005 Provincial Synods affirmed a commitment to developing a Vision Statement: a renewed expression of our identity and calling in the new era before us.

In my Installation Charge, I spoke of our need to

quote ‘seek afresh to discover what it is to be the body of Christ in our time, and who God is in Jesus Christ, for us here and now’ unquote.

Since June 2008 Ms Glenda Wildschut has chaired this process. Thank you, Glenda, and everyone who has worked with you.

Now PSC has challenged us to be:

· Anchored – in the love of Christ,

· Committed – to God’s mission,

· Transformed – by the Holy Spirit.

This call from God echoes throughout Scripture.

First, being anchored in the love of God, made manifest in Jesus Christ:

• Habakkuk tells us to wait on the Lord;
• St Paul speaks of ensuring we fulfil the law of Christ, of loving one another as he has loved us;
• Jesus declares that we live not by bread alone (but by every word that comes from the mouth of the Lord as in Deuteronomy 8:3).

Second, being committed to God, and to his mission:

• so we persevere, waiting on the Lord for his appointed time [says Habbakuk];
• we do not grow tired of doing good [St Paul];
• [and, as Jesus says,] we worship the Lord and serve only him, who alone has authority over all the kingdoms, all the nations, every part, of the whole world.

Third, being transformed by the power of the Holy Spirit at work within us, so others, too, may be transformed:

• we must not be like the proud, who do not have a right spirit within them, says Habakkuk;
• we must follow St Paul, sowing the Spirit so that we reap eternal life, for ourselves and others;
• like Jesus, we must let the Spirit inspire us, so our words and our actions may have eternal significance – so we bear the fruit that truly lasts (John 15:16).

Upon this basis of being Anchored, Committed, Transformed, we have developed this Mission Statement:

Across the diverse countries and cultures of our region, we seek:

• To honour God in worship that feeds and empowers us for faithful witness and service
• To embody and proclaim the message of God’s redemptive hope and healing for people and creation
• To grow communities of faith that form, inform, and transform those who follow Christ

Believing this is the task to which we are called, we seek God’s guidance on how we put flesh upon these bones and make them live – asking him to breathe into them the life of his Spirit (as we read in Chapter 37 of the book of the prophet Ezekiel).

Like Habakkuk, we await the Lord’s answer – an answer for us to make plain, quote ‘so a runner can read it’ unquote, for sharing clearly across this Province.

So we identified eight priority areas, and asked task teams to look at how the Province can support Diocesan life.

As you discuss their reports, do not lose sight of the overarching context – that it is God’s vision for God’s church that we are trying to implement through them.

This is very different from the way that the world around us does so much of its planning – which reflects Jesus’ temptations remarkably closely.

For we are not seeking the vision of business, investors and economists: trying to maximise material gain – turning stones into bread.

Nor are we seeking the vision of politicians: focussing on power – the status and authority of the kingdoms of this world.

Nor are we seeking the vision of celebrity, of fame and popularity – preaching whatever so-called gospel best pulls in the crowds.

No. We trust ourselves to the God whose strength is made perfect in weakness; and worship him alone, who provides the bread of life with which we feed the hungry.

Being truly Anchored, Committed, Transformed, means holding fast to Christ’s love, the Father’s mission and the Spirit’s powerful directing.

This is the heart of the agenda for this Synod.

But we must also look beyond our own walls.

A self-absorbed, self-sufficient, church is soon a dead church, as the Church in Laodicea is warned in the Revelation to St John.

So, after addressing our common life and priority themes, I will consider our role:

· within broader Christian and faith communities;

· within the Anglican Communion;

· and within the nations of our Province and the wider world.

ACSA Priorities

Our eight priority areas are:

• Liturgical renewal for transformative development
• Theological education
• Leadership formation
• Health, including HIV and AIDS, tuberculosis and malaria
• The environment
• Women and gender
• Protection and nurture of children and young people
• Public advocacy

Two further themes – transformation, and holistic mission rooted in a full commitment to evangelism – run through and undergird all these, rather than being matters to address separately.

We must also keep in mind the imperatives of justice and reconciliation, gender equality, poverty, and youth.

Many of these themes relate to the daily bread-and-butter of Christian life and Christian leadership.

These include urgent needs to nurture young Christians and to encourage vocations – especially to the ordained and religious life, and particularly among our young people.

We must also train clergy and lay leaders; and develop a new generation of theological educators for the future.

But:

· unless we faithfully uphold daily Morning and Evening prayer,

· unless we root ourselves in Scripture,

· unless we feed regularly on the body and blood of Christ,

· unless we rely only and always upon God’s leading and God’s strengthening,

we are no better than any secular organisation.

For our calling is to be channels of the transcendent power of God: his healing, his hope, his redemption, to his world.

Only those who are truly Anchored in his love, and Committed to his mission, can be agents of his Transforming promises.

Our Spiritual Calling

Liturgical renewal is therefore vital.

Worship brings us close to God. We grow as Christians, and find our identity as Anglicans, through our relationship with him, more than anything else.

All of us, laity and clergy alike, must grow in discipleship if we are to respond faithfully to God’s call.

The disciplines of spiritual formation are not an option.

Therefore we need residential training alongside diocesan schemes.

I thank Revd Canon Dr Bill Domeris, and Revd Canon Dr Peter Wyngaard, for all they have done, at the College of the Transfiguration, and the Anglican House of Studies.

We also wish Bill and Shona every blessing as he retires at the end of the year.

I am glad to announce that Revd Prof Barney Pityana has been appointed interim Rector of COTT from 1 January 2011; with a specific mandate to oversee COTT’s registration with the Council of Higher Education.

We must also help laity to apply a mature faith in every walk of life – especially those in positions of responsibility, whether

• in government and public service;
• in the judiciary, or the media;
• in the education and health sectors;
• in business and wealth creation;
• or in local community organisations

– so all can truly be salt and light.

Church Leadership

While, within the church, we are not called to operate in the same way as secular leadership, we must certainly draw on the best examples, the highest standards, of the world around.

Everyone to whom responsibility is trusted – clergy, wardens, diocesan staff, members of boards at every level, and especially where financial matters are concerned – must combine the highest ethical codes with the best of professional expertise.

We cannot afford – literally, as well as metaphorically – to be well-intentioned amateurs.

So we must, for example, follow the advice of King-III, in respect of good governance, accountability, transparency and honesty – as well as upholding all canonical obligations.

In this light, the Provincial Treasurer, Mr Rob Rogerson, reports that the Provincial Finance Sub-committee has been looking at the structures of our accounts, at better disclosure, and increasing transparency and understanding.

This is vital for examining whether we have value for money in our spending – and also ensuring our spending patterns reflect our real priorities, and are geared towards our mission and ministry goals, including our Vision.

Travel is one area requiring particular attention.

Budgets are set through juggling Provincial needs against Diocesan abilities to contribute.

In the last five years, meetings and associated travel, especially by air, have cost significantly more than planned, and overruns carry forward with a ripple effect.

In part, this is as a result of our successes – such as the birth of new dioceses, for which we thank God.

But each new Diocese means extra delegates, which is expensive.

We must also be mindful when electing members to various in-house and ecumenical bodies: that we are sensitive to the geographical location of meetings, to minimise costs.

We thank Rob and his staff for their hard work – not least in seeing the Pension Funds safely through the credit crunch.

Upholding God’s Best

Sometimes in church life we fall short of what is expected of us.

When this happens, we must also follow best practice.

Therefore I am particularly grateful to Bishop Peter Lee – with the Provincial Registrar and the Deputy Registrar – for bringing to Synod draft measures to update and improve our canons on the Tenure of Clergy, and Ecclesiastical Tribunals.

The Church has a very special relationship with its clergy, as well as all those entrusted to their care. We therefore need structures and practices that safeguard both, as far as possible.

In my August letter ‘To the Laos – to the People of God’, I set out more fully what this means.

Ours is a God of infinite mercy and infinite justice – but not of ‘cheap grace’. While God’s offer of forgiveness is without limit, we must also take responsibility for our actions where this is appropriate.

So we must always act with honesty and transparency; promoting fairness and restorative justice; not brushing things under the carpet but ensuring proper procedures take their course.

We have a weighty responsibility to be God’s salt, God’s light, in his world.

To this end, we hold the Diocese of George in our particular prayers, as legal and civil procedures are pursued. These are very painful, but we must face them honesty and openly.

Growth and Development

But, thanks be to God, the great majority of our clergy are deeply faithful, doing so very much, for such little reward.

Thanks to your dedication, we enjoy many signs of growth – both in numbers, and in spiritual depth – around our Province.

We thank God for the building of his kingdom in this way. I have already mentioned new Dioceses – False Bay, Saldanha Bay, Ukhahlamba and Mbhashe since our 2005 Synod. I am sure they will not be the last.

Earlier this year, I enjoyed attending the Anglican Students’ Federation’s 50th anniversary celebrations, and earlier this month the Provincial Youth Council Consultation.

No-one meeting our young people could ever believe the accusation that Anglicans are dead, and don’t know the vibrant life of the Holy Spirit!

We must listen to God speaking through them, taking to heart St Paul’s words to Timothy that he should not let those who are older look down on him (1 Timothy 4:12).

Children and Young People

Did you know that about a quarter, 27%, of the world’s population is aged 15 or under?

Within ACSA, though that figure is only 19% in St Helena, elsewhere it ranges from 32%, about a third, in South Africa, rising to 46%, close to a half, in Angola.

Children are not merely the church of tomorrow, they are the church of today. Nurturing our young people, not only spiritually, is therefore a vital priority.

This goal must inform every debate we have. Frankly, Synod is appallingly unrepresentative on this score!

Gender

We are also hugely unrepresentative in relation to gender.

As one motion notes, women constitute the majority in our pews, but the reverse is true at every level of leadership, lay and ordained. And I must admit that one of my dreams is to consecrate a woman bishop for our Province!

We are particularly blessed that so many women make a disproportionate contribution, as individuals, lay and ordained, and through bodies like the Mothers’ Union and Anglican Women’s Fellowship. Thank you, to all of you.

I am very glad that we have now established the Gender Desk, and we welcome Revd Cheryl Bird.

Please note that it is a Gender desk, not a Women’s desk.

The roles of men and women alike, of every culture, were distorted by apartheid.

We need to develop appropriate spiritualities for us all, for contemporary living – that are also channels of healing for the legacies of our brutalising history.

I want to name one unmentionable area that we must dare to tackle: the dehumanising effect of conscription on a generation of young men – barely more than boys.

Many are still wounded from that time, and need to be able to speak and find healing.

Our society makes this almost impossible. But before Jesus there are no taboo subjects.

I also want to challenge the St Bernard Mizeki Guild and the Church Men’s Society to fresh reflection on what it means to be a Christian man in today’s world – especially in being actively part of the solution, to the unacceptably high levels of violence, against women and children.

Let me briefly mention the request to the Synod of Bishops, from three dioceses, to consider our pastoral care of those in same-gender Civil Unions, now legal under South African law, and those in polygamous relationships.

A working group prepared papers for an initial discussion in the Synod of Bishops.

This is a very sensitive matter, with wide-ranging implications (ranging from baptism policies to legal obligations), and we are going to proceed slowly, ‘on our knees’. Please keep us in your prayers.

Health and Social Development

Let me now turn to the remarkable work we are doing as a Province in areas of social development and health, especially HIV and AIDS, malaria and TB.

I must pay considerable tribute to Bishop David Beetge for his dedication here, as in so many other areas. During Synod we shall miss his wisdom, experience, deep spirituality, and his generous humour keenly. We thank God for his life, and send Carol our love and prayers.

We also thank God for Bishop Les Walker, and send Marian our love and prayers.

We send heartfelt condolences to the family of Judge Tholakele Madala, giving thanks for his wise counsel as Deputy Chancellor of the Province, and within the Diocese of Mthatha.

Names of other members of Synod who have died since our last meeting will appear in the record.

Both the Anglican AIDS and Healthcare Trust, and Hope Africa have had to weather the global economic storms and face reductions in funding.

I thank Bishops Jo Seoka and Merwyn Castle, as well as Mr Sabelo Mashwama and Canon Delene Mark, and their teams, for all they continue to achieve, in partnership with our Dioceses.

Hope Africa’s move to the same site as the Trust will, I hope, enable synergies that help maximise the efficient use of resources.

Yet the church’s greatest resource, and its greatest treasure, will always remains its people: so developing capacity, and empowering volunteers, remains central to our strategy.

This will be at the heart of next month’s South African National Conference on Religion and Public Health, of which the Minister of Health and I are joint patrons.

Our focus is ‘Comprehensive Educational Role in Primary Health Care – Strengthening Responses to Preventable Diseases’.

I also encourage our private sectors to fill gaps left by withdrawing international donors.

Companies should look beyond using social responsibility programmes to leverage advertising opportunities, and focus where needs are greatest.

The World Around Us

This brings me to the Church’s role beyond our walls, and our need to speak truth to power, and to pursue social justice and good governance in every form.

Let me mention two particular concerns within our Province, where we cannot remain silent.

The first is democracy within Swaziland, where power and wealth is concentrated in the hands of a few, and political debate is hardly permitted.

Bishop Meshack, our whole Province stands in solidarity with you, as you declare Christ’s gospel of good news to the poor and liberty to the oppressed.

The second is the freedom of the press within South Africa, where the Protection of Information Bill actually threatens to undermine a range of Constitutional rights.

Raising our voices so our message is heard, is often best done in partnership with others, especially Christians, and those of other faiths.

One such body is the South African Council of Churches. We congratulate Bishop Jo on his recent election as President.

This is a big task, as the SACC works on re-finding its focus and voice, which is so vital within South Africa’s public life.

We thank Bishops Jo and Peter, and everyone else who represents our Province, in ecumenical and other bodies – including the Church Unity Commission, with whom we are challenged to consider how we can deepen our common life.

We also look forward to the 3rd Lausanne Congress in Cape Town later this month; and particularly the pre-conference meeting of Anglican participants, which is being jointly run by the Anglican Communion’s Evangelism and Church Growth Initiative, and our own Growing the Church team.

There is time only to speak briefly of other events around our world.

Christ called us to love our neighbours as ourselves, and we must continue to hold Zimbabwe, and the Anglican church there, in our particular prayers.

I remain in close touch with the Bishop of Harare, offering what support we can; and am thankful for Bishop Rubin’s pastoral care and support for Zimbabweans.

The presence of Bishop Duracin reminds us we must not forget the plight of Haiti.

Following the accounts that I and Revd Canon Robert Butterworth wrote of our visit following the devastating earthquake, I am glad to report that we are establishing partnership links between schools; and have agreed to train a Haitian cleric for 3 years at COTT and a further year at the Anglican House of Studies.

We must also ‘think global and act local’ in relation to safeguarding our planet; doing what we can within our homes and churches, our communities, and our work-places.

We must also press for a comprehensive and just outcome at COP17 – the UN’s 17th Conference of the Parties, on Climate Change – being held in South Africa next year.

The Anglican Communion

In his Pentecost letter to the Anglican Communion, the Archbishop of Canterbury, Dr Rowan Williams, speaks of us as having ‘not fully received the Pentecostal gift of mutual understanding for common mission’.

The differences that focus around questions of human sexuality continue to be very real, very difficult.

ACSA must contribute what we can to the painful debate, not least from our own experiences of dealing with vast diversity.

I am therefore glad that ACSA was effectively represented at the Global South 4th Encounter earlier this year, and that 10 Bishops attended the All African Anglican Bishops Conference in Uganda last month.

For us, what has mattered most is:

· being centred on Christ;

· agreeing on the central matters of who Jesus is and the salvation he brings;

· and therefore recognising one another as being united in him, and, in consequence, with each other.

In consequence, as we have found within the Synod of Bishops, when differences arise, none of us feels called to say to another ‘I no longer consider you a Christian, a brother in Christ, a member of the body of Christ – I am no longer in communion with you.’

It is as if we see the marks of the living Christ, who is also the suffering Christ, in one another and in our common life.

We find ourselves more closely bound together in our soreness, as we await the power of the resurrection within our painful circumstances.

My prayer is that the Covenant can help the whole Communion rediscover one another in Christ, encountering him at the foot of the cross in this way.

We must not expect the Covenant to be perfect, or deliver instant solutions to shattered relationships.

But it certainly offers a way of affirming our desire to live together as Provinces, within our global family: through an autonomy that is neither imposed uniformity, nor unbounded independence.

Rather, we seek appropriate interdependence, lived in ‘bonds of affection’.

It is, you might say, a framework for expressing St Paul’s apparent paradox of both bearing one another’s burdens, and carrying our own loads!

We need to share our unique experiences of letting Christ hold us together in difference, within the life of the Covenant, and help it to work as well as possible.

Meanwhile, we must not divert time and energy from the core mission and ministry of the Anglican Communion, including the functioning of its Instruments of Communion, commissions, networks and other bodies.

This includes, for example, the Mission to Seamen, where we should take greater ownership of the opportunities afforded us.

Here let me thank Bishop Paddy Glover, liaison Bishop for the Mission to Seaman, for all he does as Dean of the Province, especially in supporting me.

We look forward to welcoming to Cape Town the Inter-Anglican Standing Commission on Unity, Faith and Order in November, and congratulate the Revd Sarah Rowland Jones – our Synod preacher, and my researcher – on her appointment to the Communion’s highest ‘theological think tank’.

[Sarah is also the widow of Justus Marcus, whom old Synod and PSC hands will remember fondly for his years of service, as Dean of Kimberley then Bishop of Saldanha Bay.]

We thank Revd Canon Janet Trisk, Ms Nomfundo Walaza and her successor Mrs Louisa Mojela for representing us in the Anglican Consultative Council, and pray for Janet in her weighty responsibilities on the Communion’s Standing Committee.

Conclusion

Let me sum up this wide-ranging review of the life of our Province with a question:

What is my hope for this Synod, and the outcome of our time together?

Well, I long to see our Vision embraced enthusiastically, and for us to work hard together to breathe life into it – so that in responding to God’s call to mission, we can enhance a comprehensive response, within our Dioceses, to the many serious inter-relating spiritual and socio-economic challenges that we each face, across our vast and varied Province.

Finally, let me end with some personal reflections.

I was recently walking in the garden with my two dogs, pondering the vocation to Christian leadership.

When I sat down near the stream, two Egyptian geese rushed at me, squawking furiously. They would not stop. One even flew at my head.

Then I realised that the younger dog had a baby goose in his mouth.

Fortunately he released it unhurt, and it rejoined its brothers and sisters in the stream. We moved away and the family was reunited.

The two parent geese had fearlessly taken on what must have seemed like three giants who had come between them and their family, but they were determined to care for their children at all costs.

Since moving to Bishopscourt, I have often felt faced by giants – difficult challenges I never expected; heavy expectations laid upon me; travel to everywhere from Haiti’s devastation to the presence of Kings and Presidents.

Yet this is not because I am Thabo, but because I am God’s child, called by him to a particular task for the sake of his church, his world.

He has put around me people – family, colleagues, staff, friends – and structures (of which Morning and Evening Prayer and the daily Eucharist are central) to remind me continually that this is God’s business.

So I rely on him for courage to face the giants, and to guide me in what I say and do.

Indeed, I have become grateful that often, when I feel stretched too far, and inadequate for the task, in this way he forces me to keep depending on him.

I have found that his grace is indeed sufficient in my weakness.

He is my Anchor. To him I am Committed. And in his love, I find the Transformation I need for living out the vision he puts before me.

Let us dare to do the same, as a Province – to be Anchored, Committed and Transformed, so we may be, in Habakkuk’s words, ‘the righteous, who live by their faith.’^*

Amen