The CCIH Forum

WHY WAIT?  “The Truth for Youth”
Biblically based concepts on sexuality, love and marriage for prevention of HIV/AIDS


by Professor Dick Day
Executive Director, Sub-Saharan Africa Family Enrichment (SAFE), Malawi; Africa
Email: dayinafrica@sdnp.org.mw
Global Missions Health Conference, Nov. 2003

HIV/AIDS In Africa

Dr. Peter Piot, Executive Director of UNAIDS, said, “The AIDS situation in Africa is catastrophic, and Sub-Saharan Africa continues to head the list of the world’s most affected regions. One of the great-est causes for concern is that over the next few years, the epidemic is bound to get worse before it gets better.” Sub-Saharan Africa has only 10% of the world’s population, yet it has 70% of the estimated HIV/AIDS infection.

“Quite simply, AIDS is on track to dwarf every catastrophe in Africa’s recorded history. It is stunt-ing development, threatening the economy, and transforming cultural traditions.” (Mark Schouff, Pulitzer Prize winner in journalism, 2000)

Africa has undergone dramatic political, economic and social changes in the past several decades. Changes which occurred in Europe and North America over centuries have been compounded into a single generation. The cornerstones of traditional African culture - the family and the community - have been profoundly affected.

At the beginning of the “Winds of Change” that have swept across Africa, John Mbiti said, “The change means individuals are severed, cut off, pulled out and separated from corporate morality, customs and traditional solidarity. They have no firm roots any more. They are simply uprooted but not necessarily transplanted.” There is little doubt that this profound upheaval has contributed to the rapid and extensive spread of HIV/AIDS.

The world is looking to the West for a scientific answer to the HIV/AIDS pandemic - a vaccine. Until then, people are advised to rely on condoms. Yet we are dealing with a pandemic that is essentially a behaviourally transmitted disease. Promoting the use of condoms does not address the main causal factors. It advocates a technical solution to a problem that can be addressed only through fundamental changes in social attitudes, values and behaviour. There needs to be a transformation of one’s mind, a change in one’s worldview.

What is a worldview? It is one’s perception of reality. It may be true, partially true or entirely false; it may be held consciously or subconsciously; it may be consistent or inconsistent. One’s worldview determines one’s beliefs, values and behaviour. It involves the mind, the emotions and the will. It is what Proverbs 23:7 means when it states, “For as he thinks within himself, so he is.” Without the transforma-tion of one’s worldview, there is no transformation of one’s behaviour.

Not only do individuals have concepts of what is real but so do cultures. Values in culture are not selected arbitrarily but invariably reflect an underlying system of beliefs. At the very heart of any culture is its worldview, and the cultural worldview helps shape the individual’s worldview and consequently one’s behaviour.

Professor William Rushing, former chair of the Section on Medical Sociology of the American Sociological Association, put it well when he said, “In the final analysis, whether the HIV/AIDS epidemic in Africa slows down will depend on millions of people changing their behaviour. And since behaviour is anchored in cultural norms, social institutions and the structure of social rewards, change will be hard for health care professionals to bring about . . . African programmes must be adapted to the traditional social practices and culture of Africa.”

The World Health Organization (WHO) takes a holistic view of health when it says, “Health refers to one’s complete physical, spiritual, social and mental well being and not merely the absence of disease or infirmity.”

In Africa, perhaps as nowhere else, the holistic approach is distinctive. Dr. Mugambi of the Univer-sity of Nairobi states, “The basic worldview of African peoples is distinct from that which is discernible in the European tradition . . . In the African heritage, the world is viewed as an integrated phenomenon, from which human kind is inseparable, whether physically or intellectually.”

It is the African holistic worldview that makes the Biblical worldview so culturally appropriate in addressing behavioural change. Professor William Dyrness states, “The material and spiritual worlds are ultimately part of a single reality, and the line between the one and the other is difficult to draw. But to all Africans, the belief in a single, all-powerful God is unquestioned.”

Yet over the years, Christianity has failed in any significant way to build upon this foundational African worldview - to build a Biblical worldview either in the individual or the culture.

The General Secretary of the Association of Evangelicals of Africa and Madagascar, Dr. Tokinboh Adeyemo, states, “For decades in Africa, evangelism and missionary activities have been directed at getting people saved (that is, spiritually) but losing their minds. Consequently, we have a continent south of the Sahara that boasts of over 50% Christian population on average, but having little or no impact on society. In actual fact, it sounds like an irony that within our own rank and file such practices as witch-craft, traditional religions, orgies, tribalism and the like are regarded as normal . . .” He adds, “Africa has been evangelized, but the African mind has not been captured for Christ.”

At the dedication of the Billy Graham Center at Wheaton College, Charles Malik, one-time Secretary General of the United Nations, gave us a warning of the consequences of not winning minds when he said, “The problem is not only to win souls but to save minds. If you win the whole world and lose the mind of the world, you will soon discover you have not won the world. Indeed, it may turn out that you have actually lost the world.”

This appears to be what happened in Africa. African theologian Dr. Van der Poll states, “Because the Gospel was not brought to the people as a new totally encompassing life view, which would take the place of an equally comprehensive traditional life view, the deepest core of the African culture remains untouched.” He further explains, “The convert in Africa did not see the Gospel as sufficient for his whole life and especially for the deepest issues of life. For that reason, we find the phenomenon across Africa today that Christians in time of existential needs and crises (such as danger, illness and death) fall back on their traditional beliefs and life views. It is precisely an area where the Gospel should have most relevance,” yet the Gospel does not mean much in practical terms for the African.

But this does not have to be. As tragic as the HIV/AIDS pandemic is, it has opened doors to build into the next generation, the youth, a holistic Biblical worldview, which addresses the issues that are being faced by them and the culture in which they live. The “WHY WAIT?” Family Enrichment Educa-tional Programme addresses these needs.

IV. Key Concepts Addressed by “WHY WAIT?”

Because much of human sexuality depends on what the individual thinks rather than on biology, it is essential to develop a Biblical worldview that rightly relates the individuals to God, themselves and others in true love. Therefore, the key concepts addressed by “WHY WAIT?” are as follows:

Young people are “Special” and “Worth Waiting For!” They have been created in God’s image, both male and female. God loves them and wants them to have a meaningful relationship with Him, others and themselves - The Great Commandment. (Matthew 22:36-40)

The basis for meeting these needs is love - being loved and being able to love. Although love is a basic human need, it is something that is learned. (I John 4:19) The statement of love to others is the ulti-mate witness of the Christian faith to the world. (John 13:35) True love will always protect and provide. God is love; therefore, He will both protect and provide.

We are living in a day and age of racism, sexism, tribalism, poor self-concept, drug and sex abuse, etc, which deny the very essence of God’s creative plan. These adversely impact not only the society at large but the individual living in it. Therefore, we must first and foremost affirm God’s creative plan, which has been proven by His redemptive plan and secured through identification with Christ in spiritual birth.

We have been created in God’s image so that we might have a living relationship with Him and that we may honor and glorify Him. The very essence of the Christian life is built upon relationships and the development of godly character through these relationships. (Luke 6:40)

This is why the family is so vital in God’s plan. When God created people, He created them in His image, both male and female. (Genesis 1:27) He created the family so that the image of God is reflected to the children through the father and the mother (it takes both), and then passed from generation to generation. When a family is disorganized (i.e. through divorce, separation, death) or dysfunctional (i.e. lacking character, values, etc.), the growing child does not have the proper role models to develop a Christian worldview. (Romans 12:2)

After the establishment of individual human dignity, which is the basis for acceptance of all human-ity, including one’s enemies, there is need for and understanding of how love both provides and protects. This occurs through revelation, the Bible, Jesus Christ and His example, and the Christ-like character demonstrated by those created in His image.

In “WHY WAIT? What You Need To Know About The Teen Sexuality Crisis,” Josh McDowell and Dick Day list 37 reasons why young people do not wait and 27 reasons to wait. The reasons encom-pass the physical, emotional, psychological, relational, moral and spiritual. Although research for the book was based on American youth, the principles apply in virtually every culture. In working with students at the University of Malawi, more than 30 of the 37 reasons for not waiting are either ‘relevant’ or ‘very relevant’ to the Malawian youth.

We see from this a basic principle: human needs know no cultural boundaries only different cultural expressions. Therefore, we need to address the human needs from a Biblical basis, since Biblical prin-ciples know no timelines, geographic or cultural boundaries. However, we do need to understand the culture in order to understand what the individual in that culture is expressing. Thus, in teaching the cur-riculum, we must make the expressions (i.e. activities) relevant to the culture, even though the Biblical principles are universal.

In addition to imparting an understanding of true love and its expressions, we need to build in values that will become internalized and result in establishing healthy (i.e. Biblical) behavioural patterns and/or behavioural change.

Associated with affirming the dignity of humanity, both male and female, there needs to be an emphasis on the mind - knowing the truth and choosing to act upon that knowledge. Youth need to know that they can make right choices and with the enabling power of the Holy Spirit make behavioural changes - something that much of contemporary philosophy rejects. They also need to understand that the mind is the greatest sex organ and needs to be protected.

* affected by learning and social factors, and thus more variable within the species;

* able to serve other purposes in addition to reproduction, such as pair bonding and communication;

Without built-in guidelines, human sexuality is dependent on learning, and different societies and groups teach different things about sexuality. Therefore, there is a need for a Biblical worldview in order to properly express God’s creation of human sexuality.

The young person needs to understand that true love is first and foremost an act of the will. Christ said, “A new command I give you, that you love one another.” A commandment is an appeal to the will. The great love passage of I Corinthians 13 describes acts of the will, not expressions of the emotions.

The individual also needs to know that with right thinking and right behaviour, there can be new beginnings, through the grace of God and His forgiveness; that the new beginnings can be maintained by abiding in God’s principles, through the power of the Holy Spirit.

There is a connection between vision and virtue. One has to see correctly before one can act correctly. It is for this reason that the person of Jesus Christ becomes the model of character and moral development.

“WHY WAIT? Africa” was initially presented in 1992 at the first annual week-long Uganda Youth Conference, hosted by First Lady Janet Museveni. In 1993, the Malawi Ministry of Education requested Sub-Saharan Africa Family Enrichment (SAFE) to develop an African-oriented curriculum addressing sexual abstinence, life skills and character development that could be used in schools to help address the HIV/AIDS pandemic. The first draft of the WHY WAIT?/Family Enrichment curriculum was drafted by University of Malawi Professor Moira Chimombo. In 1994, the first teacher training and training of trainers (TOTs) workshops were conducted. The WHY WAIT? programme was launched nationally at a convocation of 3,000 students and 500 teachers hosted by State President Bakili Muluzi at Sanjika Palace in 1995

A four-year-long curriculum has been developed, field tested, revised and printed for secondary school students. Also, there has been developed a four-year primary-school curriculum for Grades 5 through 8. A team of excellent Malawian trainers has been trained and mobilized; and over 2,000 teachers have been trained in four- to five-day workshops. In addition, both a semester course and a WHY WAIT? training workshop have been introduced for Education majors at the University of Malawi. While WHY WAIT?’s integrated, value-based approach is built on Biblical principles, it also reflects a holistic African worldview and traditional morals.

There have also been to date twelve training workshops in Kenya conducted by Kenyan TOTs who were trained by Malawian TOTs. These workshops have trained over 1,500 teachers and Ministry of Education officials, as well as educators from Tanzania, Uganda and Congo. In 2003, the WHY WAIT? programme was initiated in Nigeria by Nigerian TOTs, trained by senior Malawian TOTs .

We are learning that information in itself is not enough to change the sexual behaviour that is neces-sary to curb the HIV/AIDS pandemic. According to a 1988 survey, 95% of all Ugandans were aware of AIDS and how it is transmitted. Yet even with this awareness, the killer disease continued to increase until it peaked in 1991. In a speech broadcasted live on April 7, 1990, the Minister of Health, Zaker Kaheru reported, “The only way people will survive this epidemic is by adopting disciplined social behaviour.”

In order to change behaviour, there must be a change in beliefs and values that will affect one’s attitude and behaviour. This is what happened in Uganda, particularly among the youth, beginning in 1992. Much to the surprise of most international agencies and authorities, the turn-around in the pandemic was not primarily due to condoms and the large amount of money invested in the distribution; but rather the shift was primarily due to the change in behaviour, particularly among the youth of Uganda.

The following is from a summary document synthesizing the ideas presented by four individuals with long-term experiences in HIV presentations. The presentations were made at a USAID-sponsored consultation in February 2002. The document is entitled, “What Happened in Uganda? Declining HIV Prevalence, Behaviour Change and the National Response.”

“Now considered to be one of the world’s earliest and best success stories in overcoming HIV, Uganda has experienced substantial declines in prevalence, and evidently incidence, during at least the past decade, especially among younger age cohorts . . . Estimates by the US Census Bureau/UNAIDS are that national HIV prevalence peaked at around 15% in 1991 and had fallen to 5% as of 2001. (p.2)

“Uganda’s President set the example for the nation with his matter-of-fact approach in dealing with the HIV threat and inspired thousands of community, religious and government leaders to talk candidly to people about delaying sexual activity, abstaining, being faithful, ‘zero grazing’, and using condoms (roughly in that order).” (p.10)

“Mainstream faith-based organizations wield enormous influence in Africa. Early and significant mobilization of Ugandan religious leaders and organizations resulted in their active participation in AIDS education and prevention activities.” (p. 5)

Addressing the House Committee on International Relations, Sub-Committee on Africa, Hearing on HIV/AIDS Steps to Prevention, September 27, 2000, Vivian L Derryck, Bureau for Africa, US Agency for International Development (USAID), stated, “Religious leaders (in Uganda) were instrumental in inculcating ideas about sex within marriage and delays in the age of sexual debuts.”

According to UN Wire: An Independent News Briefing about the UN, Anne Peterson, MD, head of US Agency for International Development (USAID) Global Health Bureau, referring to Uganda’s ‘ABC’ strategy to combat HIV/AIDS (Abstinence, Be faithful, use Condoms, in that order), stated, “The historical approach to HIV has been little ‘a’, little ‘b’, and big ‘C’; but Africans were far ahead of the worldwide public health community on this. The core of Uganda’s success story is big ‘A’, big ‘B’, and little ‘c’.”

From the beginning, President Museveni has been a strong advocate of big ‘A’ and big ‘B’, and small ‘c’, as indicated by his address on June 20, 1991, to the Seventh International Conference on AIDS. At that time he stated, “I don’t support the idea of condoms myself,” suggesting instead that “abstinence and self-control must be taught to our young people.”

The following November, addressing the first AIDS Congress in East and Central Africa held in Kampala, he again emphasized the need for big ‘A’ and big ‘B’, when he said, “I have been emphasizing a return to our time-tested cultural practices, which emphasized fidelity and condemned premarital and extramarital sex . . . I feel that condoms have a role to play as a means of protection, especially in couples who are HIV positive, but they cannot become the main means of stemming the tide of AIDS.”

It was in May of 1992 that the First National Youth Forum was initiated. The theme was, “WHY WAIT? - Because YOU are special and worth waiting for!” This is a programme that affirms the God-given dignity and equality of each and every human being. The First Lady, Mrs. Janet Museveni, was the patron and honorary chairperson. The first two forums were attended by the Museveni teenage children.

Addressing an international audience, on February 20, 2002, at the HIV/AIDS conference, “Pre-scription for Hope,” Mrs. Museveni informed the audience how the turn-around began in Uganda. She attributed it to the annual Uganda Youth Forum and the involvement of the “faith community.” The Forum is a seven-day conference attended by thousands of Ugandan youth each year. Mrs. Museveni continues to be the patron and honorary chairperson. Professor Dick Day (the author of this paper) was the principal speaker at the first two forums (1992, 1993), addressing the youth on “WHY WAIT?” He returned again to address the 2000 forum.

The Right Honorable Justin Malewezi, Vice President of Malawi and chairman of the Cabinet Committee on HIV/AIDS, has stated, “Evidence from Malawi and throughout the world demonstrates that when HIV prevention has been most effective, young people themselves have been in the forefront of the change. The many faith communities’ programmes in the area of behaviour change and life skills training have proved very effective in reducing HIV transmission among our youth. These programmes should be implemented on a national scale.” It appears that the faith community has a key role to play in fighting the HIV/AIDS pandemic, because it has the Biblical principles to implement both the ‘A’ and the ‘B’. It has worked in Uganda; it is working in Malawi; and now it is working in other countries.

In 1999, the WHY WAIT? programme was introduced into Ndirande Full Primary School. The school is located in a ‘squatters’ village in Blantyre, the main commercial center of Malawi. It has an enrollment of over 8,000 children, grades 1 through 8; 28% of the children are orphans, mostly due to AIDS; 90% of the children live in poverty.

There are 121 classes and 20 classrooms, resulting in the vast majority of the classes being held outdoors. In the school there are no desks or chairs for children. The primary instructional equipment is a chalkboard hanging either on a classroom wall, an exterior wall or under a tree.

The year prior to the introduction of the WHY WAIT? programme in Ndirande Primary School, 121 girls dropped out due to pregnancies. After the implementation of the WHY WAIT? programme, for two years in Standards 4 through 8, the pregnancy drop-out was reduced to zero.

Even with the lack of physical facilities, the children have excelled in character and academic devel-opment. According to the headmaster, this has been due to the model of the WHY WAIT? teachers, the message of the WHY WAIT? programme, and the method of the student-involved learning incorporated into the WHY WAIT? programme.

Dr. Urie Bronfenbrenner, Professor of Human Development and Family Studies at Cornell Univer-sity, in his summary statement at a UNESCO conference on “The Child and the Family in a Changing World,” stated, “We have learned that stresses being experienced in both worlds (developed and develop-ing) have common roots and call for common strategies grounded in the basic requirements for survival and growth of all human beings in all human ecologies.”

Billy Graham states a similar observation when he writes in his book, World Aflame, “In my travels throughout the world, some truths have made a great impact on me. One of them is the truth that man is the same all over the world. His hopes, dreams, problems, difficulties and longings are essentially the same whether he is in the heart of Africa or in the heart of America. Another truth that has impressed me, as I have studied man on every continent, is that man is essentially no different today from what he was a thousand years ago. His circumstances change, but human nature remains essentially the same.”

As Goethe (1749-1832) said, “Mankind is always advancing. Man remains ever the same.”

God has created every human being with certain basic needs of the soul that He desires to meet through the Spirit; but if one does not understand how God wants to meet the needs or rejects God’s way, the tendency is to endeavor to meet the needs of the soul through the physical senses. This leads to such indulgences as sex, alcohol, drug abuse and materialism, etc. - all contributing factors to the spread of HIV/AIDS.

Stephen Covey describes how caring people have an Area of Concern and an Area of Influence. Proactive people focus on their Area of Influence. They work in areas where they can effect change; and as the nature of their energy is positive, enlarging and magnifying, their Area of Influence increases. On the other hand, if the focus is on the Area of Concern, they tend to become reactive rather than proactive. They tend to take on negative attitudes of blaming and accusing others and feeling like victims of circum-stances. The negative energy generated by this focus causes their Area of Influence to shrink.

As caring people, we will have concern; but our focus must be on our Area of Influence – ourselves, our family, our neighbors, our students, our community and, for a few, even national policy. If caring people bond together in a caring network, we can greatly increase our Area of Influence and begin to bring about change in our Area of Concern. We need caring communities of parents, teachers, neighbors, church members, etc.

“Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it’s the only thing that ever has.” (Margaret Mead, anthropologist)

Professor Robert Webber of Wheaton College describes how the leaders of the “Great Awakening” of the eighteenth-century, “held what is known as a holistic view of salvation. They did not separate the body from the soul. Rather, their approach to revival stimulated the improvement of social conditions and the bettering of human life.” The results were changed lives and a changed society.

The Book of Acts describes the disciples as “These that have turned the world upside down are come here also.”(Acts 17:6 KJV)

Help turn the world upside down by “discipling nations.” The transformation of minds is brought about by a Biblical worldview. (Ref: Matthew 28:19 and Romans 12:2)