A Season of Difficult Hope

A guest essay by Art Ammann, the former Director of the Pediatric Immunology and Clinical Research Center at the University of California Medical Center in San Francisco. In the summer of 1981, Ammann cared for a woman who was a prostitute and intravenous drug user and three of her children. All four presented with unusual deficiencies in their immune systems that were aggravated by opportunistic infections that did not fit normal medical models of disease. He determined that the mother and all three children had contracted AIDS, a tragic diagnosis because the disease was at that time fatal. Perhaps equally devastating was the disturbing conclusion, hotly contested and very controversial at the time, that HIV-AIDS was not limited to adults. Ammann determined that HIV had passed from the mother to her children as an "acquired" and not an "inherited" disease. In 1982, he thus documented the first cases of AIDS transmission from mother to infant, and also the first blood transfusion AIDS patients.

In 1998 Ammann founded Global Strategies for HIV Prevention, where today he ministers around the world. With a special focus on women and children to reduce maternal and infant mortality, Global Strategies implements simple, inexpensive interventions with high impact in the poorest regions of the world.

           The Old Testament readings for the beginning of Advent this week coincide with World AIDS Day on December 1. They are potent reminders of the promises of God to the house of Israel. “I will fulfill the promise I made to the house of Israel and the house of Judah. In those days and at that time I will cause a righteous Branch to spring up for David; and he shall execute justice and righteousness in the land. In those days Judah will be saved and Jerusalem will live in safety. And this is the name by which it will be called: ‘The Lord is our righteousness.”’

           The promise is directed to a community of God's people. The words in Psalm 25 begin with a personal plea to God for protection from personal enemies and end with a plea for personal forgiveness. “My God, in you I trust; do not let me be put to shame; do not let my enemies exult over me.” And, “Do not remember the sins of my youth or my transgressions; according to your steadfast love remember me, for your goodness’ sake, O Lord!”

           The focus of the New Testament readings shift and imply that our intense earthly suffering is a prelude to the rescue that God will provide for the faithful. "Be alert at all times, praying that you may have the strength to escape all these things that will take place, and to stand before the Son of Man.”

           As I travel through some of the poorest and most violent countries in the world, and hear the pleas articulated by those who suffer intensely, I feel that they are also coupled with a sense of self vulnerability before God. Their voices echo the Scriptural pleas and promises that we read in this year’s Advent meditations.

           For the last several years, my friend Dan Clendenin has asked me to contribute an essay for World AIDS Day at the time of Advent. This year I thought about what I might say even before receiving his request.

           While reading Wendell Berry’s book of essays, What are People For? I came upon a poem by the title of "On Being Asked to Write a Poem Against the War in Vietnam" by Hayden Carruth that Berry had included in his book. Carruth had been asked to write a poem against the war in Vietnam. He hesitated, but then wrote one anyway. Upon reading the poem I felt an immediate sympathy, realizing that I too was having difficulty in writing a commentary about the pain and suffering of HIV because I had written about it so many times before — and the pain and suffering was still there.

           Here's Carruth's poem:

Well I have and in fact
more than one and I'll
tell you this too

I wrote one against
Algeria that nightmare
and another against

Korea and another
against the one
I was in

and I don't remember
how many against
the three

when I was a boy
Abyssinia Spain and
Harlan County

and not one
breath was restored
to one

shattered throat
mans womans or childs
not one not

one
but death went on and on
never looking aside

except now and then
with a furtive half-smile
to make sure I was noticing. >

           I haven't written any poems, but I've written many narratives about an epidemic that seemed so perverse and persistent, with the horror of HIV taking its special toll on defenseless women and children. “Surely God would hear their pleas,” I often thought. But I do not pretend to understand these things. I only know that in spite of the intensity of the pain and suffering, the people I met could only endure with a belief and hope in God.

           As I continue to labor in this area, and see and hear these people who suffer from a dreadful disease while they wait for God to intervene, I wonder, perhaps God is waiting for us who believe in him to intervene on his behalf?