The next to last time I saw Dr. James Young, former Chief Coroner of Ontario, was 23 years ago in the Penetanguishene General Hospital. He was at my feet, having arrived only minutes earlier, attending at the birth of my second child. He called my husband Gordon to witness the birth of our daughter and welcome her with loving hands into the world.

I wept last night when I saw Dr. Young again, this time on television in his role as the leader of the Canadian identification team in Phuket, Thailand. He spoke plainly and directly, like the family doctor he was in my rural Ontario town. I’ve seen him quite a few times on television, at inquests, after Halifax’s Swiss Air disaster, in New York City after September 11th, in Bali, during the SARS outbreak.

The last time I saw him in person was when he gave the four of us diphtheria, polio, tetanus, cholera and Hepatitis C vaccinations so that we could go to the diocese of West Malaysia as Partners in Mission from the Anglican Church of Canada. We raised our children in southeast Asia. Finding Christ there before us in our neighbours’ and colleagues’ welcoming hospitality transformed our lives and ministries. Gordon and I calculate our lives before and after Malaysia.

Recently, in order to write articles about our south Asian partners’ responses to the tsunami, I spent the day with e-mails that have come into PWRDF from Kumi Samuels of the Women in Media Collective in Sri Lanka, and S. Sooriyakumary and C. S. Chandrahasan of the OfERR Sri Lankan refugee organization in India. Their words … and sentences that trail off into silence … add faces and stories to those I see on the news.

Because of Mr. Chandrahasan and OfERR, I know that there is a 12-year-old refugee girl named Keerthika who was washed away by the tsunami wave. Her family, Sri Lankan Tamil refugees in India, had only recently moved to the Keelputhupattu camp where her father had found employment in the fishing colony, also washed away. But Keerthika has not been effaced, unvalued and rubbed out. She is named and mourned.

For many of us, and certainly for relatives and friends, the faces and stories of people like Keerthika, open eyes to see, hearts to sorrow, and minds to act with compassionate generosity. For me last night, it was Jim Young. He shouldn’t be there doing the job he’s doing. But he is exactly where he needs to be. As those two truths shift inside me, compassion happens and tears flow.

The root metaphor for God’s compassion comes from the Hebrew word rechem or “womb.” Compassion is not a one-way transaction. The womb from which compassion flows receives a seed, and inanimate seeds — neither dead nor alive — hold promise. Emptying tears from opened eyes water the implanted seed. Into what do those seeds grow? To what will we give birth, all of us?

As part of a collective of women’s rights groups in Sri Lanka, Kumi Samuels has been active in fact-finding missions among tsunami refugees. Their reports of rapes, molestation and physical abuse of women and girls in unsupervised rescue operations have been reported in the Canadian media. Less column space has been given to the collective’s concern and recommendations for the special needs of pregnant women and lactating mothers. Already culturally at risk because of their gender, physically at risk because of their procreative status, traumatized by sudden and instantaneous death for which they had no preparation, pregnant women and nursing mothers are further at risk of effacement in the rescue and rebuilding process.

There is a distinct phase of the birthing process, after the amniotic waters have broken and just before the child emerges, called transition. It is the time when trained rhythmic breathing can no longer deal with the pain and rapid irregularity of uterine contractions. You lose a sense of control, and it is frightening during first time childbirth. The second time you know it’s a sign—a sign that the child is ready to emerge. During transition the cervix undergoes effacement, a medical term for the natural process of the shortening and thinning of the uterine cervix walls as they dilate during labour in order for birth to occur.

The two truths of effacement shift inside me, and hope germinates. We all bear seeds from this disaster that call us to open our eyes and hearts, turn around, and go in a different direction. We are called to ongoing conversion as we live and die our faith. “Very truly, I tell you, no one can see the kingdom of God without being born from above…Very truly, I tell you, no one can enter the kingdom of God without being born of water and Spirit.” (John 3.3, 5)

We are all in transition together, moving into a vulnerable future seeded with promise. God is here at the heart of the pain and compassion. And God reaches out for us with loving hands from a future we cannot yet see.

In 1998, there were 33 million people worldwide living with HIV/AIDS, and almost 6 million new infections. Seven years later, the number grew to a staggering 40.3 million. Moreover, the epidemic is now rapidly spreading to new locations such as rural India and Eastern Europe. Each day, 16,000 people are newly infected with AIDS. AIDS has now become a poor person’s disease, taking a heavy toll on life expectancy and reversing the gains of recent decades. Sub-Saharan Africa alone has 25.8 million women, men, and children living with AIDS. For at least nine nations in Africa, the prediction is for a loss of about 17 years in life expectancy by 2010. This will set those nations back to the levels of the 1960s.

In the seven years from 1998 to 2005 the picture has not improved. Today we see countries on the brink of collapse due to AIDS. Again, the truth is stark. The ravages of AIDS are far more devastating in the slums of Nairobi, Johannesburg, and Lusaka than in those cities’ wealthier neighbourhoods. The discrepancy can be found in the residents’ savings accounts — the more financial padding the more effective the coping mechanisms. The fact is that in one part of town, people have access to and can choose among life-prolonging drugs. In poor neighbourhoods where most people live on an income of $1 a day, the choice is either having one meal a day or buying anti-retroviral drugs.

For many victims living with AIDS, it is affirming to have someone of Nelson Mandela’s stature acknowledge that his son, a middle-class lawyer in his 40s, died of the disease. Mandela’s statement confronted the stigmatization of the AIDS disease and helped make the conversation public. But the dour reality of AIDS in Africa is that it is intrinsically linked to poverty and in Africa, women are the poorest of the poor. All statistics agree: women are the group most affected by AIDS in Africa. In some southern African countries, the infection rate for women is 57 per cent. As well as poverty, their vulnerability to HIV infection is related to biological differences, the sexual behaviour of their partners, the exercise of power, social attitudes and pressures in a context where poverty has a feminine face.

While rooted in the African social context, feminine poverty has been intensified by economic policies and structural adjustment programs advocated and fiercely implemented by international monetary institutions such as the World Bank and the International Monetary Fund. Their economic polices have reduced ”development” to the simplistic exercise of resource allocation, efficiency, and cost-effectiveness. This short-sighted, business-like approach discounts human development and in the process has undermined the small gains Africa had made on health and education, the two sectors that most help women to overcome structural, systemic, and social disadvantages by giving them resources to rise out of poverty. Because health and education do not generate revenue or resources, African governments chose to sacrifice them to repay their international debts. Without addressing the root-causes of poverty by increasing and sustaining development aid for at least one generation, the battle against AIDS and poverty is at risk of being lost. In some situations, it has become easier to obtain anti-retroviral drugs than adequate nutrition and clean water. What is the point of having drugs but no access to food?

An important facet of AIDS in Africa is that women and girls are the primary caregivers for those suffering from AIDS. Disproportionately more girls than boys drop out of school to take care of infected family members, exacerbating the pre-existing gender-biased disparities in education. The situation creates conditions that place people and especially women at greater risk of HIV infection. It is within poor communities and social groups most affected by declining health conditions that HIV infection has gained the strongest foothold.

More than on any other continent, African women carry on their shoulders responsibility for the economic development and well-being of families. Women are providers, and caregivers. They work in the fields, markets and in the informal business sector, which accounts for 60 per cent of the African economy. Women play an incredible role as food growers, merchants, educators and caregivers, and they do all this while keeping the family together. In light of all these factors, we can infer that investing in women and girls is strategic in the battle against AIDS and poverty.

With the economic fabric of Sub-Saharan Africa rapidly disintegrating due to the impact of AIDS, people are pushed towards riskier behaviour. Young girls with neither skills nor education step into the roles of their sick or dying mothers and look for ways of providing for families for whom they have become the sole breadwinners. Women, and young women in particular, become increasingly vulnerable given their increasingly restricted access to health, education, and economic resources. The situation forces them into precarious lifestyles, often involving the sex trade. In such a context, they have little ground to negotiate for safer sexual practices.

HIV/AIDS is a barometer of women’s status in African societies, and it is killing them at an unprecedented rate. It is killing them because they are uneducated, poor and have limited choices. As the refrain says: “HIV kills everyone—men, women and children. They are all being killed.” A new line could be added: “It kills more women because they are poor”.