PHOKENG, South Africa — When the women of the Freedom Park squatter camp die during the wet season, their emaciated bodies must be carried out by hand through the oozing mud, past the rusting tin shacks and open sewers and scrubby trees covered in windblown trash, to the nearest road for a pauper's funeral.

The camp, close by the region's platinum mines and mine hostels, has no electricity, no water and few jobs, apart from prostitution. What it has in abundance is poverty and sex and AIDS and death.

On one of his first visits to the settlement, Roman Catholic Bishop Kevin Dowling had an unforgettable encounter when he ducked into the hut of a skeletal young mother with AIDS.

"She looked in my eyes and said, 'There is no hope for me, Father. I have no hope,' and tears started running down," recalls the lanky, 61-year-old bishop. "I looked around the house, and there wasn't a stitch of food."

The Roman Catholic Church bans the use of condoms, but Dowling believes the prophylactics — at least in his diocese — are a key to saving lives.

Abstinence and faithfulness in marriage, the church's answer to the AIDS epidemic, "are the only way to be sure you won't get infected. I have no problem with that," the controversial South African bishop admits. But in his diocese, full of desperately poor women with few options beyond prostitution to feed their children, using condoms seems to him "a pro-life option in the widest sense."

"For me, the issue is simply this: How do you preserve and protect life?" he said recently at his offices in Phokeng, a poor township on the outskirts of Rustenburg, an hour's drive west of Pretoria. In a diocese like his, he said, "the only solution we have at the moment is condoms."

Bishop Kevin, as everyone calls him, is in some ways an unlikely campaigner. The slim, soft-spoken man with gentle brown eyes and gold-rimmed aviator glasses was raised in Pretoria, the conservative Afrikaner heart of South Africa, and spent time in Rome, working in the international leadership of the Redemptorists, a religious order.

But since 2001, when he first made public his views on condoms at a United Nations meeting on AIDS, the bishop of Rustenburg has become the church's most persuasive voice in favor of using condoms to stem the spread of acquired immune deficiency syndrome.

"If there's an AIDS bishop in the church today, it's Kevin Dowling," said the Rev. James Keenan, a theology professor at Boston College and a Jesuit priest who has written extensively on ethical issues surrounding AIDS.

"To have someone of his magnitude saying it so clearly and, more importantly, with so much experience, sets him apart from everyone else. There's no one else like him in the church today."

Dowling first began advocating for Rustenburg's poor when he became bishop 15 years ago, near the end of South Africa's apartheid era. In 1992, the church moved nearly 700 farmworkers — who Dowling said had been terrorized on white farms — onto mission land until they could be given permanent resettlement property. To serve them, and thousands of other people who had begun moving to the mining region, the diocese opened its first health clinic.

Doctors and nurses there quickly saw that AIDS was burning through the community. Thousands of platinum miners, living in hostels far from their families, were regularly buying sex from poor women who flocked to camps like Freedom Park looking for work around the mines. With no jobs to be had, most of the women had little choice but to sell their bodies to feed themselves and their children. Soon, men, women and children sick with tuberculosis, oral thrush and other AIDSrelated illnesses were flocking to the clinics.

The diocese responded by setting up teams of homecare nurses to visit and assist the sick and starting its own anti-retroviral treatment centers. Today the diocese has 10 teams of home-care nurses, its own 30-bed hospice so poor people with AIDS "can die in dignity and peace" and eight anti-retroviral treatment sites, with 400 people — including children — on AIDS treatment drugs.

By giving pregnant women the best available triple-therapy anti-retrovirals, the diocese has been able to halt mother-to-child transmission of the disease, with a 100 percent success rate in its 30 cases so far, and allow mothers infected with the human immunodeficiency virus to breastfeed babies without passing on the disease, crucial help in an area where "people are too poor to buy (baby) formula," Dowling said.

Health workers attribute most of the successes to Dowling's tireless work.

He's "incredible," says Hilda De Bees, the administrator at the diocese's new AIDS hospice. "He's hard-working, he's compassionate, he's very, very supportive. Without him, we wouldn't be here."

But despite the church's campaign to ease suffering from AIDS, many continue to die. At the hospice, a short walk down a red-dust road from the bishop's house, a skeletal 7-year-old boy in a frayed pink robe sits curled on his mother's lap, waiting for the end.

"He won't survive no matter what we do now," the bishop laments softly.

Church clinics also are seeing babies born with fully developed AIDS, he said, the product of mothers constantly reinfected with the virus through unprotected prostitution. In Freedom Park, 47 percent of pregnant women tested for HIV this year have turned up positive, Dowling said.

Condoms, he believes, are one answer. Under long-standing church doctrine, condoms and other birth-control methods can be used in some specific cases — by an HIV-positive husband whose wife is post-menopausal, for instance, or in other cases where contraception isn't the primary effect.

Dowling believes that in his diocese — and in much of AIDS-afflicted Africa — the primary effect of using condoms would not be contraception but "to stop transmission of a death-dealing virus." Under church doctrine, that is "not only allowable, it's a moral imperative," he believes: "The principle is to protect life. I'm fighting for the principle here."

Few church leaders agree with him. Pope Benedict XVI has made clear he supports a continuing ban on the use of condoms, and the Southern African Bishops' Conference calls efforts to promote condom use an "immoral and misguided weapon against the disease," saying condom availability leads to moral decay and broader transmission of AIDS. Most African church leaders agree.

A few European cardinals and archbishops — in Brussels, London and Paris — back Dowling's view. But most church officials "have already made their decision and they just say no," Keenan said.

Dowling believes that the church's continuing rejection of condoms reflects a lack of firsthand experience with the AIDS epidemic and an inherent conservatism that makes questioning old doctrine unsettling.

"There's a sense of security from black and white," he said. "You can't do this. You can do that. But most of life is gray.

"I often think unless you've gone through what I've gone through personally, you can have a very ivory-tower approach to this."

What he would like to see from Rome, he says, is a "humble attitude" and a recognition that "we have to develop a theology for the HIV-AIDS pandemic that (recognizes) the poor and the suffering and the marginalized and the vulnerable" and is based on an ethic of "human dignity and justice and human rights instead of just on an ethic of sexuality."