In-depth: Our World: AIDS and childhood in southern Africa


Photo: Greg Marinovich/South Photographs
JOHANNESBURG, 28 May 2007 (IRIN In-Depth) - “My sister is six years old. There are no grown-ups living with us. I need a bathroom tap and clothes and shoes. And water also, inside the house. But especially, somebody to tuck me and my sister in at night.”
Apiwe, aged 13

The death of a parent turns a child’s life upside down, but when AIDS is the cause, the tragedy is magnified.

Unlike other illnesses, there is a strong likelihood the second parent will also succumb to debilitating sickness and die. In addition to this trauma, the children often feel the sting of a stigma that communities - and even relatives - still reserve for this particular disease. With survival options narrowed, they are at heightened risk of exploitation and abuse, and consequently of becoming infected with HIV themselves.

The scale of the suffering is staggering. Across sub-Saharan Africa there are an estimated 11 million children under the age of 15 orphaned by AIDS; by 2010 that figure is expected to swell to 20 million. In five countries - Botswana, Swaziland, Lesotho, Malawi and Zambia - children orphaned by AIDS make up more than half of all orphans; but in Zimbabwe the proportion has reached 77 percent.

Even if a nation manages to stabilise its HIV prevalence, orphan numbers will continue to climb due to the time lag between HIV infection and death.

The challenges

The struggle faced by children in AIDS-affected households begins before the parents pass away. Illness and doctors’ bills devour family budgets; in one study in South Africa, the average monthly per capita income dropped by more than half in households where at least one person was known to be HIV-positive.

Girls are typically pulled out of school to cut costs and help in the house, denying them an education. In the gathering crisis of sickness and impoverishment, children can suffer emotional neglect before having to cope with the bereavement of one or both parents. In the worst scenario, the children themselves may be living with HIV.

The extended family has traditionally been a refuge in time of need. In southern Africa it is buckling under the pressure of AIDS, deepening poverty, and, to an extent, accelerating urbanisation. It is no longer automatic that family members will take on the financial burden of looking after orphans; widows also run the risk of having property grabbed by relatives, even when the law protects their rights. Often it is grandparents that finally assume responsibility for the children’s care.

As families sort out what to do, orphaned siblings face being separated and placed in different homes to help share the load - with all the emotional trauma that entails. Access to education for orphans is a critical issue; they are more likely to drop out, perform poorly, or not be enrolled at all. Children orphaned due to AIDS are also more likely to suffer from malnutrition, further robbing them of their potential.

Who’s responsible?

Much has been said of a ‘lost’ generation of parentless children growing up abandoned and bitter to become a budding security risk to the rest of the community. But it is society that must be held accountable for how it treats its most vulnerable members. Without proper support and care, orphans are more likely to end up on the streets, be exploited as cheap labour, take drugs or sell their bodies - victims of society’s neglect and policy failure.

But communities in southern Africa are trying to respond to the challenge. Even when children are in households headed by an adolescent or a young adult, and seemingly left to fend for themselves, there may also be a member of the extended family who keeps an eye on them. Home-based care schemes staffed by local volunteers, such as the ‘Care Facilitators’ initiative of the Red Cross national societies in the region, offer another vital intervention. They can provide a shoulder to lean or cry on and, in the case of the Red Cross, direct assistance with school fees, uniforms and nutritional support.

Southern Africa’s orphan crisis has to be seen in the context of a still-growing AIDS epidemic that touches everyone. As it deepens poverty at the household level, it places enormous strain on public services such as health and education, sectors that are also being hollowed out by the loss of skilled staff to the disease.

Lead Feature
  • Introduction
  • Chapter 1 - sickness
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  • Chapter 2 - treatment
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  • Chapter 3 - survival
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  • Chapter 4 - helping hands
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  • Endnotes
Radio reports

Giving children a chance to live
'I don't want to die alone' - the challenge of prevention
Looking forward to life
Children bear the brunt of AIDS crisis

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