All information provided below is from AVERT. AVERT is an international HIV and AIDS charity, based in the UK, working to avert HIV and AIDS worldwide, through education, treatment and care. Website: http://www.avert.org/aids-orphans.htm
The problems faced by AIDS orphans
Emotional impact
Children whose parents are living with HIV often experience many negative changes in their lives and can start to suffer neglect, including emotional neglect, long before they are orphaned. Eventually, they may suffer the death of their parent(s) and the emotional trauma that results. In this case, they may then have to adjust to a new situation, with little or no support, and may suffer exploitation and abuse.
Household impact
The loss of a parent to AIDS can have serious consequences for a child’s access to basic necessities such as shelter, food, clothing, health and education. Orphans are more likely than non-orphans to live in large, female-headed households where more people are dependent on fewer income earners. This lack of income puts extra pressure on AIDS orphans to contribute financially to the household, in some cases driving them to the streets to work, beg or seek food.
Education
Children orphaned by AIDS may miss out on school enrolment, have their schooling interrupted or perform poorly in school as a result of their situation. Expenses such as school fees and school uniforms present barriers to school attendance if orphans’ caregivers struggle to afford these costs.
The loss of a productive family member is likely to be a financial burden and might push a family into poverty, increasing the likelihood that a child orphaned by AIDS will miss out on school. Moreover, most orphans and their caregivers still do not receive any type of external support in the form of healthcare, nutrition, or psychosocial support.
Outside of school, AIDS orphans may also miss out on valuable life-skills and practical knowledge that would have been passed on to them by their parents. Without this knowledge and a basic school education, children may be more likely to face social, economic and health problems as they grow up.
Stigmatisation
Children grieving for dying or dead parents are often stigmatised by society through association with AIDS. The distress and social isolation experienced by these children, both before and after the death of their parent(s), is made worse by the shame, fear, and rejection that often surrounds people affected by HIV and AIDS. Because of this stigma, children may be denied access to schooling and health care. Once a parent dies children may also be denied their inheritance and property. Often children who have lost their parents to AIDS are assumed to be HIV positive themselves, adding to the likelihood that they will face discrimination and damaging their future prospects.
Family structures
In African countries that have already suffered long, severe epidemics, AIDS places pressure on families and communities. Traditional systems of taking care of children who lose their parents, for whatever reason, have been in place throughout Sub-Saharan Africa for generations. But HIV and AIDS are eroding such practices by creating larger numbers of orphans than have ever been known before. The demand for care and support is simply overwhelming in many areas. HIV reduces the caring capacity of families and communities by deepening poverty, through medical and funeral costs as well as the loss of labour.
The Way Forward
Keeping children in school
Schools can play a crucial role in improving the prospects of AIDS orphans and securing their future. A good school education can give children a higher self-esteem, better job prospects and economic independence. As well as lifting children out of poverty, such an education can also give children a better understanding of HIV and AIDS, decreasing the risk that they will become infected. Schools can also offer benefits to AIDS orphans outside of education, such as emotional support and care.
Empowerment for children
If AIDS orphans are as active members of the community rather than just victims, their lives can be given purpose and dignity. Many children already function as heads of households and as caregivers. They are a vital part of the solution and should be supported in planning and carrying out efforts to lessen the impact of AIDS in their families and communities.
Meeting emotional needs
The physical needs of orphans, such as nutrition and health care, can often appear to be the most urgent. But the emotional needs of children who have lost a parent should not be forgotten. Having a parent become sick and die is clearly a major trauma for any child, and may affect them for the rest of their life.
The AIDS epidemic in Zambia is among the worst in the world. Under the twin pressures of poverty and disease, many extended families (which traditionally care for vulnerable children in Zambia) are breaking down.
“It’s very hard to find a family in Zambia that hasn’t been personally touched. It’s very hard to find a child that hasn’t seen or witnessed a death related to HIV/AIDS. The extended family in the community structure, they’ve really broken under the weight of the HIV/AIDS epidemic and poverty, and when the burden becomes too great, families are unable to cope anymore, and so we’re seeing tremendous numbers of orphans and children who are no longer able to be cared for by their extended family.”
In September 2003, Stephen Lewis, then UN Secretary-General’s Special Envoy for HIV/AIDS in Africa, spoke about the AIDS orphan problem:
“… in Zambia, [we] were taken to a village where the orphan population was described as out of control. As a vivid example of that, we entered a home and encountered the following: to the immediate left of the door sat the 84-year-old patriarch, entirely blind. Inside the hut sat his two wives, visibly frail, one 76, the other 78. Between them they had given birth to nine children; eight were now dead and the ninth, alas, was clearly dying. On the floor of the hut, jammed together with barely room to move or breathe, were 32 orphaned children ranging in age from two to sixteen… It is now commonplace that grandmothers are the caregivers for orphans.”
“The grandmothers are impoverished, their days are numbered, and the decimation of families is so complete that there’s often no one left in the generation coming up behind. We’re all struggling to find a viable response, and there are, of course, some superb projects and initiatives in all countries, but we can’t seem to take them to scale.”
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