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AIDS and childhood in southern Africa

Lineo Makojoa, 15, cooks dinner at her home in Ha Majoro Village in Lesotho. Orphaned by HIV and Aids, she often cooks dinner for her grandparents and her older brother. Eva-Lotta Jansson/IRIN
Lineo Makojoa, 15, orphaned by AIDS, prepares dinner for her grandparents in Ha Majoro Village, Lesotho
The term 'AIDS orphan' is misleading. It suggests the child itself is HIV-positive, which invariably is not the case, and perpetuates the stigma and discrimination experienced by AIDS-affected children.

The term 'orphans and vulnerable children' is now more commonly used to better express the devastating impact of the pandemic on households, even before parents die. The definition of an orphan is generally a child under the age of 18 who has lost either one or both parents (a double orphan). Surveys suggest the age of orphans is fairly consistent: around 50 percent are 10-14 years old; 35 percent are 5-9 years old, and 15 percent are 0-4 years old. Tragically, children who are HIV-positive do not survive long enough to make up a sizeable proportion of the numbers.

In Angola, Malawi and Zambia, the majority of orphans are found in urban centres; in Namibia, Zimbabwe, Botswana, Lesotho, Swaziland and South Africa, parentless children live mainly in the countryside, reflecting the migration of sick parents back to their villages to die.

Most orphans stay with their surviving parent, but women are much more likely to take on the responsibility of their own children as well as other orphans. Fathers are usually more prepared to look after orphaned sons than daughters, and grandparents are the safety net when all else fails.

AIDS impoverishes families, and female-headed households are the poorest of all. Productive assets like draught animals are often sold, so land under cultivation may drop, exacerbating the crisis.

Poverty makes it so much worse

Plummeting family incomes and the additional work expected of children reduce their chances of attending school, while anxiety over sick adults and the trauma of loss may mean they don’t do as well in class as their peers. "It is common for teachers to report that they find orphaned children daydreaming, coming to school infrequently, arriving at school unprepared and late, or being nonresponsive in the classroom," a United States Congressional report commented.

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The psychological impact of a loss of a parent is heightened if siblings are separated when families share rearing duties. Parcelled out to new households, they may feel they do not receive enough love or attention. Girl children are at increased risk of sexual abuse, but are under pressure to remain silent because they have nowhere else to turn.

New research suggests that poverty is the over-riding factor that bedevils care of orphans and non-orphans alike. A study in South Africa's KwaZulu-Natal Province, testing some of the commonly held assumptions about orphan welfare, found there was no significant difference in how the extended kin cared for children in a household, whether or not they had lost a biological parent.

According to Timothy Quinlan, research director of the University of KwaZulu-Natal's Health Economics and HIV/AIDS Research Division: "The welfare of a child can be very bad just because the parents are poor."

Studies on AIDS-affected children have tended to be anecdotal, often focusing on the perceived threat orphans pose to society as an angry and maladjusted generation. What psychosocial research is available suggests that children in AIDS-affected families exhibit more symptoms of depression, anxiety, psychosomatic reactions and post-traumatic stress disorder; they are more likely to have low self-esteem than display aggressive behaviour.

Poverty deepens their vulnerability: a rapid assessment in Zambia found a high proportion of orphans among child sex workers and street children. Child labour exploitation is another area of concern. The problem is not the threat parentless children pose to the community, but rather the dangers that societal neglect and discrimination pose to them.

What is to be done?

The Convention on the Rights of the Child recognises children as rights holders, and affirms that governments have the principal responsibility in ensuring that those rights are protected.

The United Nations Children’s Fund (UNICEF) has highlighted five priority areas to meet those goals: 

•  Strengthen the capacity of families - rather than institutions - to protect and care  for orphans and other children made vulnerable by HIV and AIDS 
•  Mobilise and improve community-based responses 
•  Ensure access to essential services for orphans, particularly education 
•  Ensure that governments protect the most vulnerable children 
•  Raise awareness to create a supportive environment for affected children

All these remedial actions need to work alongside far broader access to antiretroviral drugs to keep parents alive for longer, and more effective prevention programmes to guard against HIV infection in the first place.

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This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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