Raw deal for children orphaned by HIV/AIDS

"I found out I am HIV positive last year, but I don't want the other children here to know because they may leave me out," said 17-year-old Alfred [not his real name] as he looked out over the lush green hills of Mpigi District, 20km southwest of the Ugandan capital, Kampala. Alfred is one of seven HIV-positive orphans living with more than 500 other orphaned youngsters at a children's village run by the Watoto Child Care Ministry in the village of Suubi. "When I discovered the news [I was infected] I wanted to leave Watoto because I thought it was not possible to live for a long time with the virus." Children orphaned by HIV/AIDS are the pandemic's forgotten victims. In Uganda, it is estimated that there are up to 900,000 children who have lost either one or both parents through AIDS-related illnesses. The death of a parent marks the beginning of a long-term struggle for their children and the relatives left to pick up the pieces. "Nearly all our orphans come from relatives of children who cannot cope with supporting them after their parents' death," said Joshua Mugabi, manager of the immaculately landscaped 93-house Watoto children's village. Mugabi is surprised that just seven of his children are orphaned by HIV/AIDS, given the large percentage of Uganda's orphans that have lost their parents to the pandemic. HIV/AIDS orphans, Mugabi said, have a tremendous social stigma to overcome. "They are frequently ostracised by their local communities due to the stigma and lack of understanding surrounding the virus. In Uganda it is almost sinful for someone to die of AIDS, so anyone related can find themselves shunned, including children, in circumstances beyond their control." James Kaboggozza, co-ordinator of the orphans and vulnerable children secretariat within the Ministry of Gender, says Uganda is now in the grip of an "orphan crisis". "Unfortunately, it is likely to get worse before it gets better, given that we still have tens of thousands of parents dying of HIV/AIDS," he said. People are slowly waking up to the fact that there is an orphan crisis in the country. Ugandans always believed that the extended family could cope with caring for children who lost their parents. Gradually, however, the government realised this was not the case, and in 2002 conducted a situation analysis. "We registered a total of 1.8 million orphans in Uganda, half of whom have been orphaned by HIV/AIDS," Kaboggozza said. "We project that in the next 10 years the number of orphans will increase by a million." Furthermore, he observed, the analysis highlighted the extent to which the HIV/AIDS pandemic in Uganda was placing the burden squarely on the shoulders of the Ugandan extended family. "In 2002, one in four households was caring for at least two orphans," he added, a daunting challenge for the country's mostly rural population. The approach taken by President Yoweri Museveni's administration has been to focus assistance on local communities. Government policy in Uganda is to discourage the institutionalisation unless all other alternatives have failed. The approach is shared by the Uganda Women's Effort to Save Orphans, UWESO, established in 1986 by the First Lady, Janet Museveni, to help the then growing number of war-orphans. "We believe orphans should remain with the extended family, as has traditionally been the case in African culture," said Ian Nshana, a UWESO programme officer. One scheme operated by UWESO to help relatives take care of orphans and child-headed families is a savings and credit scheme that enables single and adoptive foster parents to increase their incomes. According to a UNAIDS report, studies in Uganda show that after the death of one or both parents, their children's chances of attending school are halved, and they are at greater risk of malnourishment and stunted growth - all because the extended family cannot cope with the financial demands orphans present. The political will to tackle the orphans crisis is there, said Nshana, but the funding is not. The Ugandan government's National Strategic Plan for Orphans and Vulnerable Children will require an estimated US $500 million over a period of four years, according to Kaboggozza who added that $56 million had already been approved by the Global Fund for AIDS, Malaria and Tuberculosis, while the US President's Emergency Plan for AIDS Relief had put forward an additional $16 million. For Alfred, the Watoto children's village has given him the chance to look ahead once again to the future. "I want to be a doctor so I help other HIV positive children like me," he said.