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EarthTrends 2001 World Resources Institute. All rights reserved. Fair use is permitted on a limited scale and for educational purposes.

EarthTrends: Featured Topic

Title: A Generation of OrphansAuthor(s): Laura DeameEditor: Wendy VanasseltSource: Written for EarthTrendsDate written: May 2001

With the staggeringdeath toll thatHIV/ AIDS takes, it'seasy to overlook thechallenges faced by thepeople the diseaseleaves behind. Thesesurvivors includechildren who will

become a generation oforphans as thepandemic stretches intothe first three decadesof the 21st century.This is especially true insome sub-SaharanAfrican countries,where AIDS will killone-fifth to one-third ofall adults over the next

7-10 years unless massiveefforts are made to provideantiretroviral treatment(Hunter 2000:9-10). Theseorphans, the vast majority ofwhom are HIV-negative, are atenormous risk of growing upwithout adequate heath care,food, education, or emotionalsupport.

By 2000, the HIV/ AIDScrisis had created more than 13million orphans worldwide,children who before the age of15 lost either their mother orboth parents to AIDS. Morethan 90 percent of thesechildren live in sub-SaharanAfrica (UNAIDS 2000a:27)(see Figure 1). Before AIDS,

about 2 percent of children

living in developing countrieswere orphans (UNAIDS2000a:27-28). Today, in eightsub-Saharan countries, morethan 20 percent of all childrenunder 15 are orphans of AIDSor other causes of death, asituation that will prevail in 11countries by 2010 (Hunter2000:164).

By 2010, the total orphan

population in 34 African,Asian, and Latin Americancountries with severeHIV/ AIDS epidemics isprojected to reach 44 million25 percent more than todaywith two-thirds orphaned as aresult of parental deaths caused

by AIDS (Hunter andWilliamson2000:Appendix 1).This will create a child-care crisis never beforeseen in any war,famine, or othertragedy. Botswana,Namibia, Swaziland,

Zimbabwe, CentralAfrican Republic, andSouth Africa areexpected to have thehighest proportion ofchildren orphanedabout one-third ormorewhile Ethiopiaand Nigeria have thelargest number oforphans under age 15

(Hunter and Williamson2000:Appendix 1) (see Figure2.)

The enormity of the AIDSorphan problem in Africaderives from the fact thatHIV/ AIDS in this region ismost prevalent in heterosexualpopulations, and more sub-Saharan African women thanmen are now infected (Hunter2000:26, 33, 40). Bycomparison, worldwide moremen than women are infectedwith HIV/ AIDS. Also, insome other regions of theworld AIDS is concentratedamong gay men andintravenous drug users, whoare not as likely to father or


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bear children (Altman2001:15).

The Impact of Orphans on

the African Society

Before the AIDS epidemic inthe 1970s, there were,effectively, no orphans inAfrica. African marriagecommonly links not only twoindividuals, but two familiesand their financial resources;extended family groupstypically pool economic

resources and pull together intimes of crisis or tension.Normally, with the loss ofparents, orphans might becared for by grandparents,aunts or uncles. However, theAIDS epidemic has frayed thattraditional safety net, forcing

the creation of an alternatesafety net of more distantrelatives. Although familieshave been found to be

enormously resilient in termsof coping with a shrinkingnumber of adults and agrowing number of orphans,family resources may bestretched to the limit as theyabsorb orphaned relatives. Incountries with severeepidemics, 30-70 percent ofhouseholds areaccommodating an orphan

(Hunter 2000:213). Sometimes,however, even the alternatesafety net of distant relatives isnot available, and orphans carefor themselves and theirsiblings (Hunter 2000:192).

Without a traditional familysupport system, the problems

for orphans mount quickly. Insome countries, children inAIDS-affected households maybe more likely to drop out ofschool because remainingfamily members cannot affordto pay fees or buy books, orthe child may be needed tocare for other relatives, or towork. Studies in Ugandasuggest that after the death ofone or both parents, thechance of orphans going toschool is halved, and thosewho still attend school spendless time there (UNAIDS2000a:27). In Zambia, nearly

one out of three urban orphansand two out of three ruralorphans don't attend school,which is significantly worsethan attendance rates fornonorphans(UNICEF/ UNAIDS 1999:17).

Orphans face an increasedrisk of stunted growth andmalnourishment(UNICEF/ UNAIDS 1999:4;

World Bank 1997:223-224). Incommunities where adultdeaths are high, food suppliesoften dwindle. When familiescan no longer absorb moreorphaned relatives, orphansmay end up on the streets.Many suffer social isolation,and some are pressured bypoverty into prostitution(UNICEF/ UNAIDS 1999:5;

Hunter 2000:191).

The Response to theOrphan Crisis

The hardships faced by AIDSorphans have beendocumented for more than adecade, and African


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governments are trying todevelop and implementsolutions. Some have creatednew laws and policies toprotect children and to helpwomen and children defendtheir inheritance and rights toproperty, and provided childadvocates to help childrenredress exploitation. Whilegovernments also try to offeradoption and fosteringstipends, public welfareassistance, and access toeducation and health servicesfor poor children and families,perhaps only 2 percent of

needy families have access tosuch government safety nets(Hunter 2000:215-216, 236-237). Governments stillgenerally rely on communitiesand volunteers to provide thebulk of social services forAIDS orphans and families(Hunter 2000:236-237).Orphanages, hospices, andother institutions in a

developing country have theestimated capacity to take inperhaps 5 percent of AIDS andnon-AIDs orphans (Hunter2000:262).

In Africa, increases inorphanages or other forms ofinstitutional care would beeconomically impossible, giventhe degree of national debt andpoverty that governments

already face. In Ethiopia, forexample, caring for a child inan orphanage costs betweenUS$300-500 per yearmorethan three times the nation'saverage per capita income(UNAIDS 2000b:13). InZimbabwe, the cost per childfor care in an orphanage is

$1,600 annually, compared toabout $4 annually for family-based child care programs(Sternberg 2000:8A).

Furthermore, institutionalcare is not a socially acceptablesolution in the African culture.Many African countriesdepend on a subsistenceeconomy, and children sentfrom their village may loserights to their parent's land. Inaddition, an institutionalizedorphan would be removedfrom the companionship ofany remaining siblings andtheir community. In

Zimbabwe, where AIDS hasorphaned 7 percent of allchildren under the age of 15,the National Policy on theCare and Protection ofOrphans advocates thatorphans be cared for by thecommunity whenever possibleand only placed in institutionsas a last resort (UNAIDS2000a:28). Most surrounding

eastern and southern Africancountries have also taken astance against building moreorphanages because it drainsresources needed to supportfamily and community-basedprograms (Hunter 2001).

Accordingly, governmentsand NGOs focus on helpinglocal communities care forfamilies, children, and orphans

affected by HIV/ AIDS, anddirect donors and NGOs towork with community projects.In Malawi, for example, Savethe Children mobilizes andhelps more than 200 villagecommittees that care for about23,000 orphans and others inAIDS-stricken areas; the

program is serving as a modelfor similar efforts in Ethiopia,Mali, and Mozambique (Savethe Children 2001).

Studies suggest that localsystems in sub-Saharan Africaprovide 95-98 percent of careto HIV/ AIDs families, victims,and orphans (Hunter2000:206). Examples ofcommunity-based supportprojects for orphans include aUgandan project launched byJanet Museveni, wife ofPresident Yoweri Museveni, in1986 that assists orphans inresettlement camps and returns

them to their extendedfamilies. Museveni'sorganization also helps fundeducation and training for thechildren and provides credit tocaretakers to start smallbusinesses and tradingactivities (UNAIDS 2000a:28).In Zimbabwe, church groupsrecruit community members tovisit orphans who live with

foster parents, grandparents, orin child-headed households, asa way to help the children getthe financial and emotionalsupport they need and to keepthe household together. Thegroup regularly providesclothing, blankets, school fees,seeds, and fertilizer (UNAIDS2000b:13). In Malawi, districtAIDS committees supply

funds and resources to villagecommittees; thesecommunities, in turn, developcommunity gardens anddistribute improved sweetpotato and cassava varieties toAIDS-affected households andtry to educate the communityabout HIV/ AIDS prevention


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(Hunter and Williamson2000:8).

The AIDS orphan crisisstands to become yet anothercomplex issue affecting someof the world's poorestcountries. Raising adequatefinancial resourcessomeestimate more than $1-$2.3billion is needed to mount aneffective prevention campaignin sub-Saharan Africa aloneis only part of the challenge(Hunter and Williamson2000:6). Programs to helpAIDS orphans must be able tobe implemented quickly, given

the speed with which the

orphan problem is growing, besustainable for several decades,and be able to adapt to theepidemic's growing andchanging impacts (Hunter andWilliamson 2000:2).

Many of the AIDS orphanslive where poverty,malnutrition, and a lack of safewater, sanitation, and basichealth and education servicesalready make children's livesrisky; solutions to orphanproblems must address a broadrange of community needs.Where AIDS-strickencommunities have easy access

to water or to fuel-efficient

stoves, for example,households can spend moretime undertaking incomegenerating activities, and lesstime collecting firewood(Hunter and Williamson2000:7). And where familieshave better economicopportunities, they can bettercare for orphans. Even theavailability of savings andcredit mechanisms can make adifference to AIDS orphans; inUganda, three out of fourmembers of a successful villagebanking program are caring fororphans (Hunter and

Williamson 2000:7).

REFERENCES

Altman, L. K. 2001. New ideas sought to help AIDS orphans. The N ew Y ork T imes (New York City)(February 5):15.

Hunter, S. 2001. Personal Communication. E-mail. 31 May 2001.

Hunter, S. 2000.Reshaping Societies: H IV / A ID S and Social Change. Glens Falls, NY: Hudson RunPress.

Hunter, S. and J. Williamson. 2000. Children on the Brink 2000: E x ecutive Summary. Washington, DC:USAID.

Save the Children. 2001. 2000 Annual Report. Online at:http:/ / www.savethechildren.org/ annualreport00/ crisis3.shtml# sub8. Viewed July 27, 2001.

Sternberg, S. 2000. Number of AIDS orphans to reach 29 million in 10 years. USA Today (July14):8A.

UNAIDS (Joint United Nations Programme on HIV/ AIDS). 2000a. Report on the Global H IV / A ID SE pidemic (June). Geneva, Switzerland: UNAIDS.

UNAIDS (Joint United Nations Programme on HIV/ AIDS). 2000b.A ID S E pidemic Update(D ecember). Geneva, Switzerland: UNAIDS.

UNAIDS (Joint United Nations Programme on HIV/ AIDS). 2000c. Graphics Epidemic UpdateDecember 2000. Online at:


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http:/ / www.unaids.org/ wac/ 2000/ wad00/ files/ wad2000Master/ index.htm. (Viewed 25 July2001).

UNICEF/ UNAIDS. 1999. Children Orphaned by AIDS: Frontline Responses from Eastern andSouthern Africa. (December). New York: UNICEF. Online at:http:/ / www.unicef.org/ pubsgen/ aids/ AIDSen.pdf.

World Bank. 1997. Confronting A ID S: Public Priorities in a Global E pidemic. New York: OxfordUniversity Press.

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