The Messenger - July 2008 - A World Apart
By M.J. Kelly, SJ - 01 July 2008
HIV and AIDS concern the whole world, but it is in Africa that the effects of this modern-day catastrophe are most widely experienced. This month, we examine the human cost in that devastated continent.
Many of us will recall the tsunami which erupted near Indonesia on 26 December 2004. It swept over a wide area, causing devastation and great loss of life. But we also know that AIDS is sweeping through our people like a gigantic, relentless tidal wave. In spite of the power of antiretroviral drugs to prolong life, the AIDS epidemic continues to wreak havoc in families through sickness and death, with about ten people in Zambia dying of the disease every hour of every day.
This brings suffering to everyone, but particularly to children. While we would like to create a world fit for children, AIDS makes this an enormously difficult task. The United Nations estimates that there are 1.2 million orphans in Zambia out of a total population of about 12 million. Almost 750,000 of these children are believed to have lost one or both parents to AIDS. Moreover, in addition to the orphans, there are the millions of other children whose lives are affected in one way or another by the epidemic.
Just think of the children who are vulnerable: those whose parents are alive but have HIV or AIDS; those in a household where there are no adults; children in households where there are only elderly care-givers; children in households caring for other orphans; children in households no longer able to look to wealthier relatives for assistance in time of need; children who are exploited for their labour.
In many ways, the orphans whom we can see are like the eyes of a hippo peering over the water. Underneath there is a huge body. In addition to the orphans whom we can identify, there are the millions of other children who are affected by HIV and AIDS.
The consequences for orphans and other affected children are grave. Households hit by AIDS frequently suffer economic insecurity and have difficulty in ensuring sufficient food, proper health care, and good education for their children. Because of the situation in which they find themselves, many children experience trauma, anxiety, sadness, and a pervasive sense of helplessness. As the economists Barnett and Whiteside have noted, becoming an orphan is slow and painful. Caring for a parent who is weak and requires food to be cooked or water to be brought is one thing; caring for a parent with severe diarrhoea or declining mental function is quite another.
Orphans and other children from households affected by the AIDS epidemic frequently experience other negative consequences. Many encounter stigma, discrimination, and taunting in school. Because they are often last in line at meal times, orphaned children may be malnourished and underweight. Studies have found that they are more likely than other children to work for more than forty hours a week. They have also been found to be at higher risk of sexual abuse and therefore at greater risk of becoming HIV-infected.
One of the most tragic consequences of the epidemic for children is the way it deprives them of their childhood and of their right to happiness. Child after child watches helplessly as AIDS snatches both of these away. It transforms many amongst them into adults before their time - juvenile adults who must care for the sick, generate income (even by selling sex), head households, and assume respon-sibilities beyond their years.
In 1990, the World Summit for Children proclaimed that childhood should be a time of ‘joy and peace, of playing, learning and growing’. But for millions of children, including more than a million in Zambia, the reality of childhood is altogether different because of the way the AIDS epidemic deprives them of their right to rest and play. It deprives them of their right to happiness. When children enjoy that right again, then we will know that we have conquered AIDS. When the sound of healthy, happy, laughing children fills homes, schools and villages, then we can be certain that we are entering a world without AIDS.
On the surface, it may appear that families and children are coping with the difficulties to which the epidemic gives rise. Because they are surviving, they seem to be responding to the challenge. Certainly one must acknowledge the heroism and generosity of ordinary people, especially the women who continue to manage households, produce food, generate income, rear children and care for the sick. These are the unsung heroines of this generation.
But AIDS brings growing problems of deepening poverty and having to make less go further. Many households affected by HIV and AIDS do not cope. On the contrary, they break up and their members - orphans, widows and the elderly - join other households. And in households that survive, we see the poor helping the destitute by sharing what they cannot afford. Clearly this is not a good model of coping. It only masks the reality that many families are coping neither with the way HIV and AIDS increase poverty nor with orphans.
The burden of caring for children and orphans is falling increasingly on the weaker members of society - the elderly, grandparents, the poor - those who themselves experience indifferent health. In Zambia, because of the death of their parents, at least one third of the orphans are being cared for by their grand-parents. Driven by an overwhelming sense of worry and concern for the young, and almost under protest, they have undertaken childcare responsibilities in their old age.
The way in which old people have assumed this role is superb. But the fact that they have done so forces us to ask two questions. First, what systems do we have in place to help these elderly caregivers cope with the economic, caring and psychosocial demands that are being placed on them? Second, who will care for these elderly caregivers when they are no longer able to care for themselves or their dependants? So far, we are not able to give good answers to either question.
Responding to the Challenge of Children in a World with AIDS
1. The world has agreed that five key strategies must be adopted in response to the challenge of children in a world with AIDS:
2. Strengthen the capacity of families to protect and care for orphans and vulnerable children by prolonging the lives of parents and providing economic, psycho-social and other support.
3. Mobilize and support community-based responses.
4. Ensure access for orphans and vulnerable children to essential services, including education, health care, birth registration and social protection.
5. Ensure that governments protect the most vulnerable children through improved policy and legislation and by channelling resources to families and communities.
6. Raise awareness at all levels through advocacy and social mobilization to create a
supportive environment for children and families affected by HIV/AIDS.
Each one of these strategies, especially strengthening families and communities, is deeply embedded in our Christian principles. As Christians and as citizens of the world, we know what to do. Can we face up to the challenge of doing it? When will we begin?