The US Agency for International Development estimates that by 2010, about one in three children in Namibia, Swaziland, Zimbabwe, and South Africa will have lost a parent, many of them to AIDS. This estimate does not include children born with HIV, since most of them will likely die before they reach age five.
At the House of Resurrection Haven, a former convent that was transformed a few years ago into a hospice for children and adults dying of AIDS, these estimates pose troubling questions for the future. Thanks to the House’s healthy environment and carefully prepared meals, about 50 % of the patients who go to the House to die get well enough to leave after a few weeks. But, as head nurse Maggie Williams explains, many of the children often have nowhere to go.
"Most of the children that are here have been abused, either sexually, or physically, or both," says Williams. "We are trying to get children’s homes to take the well children out of here, because they are getting older and we’ve kind of ended up being a children’s home, which we are not supposed to be. We are supposed to take symptomatic children in and send them out again when they are better. [But the problem is] that once the children come to us you can’t send them back to the environment they came from."
A few months ago, the House reached full capacity and couldn’t take in any more sick children. The staff are trying to find foster homes or "children’s villages" for the kids, but with little success. The government has been reluctant to create orphanages, instead focusing on getting extended families to care for the orphans. Yet, with foster care grants only available for children under the age of seven many families cannot afford to do so. The problem does not stop there.
"People don’t want to go near the children because of the stigma of HIV that still surrounds the disease," says Williams. "They think you can just get HIV by walking into the house. And I’ve heard from people myself that they will not go into that house because they don’t want to get HIV."
The result is that many orphans are trying to raise themselves and often their younger siblings. Given that 95 percent of all AIDS orphans are in sub-Saharan Africa, it’s common to see small children sleeping barefoot on city sidewalks or rifling through garbage cans to find food.
"The scenario we are seeing and hearing about at the moment is that we are having child-centred families where perhaps a 15 or 16 year old is becoming the head of the household," explains Williams. For many of these children, raising themselves and their younger siblings means dropping out of school and turning to crime or prostitution to raise their families.
Activists caution that if not dealt with, the number of uneducated and psychologically traumatised AIDS orphans could create serious problems for societies that are already struggling socially, economically, and politically. "This is going to have major consequences for the stability of societies," said the head of the United Nations AIDS programme, Peter Piot, at a congressional briefing on the subject. "No society can really cope with such an enormous number of orphans and of desocialised youth." A life of social exclusion, poverty, and exploitation is also having serious consequences on the physical and mental well being of the affected youth.
In 1997, a study was done of orphans and community members from a rural area near Mutare, Zimbabwe. The study highlighted the orphans’ concerns, including "feeling different from other children, stress, stigmatisation, exploitation, quality of schooling, lack of visits and neglect of support by relatives."
While church groups and aid organisations are struggling to come up with the solutions to these problems - including peer education programs to teach youth how to properly care for their younger siblings - the first challenge is to find all the youth that need help. Although over 12 million are believed to be AIDS orphans, few children will admit it. They remain the hidden victims of the pandemic, struggling to survive in the shadow of death.