Everyday heroes: Zambian communities' response to the AIDS orphans crisis

7 October 2010
Lwanga Mwilu

An African proverb asserts that it takes an entire village to raise a child. Previously, this meant that it was everyone's responsibility to socialise children well, but today it also means that children often end up being raised by other families in their communities, because HIV & AIDS leave increasing numbers of orphans and vulnerable children in its wake.

Statistics estimate that 16% of Zambia's adult population lives with HIV & AIDS. Although infection rates have declined over the years, mortality amongst those already infected stands at an estimated 47,000 to 66,000 deaths per year. In the year 2000, the 930,000 AIDS orphans in Zambia constituted a large percentage of the country's total number of orphans, estimated at 1.2 million (10 per cent of Zambia's population).

However, Zambian communities have drawn on local skills and available resources to respond to the crisis of AIDS orphans in a context where the extended-family system is struggling.

Communities respond to AIDS orphans in crisis
Since HIV & AIDS started spreading through Zambia, plenty and varied responses have surfaced. Some of the best, most humane responses have been community driven. According to the organisation Zambia Orphans of Aids (ZOA), "hundreds of religious and community-based children's committees and homecare projects have been established to care for the sick and provide counselling and support for orphans and their families." Non-governmental organisations (NGOs), extended families and communities have supplemented Governmental efforts to provide safety nets and set up initiatives to keep orphans from almost inevitably living lives of destitution, extreme poverty, stigma and an end to schooling. About 40% of AIDS orphans are taken in and raised by their usually aged and financially incapable grandparents. Another 30% are taken in by aunts and uncles. The rest are taken in by friends of the family, neighbours, or the country's limited orphanages and residential facilities, or they end up on the streets, begging and committing petty crimes.

While he served as United Nations (UN) special envoy for HIV & AIDS in Africa, Stephen Lewis observed that taking care of AIDS orphans was not just a moral imperative, but was also essential to Africa's development prospects. He praised those who supported the extended-family system by taking in orphans, often at great personal sacrifice. "It is an unbelievable act of self-sacrifice on the part of the families, because frequently it pushes them over the edge. They have just enough for themselves and suddenly they take [in] two kids... I don't think anybody can imagine the unprecedented assault on the extended-family system which has occurred in grievously affected countries. This is just a huge challenge."

Sometimes these families receive support from their communities. This is often the case in rural areas where communities are more close-knit. According to the ZOA website, "in rural areas, the Government, religious and community organisations have worked with traditional leaders to keep vulnerable families on their land, and, where families are no longer able to provide for themselves, create sustainable nutritional programmes with local resources. In rural eastern Zambia, the Kanyanga Orphan Project - originally established as an AIDS homecare programme - recognised an urgent need to improve the farming skills and nutrition of families with vulnerable children."

An NGO in Kitwe called Children in Distress (CINDI) established communally tended ‘orphan gardens' to generate income for vulnerable families and improve their nutrition at the same time. Hundreds of charities and NGOs have taken up the task of aiding AIDS orphans in different ways. For example, Zambia Orphans of AIDS (ZOA) mobilises funds to provide skills training and respond to the orphans' educational, nutritional and medical needs. The World Bank also raises money for ZOA's work. ZOA has reached and assisted about 8,000 orphans. Similarly, the SOS Children's Villages aim to support children from families that are affected by HIV and AIDS. The SOS social centres in Kitwe and Lusaka work with local schools to raise awareness and to identify children at particular risk.

From the government's side, the Zambian Ministry of Education runs a school feeding programme that ensures that AIDS orphans and other children receive free meals at school. This initiative falls under a nationwide programme called Schools Health and Nutrition (SHN). According to the ministry, "the overall educational goal of the SHN component is to improve learning and equity among children attending basic education through integrated health and nutrition interventions in collaboration with community and inter-sectoral partners." SHN addresses two of the most pressing challenges for AIDS orphans in Zambia: food and education. SHN improves children's ability to learn by reducing burdens like intestinal parasitic infections, bilharzia and malnutrition, and creating a ‘healthy child in a healthy school environment.'

According to Adonia Ngosa Shakaboshya of the Ministry of Education's Ndola Resource Centre, SHN emphasises the holistic development and wellbeing of learners. "As schools we are not only interested in their academic performance but also their state of health and social welfare so we come in where we can," she said. "We also know that HIV has had severe social and economic effects such as children ending up as heads of households, so a seemingly simple free meal at school can go a long way in easing the mind of such a child and helping them focus on school." Shakaboshya added that teachers have been trained to respond to the HIV & AIDS pandemic in a humane way and that infected learners receive support at school. "There are several cases where a teacher acts as ‘time keeper' for a learner who is taking anti-retroviral (ARV) drugs because we realise that these children need to take their drugs consistently and if their time finds them at school then their teacher has a responsibility to ensure that they are reminded and helped to take their drugs. Teachers assume the role of guardians for the entire duration that the children are on school premises."

Children are the future
Some argue that efforts should aim to strengthen family structures, so that orphans can once more be cared for by their own families. The combination of devastating structural factors makes this a complicated problem, however, one unlikely to be solved by efforts to strengthen families. Community efforts like those in Zambia should instead be encouraged and supported. The success of community responses depends on a variety of factors, but the common denominator that underpins them all is compassion. Hopefully more governments and NGOs can work together to mobilise support for this cause. People need to be aware of the available channels to follow when they want to help. What can you do for children in your community?

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