Children orphaned by HIV/AIDS: Over the edge

© UNICEF/MOZA/00880/G.Pirozzi

Nicoadala, Zambézia - It is two days since the family of six has eaten anything, but when Margaret (all names changed) is given some money by an aid worker to go to the market to buy basic food items, her aunt starts to panic.

Twelve-year-old Margaret is looking after her aunt and her three-year-old cousin, Paulo. The other children are away from home that afternoon.

The aunt’s hollow anaemic eyes look scared. Her breathing gets faster. Her face grimaces with pain. Her emaciated body covered by a grubby old sheet, is too weak to move. She can only lie there, in front of their tiny, empty, crumbled mud hut on an old mat and watch Margaret disappear through the overgrowth.

Her aunt is not the only one upset. Paulo, who had been sitting on Margaret’s tiny lap, is screaming hysterically at being left.

But Margaret has no choice; food is critical now for the survival of the family. The children are all hungry and Irene Matos, the aunt, is dying from AIDS-related diseases, including tuberculosis, as well as from severe malnutrition. “I haven’t taken my TB tablets for five days, because I’m too hungry,” she says in a faint voice. The pills have strong side effects, if taken without food. “I had to sell my plot.” Tears roll down her cheeks. 

Irene is only 20 years old, but she has not had much of a youth herself. She dropped out of school when she was 15 years old to look after her own parents. “They were ill for a long time before they died,” she says.

Then, Irene got married, but she has no children of her own. The children living with her are offspring of her three sisters who all died of AIDS. Three years ago, Irene herself became sick, and her husband abandoned her.

The eldest niece who is now 14 already has a baby of her own.

The family’s hut, situated 15 minutes walk from the main road, is only reachable by foot along overgrown pathways. They live in isolation in their tiny home, which is falling apart. Inside, the mud hut is dank and empty. It has just been raining and water seeps through. The only belongings are a couple of old rusty pots and a few ragged clothes on a mat.

The family receives weekly visits from activists belonging to KEWA, an association of people living with HIV/AIDS (PLWHA) in Mozambique’s central province of Zambézia. This is part of a 120,000 US Dollar UNICEF-supported project with PLWHA organisations.

Like the other PLWHA associations in the country, KEWA (“to listen” in the local language Chuabo) fights against stigma and discrimination of people living by HIV/AIDS. The organisation supports families affected by the pandemic, especially children orphaned and made vulnerable. Their activists facilitate access to birth registration, to education and to health services. And they also provide psychological support, which is of crucial importance.

PLWHA organisations cooperate with the Provincial Directorates for Women and the Coordination of Social Action and other Government institutions, helping them develop data bases on vulnerable families and children.

KEWA activists visit Irene and her family and other orphaned children. At the moment, they reach a total of 2,379 children in Zambézia province, which was once known as the breadbasket of Mozambique, having the potential to feed the whole country.

Yet, 16 years of civil war, poor infrastructure, widespread poverty and unpredictable weather patterns, has had a negative impact on many people in the province.
The HIV/AIDS epidemic has pushed families like the Matos’ over the edge. Some 14.9 per cent of Mozambique’s 15 to 49 year olds are estimated to be living with HIV/AIDS in 2004. In Zambézia province the prevalence rate stood at 12.5 per cent in 2002 (latest data available).

When people infected by HIV develop full-blown AIDS, like Irene, they no longer have the strength to farm, and the little they have, they sell. More than 270,000 children have already lost their mother, the father or both parents to HIV/AIDS.

With UNICEF support, Anita Martinho, one of the KEWA activists, has distributed school materials to many of the school-aged orphans throughout the province, including to Margaret, and her brother, Rafael (name changed), who is 13. The eldest niece, Naima, only 14 years old, dropped out of school when she fell pregnant. Now with her eight-month old baby strapped to her back she tries to do odd jobs to survive.

Margaret does not want to drop out of school. However she says, “some days I can’t attend classes because I have to take care of my aunty. She is now too ill to walk to the hospital.”

Margaret gives her aunt baths, and assists her with her daily needs as well as doing the usual chores of fetching water, firewood and cooking – if they are fortunate enough to have any food to cook.

What does she hope for the future? What are her dreams? Margaret looks blank and despite some prompting from the translator from the local language, she says flatly, “I don’t think about anything.”  It is not said defiantly but truthfully.

Margaret has a calm dignity about her. She holds her head high. Her hair is neatly braided, her large eyes look directly at you when she speaks. She rarely smiles, but when she does manage, her smile is beautiful. Despite her hunger and skinny frame, she lifts the gift of a heavy sack of pumpkins with graceful ease and walks barefoot quickly back to her dying aunt and her young cousin, Paulo.

One month after the interview, her aunt died. The children were forced out of their home and were taken into the home of the KEWA activist, Anita Martinho.




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