Tragically, it is children who shoulder the greatest burden of the epidemic. Worldwide, more than 8 million children have had to grow up without their mothers. Over 90% of those orphaned by AIDS live in sub-Saharan Africa. To lose one or both parents to AIDS is to face a childhood of pain and peril. The suffering starts with the grief and horror of watching their parent waste away. Soon they suffer prejudice and neglect at the hands of their guardians and community. Every tenet of the Convention on the Rights of the Child is violated, from their right to education, health and development, to protection from exploitation and harm. Our experience tells us that orphans have alarmingly higher rates of malnutrition, stunting and illiteracy. Often their community shuns them, presuming that they, too, harbour the fatal virus. Relatives who take them in often seize their paltry inheritance, and local laws offer little recourse to these lonely children. Worse still, as surveys here in Uganda have shown, children whose parents have died often must shoulder heavier workloads and are treated more harshly than the foster family's own children. They are less likely to go to school and more likely to be depressed. One of our current district development plans reports that "orphan children [are] being defiled, married, neglected and…subjected to many forms of abuse." Throughout the continent, young girls are especially vulnerable, and a reported rapid rise in sexual abuse in Zimbabwe, for example, has prompted the Government to set up a special hospital clinic to deal with the victims of this unconscionable behaviour. Tens of thousands of orphans are simply abandoned to fend for themselves, like the 90,000 in Zambia living on the streets. Tens of thousands more are struggling in households headed by the eldest child. Newspaper reports chronicled the fate of little girls like Kugu Sengane, in Kwazulu Natal (South Africa), who was only 11 years old when she had to nurse both of her parents through the torment of their dying days. As they languished in pain, Kugu was barely able to keep them washed and fed, while having to care for her toddler brother. This is no life for a child. Nearly half of those caring for orphans in some regions of Africa are elderly grandparents like Ennie Gambushe, who lives up the road from little Kugu Sengane. At age 64, Ennie aches so badly from her chronic arthritis that she has difficulty merely standing up. Yet after both of her daughters died from AIDS, she was left to look after 15 grandchildren, none of them older than 12. From South Africa up through central and eastern Africa, such scenes highlight the catastrophic impact AIDS has had on our families and communities, leaving our aging grandparents with an exhausting responsibility. "Young girls — our children, our grandchildren, they are dying before we die," says 79-year-old Elizabeth Chipepa from Zambia, who inherited three small great-grandchildren when her granddaughter succumbed to AIDS. "You can hear others my age saying things like, 'I've lost my three children; the first one has left three children, the second has left six….'" In my own country, a 60-year-old woman named Honodinta Nakayima is looking after 42 grandchildren, ranging from age 13 down to a few months, after seven of her children died.
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