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A mother died. A toddler died. Another child dies. Then the father died.

The effects of HIV/AIDS on early childhood

Today, 34.3 million people in the world live with HIV/AIDS, including 1.3 million children under 15 years of age.41 The overwhelming majority of these children were born to mothers with HIV, acquiring the virus in the womb, around the time of being born, or during breastfeeding. With their right to survive, grow and develop threatened from their very beginnings, most of these children will live shortened lives, dying before they are in their teens.42

The firestorm rages most ferociously in sub-Saharan Africa, the home of 10 per cent of the world’s population, 70 per cent of the world’s HIV-infected people, 80 per cent of AIDS deaths and 90 per cent of AIDS orphans.43

In some African countries, more than 10 per cent of children under 15 are now orphans.44 Earlier estimates that more than 13 million children worldwide would lose their mothers or both parents to AIDS by the year 2001 were passed by the end of 1999.45 Ninety per cent of these orphans live in sub-Saharan Africa.46

And with 5.4 million new HIV infections in the world in 1999 alone, the worst is yet to come.47

In Shiri-njoro (Tanzania) not far from Mount Kilimanjaro, Felicia Mbonika, a village elder and counsellor, knows intimately the waste laid by AIDS in her country. A plump woman, dressed in a multicoloured wrap, she has a soft, serene face that belies her despair. Sitting in her small house, located on the main road that runs from Arusha to Kilimanjaro, she talks about her constant condolence calls to neighbours. It is not only her arthritic hip that makes these walks so difficult, but also her heavy heart. In the area where she lives, with just about 300 households, she says that she knows 15 people who have died from AIDS this year.

“Almost every week, we bury someone,” says Ms. Mbonika. “I fear for the future of my country. Those dying are young people. These are the people who are supposed to be productive and continue the next generation.”

She is right. AIDS is cutting down people in the prime of their lives and ravishing Africa. Schools are losing teachers, clinics are losing health workers, companies are losing workers and children are losing parents.

Felicia Mbonika’s accounts of AIDS in her Tanzanian village bring statistics into focus.

Within the last few years, this mother of grown children watched as, one by one, the members of two families in the village completely vanished. A mother died. A toddler died. Another child died. Then the father died. A variation of the pattern repeated itself in the second family, death by death.

Just down the road from her home is a house where both parents died from AIDS, says Ms. Mbonika. The household now consists of four children. The youngest is four years old, and three other children are in primary school. Their oldest brother, 19 and overwhelmed by the responsibility of caring for his young siblings, married specifically so that his new wife could help.

Such stories are not unique to Tanzania. In families, villages, cities and countries all over Africa, there are countless similar stories of the devastating human toll this disease takes.

The epidemic and the economy are negatively intertwined as poverty fuels the AIDS crisis and the disease strips the coffers bare. By 2005, the costs of treatment and care related to HIV/AIDS are expected to account for one third of all government health spending in Ethiopia, more than half in Kenya and nearly two thirds in Zimbabwe.48

In addition to stretching national budgets, AIDS has taken a toll on the kinship system, a network of extended family members that makes up the backbone of African societies. In Zimbabwe, where 26 per cent of all adults are infected with HIV,49 a government-sponsored survey in three rural communities found that of 11,514 orphans, more than 11,000 were being cared for by relatives. Most of the caregivers were poor women, widowed and over 50.50 The soaring numbers of children orphaned by AIDS drain the emotional and financial resources of families. In Côte d’Ivoire, for instance, when a family member has AIDS, the average household income falls by a range of 52 per cent to 67 per cent and the health costs quadruple. And as family income plummets and the cost of caring for the patient escalates, food consumption drops.51

Orphaned by HIV/AIDS. Whether their parents die from AIDS or are too sick with HIV to provide the essentials of care and nurturance, children orphaned by the epidemic are likely to be malnourished, unschooled and aged beyond their years, with their rights to grow and develop fully, violated. A study in Zambia, for instance, reported that 32 per cent of orphans in cities and 68 per cent of orphans in rural areas were not enrolled in school.52 Children orphaned by AIDS are at greater risk of becoming HIV infected.53 Emotionally vulnerable, they are more likely to seek comfort in risky sexual behaviour. Financially desperate, they are more likely to be exploited, often turning to prostitution for survival.

Despite the enormous gravity of the HIV/AIDS crisis, families, villages, communities and nations have pressed on. Refusing to give in to despair, many communities have responded with courage and resourcefulness.

Some of the most valiant efforts on behalf of young children have been made in the wake of this tragedy. Recognizing the importance of the first months and years of a child’s life, several African countries have shown the way in caring for their youngest children during the epidemic.

In Namibia, for instance, where the number of children orphaned by AIDS increased fivefold between 1994 and 1999, the Government and UNICEF offer equipment, supplies and materials to day-care centres that provide free services to orphans. A centre receives pit latrines, tarps, crayons and paper to be used by all the children, and the orphans are assured much-needed care. And families are more likely to adopt children orphaned by AIDS because they are guaranteed free day care.54

HIV and mortality among children under five years old in selected African countries.

Hazards to child health in the environment

Country Profile: Turkey

Panel 6. The vortex where values are worthless by Ernesto Sábato, an Argentine nuclear physicist and humanist.


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