HIV/AIDs and the Orphan Crisis

"We witness today throughout the continent the unfolding of an unprecedented phenomenon where siblings bear the awesome responsibility of providing for the material and psychological needs of children of their own age or of their sick parents. Young children are now caring for entire households spending sleepless nights in an attempt to make ends meet and to ensure family continuity in a world that is littered with uncertainties."

'The Emerging Challenge of Children Heading Households: Some Reflections' Assefa Bequele, Ph.D., The African Child Policy Forum, March 2007

Uganda was one of the first countries to be hit by the HIV/AIDs pandemic. In Uganda HIV has spread mainly by heterosexual transmission and has affected huge numbers of young adults, the parents, breadwinners and carers of families with an average of 6-7 children, leaving communities struggling to cope with the many orphaned children.

By the mid-eighties the number of orphaned children had soared and a generation later the knock-on effects are devastating. Around half of Uganda's 2.4 million orphans have lost one or both parents to AIDS. Traditionally the extended family and community have stepped in to take care of children but with so many parents, aunts and uncles gone communities are struggling to cope.

Uganda has won praise for its vigorous campaign to reduce the spread of the virus and raise awareness, using peer-to-peer education to pass on its 'ABC' message - Abstain, Be faithful, use a Condom - to communities around Uganda. This has helped to reduce prevalence from a peak of almost one in three to around 6.4%, and the campaign has been used as a model by other African countries.

An estimated 25% of families care for at least one orphan. Elderly grandparents are often fored into greater poverty to care for multiple families of grandchildren, while others are left to care for themselves in sibling-led households, sometimes headed by children who are left to take care of younger siblings before they have had the chance to have the experience of being parented themselves.

There is a strong link between HIV and poverty - household and community poverty increases vulnerability to infection, and infection increases poverty. HIV disables the most able-bodied members of households and communities and lessens the ability of households to recover from bouts of illness.

The costs of extended chronic illness and funerals means that family finances are already in a bad state and child-headed families may be left in great poverty. Without assistance they have little or no chance of accessing the education necessary to improve their future chances. Education reduces the chances that a child will go on to contract the HIV virus, vital to prevent a new generation of orphans, this time with even fewer grandparents. It is also needed in order to reduce the stigma suffered by HIV sufferers and their families, which can discourage children from attending school.

Friends of Bwindi supported the costs of a poster campaign by Bwindi Community Hospital, which featured peer-to-peer educators. The posters inform people over a wide area about HIV testing and treatment available at the hospital. Pregnant women in particular are encouraged to get tested, so that appropriate treatment can be given to minimise risk of mother-to-child transmission.