Who has to take care of the HIV/AIDS orphans?

THE real battle against HIV/AIDS disease in most communities is entirely being played out by members of the affected victims in villages where the authorities of most governments rarely extends crucial services. It’s known that HIV/AIDS disease is striking at the heart of families and communities. It is an unprecedented global development challenge which has already caused too much hardship, illness and untimely death. The pandemic affects individuals, devastates households and communities and now threatens entire nations. Tanzania already had long severe records of the HIV/AIDS epidemics that is generating orphans so quickly that family structures can no longer cope. As the number of adult deaths is rising now and then, an increasing number of orphans is growing up without parental care and love. The increased spiral of adult deaths means that the number of children orphaned each day is expanding exponentially. Families and communities can barely fend for themselves, leaving behind a generation of children to be raised by their grandparents. The vulnerability of AIDS orphans starts well before the death of a parent. Children living with caregivers often experience many negative changes in their lives and can start to suffer emotional neglect even before the death of the parent or caregiver. In Tanzania, there have been traditional systems in place to take care of children who lose their parents for various reasons. But the onslaught of HIV/AIDS slowly but surely erodes this good traditional practice by simply overloading its caring capacity by the sheer number of orphaned children needing support and care.
A larger proportion of orphans in the country have lost their parents to AIDS disease than to any other cause of death - meaning that, were it not for the AIDS epidemic, these children would not have been orphaned. Statistics by the government shows that, about 10 percent of population are HIV positive and one in seven children is an orphan. The government estimates that there are about 3 millions of them here in Tanzania. Reports by the government through the Ministry of Health indicates that, Iringa region has the highest HIV/AIDS infection rate at 15.7 percent in the country, but authorities hope to bring down the figures by half in 2012. The region has two times the national average infection rate, which according to latest statistics, stands at around five percent.
Since the inaugural of HIV/AIDS Voluntary Testing campaign by President Jakaya Kikwete in July 2006, the testing campaign has shown a remarkable achievements in the previous three years as 5 million people have tested countrywide. According to the data from Tanzania HIV/AIDS and Malaria indicator, survey 2007/08, the national prevalence among the sexually active populations (between 15 and 49 years of age), is reported to be 5.7 percent. The data shows that, more women (about 6.6 percent are infected than men who stands at 4.6 percent). Compared with HIV prevalence data from the 2003/04, there has been a slight decrease in overall prevalence of HIV among sexually active population from 7.0 percent in 2003/04 to 5.7 percent in 2007/08.

A lady undergoing HIV/AIDS test at Voluntary Counseling Testing centre. To know each others’ status would help reduce AIDS infections.

Statistics further shows that, there is also a decrease in prevalence from 6.3 percent in 2003/04 to 4.6 percent 2007/08 for men and 7.7 percent to 6.6 for women respectively.
The economic impact of HIV/AIDS illness and death has serious consequences for an orphan's access to basic necessities such as shelter, food, clothing, health and education. Orphans run greater risks of being malnourished than children who have parents to look after them. In addition there is the emotional suffering of the children which usually begins with their parents' distress and progressive illness. Eventually, the children suffer the death of their parent(s) and the emotional trauma that results. They then may have to adjust to a new situation, with little or no support, and they may suffer exploitation and abuse, this is because of the fact that most of their care givers are old people who lives in extreme poverty in remote rural areas where the provision of health services is very scarce. The distress and social isolation experienced by these children, both before and after the death of their parent(s), is strongly exacerbated by the shame, fear, and rejection that often surrounds people affected by HIV/AIDS. Because of this stigma and often-irrational fear surrounding AIDS, children may be denied access to schooling and health care. And once a parent dies, children may also be denied their inheritance and property.
The only way forward is prevention and care. Preventing more adults from becoming infected with HIV viruses in the future, and providing treatment and care, will prevent even more children from becoming orphans in the future. In the early days of the AIDS orphan crisis, there was a rush by well meaning non-governmental organizations to build orphanages. But this response was unsustainable given the scale of the problem as the cost of maintaining a child in such an institution needs great care. Most people now believe that orphans should be cared for in family units through extended family networks, foster families and adoption, and that siblings should not be separated. But the extended family can only serve as part of the solution to mass orphan hood if adequately supported by the state, community and other sectors. The community needs to be supportive of children when they are orphaned. Orphans need to be accepted as part of the community and to have access to essential services such as health care and education.
A variety of different community organizations in the country do now provide support for orphans, and the government does encourage communities to provide care for orphans within the community, and to rely on institutional care only as a last resort. In recent years, Tanzanian government established a National Orphan Care Task Force. The Task Force is made up of various representatives and organizations which are responsible for planning, monitoring and revising all programmes on orphan care. An important aspect of the government's strategy has been to promote and support community based programmes, and in both rural and urban areas across Tanzania, communities are developing a variety of ways to cope with the growing crisis of AIDS orphans whose parents have died of AIDS disease. In many villages orphanage committees have been established to monitor the local situation and to take collective action to assist those in need. Older people who takes care of orphans in these villages are themselves at risk of infection. However International data on infection rates does not include those older than fifty. A report from Help Age International Tanzania, presents the findings of a participatory study of older Tanzanians saying nearly two million people in Tanzania are over 60 years old. One of the most devastating aspects of the HIV/AIDS epidemic is the growing proportion of children the disease has orphaned. Unlike most diseases, HIV/AIDS generally kills not just one, but both parents. On top of the psychological impact of losing one’s parents, children who lose their parents to AIDS are often stigmatized or ostracized by their communities. These children are often much more at risk of becoming a victim of violence, exploitative child labour, or other abuses. What is more, the stigmatization and discrimination that people affected with HIV often live with is passed onto these children, making their fight for survival that much more precarious.
Surviving children face malnutrition, illness, physical and psychosocial trauma, and impaired cognitive and emotional development. Unaccompanied girls are at especially high risk of sexual abuse. And because of all this, they too are very likely to become HIV-positive. When parents or caregivers fall sick and die, children’s life often falls apart. The entire family feels the economic impact in the sense that the majority of the children becomes street children. Other impacts are related to school dropouts, the attitude which later drives them to child labour extremes, and for girls are vulnerable to sexual abuse in domestic housework because of the stigma attached to their orphaned status. Studies from numerous regions in the country have shown that orphaned children have substantially lower levels of education than children who are not orphaned. But extended families traditionally steps in to take care of these children.