Children of AIDS

Emma Guest

Description

This is the new, fully updated, first paperback edition of Emma Guest's acclaimed book that explores how the AIDS crisis has devastated the world's poorest continent, and shows how families, charities and governments are responding to the next wave of the crisis - millions of orphans.



Based on extensive interviews, Guest lets people tell their own stories in their own words. The result is a moving and disturbing account of the experiences of orphans, street children, grandparents, aunts, foster parents, charity and social workers and foreign donors across South Africa, Zambia and Uganda.
Preface to First edition

Preface to New Edition

Introduction

Section I: Families

1. Mbuya's Story

A Grandmother's Story, Lusaka, Zambia

2. Extending Families

An Aunt's Story, Kampala, Uganda

3. Strangers Step In

The Tale of Two Foster Parents, South Africa

Section II: Projects

4. Childcare by Committee

A Social Worker's Story, Pietermaritzburg, South Africa

5. Hope in the Hills

'Cluster Fostering' in Rorual KwaZulu-Natal, South Africa

6. Institutionalised

An Orphanage in Cape Town, South Africa

7. A Hundred Dollars for a Bull

A Social Worker's Story, Luweero District, Uganda

Section III: International Involvement

8. Foreign Aid or Interference?

United Nations Children's Fund (UNICEF), Lusaka, Zambia

Section IV: Children Alone

9. A Mother to her Brothers

A Child-headed household's story, Johannesburg, South Africa

10. Falling through the Net

A Street Child's Story, Lusaka, Zambia

Conclusion

Notes

List of organisations

Index

Sujets

• África
• AIDS
• Development studies
• Africa
• Science
• Syndrome d'immunodéficience acquise

Informations

• Publié par: Pluto Press
• Date de parution: 20 juillet 2003
• Nombre de lectures: 0
• EAN13: 9781849641982
• Langue: English

Extrait

Children of AIDS

Africa’s Orphan Crisis

SECOND EDITION

Emma Guest

P Pluto Press LONDON • STERLING, VIRGINIA

UNIVERSITY OF NATAL PRESS Pietermaritzburg South Africa

First published 2001 by Pluto Press 345 Archway Road, London N6 5AA and 22883 Quicksilver Drive, Sterling, VA 20166–2012, USA

Second edition 2003

www.plutobooks.com

Published in South Africa by University of Natal Press Private Bag X01 Scottsville 3209 South Africa E-mail: [e-mail]

Copyright © Emma Guest 2001, 2003

The right of Emma Guest to be identified as the author of this work has been asserted by her in accordance with the Copyright, Designs and Patents Act 1988.

British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library

Library of Congress Cataloging in Publication Data Guest, Emma, 1970– Children of AIDS : Africa’s orphan crisis / Emma Guest. p. cm. Includes index. ISBN 0 7453 1769 3 1. Orphans—Services for—Africa. 2. Children of AIDS patients—Services for—Africa. 3. AIDS (Disease)—Social aspects—Africa. I. Title. HV1337 .G84 2001 362.73'096—dc21

ISBN 0 7453 2076 7 hbk (Pluto) ISBN 0 7453 2075 9 pbk (Pluto) ISBN 1 86914 030 3 (Southern Africa only)

10

9

8

7

6

5

4

3

2

1

Designed and produced for the publishers by Chase Publishing Services, Sidmouth, EX10 9QG Typeset from disk by Stanford DTP Services, Towcester Printed in the European Union by Antony Rowe, Chippenham and Eastbourne, England

00–012928

For Robert and Heidi

Contents

Preface Preface to the Second Edition

Introduction

Section I: Families

1

2

3

Mbuya’s Story A Grandmother’s Story, Lusaka, Zambia Extended Families An Aunt’s Story, Kampala, Uganda Strangers Step In The Tale of Two Foster Parents, South Africa

Section II: Projects

4 Childcare by Committee A Social Worker’s Story, Pietermaritzburg, South Africa 5 Hope in the Hills ‘Cluster Fostering’ in Rural KwaZulu-Natal, South Africa 6 Institutionalised An Orphanage in Cape Town, South Africa 7 A Hundred Dollars for a Bull A Social Worker’s Story, Luweero District, Uganda

Section III: International Involvement

8

Foreign Aid or Interference? United Nations Children’s Fund (UNICEF), Lusaka, Zambia

Section IV: Children Alone

9

A Mother to Her Brothers A Child-headed Household’s Story, Johannesburg, South Africa

ix xiv

1

17

28

41

57

71

85

97

113

131

viii

10

Children of AIDS: Africa’s Orphan Crisis

Falling Through the Net A Street Child’s Story, Lusaka, Zambia

Conclusion Notes List of Organisations Index

144

157 167 169 174

Preface

Deadlier than war, deadlier than tyranny, deadlier even than malaria, AIDS is silently tearing Africa apart. The epidemic is throwing millions of households into turmoil. Often the middle generation is wiped out, and children and the elderly are left to fend for themselves. In this book, I have tried to give a glimpse of the lives of a few of these survivors, whether struggling to keep their families intact or eking out a precarious existence on the streets. And I have tried to recount the tribulations of those who try to help this new generation of orphans, often despite minimal resources and obstructive bureaucracy. It is the story of people’s lives after AIDS. ‘A book on AIDS orphans? How depressing!’ This was the reaction of almost everyone I met in South Africa. Friends were bemused. Why would anyone choose to spend 18 months researching and writing a book on such a gloomy subject? I am a white foreigner in Africa. This status bestows numerous obstacles but also a few freedoms. As an outsider, it was not always easy to gain people’s trust. But I could bring a fresh perspective to the subject. Many of the courageous people I met during the course of my research – social workers, doctors, volunteers – devoted all their time and effort to keeping their various projects afloat. Finding enough food to keep orphans in their care healthy, ferrying sick children down awful roads to distant clinics, scrabbling for funds … with so many immediate and pressing concerns, one could hardly expect them to spend much time studying the experiences of other people in similar situations in other parts of the continent. I felt that such a study would prove useful. So I interviewed dozens of people at the front line, if I can call it that, of the battle against AIDS. In these conversations, I tried to find out three things. How does AIDS affect African families? How do Africans cope with the epidemic? And what can others do to help? I pursued my research in three very different countries: Uganda, Zambia and South Africa. I chose Uganda because the AIDS epidemic there is mature. HIV prevalence has peaked, albeit at a horrifyingly high level, and is now

ix

x

Children of AIDS: Africa’s Orphan Crisis

falling. Uganda is poor, but its government is open and has shown an impressive commitment to fighting the disease. Posters everywhere warn about the virus. President Yoweri Museveni urges abstinence or safe sex in almost every speech. A multitude of non- governmental organisations (NGOs) is given free rein to preach prevention in any way they choose. Zambia is enjoying less success. Roughly 20 per cent of Zambian 1 adults are infected. Zambia and Zimbabwe have perhaps the highest proportion of orphans in the world with an estimated 17.6 per cent of children under 15 having lost their mother, father or both parents 2 by 2001, mainly to AIDS. Tackling AIDS in Zambia is made harder by the fact that the country is poor and the government is somewhat ineffectual and sometimes corrupt. Finally, I chose South Africa because it is the richest and most developed country in the region, but still has problems curbing the epidemic. AIDS came late to South Africa, partly because the place was so isolated during apartheid. People in the Western Cape, the southernmost province, still talk of a ‘window of opportunity’ to learn from other provinces, and the country’s northern neighbours, where the epidemic is already severe. But this window is closing fast. South Africa now has about 5 million infected citizens, more than 3 any other country. The South African government woke up to the crisis at the end of 1998, but is still floundering. The president, Thabo Mbeki, continues to flirt with discredited theories about the cause of the disease. Little in my previous experience prepared me for this task. I came from a comfortable British background, the daughter of a country doctor and a marriage guidance counsellor. Before I came to Africa, I did a job I loved: publicising a charity called The Samaritans, a helpline for the suicidal that was established by an eccentric vicar in 1953. My days were spent encouraging sometimes cynical journalists to write sympathetically about depression and suicide. Outside work, I took an interest in AIDS. Once a week, I’d meet up with a woman living with the disease. We’d sit in a pub if she was feeling good, or a hospital if she wasn’t, and I’d listen to whatever she wanted to talk about. It never felt like a chore. She was a survivor. Originally from Kenya, she made her living importing African artwork and selling it from a stall in a London market. Britain’s National Health Service provided her with anti- retroviral drugs – dozens of pills a day – to keep the virus at bay. The 4 drugs work, but they have nasty side effects, so my buddy refused

Preface

xi

to swallow them. She’d collect her prescription, to keep the doctors from nagging, but then stockpile the bottles in her bedroom. The irony of all this struck me when I came to Africa. On the world’s poorest and most AIDS-ravaged continent, AIDS drugs are impossibly expensive. The pills that my buddy received for free, but discarded, cost about $10,000 a year. In a typical African country, providing them to everyone with HIV would cost more than the entire national income, leaving nothing over for food or clothes. Activists lobby for cheaper medicines, but even at huge discounts, probably only South Africa will be able to afford even a limited number of the treatments available in the West. I came to Africa by chance. I met my future husband at a wedding and three months later we were engaged. Then his employer, the Economistmagazine, asked him to go to South Africa. I agreed to accompany him. After seven years working in London, I was ready for a change. We got married, waved goodbye to everything familiar and flew to Johannesburg the next day. I knew very little about what I was going to. I’d heard that AIDS was a big problem in Africa, but had no idea of the level of suffering it was causing. I’d also naively assumed that there’d be plenty I could do to help. But I swiftly learnt that there are few spaces for full-time public relations staff in South Africa’s small and impecunious NGOs. The fact that I was white and foreign did not help either. Four years after apartheid, my background aroused distrust. So I freelanced. I provided consulting services about AIDS to companies, and ghost-wrote reports on the subject for independent consultants, who in turn had been contracted to supply them to the government or NGOs. While researching my various reports, I noticed that there wasn’t a book on AIDS orphans in Africa. The disease was, at last, featured daily in the South African press and on television. But little thought was being devoted to the estimated 2–4.5 million AIDS orphans 5 South Africa would be home to by 2010. It is perhaps presumptuous on my part to write a book about AIDS in Africa. It is a controversial field, riven with passionate disputes and hair-trigger sensitivities. ‘What are your credentials?’ I have sometimes been asked, and, ‘What’s your methodology?’ This book is unapologetically anecdotal. It is the result of gently questioning people about their lives and faithfully transcribing their words. By recording their stories, I hope to shed light on different aspects of, and responses to, the AIDS orphan crisis.

xii

Children of AIDS: Africa’s Orphan Crisis

To persuade people to open up to me, I had to overcome linguistic, cultural and racial obstacles. I would usually start by contacting local NGOs. Once I had gained their trust, I would be introduced to people who’d benefited from their services and the NGO staff would sometimes translate local languages for me. Consequently, many of the individuals featured in this book are relatively lucky. They had at least found lifelines. Some had also been selected, by the NGO that looked after them, for being ‘success stories’. Most African families receive no outside assistance, so AIDS orphans beyond the reach of NGOs and researchers are likely to be much worse off. In Zambia and Uganda, it is assumed that amuzungu(white) visiting a project represents a donor agency. Children and grand- mothers would constantly ask me for money. My response that I was there not with cash, but with a pen, was often greeted with incom- prehension. Of what possible use was my book to this particular street child? He wanted shoes now. Everywhere I went, I observed that projects tend to run on the energy and ideas of a single individual. If that person leaves, they often collapse. These caring individuals get things done, but not always in a focused, strategic way. Relationships with the civil servants and foreign donors who approve their funding are sometimes fraught. NGO leaders, believing so passionately in their cause, sometimes find it hard to learn from, or co-operate with, others who have different ideas about how to reach the same goals. During one AIDS conference in South Africa in 1999, when the discussions reached an impasse, a priest who runs an orphanage leapt up, crying, ‘There are kids dying out there!’ No one working in the field, who sees death daily, can figure out why everyone else doesn’t share their sense of panic. The projections for the numbers of AIDS orphans are terrifying. Without help, many of these children will end up uneducated, alienated and on the streets. And yet some African governments seem to lack a sense of urgency about the crisis. In places where corruption is widespread and politics simply the easiest way to get rich, government funds are often squandered rather than used to alleviate poverty. The naked self- interest of some of the politicians I met shocked me. How would rich countries respond to a similar crisis? Perhaps the question is futile. In Western Europe, Japan and North America the basic needs of the poorest – enough to eat, a roof and a pair of trainers – are largely taken care of. Governments in rich countries

Preface

xiii

have the time and money to concern themselves with the psy- chosocial impact of their much smaller AIDS epidemics. In the US, where there were about 80,000 AIDS orphans in 2000, 6 there are armies of counsellors to help children with their ‘grief work’. Children are encouraged to talk through their feelings of denial, abandonment, anger and sadness, in peer support groups, family therapy or one-to-one sessions. Dying parents make ‘memory’ videos. Before coming to South Africa, I had been working for an organ- isation which believed that everyone had the right to be listened to, and that an individual’s emotional wellbeing depended upon such an outlet. I swiftly learnt that before you can worry about a child’s mental state, you have to make sure she has something to eat, and maybe some antibiotics. The lives of many AIDS orphans are bleak, but I hope that readers will not find this book wholly depressing. It’s full of stories of extra- ordinary resilience. Of course, many of my subjects have little choice but to be resilient, but their struggles are still frequently awe- inspiring. The orphans, aunts and grandmothers I’ve interviewed battle on despite poverty and bereavement. When I meet a 17-year- old who is bringing up her siblings alone, I’m humbled. I hope, too, that the example of the social workers, NGO staff and international donors I have described will inspire others to get involved or give money to a reputable charity. Details of the organ- isations featured in this book can be found at the end. I am grateful for the expert input of Professor Alan Whiteside, Dr Neil McKerrow, Professor Brian Williams and Lynn van Lith. Finally, I would like to thank all those who have let me into their lives. I have changed names where necessary to protect people’s privacy. But all the stories, sometimes unfortunately, sometimes happily, are true.