The AIDS epidemic has hit children head-on in many ways. This infection can directly affect children since, in the absence of prevention, a mother can pass the virus to her baby during pregnancy, delivery, and breastfeeding. Children can also be infected through contaminated blood during transfusions or by sexual abuse. But the consequences of the AIDS epidemic on children go well beyond these infection risks. By reaching their parents, the AIDS epidemic deprives the family of its foundations and resources. Infected or non-infected children living in families affected by the disease are made vulnerable well before the death of their HIV-positive parents and all the more when their parents die. The pandemic not only deprives orphans of their rights to enjoy a good or a least a normal childhood, but it also has deleterious effects on their chances of survival or well-being.
The death of a mother during the child’s first years of life implies the lost of his or her principal caregiver but also jeopardises the fulfilment of basic needs such as access to health care, sufficient food, etc. Generally, for a child orphaned or made vulnerable by HIV/AIDS, the loss of one or both parents affects all dimensions of his or her life: emotional stability, safety, mental development, health, etc. After the death of their parents, children are totally or partially deprived of the basic rights to live and grow in a family and to be protected from violence, ill-treatment, exploitation, stigma, and discrimination. Children whose parents fall sick and die of AIDS have another right that is usually compromised: the right to education. Many AIDS orphans are compelled to give up school early due to lack of financial resources or because they must support other members of their family in the absence of parents. Generally, when AIDS affects families with the loss of one or both parents, it will deepen the family’s poverty and increase the risk that children will be forced into illegal or reprehensible activities.
Extended families affected by AIDS must face the reality that they need to be supportive of orphans. Given the increasing number of orphans and the fears that HIV infection usually stirs, few households in the family circle agree to look after them. In a large number of African societies, grandparents are approached to take care of orphans. With the rapid spread of AIDS in Africa, family mechanisms to provide support or shelter for orphans within the kinship have reached their limits. In the face of the children’s own relatives’ reluctance to shelter and protect them and the small number of institutions and public structures likely to support these children, the future of these children orphaned by the AIDS epidemic addresses a key social issue.
This research presented here is a bibliographical synthesis based on available data on children who have at least one parent infected with HIV/AIDS or one who has died. This document does not deal with medical support for children infected by HIV/AIDS but rather with family, social, and institutional support of children affected by HIV/AIDS. Over the past few years, the international community became aware of the extent of the crisis in Africa—where we are witnessing a rapid increase in the number of orphans and a growing number of adult deaths due to AIDS. Several reports on this issue have been published in particular by UNICEF, WHO, and UNAIDS UNICEF, UNAIDS et al., 2004, Landis, 2002, WHO and UNAIDS, 2002. Our purpose is not to duplicate or repeat the information provided by these reports but to add the contribution of researchers focusing on population and development issues. We endeavour to specify the criteria adopted to define (section 1) and measure (section 2) the number of children who have been orphaned or more generally made vulnerable by the AIDS epidemic. This report cites current estimates of the scale of the problem (section 3) before examining responses based on available knowledge on family care systems and other support mechanisms for orphans (section 4). Lastly, in the fifth section, the various consequences of this crisis on children are presented (section 5). This review aims to make most of the literature on these themes accessible to the reader. It includes figures and reports published by international organisations, but also research findings from demographers and sociologists on the family and traditional systems of support between generations in Africa. Lastly, this work reports on the most recent research conducted on orphans due to HIV/AIDS.
| Acknowledgments |