WUNRN
AIDS ORPHAN GIRLS
Worldwide, it is estimated that
more than 15 million children under 18 have been orphaned as a result of AIDS.
Around 11.6 million of these children live in sub-Saharan Africa.1
In countries badly affected by the epidemic such as
Even with the expansion of antiretroviral
treatment access, it is estimated that by 2015, the number of
orphaned children will still be overwhelmingly high.3
As the tables below show, the
number of orphans in some sub-Saharan African countries exceeds half a million,
and, in some countries, children who have been orphaned by AIDS comprise half
or more of all orphans nationally.4
Number of orphans due to AIDS, alive in 2007 |
|
1,400,000 |
|
1,200,000 |
|
1,200,000 |
|
1,000,000 |
|
|
970,000 |
|
650,000 |
600,000 |
|
560,000 |
|
|
420,000 |
AIDS orphans as a percentage of all orphans, 2005 |
|
|
77% |
76% |
|
66% |
|
64% |
|
|
57% |
|
57% |
|
49% |
|
46% |
|
45% |
AIDS is responsible for leaving
vast numbers of children across
In some countries, a larger
proportion of orphans have lost their parents to AIDS than to any other cause
of death - meaning that, were it not for the AIDS epidemic, these children
would not have been orphaned. The second table shows the countries in which the
children who lost their parents to AIDS make up the highest proportion of the
total national number of orphans.5
Most of the AIDS orphans who live
outside of Africa live in
As the number of orphans varies
between countries, so it varies between different regions within those
countries. Particular areas may have higher or lower percentages of orphans,
largely depending on the local HIV prevalence rates. There can also be
substantial differences between rural and urban areas.
The age of orphans, however, is
fairly consistent across countries. Surveys suggest that overall about 15% of
orphans are 0-4 years old, 35% are 5-9 years old, and 50% are 10-14 years old.7
The scale of the orphan crisis is
somewhat masked by the time lag between when parents become infected and when
they die. If, as expected, the number of adults dying from AIDS rises over the
next decade, an increasing number of orphans will grow up without parental care
and love.
“The increased
spiral of adult deaths in so many countries means that the number of children
orphaned each day is expanding exponentially.
Children whose parents are living
with HIV often experience many negative changes in their lives and can start to
suffer neglect, including emotional neglect, long before they are orphaned.
Eventually, they suffer the death of their parent(s) and the emotional trauma
that results. They may then have to adjust to a new situation, with little or
no support, and may suffer exploitation and abuse.9 10
In one study carried out in rural
These psychological problems can
become more severe if a child is forced to separate from their siblings upon
becoming orphaned. In some regions this occurs regularly: a survey in
A member of the community takes
care of children orphaned by AIDS,
The loss of a parent to AIDS can
have serious consequences for a child’s access to basic necessities such as
shelter, food, clothing, health and education. Orphans are more likely than
non-orphans to live in large, female-headed households where more people are
dependent on fewer income earners.13 This lack of income puts extra
pressure on AIDS orphans to contribute financially to the household, in some
cases driving them to the streets to work, beg or seek food.14
The majority of children who have
lost a parent continue to live in the care of a surviving parent or family
member, but often have to take on the responsibility of doing the housework,
looking after siblings and caring for ill or dying parent(s). Children who have
lost one parent to AIDS are often at risk of losing the other parent as well,
since HIV may have been transmitted between the couple through sex.
Children orphaned by AIDS may
miss out on school enrolment, have their schooling interrupted or perform
poorly in school as a result of their situation. Expenses such as school fees
and school uniforms present major barriers, since many orphans’ caregivers
cannot afford these costs.15 Extended families sometimes see school
fees as a major factor in deciding not to take on additional children orphaned
by AIDS.16
AIDS orphans may also leave
school to attend to ill family members, work or to look after young siblings.
Even before the death of a parent, children may miss out on educational opportunities;
research in
Outside of school, AIDS orphans may
also miss out on valuable life-skills and practical knowledge that would have
been passed on to them by their parents. Without this knowledge and a basic
school education, children may be more likely to face social, economic and
health problems as they grow up.18
Children grieving for dying or
dead parents are often stigmatised by society through association with AIDS.
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 and AIDS.
Because of this stigma, children may be denied access to schooling and health
care. Once a parent dies children may also be denied their inheritance and
property. Often children who have lost their parents to AIDS are assumed to be
HIV positive themselves, adding to the likelihood that they will face
discrimination and damaging their future prospects. In this situation children
may also be denied access to healthcare that they need. Sometimes this occurs
because it is assumed that they are infected with HIV and their illnesses are
untreatable.
AIDS orphan in
“We should
remember that the process of losing parents to HIV/AIDS for the children often
includes the pain and the shame of the stigma and the fear that the disease
carries in most our societies.” UNICEF representative Bjorn Ljunqvist19
In African countries that have
already suffered long, severe epidemics, AIDS is generating orphans so quickly
that family structures can no longer cope. Traditional safety nets are unravelling
as increasing numbers of adults die from HIV-related illnesses. Families and
communities can barely fend for themselves, let alone take care of orphans.
Typically, half of all people with HIV become infected before they are aged 25,
developing AIDS and dying by the time they are 35, leaving behind a generation
of children to be raised by their grandparents, other adult relatives or left
on their own in child-headed households.
Traditional systems of taking
care of children who lose their parents, for whatever reason, have been in
place throughout Sub-Saharan Africa for generations. But HIV and AIDS are
eroding such practices by creating larger numbers of orphans than have ever
been known before. The demand for care and support is simply overwhelming in
many areas. HIV reduces the caring capacity of families and communities by
deepening poverty, through medical and funeral costs as well as the loss of
labour.20
The way forward is threefold:
firstly new HIV infections must be prevented so that children do not lose their
parents; secondly access to antiretroviral treatment needs to be stepped
up; and finally care must be provided for those children who are already
orphaned. The rest of this page is devoted to issues around the care of AIDS
orphans in
In the early days of the AIDS
orphan crisis, there was a rush by well meaning non-governmental organisations
to build orphanages. Given the scale of the problem, though, this response was
unsustainable, as the cost of maintaining a child in such an institution is
much greater than other forms of 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. Studies in
sub-Saharan
Ultimately, though, the extended
family can only serve as part of the solution to mass orphanhood if adequately
supported by the state and the community, as well as other sectors of society.
The community needs to be
supportive of children when they are orphaned, making sure that they are
accepted and have access to essential services, such as health care and
education. This means improving existing services and reducing the stigma
surrounding children affected by AIDS so that they do not face discrimination
when trying to access these services.
“My sister is six years old. There are no
grown-ups living with us. I need a bathroom tap and clothes and shoes. And
water also, inside the house. But especially, somebody to tuck me and my sister
in at night-time.”
Apiwe aged 1321
Schools can play a crucial role
in improving the prospects of AIDS orphans and securing their future. A good
school education can give children a higher self-esteem, better job prospects and
economic independence. As well as lifting children out of poverty, such an
education can also give children a better understanding of HIV and AIDS,
decreasing the risk that they will become infected. Schools can also offer
benefits to AIDS orphans outside of education, such as emotional support and
care.
Unfortunately orphans may be the
first to be denied education when extended families cannot afford to educate
all the children of the household.
See our HIV, AIDS and Schools page for more about the
ways that schools can provide support to children affected by HIV.
If AIDS orphans are as active
members of the community rather than just victims, their lives can be given
purpose and dignity. Many children already function as heads of households and
as caregivers. They are a vital part of the solution and should be supported in
planning and carrying out efforts to lessen the impact of AIDS in their
families and communities.
Much can be done to ensure the
legal and human rights of AIDS orphans. Many communities are now writing wills
to protect the inheritance rights of children and to prevent land and property
grabbing, where adults attempt to rob orphans of their property once they have
no parents to protect their rights.
“You find that
the parents have been productive and have left assets for the children but
immediately after their deaths, the relatives squander everything. Those that
are left without anything are just being used for the food rations.” Pelonomi
Letshwiti, a social worker for Childline Botswana22
Children orphaned due to AIDS may
face exploitation in other areas of their lives as well. For instance, evidence
suggests that there is a relationship between AIDS orphans in sub-Saharan
The physical needs of orphans,
such as nutrition and health care, can often appear to be the most urgent. But
the emotional needs of children who have lost a parent should not be forgotten.
Having a parent become sick and die is clearly a major trauma for any child,
and may affect them for the rest of their life.
“My sister is six
years old. There are no grown-ups living with us. I need a bathroom tap and
clothes and shoes. And water also, inside the house. But especially, somebody
to tuck me and my sister in at night-time.” Apiwe aged 1324
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