by David Kabiswa.
Photo: Mike Webb/Tearfund
Children are often the silent victims of the HIV and AIDS pandemic. In many traditional Ugandan societies, children were ‘seen, not heard’. As HIV and AIDS tore apart communities and countries in the 1980s and 1990s, people tried to understand what was happening. However, children’s needs were largely ignored. Younger children were rarely given any explanation for the loss of their family.
Uganda’s national newspaper, The New Vision, carried an article some years ago about ‘children playing burial’. In a village in Mbale District, two children were found ‘burying’ their friend as they went through the process of a funeral. When asked what they were doing, they explained that they were putting their friend in the ground, just like many of their neighbours had been. The article captured the attention of many people. It helped organisations consider an aspect that was often ignored. Children need time and help to make sense of what happens around them.
Initial policy responses
As the Ugandan government sorted out its priorities, research by the Ministry of Health in 1993 showed that young people had the highest infection rates. Children as young as 12 were developing AIDS. (These statistics included children born with the virus.) The figures revealed that many young people were having sex, with or without consent. It meant that Ugandan people needed to talk openly about sex and sexuality – culturally a very difficult thing to do.
People began to realise, too, how often moral condemnation, misinformation and prejudice resulted in discrimination, child abuse and neglect. These attitudes resulted in great harm to children already struggling to cope with the effects of HIV and AIDS.
What is the impact of HIV and AIDS on children?
The impact of HIV and AIDS on children has been grouped into three broad categories. These effects are closely linked to the social and economic status of a family and the level of the epidemic in a country:
- loss of social and family support
- shame and discrimination
- physical and economic impact.
Loss of social and family support A child belongs not only to a particular family, but also to a community, wider family, culture and religion. Their education, health and self-esteem are closely linked to these. The loss of a parent often means these other support systems are lost too. Some children are separated from their brothers and sisters and taken to other homes. Others stay with grandparents who are too old to teach them life skills. The emotional impact is great.
Stigma and discrimination Children often face discrimination and are labelled as ‘AIDS orphans’. When people know their parents are HIV-positive, children may lose playmates, and be denied the chance to attend school or church (because of their ‘immoral’ parents). Children who are HIV-positive are sometimes denied food because people assume they are going to die anyway.
Physical and economic impact Some children leave school to look after their sick parents. At the death of a parent, children may lose their property to greedy relatives and neighbours. Access to other services, such as education and healthcare, becomes difficult and many children have to fend for themselves.
The response
In Uganda, information and education programmes have helped raise people’s awareness of children’s needs. Committees to support orphans are a common coping strategy. Clubs for children of HIV-positive parents have been developed. Children are helped to cope and understand what is going on. Life skills training and counselling help children to cope with their emotional needs.
Political structures help to ensure that children’s practical needs are met. The government now provides free primary education. Several NGOs introduced programmes to help pay school fees. Legal protection was provided to prevent children losing their family property.
Recent progress
In recent years there has been a steady decrease in the rate of HIV infection in Uganda – particularly among young people. This success is thought to be due mainly to good health education. Sexual issues are discussed openly with children. They are taught about ABC:
A Abstinence Delay the first sexual relationship
B Be faithful Have very few sexual partners (preferably just one)
C Condoms Use condoms to reduce the spread of HIV infection.
Today, people in Uganda are very open about HIV and AIDS. Many radio programmes have talk shows to help raise people’s awareness. Faith-based organisations, which in the past would judge people with HIV and AIDS, now provide most of the home-based care services.
In recent years, children have benefited from many changes in Uganda. However, children affected by HIV and AIDS still need to make difficult decisions. They reach adulthood before their time!
Challenges for the future
Many NGO programmes still do not give enough attention to children’s emotional and social needs. For example, children really need an adult to provide a substitute for their parents. They need someone to talk to about their hopes and dreams. The challenges are greater when children lose access to education.
Children’s support programmes (tuition fees, material support) often stop at the age of 18. However, many of these young people continue to live a difficult life with many challenges. Their need for counselling and other support may not stop just because they become ‘adults’.
The challenge of this work needs us all to be involved. May this article help to move you forward, rather than making you think, ‘Oh no… Uganda again!’
David Kabiswa is the Director of ACET Uganda. His address is: ACET Uganda, PO Box 9710, Kampala, Uganda.