Washington Post
17 March 1995

African AIDS Epidemic Creating a Society of Orphans
Hundreds of Thousands of Children Left Parentless as Scourge Sweeps the Continent

by Stephen Buckley

Kakuuto, Uganda: Elizabeth Nakaweesi, 17, became head of her household at 13.

In 1989, her mother died of AIDS. In 1991, AIDS killed her father. That left Elizabeth to care for her four brothers and sisters, now aged 10 to 15.

Instead of spending her days in school, she spends them making straw mats and cultivating her family's half-acre of banana trees. She makes $40 a year.

`It is painful to have no parents,' Elizabeth said recently, sitting in her family's battered clay hut. "If they were here, they would take care of us: we would have the things we do not have.'

Nakaweesi's plight has become a familiar one in Africa, where AIDS has left millions of children without parents and has afflicted thousands of others who contracted the AIDS virus through their mothers.

Statistics on the impact of AIDS among African children are sketchy but nonetheless grim. UNICEF predicts that by 1999, up to 5 million African children will have lost their mothers to AIDS. Of the 9.5 million people in sub-Saharan Africa who either have the human immunodeficiency virus (HIV)--which causes AIDS--or the disease itself, an estimated 1.3 million are children.

`They don't get the attention they need at home,' said Gelazius, who has seen 11 relatives die of AIDS. `Their grandparents are usually too old, and the children don't respect them.'

A study in neighboring Tanzania found that children who have lost their mothers to AIDS `have markedly lower enrollment rates and, once enrolled, spend fewer hours in school' than youngsters with two parents, the World Bank Research Observer reported. The same study concluded that by 2020 the AIDS death rate among children in Tanzania will have cut primary and secondary-school enrollments by 14 and 22 percent, respectively.

Doctors also fear that AIDS will wipe out improvements in infant mortality rates over the past decade. For now, the rate remains stable, but a 1994 World Bank report on AIDS in Uganda warned: `Because of the large numbers of women carrying the virus, there are increasing numbers of infants and children infected. This together with the loss of mothers due to AIDS will increase infant and child mortality significantly.' At the Kakuuto offices of Doctors of the World, a medical relief group, AIDS program coordinator Fred Sekyewa said babies born to mothers with AIDS have a 25 to 50 percent chance of being infected and that one in three pregnant women examined here tests HIV-positive.

Sekyewa added that many women with AIDS have babies because of cultural pressures. `In African societies it is an abomination for a woman to die without a child,' he said. `A woman in her twenties who has AIDS will say, `I must have a child now because I may die before I get the opportunity.'

In Nairobi, Kenya, hundreds of HIV-positive children die in hospitals annually after being abandoned by their mothers. Three years ago, the Rev. Angelo D'Agostino, a Jesuit priest, founded a home in Nairobi for such children. A surgeon and psychiatrist who taught at George Washington University for 14 years, D'Agostino said he gets calls from hospitals and social workers seeking homes for 100 AIDS babies every month.

D'Agostino, 69, has taken in about 80 children. He said that some have become healthy after receiving a steady diet of nutritious meals and attention.

`They were born with their mother's HIV antibodies, so they initially tested positive. But they never got infected,' D'Agostino said. `So after a while, they're fine. But usually these kids die of malnutrition or something else in a hospital; because they once tested positive, everybody gives up on them.'

The priest said that his children, most of whom are under 5, often show the strains of losing their parents. They cry for hours. They have nightmares. They stare into space.

`They talk about seeing their parents die,' D'Agostino said. `They talk about being alone with their 10- or 12-year-old sibling.'

Elizabeth Nakaweesi understands their pain. The teenager said she quit school in the sixth grade to care for her young siblings after her parents' deaths because `there was nobody else to do it.'

Elizabeth's father, who died at 51, had collected taxes at the local market. Her mother, who was 39, had cultivated their plot of bananas, sweet potatoes and cassavas.

Sometimes, when crops are poor and her straw mats are not selling, Nakaweesi must beg neighbors for help. She said that without assistance from neighbors and World Vision--which pays school fees, bought her a bicycle and provides other necessities--she and brothers and sisters would not survive.

Elizabeth works hard to foster a spirit of family teamwork. After her siblings return from school, everyone works in the field before dinner. At supper time, one child fetches water. Another finds firewood. Another picks bananas. Another puts out bowls and eating utensils. Another does the cooking.

But the teenager knows that she cannot replace her parents. When she tries to speak of them, tears will in her eyes. She turns her face to the wall.

`They must be mother and father now,' said Grace Mayanja, a staff worker with World Vision, referring to children in Kakuuto left to raise siblings. `But in their hearts, they're still little girls.'

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