For children in Mozambique who are orphaned by Aids, burying parents may simply signal the start of their battle with the pandemic. All too often, these orphans also find themselves among those most at risk of contracting HIV.
”There are lots of dramatic stories,” said Beauty Jorge, a community worker at Help Age International, during a conference that was held recently in the capital, Maputo, to discuss support for the elderly in caring for orphans. HAI is an umbrella group for NGOs that assist impoverished older persons.
Jorge said how in Cachembe, a district of about 4 000 people in the northern Tete province, HAI aid workers had tried to help a 15-year-old orphaned girl who came to live there when her grandmother, who was looking after her, died.
”We built a house for her to live in as she had nowhere to go, and no relatives that she knew who could take care of her,” she said.
However, the girl became pregnant this year and had to leave school.
”She told us that a trader gave her 10 000 meticais [about R3] and a petticoat in exchange for a sexual relationship with her whenever he was in the neighbourhood. Since she became pregnant, the trader stopped coming around,” said Jorge.
While community workers continue to visit the girl, they have been unable to help her ascertain her HIV status. According to Jorge, the nearest HIV testing service is a 60 000-meticias (about R15) bus ride away, and there are no funds to send the girl there.
Unhappily, there is a strong chance that she may have contracted the virus: adolescent girls are especially vulnerable to HIV infection in Mozambique. The National Statistics Institute (INE) estimates that of the 130 000 people aged 15 to 19 who are thought to be living with HIV/Aids, 100 000 are girls.
Moreover, HIV is on the increase among the youth: 500 new infections are believed to take place every day, mostly among young people. Mozambique now has a prevalence rate of 15,6% among 15- to 49-year-olds, compared with 14,9% last year — and 8,2% seven years ago.
The government acknowledges that special emphasis needs to be placed on assisting young people, especially orphans. According to the INE, more than 325 000 children and young people under the age of 18 will have lost their mother, father or both parents to Aids by the end of this year.
”We know there is a real problem, and we are taking action,” said Estrela de Jesus Herculano, the head of the department of women and the family in the ministry of women and social action.
In many instances, financial need pushes children into situations where they are more vulnerable to HIV: young women, for instance, may feel that they have little choice but to prostitute themselves. Nonetheless, officials are trying to prevent Aids orphans from engaging in risky sexual activity.
”Behaviour change is slow because people become used to certain behaviours, so we can’t change things just like that. I’ve been talking to my own daughter since she was 14 years [old] about these matters,” said Herculano.
However, ”We have come a long way over the past 10 years,” she added.
In 2004, the ministry of women and social action, with support from the United Nations Children’s Fund (Unicef), established a system that allows all relevant branches of the government to work together, to ensure the best possible response to problems confronting Aids orphans and other children at risk of contracting HIV.
Officials at national, provincial and district level, representing a cross-section of ministries, have joined forces to protect the children against abuse, and to uphold their rights.
The government also set up an initiative called Youth Friendly Health Services in 1999, to provide young people between the ages of 10 and 24 with health services that are affordable and accessible — and which are offered in a non-judgemental, friendly environment. The services include voluntary, confidential testing and counselling for HIV, condom distribution, treatment of sexually transmitted infections, family planning, and education on HIV/Aids and sex.
Peer educators play a key role in sharing information about sexual and reproductive health at the youth services.
”At first, some parents thought we were trying to encourage prostitution, but of course that is not so. Young people find it easier to talk to their own age group and not to use the same health services for reproductive health matters as their parents,” said Herculano.
Along with the provision of health services, keeping Aids orphans in school is of central importance.
A difficult matter at the best of times, this becomes even more problematic when the children are being cared for by elderly relatives who make their living as subsistence farmers.
As the first concern of these care givers is producing enough food, they may often put children to work on their land. Alternatively, the children could be sent out to do other forms of work, which opens the door to exploitation and sexual abuse.
These trends have prompted HAI to assist the elderly with income-generating projects, so that they feel free to send Aids orphans to school. To date, the NGO has helped about 200 000 elderly persons in Tete province and the southern province of Gaza, where poverty, drought and HIV/Aids have placed families in desperate straits.
HAI conducts campaigns in communities to make people aware of the need for orphaned children to continue their education. In addition, it works closely with the local government to make sure that orphaned and vulnerable children are exempt from paying school registration fees and from having to wear school uniforms. The group also provides the children with basic school materials.
The Canadian International Development Agency recently announced funding of almost $1-million for a Unicef programme that aims to ensure that all children are enrolled in school, that they are reached by health services — and that they have access to clean water and sanitation.
Furthermore, the UN World Food Programme has provided food to households with orphans, ”which is also another way of stopping young people and children going on the streets for survival”, said Herculano.
Jorge (56), herself the grandmother of Aids orphans, agreed that school attendance plays a crucial role in ensuring that orphaned children do not follow in their parents’ footsteps. Two of her 11 grandchildren, girls aged 13 and 11 years, could not afford to go to school for two years after their parents died of Aids-related diseases. Now they live with her — and have returned to school.
”I was very worried about them being out of school and what they could get up to,” said Jorge. ”I told them they could play with their friends but they must be careful and be at home at 6pm. I told them that their parents died of Aids. They needed to know.” — IPS