Millions of AIDS Orphans Strain Southern
By SHARON LaFRANIERE
CEMENTO, Mozambique - On the day last July that he and his
wife died of
AIDS, 36-year-old Samossoni Nhambo leaned up from a hospital
bed a few miles
from this dirt-road village of thatched huts and asked his
despairing question: who would take care of his children?
Five months later the answer is glaringly obvious: no one.
Three-year-old Fátima died in early December, perhaps from
from malnutrition. Five-year-old João, infested with worms
that have reduced
his toes to red stumps, can walk only on his heels. His 7- and
brothers, Ricardo and Samsoan, are covered with dime-size
sores from scabies
mites, which infect the entire family.
Sixteen-year-old Maria, who dropped out of school to care for
parents, was pregnant by a man whom she refuses to identify,
and in early
December she gave birth to a boy.
That leaves the eldest, José, a slim, short 17-year-old who
seventh grade, as the surrogate father. In their half-built
stones and sticks on the bad side of a poor village, with no
walls and a
single cane chair for furniture, the Nhambo children reel from
"Life is very difficult," José said. "No food,
no clothing, no bed covers.
We have to struggle."
So do millions of others like them. Southern Africa is
increasingly home to
children like the Nhambos, robbed of their childhood by AIDS
under adult-size hardships.
The United Nations Children's Fund estimates in a new report
that 11 million
children under 15 in sub-Saharan Africa have lost at least one
AIDS. About a third of them have lost both parents. By 2010,
predicts, AIDS will have claimed at least one of the parents
of 15 percent
of the region's children - 20 million in all.
The social implications are enormous, Unicef and other relief
say. Orphans are more likely to drop out of school, to suffer
malnutrition, to live on the street, to be exploited by
adults, to turn to
prostitution or other forms of crime and to themselves become
H.I.V., the virus that causes AIDS.
African social traditions dictate that relatives should take
them in. But
AIDS has pushed so many families to the brink that the
surviving adults are
beginning to turn away their young relatives. An aunt and a
down a dirt path from the Nhambos, but the grandfather says
neither can help
So far, governments have done little either: of 40 sub-Saharan
by the AIDS epidemic, only six have plans in place to deal
Unicef says. Their sheer numbers, plus the state of African
make even the simple act of registering orphans so that they
can be exempted
from school fees an enormous task. In countries like Zambia
only 1 in 10
births is even documented.
For Mozambique, a nation nearly twice the size of California
along the Indian Ocean coast, orphans are not a new
phenomenon. When 17
years of civil war finally ended in 1992, hundreds of
thousands of children
were left without one or both parents.
But AIDS has sharply multiplied their ranks. Now, in a nation
of 18 million,
16 percent of the children - more than 1.2 million - are
already missing at
least one parent. AIDS is responsible for the plight of a
third of these
children, according to Unicef.
Maria Cemedo, an official of an agency that serves women and
Sofala, the region where the Nhambo children live, said an
was being lost. "We may become a society of old people
and children," she
Sofala, in Mozambique's narrow center, has been particularly
because it has both a port and a major highway running to
combination of poverty-stricken women and lonely truckers
spreads the AIDS
virus all along the corridor. Now 1 in 4 adults in the
province is infected.
Of the 46,000 registered orphans in the province, said Antônia
agency's director, few receive any government help. Fewer than
obtain food through the World Food Program, she said.
"It's a shocking situation," she said. "It is
not clear how some of these
children survive from one day to the next."
Group homes are one possible solution. But as yet, few exist
government's only orphanage - by far the largest in this
region - houses
just 78 boys and girls. Paula Salgado, its energetic
coordinator, said 16
H.I.V.-infected children were housed this year at the airy
by the ocean at Beira, the nation's second-biggest city. Only
One of them, Mavis, 5, was taken to the center by government
workers in late
October, weighing just 24 pounds and suffering from
parents were dead, apparently from AIDS, and her 15-year-old
reduced to begging for food from neighbors, Ms. Salgado said.
Although the institution lacks the money to buy the
needed to prolong Mavis's life, her health has improved in her
six weeks at
the orphanage. But she has yet to smile, Ms. Salgado said.
During a visit,
she refused to accept a cloth doll or to acknowledge a guest
who stopped to
button her dress.
Such stories of separation and suffering seem as common as
mango trees here.
Sixty miles away, in the village of Nhamatanda, Jorge
Danielle, 15, said he
had cared for his two younger sisters for four years after his
died of AIDS.
Then, quite recently, a couple who claimed to be friends of
his dead parents
took the 9- and 12-year-old girls away, he said. He now lives
alone in an
8-by-9-foot hut and survives on handouts of rice and the
pennies he earns by
carrying parcels at the local market.
"They told me, `We cannot feed you too, so you must fend
for yourself,' " he
said. "I am very sad because they are far away from me.
Now I am always
Amador Ernesto Luís, a volunteer with a Unicef-financed
relief group called
Asvimo, said he feared that the two girls had been taken away
for labor or
prostitution. But without relatives to care for the children,
and in the
absence of government help, he said he was powerless to stop
The Nhambo children remain together. But there are few other
Their hut was always on the bad side of Cemento, far from the
the single hand-pumped well that serves 600 people. The
Nhambos fed their
children rice and sweet potatoes they grew in a tiny kitchen
Mr. Nhambo never held a steady job. His wife, Caterina Tole,
held the family
together with her industry and love for her children, said José
Christian Evangelical pastor who knew the family well.
"She had great love
for her children," he said. "She was very
conscientious. The house was
clean, clean, clean - right up until the day she could no
Their family life began to fall apart five years ago, when
left to live with the wife of a deceased uncle. When he
returned, in 1999,
José said, he and Maria, the eldest children, were not happy
to see him.
Nor was his mother, he said. "They very seldom
spoke," he said. "My mother
would cook for herself and the kids, and my father would cook
his own meal."
In African culture, women are obliged to meet their husband's
and so Fátima was born within a year. Later, Mr. Missasse
recognized the symptoms of AIDS in both parents and the baby.
He said he had seen Caterina Tole a month before her death.
forgave her husband," he said. "She said, `I am
going to die because of him
and leave my children alone.' She was very angry. I would tell
her, `God may
send someone to care for your children.' But it would end with
Ms. Tole died on a mid-July morning, stretched out on the dirt
floor of her
neighbor's mud hut. Mr. Missasse told her husband of her death
as he lay on
a cot in a clinic with broken windows and dark halls that
serves as the area
hospital. Stricken with remorse, Mr. Nhambo told Mr. Missasse:
have been better if I died first." Six hours later he
With heavy sticks, rocks and corrugated iron donated by Asvimo,
built the children a basic open-walled shelter to replace
their tiny reed
hut, which had collapsed. But no one offered to feed the
children - not
their mother's sister, who lives with her own seven children
about 50 paces
away, nor their widowed grandfather, a frail 70-year-old in
The children eat one meal a day of corn porridge, along with
70 other needy
children at Mr. Missasse's church, a half-hour's walk away.
They also get a
110-pound bag of rice monthly from the World Food Program, and
in the summer
they pluck mangoes from the tree that shades their hut.
The younger boys share one toy - a metal car they built out of
bits of wire
and beer cans. Their few clothes are filthy. Mr. Missasse said
there was no
hope for João's fly-covered feet because the children could
medicine nor cleaner living conditions.
José said he had planned to carry Fátima two miles on foot
to the nearest
doctor when he woke up on Dec. 10, surprised she had not
aroused him as
usual with her crying. Neighbors buried her in an unmarked
grave between her
Exactly a week later, Maria delivered a baby boy, and the
scramble to feed
another mouth began.
Dr Rana Jawad Asghar
Program Manager Child Survival, Mozambique
Provincial Coordinator Sofala Province, Mozambique
Health Alliance International, Seattle, WA, USA
Coordinator South Asian Public Health Forum http://www.saphf.org