The Vicious Cycle of Aids

19 Sept 2007

By Vida Li Sik

Children, who are orphaned when their parents die of Aids-related illnesses, suffer from much more than an empty stomach.

Mapule* is only 17-years-old, but she has to take care of six children (aged from 10 months to 16 years) all on her own.

Once a month they receive a food parcel from a non-governmental organisation, but they often go to bed hungry.

"The little ones cry. I comfort them and say, 'maybe tomorrow we'll have something to eat.' But I worry a lot, because I never know if that will be the case," she says.
Mapule cannot apply for a social grant because she doesn't have an I.D. book, and she must wait to turn 18 before she can be considered a caregiver.

She only went to school as far as grade eight, and although she'd like to become a hairdresser one day, her responsibilities at home make that a distant dream.

She used to braid people's hair at home, she says. "But I can't do that any more. People refuse to come to the house because I'm always surrounded by little children."
Sometimes Mapule thinks about killing herself: "I want to end my life because I'm sad that my late mother's family won't help us."

When she starts to think this way, she phones a woman from HOPE Worldwide (an organisation that helps orphans and vulnerable children).

"Sis Thembi encourages me and gives me hope," she says.

Other than that, the only adult assistance Mapule and her siblings receive is from a schoolteacher who gives them a little food and money each month. Mapule has applied for an I.D. book, and she hopes things will get better when she can get child grants for her siblings.

When children take on the responsibilities of adults while they are still emotionally and intellectually immature, they can become stressed and anxious, says child psychologist Tanya Robinson.

"Mapule has children depending on her for emotional, educational, psychological and financial support. This puts a lot of pressure on her and it can cause her to feel desperate.

"Children like her can often resort to prostitution or drug dealing to meet their families' needs. Some may end up on the street," she says.

In general, according to a study by Oxford University and Cape Town Child Welfare, the mental health of children orphaned by Aids is worse than that of other orphans and other children.

Aids orphans are twice as likely to be depressed, have post-traumatic stress disorder PTSD), consider suicide and have relationship problems as other orphans.
Their levels of PTSD were similar to children experiencing war and sexual abuse.
A team led by Oxford University's Lucie Culver worked with 1 200 Xhosa-speaking children in the poorest areas around Cape Town during 2005 and 2006.

Lucie presented their findings at the South African Aids Conference in Durban.

She said it is possible for the government to improve the mental health of these children.

"If they have food, education and a social grant, we can reduce their depression and behavioural problems.

"Many carers of Aids orphans are old or sick, and if their health could be improved, the children's anxiety would be reduced," she says.

Besides depression, the orphans in the study had to put up with high levels of Aids-related stigma at school and in the community, which made their post-traumatic stress worse.

The number of South African children who were orphaned by Aids had been estimated at 800 000. According to the Actuarial Society of South Africa, by 2020 there will be approximately 2,3 million children orphaned by the disease.

Lucie's study provides evidence on which the government can base its policy about Aids orphans.

Dr Zola Skweyiya, the minister for social development, has decided to repeat the study in the cities and rural areas of all nine provinces, interviewing about 13 000 children.

The minister says this will give him the evidence he needs to ask the treasury for a very large amount of money for South Africa's vulnerable children.

As one in five of our children will be orphaned by 2015, this study is extremely important.

Lindiwe* is another child facing terrible hardship.

She was orphaned at 10 and lured to Johannesburg, hoping to go to school while living with her mother's friends. Instead, she was physically abused.

She then escaped to the streets where she became a prostitute. The police arrested her five times for not having identity documents, and finally placed her in an orphanage.

Now aged 16, Lindiwe still struggles with thoughts of suicide. But, she says, "I'm thankful I can be a child again. When I look at the little ones' smiles, that gives me hope for the future."

When adults lend a hand it can make a big difference in the lives of these orphans, as in the case of Siyabonga. *

After two years of struggling to look after his younger sister on his own, Siyabonga finally received some help from an aunt.

"She applied for a foster care grant for us. That R600 ($100) a month is the only income we have.

"I get up at 5 am every day to help my sister get ready for school. When I get home in the afternoon, I help her with her homework, cook and do some other chores before I can do my own homework. My aunt goes out to look for work, and although it's good to have her with us, I still worry a lot about our future."

Siyabonga looked after his sick mother before she died. She prepared him by teaching him to cook, clean the house and wash clothes.

She also made him promise to get an education, but that hasn't been easy for Siyabonga. "The other children at school made fun of us when she died. That made me angry and sad," he remembers.

An additional problem is that if a child takes care of others to his own disadvantage, it could lead to resentment and possibly emotional or physical abuse towards the other children, warns Tanya.

*Children's names have been changed to protect their identity.

To see the article as it appeared in Move! Magazine, click on the link below:

The Vicious Cycle of Aids.pdf

Published in Move! Magazine, 19 September 2007. Used with permission from Vida Li Sik.