Article: Congressional Panel Seeks Ideas on Helping AIDS Orphans

17 April 2002

Article: Congressional Panel Seeks Ideas on Helping AIDS Orphans

Lawmakers alarmed by prospect of 44 million AIDS orphans in 2010

By Charlene Porter
Washington File Staff Writer

Washington -- More than 34 million children around the world have lost one or both parents to HIV/AIDS, according to a U.S. government study. As the disease continues to spread through many countries, officials project that 44 million children will be orphaned by 2010. The House International Relations Committee considered those sobering statistics in a hearing April 17 and heard a variety of proposals on how the United States might help educate, nurture and provide for the abandoned and suffering children.

"The street kids, the broken families, severed communities and fallen economies could swell into a tidal wave of instability across Africa and beyond," said Republican Committee Chairman Henry Hyde of Illinois. "We have already come to the gruesome realization that this scenario creates an enabling atmosphere for religious extremism and terrorist activity."

Hyde was a leading sponsor of the Global Access to HIV/AIDS Prevention, Awareness, Education, and Treatment Act of 2001, passed by the House of Representatives late last year and now pending before the U.S. Senate. The legislation would increase U.S. funds devoted to combating HIV/AIDS as an international public health threat. The current Bush administration budget proposes $13,000 million for HIV/AIDS - to be distributed among domestic and international programs for prevention of transmission, support and care of patients and ongoing research efforts.

California Democratic Representative Tom Lantos cosponsored the legislation with Hyde, reflecting the broad bipartisan support with which the measure passed. Lantos said at the April 17 hearing that the mounting number of orphans and other children made vulnerable by the HIV/AIDS pandemic is overwhelming the villages and extended families that would traditionally care for them in the event of any other crisis.

"There is no doubt that caring for children in family and community settings is consistent with African social and cultural norms that have been cultivated over the centuries," Lantos said. "While there is no single 'best practice' that fits all countries, all children and all needs, it is safe to say that the African tradition still favors extended family or other families within the kinship network as the primary caregivers for orphans and vulnerable children."

Lantos said he supports the strategy being pursued by the U.S. Agency for International Development (USAID), which is providing support for 60 projects in 22 countries for youngsters affected by HIV/AIDS.

"The fundamental principle underlying our programs for children affected by AIDS is that children are best helped by keeping them within a family environment," said Dr. E. Anne Peterson, assistant administrator for global health at USAID. Rather than waiting until children are orphaned, Peterson said some of USAID's projects work to prolong the lives of HIV/AIDS parents and minimize the disruption of family life caused by the disease. USAID programs work to insure that children do not suffer from hunger and lack of education as disease saps household resources.

Communities offer the next safety net for children whose families have been devastated and impoverished by disease, Peterson said, and USAID programs also work to strengthen that traditional system for coping with tragedy and loss. She said the agency's programs provide direct assistance to communities in some cases, and in others, to nongovernmental organizations (NGOs) that are mobilizing community efforts.

"Communities that have organized themselves to protect and care for vulnerable children are able to determine which children and households are most vulnerable and to channel outside resources to those most in need," Peterson said. "They are also able to identify and reintegrate those children who have slipped through the primary safety net back into families and communities."

Establishing institutional homes for orphaned and HIV-infected children is another idea for caring for needy youngsters, but Peterson doesn't think it's a strong option for developing countries where communities have provided traditional social safety nets. She told the committee that international children's welfare organizations have found that children raised in institutions have a difficult time adjusting to society in adulthood because of their isolation from the traditional community bonds.

Another respected figure involved in this humanitarian work disagrees. The Reverend Angelo D'Agostino is the medical director of the Nyumbani Orphanage of Kenya, an institution he founded in 1992. It is home to 75 children who are receiving an education, HIV/AIDS medication, if necessary, and other social and psychological support. The Nyumbani Orphanage also supports a foster care program in which children are placed with families in the community, but may not receive all the same benefits of education and medical care.

D'Agostino told the committee the orphanage is the better system. "Some critics do not agree and believe that the community should absorb the children," D'Agostino said. "Mr. Chairman, that alleged community, in Kenya at least, is rapidly dissolving. With 900 deaths a day, that community is overstretched in its ability to survive."

D'Agostino proposes another form of group care not only for orphans and vulnerable children, but for another overlooked group -- the elderly. D'Agostino proposes "Villages of Hope" where youngsters and oldsters, whose ties to traditional family support systems have been severed by disease and social upheaval, might live together in a mutually supportive arrangement.

As various options are considered, research indicates that good intentions could prove damaging to children whose lives have been affected by HIV/AIDS. The Population Council, a research-oriented NGO, has found that the stigma of the disease is still very strong in the developing world despite widely acknowledged statistics that show how the AIDS toll is continually mounting. Laelia Zoe Gilborn told the committee that researchers have found people are still secretive about revealing their HIV status.

"Community programs can spend valuable resources on elaborate systems of identifying AIDS-affected children, only to further label them and to leave behind other vulnerable children," Gilborn said. She urged the committee to support programs that provide help to all vulnerable children.