Imagine this You are from a country that is already one of the poorest places on the planet - with over half of the population unable to afford an adequate diet, even if they spend all their income on food. More than half a million children do not have access to primary education, and this number is on the increase. Thousands of children die every year due to not having access to basic health care. It couldn't get any worse . . .
Or could it ? Suddenly, people in your country start dying from a new disease - young women and men, mothers and fathers, teachers, nurses and business-people. The overall life expectancy plunges from an already miserable 54 years to 37 years. Health facilities are stretched to breaking point - and government staff die faster than new trainees can replace them. Business and agricultural productivity slumps due to absenteeism and the loss of productive labour, and this is on top of the new costs associated with steeper health care and funeral costs. One in five adults become infected with the killer virus but don't know it. As these adults die, their children are condemned to a life of poverty as orphans.
This nightmare scenario is no imaginary Armageddon. It is modern day Zambia which has been hit by the full wrath and fury of HIV/AIDS. The groups that are arguably the most vulnerable and the most adversely affected by the epidemic are Zambia's children and youth. There are approximately 600,000 orphans in the country and that figure is expected to rise to over one million by the end of 2001.
In the absence of functional public health or social welfare systems, Zambian communities have been forced to rely on themselves and the usual coping strategies that they have always drawn upon when times are hard. Despite the already crushing burden of poverty that most families are faced with, almost three-in-four households have taken at least one orphan into their care. It is becoming rare to meet a Zambian adult who is not providing support of some kind to orphaned relatives.
AIDS is generating orphans so quickly however that family structures and traditional safety nets can no longer cope. Families and communities can barely fend for themselves, let alone take care of orphans. In most parts of rural Zambia, old people are left to care for the young, and many children are left in charge of their own households. According to UNAIDS, such orphans are at a great risk of malnutrition, illness, lack of access to education, abuse and sexual exploitation. They must also grapple with the stigma and discrimination so often associated with AIDS, which can serve to further deprive them of basic social services and education.
While the Government of Zambia has taken a number of steps to mitigate the impact of HIV/AIDS, it is the local NGO (non-governmental organisation) sector, which has been at the forefront of addressing the problem, particularly in relation to programmes targeted at orphans and vulnerable children. These NGOs have supported a wide range of HIV/AIDS related activities such as advocacy, peer education, orphan care and home-based care.
One such organisation is CINDI Kitwe, a local Zambian NGO, which has received support from Ireland Aid for a number of years. CINDI is short for 'Children in Distress' and works in most of the townships of Kitwe, the capital of Zambia's Copperbelt Province. CINDI-Kitwe's core programme is to register the orphans, identify their needs, act as their advocate with local authorities, and help and encourage communities to look after the orphans within the community so that these children can grow up in as normal an environment as possible.
Already CINDI-Kitwe has close to 15,000 orphans on its books of which 65% are girls. With a small staff and a large dependence on community volunteers and 'community spirit', the organisation is determined to find homegrown non-institutional solutions to the orphan problem in Kitwe. There is a realisation that sufficient resources just do not exist to even think about institutional care for these children. In any case, CINDI believes that the provision of support to potential caregivers is a more sustainable longer-term solution than orphanages or other forms of institutional care.
In addition to identifying vulnerable children and ensuring their access to adequate health care, education, emotional and material support, the organisation has also recognised that it has a role to play in preventing the further spread of HIV/AIDS. To this end, a significant amount of resources are targeted at school-based information, education and communication interventions.
It is also quite likely that the work of CINDI-Kitwe has an impact beyond the direct target group of orphans and vulnerable children in Kitwe. The high profile that the organisation enjoys both in Kitwe and throughout the country, and the manner in which it has managed to galvanize support from all sectors of society (church, private sector, community) has, in itself, raised public awareness of the devastating impact of HIV/AIDS. This is worth reflecting upon, as Zambia is in urgent need of new creative ideas about how to get the AIDS message across in a way that will result in actual behavioural change.
The progression of the HIV/AIDS virus is directly influenced by social behaviours that are part of local cultures and contexts, and sustained societal behaviour change usually comes as a result of shared social reaction. Such a reaction may occur when the level of infection becomes highly visible along with a clear perception that deaths are attributable to HIV/AIDS. According to recent research, the emotional impact of the disease may trigger a series of reactions in the community, as many people begin to realise that the virus poses a real threat, and that they and their families are at serious risk.
The highly visible work of CINDI, which uses a variety of strategies to raise and maintain public awareness of the gravity of the orphan problem in Kitwe, is likely to have a greater impact on community consciousness of the problem than any number of information posters, pamphlets or condom campaigns. The sheer spectre of 15,000 children orphaned by this virus in one town, and the promotion, by CINDI and others, of social collective responsibility to deal with this problem within the community, may in fact serve to build real momentum for a greater understanding and response to the terrible challenge posed by HIV/AIDS in Zambia.