United Nations Children's Fund (New York) - April 8, 2003

Now half of the children in Makete district have lost either one or both parents due to HIV/AIDS. You can now find places with no adults left at all - only child-headed households or houses full of children being looked after by some elderly grandmother. Now, even young girls from 12 and onwards have to walk for days across the mountains to look for some labour opportunities in the plantations to enable them to look after their younger brothers and sisters.

Often they return home, raped and infected. The situation is truly desperate.

This is not an isolated phenomenon. All over Eastern and Southern Africa we witness these situations with rapidly growing orphan populations because of HIV/AIDS. We know that there are now some 13 million AIDS orphans in the world and that 12 million of those are in sub-Saharan Africa. This rapid increase of children orphaned or made vulnerable because of HIV/AIDS is affecting the traditional ways of caring and protecting children who have lost their parents.

Almost throughout sub-Saharan Africa, there have been traditional systems in place to take care of children who lose their parents for various reasons. But the onslaught of HIV slowly but surely erodes this good traditional practice by simply overloading its caring capacity by the sheer numbers of orphaned children needed support and care. HIV also undermines the caring capacity of families and communities by deepening poverty due to loss of labour force and high costs of medical treatment and funerals.

Some scientists have started to articulate this process through the concept of effective dependency ratio, EDR. For example, you have the common situation of two parents caring and supporting four children. If the father falls ill due to HIV, he will be unable to work. Instead, he usually ends up requiring quite extensive care from his wife and the rest of the family. He, therefore, becomes a new dependent and a single parent now has to support 4+1=5 dependents. Maybe then, the sister of the mother dies and she has to take over her 4 children. So in this case the dependency ration changed from 4 over 2 to 10 over 1 within a rather short period.

The effect of this HIV/AIDS-induced process is gradual but usually rapid erosion of the social, economic, and emotional security of the children affected. We should also remember that the above process of losing parents to HIV/AIDS for the children often include the pain and the shame of the stigma and the fear the disease carries in most of our societies.

Ethiopia, according to the report we are here to review, is in a comparatively early phase of the process of how children orphaned and made vulnerable by HIV/AIDS are losing their care and support. Most of the children covered by the report are still 'adopted' into extended families. However, a significant number of them are starting to feel 'not loved', not given education or health care or even food. Based on experiences from other countries we should not believe that this is a stable 'Ethiopian situation'. What is likely to happen is that the number of children needing care and support will continue to increase and the capacity for the fostering families will continue to be inadequate. At some stage, the children will start running away or their foster parents will feel forced to send their foster children into hazardous labour or other chores to increase the family income. Or the foster parents, themselves, may fall ill.

What we will see repeating itself is the familiar picture where the increase of HIV infections in the population will be followed: after a period of 5-10 years - of an increase in AIDS orphans and then - after additional 5-10 years - the full social impact with the breakdown of social services, governance and safety nets, what we now notice in many southern African countries.

What do we do? In Tanzania, we agreed that two fundamental 'capacities' have to be there in order to provide a minimum caring 'safety net' for children made vulnerable by HIV/AIDS:

A child 'minding' system (persons or institutions) that identifies and monitors children's vulnerability and that tries to ensure that they are cared for, sent to school for example. A 'response capacity' that can be called upon to meet the special needs of the child when the capacity of the minders or fostering parents is not sufficient.

The response has to be community-based by definition. Furthermore, we have to build upon existing practices. In most African communities I know of, there are always some people - normally some mature woman - who is both expected and accepted to intervene in case a child seems to face problems. Regarding a community-based 'response capacity', I understand that here in Ethiopia you have a system of idir which can be drawn upon when community members need it. I am sure that the approach to follow will need to be adapted to different cultural settings in the country, but I think that the basic two 'capacities' still will apply.

Regarding institutional care, we know that it is very difficult to achieve a good caring and loving environment for the orphaned children. We also have to recognize that there is no chance to provide places for all the millions of children that we know will become orphaned by the HIV/AIDS pandemic over the next 5-15 years. Still, we should not condemn orphan care in good institutions.

They will play an important role for a large number of children who can't find any fostering arrangements in their communities or families.

Most importantly, we have to realize that the human, economic and organizational resources needed to address the problem of children orphaned by HIV/AIDS will be very huge. I hope that this meeting, after three days of deliberating, will agree on the key issues we need to address, and provide ideas on what strategies to follow. I would especially like to thank our colleagues from the Ministry of Labour and Social Affairs (MOLSA) for their continued collaboration on this issue and the Italian Government for their generous support of this study.

I finally hope and trust that we will all agree that we have to start now.

Thank you.

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