AIDS orphans
Ticking time bomb
[ By Ulrike Block ]
“I see a major problem in store for our nation if we do not look after the orphaned children,” fears Charles Francis, an aid worker with a relief agency for orphans and HIV-infected persons in Dar es Salaam. He speaks of a “ticking time bomb” with large numbers of people who have neither work nor education – and a danger of rising crime rates.
The crisis is about more than the unfortunate fate of many individuals. Any nation’s social peace is at risk if masses of adolescents are traumatised, emotionally neglected and materially disadvantaged because of the death of their parents. Problems are compounded if they get no or only inadequate education.
The AIDS epidemic indirectly affects many children and young people in sub-Saharan Africa. UNICEF estimates that, in 2005, one in eight children in Tanzania under 18 years of age had already lost one or both parents. The number of double and single orphans is rising. It is not just the death of a child’s father or mother which causes problems. HIV typically involves a long period of illness, and parents are usually unable to care adequately for children in such times. All money is spent on the sick.
Traditional safety nets are overburdened. Orphans in Tanzania are traditionally taken in by their extended families, which, however, tend to be over-stretched by now. A family that takes in orphans has less resources for its own offspring. Those with jobs do not earn more simply because they have more hungry mouths to feed. Accordingly, there are more and more street children and households that consist exclusively of children. Often, grandparents take care of orphans.
Institutional facilities are neither capable of fulfilling the emotional and social needs of the children, nor of integrating them into society. In any event, it is impossible for a country of 35 million people to provide institutional care for more than 2.4 million orphans.
In 2001, Tanzania endorsed the UNGASS Declaration of Commitment on HIV/AIDS. The Ministry of Health and Social Welfare intends to meet the respective obligations with the 2006-2010 National Action Plan for Most Vulnerable Children (MVC).
The plan promises change in various areas by 2010. The legal standing of orphans is to be improved; and responsibility for them will no longer be shifted between various government departments. In terms of education, healthcare and social security, support was pledged to households with orphans and other children at risk. Psychosocial support for such children is to be given particular attention. Data will be collected to evaluate the success of the Action Plan. It contains a total of 136 specific measures, ranging from the reform of relevant laws to provision of shoes and clothes to needy children. Objectives, measures, the people responsible, timelines, costs and measurable indicators of success have been defined.
One objective at the household level, for example, is adequate food for orphans. The goal is to be achieved thanks to two approaches. Food will be provided to needy households, which is the task of local Village MVC Coordinating Committees; and the Ministry of Education will make school meals more widely available. Success will be measured by the number of needy orphans receiving food aid and the number of schools offering their pupils a hot meal.
Various bodies will have to bear the costs of implementing the Action Plan. Municipal authorities and families are particularly important, they are supposed to cover 80 % of the orphans’ food requirements. However, the Tanzanian government will shoulder some of the burden too. Aid agencies from Tanzania itself and from abroad are expected to contribute to the Action Plan’s success by providing aid at the household level.
Local decision-making
The basic idea behind the Action Plan is that the best way to help children is for the local community to look after them. For that to happen, a local strategy is needed. Actors at the community level need to be strengthened. Making decisions, mobilising and using resources, and monitoring implementation – all should be done locally.
In line with this principle, the Action Plan focuses on working with, and expanding, established structures. The already existing Village AIDS Committees, for instance, are to support orphans and other needy children, on top of their original health-related tasks. Local authorities in some regions have also begun to support the establishment of Village MVC Coordinating Committees, involving relevant local actors.
In future, democratically legitimate community members, rather than relief-agency staff will decide which children are needy. It is hoped that all involved will assume responsibility for implementation – and not only the families immediately affected and the charitable non-governmental organisations (NGOs). In practice, however, it is proving difficult to assign local responsibility. Many NGOs notice, after caring for orphans for years, that local communities no longer regard those children as their own problem. They consider them a problem for the NGOs.
Success is possible only if all local actors get involved. Gertrude Kulindwa, regional social welfare officer in the Mwanza region, says that introducing this process at the grass-roots level is “a challenge in itself”. In 2006, the authorities in her region convened the various relevant actors and discussed the Action Plan and its measures with them. They thus reached about half of the relevant people.
Unfortunately, reliable and efficient Village AIDS Committees or other community-based agencies are not found everywhere. In many places, there is no resilient social infrastructure. And even if there are some good initiatives, the Action Plan will fail without competent participation of the authorities. In Dar es Salaam, for example, 80 % of the relevant institutions had still not heard anything about the MVC Action Plan last year.
It does indeed take time to set up committees, but it is worth it, says Gertrude Kulindwa from Mwanza. She speaks of “laying a base”. She emphasises that the process belongs to the local communities. If they implement projects, a rigid system of inspection and monitoring will automatically result.
Nevertheless, the Action Plan can only succeed in an adequate public-sector environment. If the governance conditions are not right, no one can assert any rights, and political initiatives will die down without any chance of success. In the past, inadequate coordination within the government led to problems time and again. This is also the case at the regional and local levels. Moreover, coordination with NGOs often left something to be desired, and there were conflicts over responsibility. Some regions were fortunate to benefit from aid programmes more than once, while others missed out completely.
The MVC Action Plan addresses failings of this kind. The paper says that a lack of clear jurisdictions has led to incomplete, precipitous and inconsistent efforts in dealing with the complex problem of the orphan crisis.
The Tanzanian Department of Social Welfare has therefore designed new structures to coordinate MVC programmes, encompassing the national, regional, district and village levels. In addition, an informal body was formed in October 2006, which meets on a monthly basis with the purpose of ensuring that the Action Plan is implemented nationwide. According to Robert Mhamba, senior advisor for the MVC Action Plan, it is an “informal ad hoc forum”, which brings together government representatives and all actors who implement the various programmes. A government representative was elected chairperson, so the accountability of the public authorities is ensured.
Mary Mpangala from the Salvation Army in Kagera believes it is sensible for the Action Plan to look principally at the community’s competence to cope. “There are so many problems in the world, everyone has problems, even the donor countries. We have therefore reached the point where we have to look after ourselves.” Self-help is necessary before aid is sought elsewhere.
It is clear that the government, international agencies and NGOs must support the people and the communes, without undermining their individual initiative. Finding this balance is difficult. But the huge number of orphans means that something needs to happen quickly. “Otherwise society will be destroyed“, believes Kulindwa. “There are so many of them that we cannot ignore them. We must accept our responsibilities.”