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The impact of AIDS on families in Africa: How do we deal with the catastrophe?

Derek James is Director of SOS Children's Village in Botswana

When one has been in child care and education for over 30 years and in business for seven, it makes one squirm when newly trained social workers, managing directors of companies, and university lecturers tell you that such and such a model of child care is outdated, or cruel, or completely wrong. Don’t mention an institution, as if it is a swearword.

We, in the child care field and at the coal face, are often confronted by such arrogance and ignorance on the part of most politicians, self-styled experts, and civil servants who claim to know how to care for children, but surely we don’t expect it from Community Development Officers, social workers, and top people in international NGOs and Aid agencies.

To be frank, we know that there is no perfect system of child care — even stable families headed by priests can find their children in jail when they are 20. We hear that even some Catholic priests and scout masters abuse their servers or charges. The much maligned institutions and orphanages have good and bad methods, as do many scoutmasters and priests! The successful foster care and adoption services are impressive but the unsuccessful ones are not mentioned. The home-based care system works sometimes, but more often these days it fails!

Our perhaps misguided "respect for other cultures" leads us to think that "ubuntu" and the "extended family system" are so impressive, but in truth these concepts are theories useful in discussion, but not often present in reality. Cultures are in a constant state of flux and should not be blindly respected. Trying to be politically correct and or bending over "blackwards" not to offend other races, is insulting to those who are doing good work regardless of their colour.

What is the reality in Southern Africa? Ms Carol Bellamy, UNICEF Executive Director, put it plainly and unambiguously: "Today over 11 million children in Africa are orphaned, many millions more are living in families touched by HIV/AIDS, nearly 3 million children today living with AIDS in Africa, and the pandemic steamrolls on with over 7 000 children and young people being infected daily. If this situation is not addressed and not addressed now with increased urgency, millions of children will continue to die and tens of millions more will be further marginalized, stigmatized, malnourished, uneducated, and psychologically damaged."

The answer is not as simple as "home-based care" or adoption or orphanages or villages or whatever, but perhaps a combination of these will prove the way to go.

Note also what Ms Bellamy says about African solutions: "Traditional African strengths such as the extended family and community structures are collapsing under the weight of HIV/AIDS. Let me be frank: Families and communities in many parts of Africa are no longer coping."

In Botswana where I work, home-based care is not working in the majority of cases, and the extended family is dead or dying. We have 60 000 orphans and close to 40% of the sexually active population is HIV positive. We have close to 100% of our hospital beds filled with AIDS patients. Unless there is behaviour change the country will be importing thousands of expatriates to keep the economy functioning. Other countries like Zimbabwe and South Africa are in similar positions, but their counting and record keeping is worse than in Botswana, which has a small population and reasonably accurate statistics.

Here in Botswana we are opening new institutions (one partly funded by a previous Miss World, Mpule Kwelagobe) and we have so-called child havens, Houses of Hope, SOS Children's Villages, Catholic and Anglican child shelters, home-based care givers, foster care and adoptions. All will be needed as the full effect of the AIDs catastrophe becomes felt by the children.

Let us stop theorizing about the best methods and instead use our skills to address the situation in every possible way. We are in a "war situation," not one which needs to be analysed by "experts" whose theories are fashionable for a particular time or place. The average life expectancy in Botswana, Malawi, Mozambique, Zambia and Zimbabwe will soon be below 40 years of age, and that of South Africa, Namibia and Kenya is already below 50. There will soon be millions of orphans and only thousands of old people in our region. The middle-aged are dying. As President Mogae of Botswana said: "There is a drought of good governance in the region." He did not elaborate, but all of us have to become worthwhile leaders, and when we look around us with honesty we must admit that most of our existing leaders are selfish or senile or stupid!

As leaders in child care, let us take every opportunity to create shelters for the children who are our present as well as our future.