ANALYSIS

The future appears to hold little hope for the children of central Africa trapped in a world of horror

AIDS orphans receive a hot meal at a day care center in Kibera, one of the largest shantytowns in Nairobi, Kenya

By Joyce Maxwell
Special to CNN Interactive

NAIROBI, Kenya (CNN) -- I was so struck by a story last September in the local newspaper, Daily Nation, that I clipped it for my files. To me, it captured the hopelessness of the AIDS tidal wave facing Africa's children.

A photograph accompanying the story moved me in particular. The picture shows a woman named Veronica and her newborn daughter. Veronica's baby looks calm and alert, loose curls framing her face. Her long fingers curl under a chin tucked into a soft, fringed blanket.

Beyond the blanket, the baby's world looks much less secure. Her mother's dejected hands barely keep her from sliding off her blue cotton lap. Her mother's face is lowered, eyes avoiding the camera, and avoiding her daughter. Her mother's forehead is concentrated in a confused frown.

Clearly unhappy about having her photo taken, Veronica seems resigned to this intrusion only because she doesn't know how to make it go away.

According to the newspaper story, the baby was conceived when Veronica was raped, and infected with HIV, in an AIDS cleansing ritual in western Kenya. Veronica's baby, yet unnamed, will be affected by AIDS her entire life.

Children face a double threat

AIDS in Africa touches children in two ways -- as a disease that kills their parents, leaving them orphans, and as a disease that infects children themselves.

Ten percent of the world's people live in Africa, but it is home to 90 percent of the world's HIV-infected children. In sub-Saharan Africa 470,000 children die every year from AIDS. For more than 90 percent of these children, the deadly virus is transmitted from their mother.

Of 30 children born to HIV-positive mothers, approximately 10 will acquire the virus simply by being born. Another four will become infected from breast-feeding. Most of these children will not live to see their 5th birthdays.

In Tanzania, a sister and brother stand between the graves of their parents who died of AIDS

Children also become infected through sexual contact. Among young people, girls have higher rates of infection than do boys of the same age. One study found that among youths under 20, for example, for every HIV-positive boy three to seven times that many girls were infected.

Veronica, like many other girls, was infected by a man convinced that having sex with a virgin would cure him. This cruel myth is being perpetuated across Africa. In a bid either to avoid or to cure their HIV infection, men are targeting younger and younger girls as sexual partners, willing or not.

Girls also may agree to exchange sex for favors, or more typically, for payment of school fees.

Extended families overextended

In Africa, where medical care and drug treatment for HIV/AIDS is unaffordable for most individuals, families and governments, an HIV-infected person can expect to live six to 10 years before dying of AIDS.

More than 5.5 million children in eastern and southern Africa, at the epicenter of the epidemic, have lost their mothers or both parents to AIDS.

A woman whose husband died of AIDS washes dishes outside her house in Lusaka, Zambia. She sells vegetables to support her three children.

The existence of orphans is not new. Orphans in Africa are by tradition absorbed into extended family networks. With the advent of AIDS, however, the extended family has become overextended.

AIDS has by now orphaned 9 percent of Zambia's children. In Zimbabwe 7 percent are orphans; in Malawi 6 percent. Eleven percent of Uganda's children are AIDS orphans, the highest percentage in the world.

The numbers continue to grow. In the hardest hit countries the number of AIDS orphans quadrupled between 1994 and 1997.

AIDS orphans suffer on many levels. They may need to drop out of school to care for a dying parent or to care and provide for younger siblings. They are likely to have been exposed to tuberculosis and other opportunistic infections plaguing an HIV-positive adult.

They may be sent to live with relatives, all too often a grandparent already catering for grandchildren from three or four families.

An orphan is even more vulnerable

Orphans are less likely than are other children to be able to go to school or to have access to adequate health care. They are more likely to live in poverty and to be malnourished.

They are more likely to engage in hazardous labor, including commercial sex work that in turn exposes them to greater risk of HIV infection.

Orphans in some cases have no choice but to form child-headed households in which older children raise their younger brothers and sisters. Child-headed households are among the most economically vulnerable in Africa.

Orphans are more likely to live in communities in which services and institutions have been weakened by HIV/AIDS and they are more likely to suffer from psychosocial problems.

Young people already make up the majority of the population in sub-Saharan Africa. As adults continue to die of AIDS, the children are left behind in a vacuum deprived of parental guidance -- a sea of youth, disadvantaged, vulnerable, undereducated, without hope and opportunity.

Will Veronica's daughter become part of this "lost generation"? She need only to look at the confused but resigned frown on her mother's face to get a glimpse of what the future holds for her.

The author, Joyce Maxwell, lives in Nairobi, Kenya. She is a consultant and publishes materials related to development. She grew up along the shores of Lake Victoria in East Africa and has lived there and in Ghana as an adult. Her husband is Daniel Maxwell, Ph.D., a food security consultant for CARE-International. She has two children, Patrick and Clare, one of whom was born in Uganda.