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Since the first rumors of AIDS twenty years ago, AIDS has killed over 20 million worldwide, with the majority in Africa, and has left 14 million orphans worldwide, 11 million of those in Africa. Over 40 million people are still living with the virus. According to the United States government, Zambia and South Africa (countries representative of sub-Saharan Africa) have a 19.95% HIV adult prevalence rate as compared with 0.61% prevalence in the United States. While these statistics are of themselves overwhelming, the ramifications of AIDS are far reaching, extending beyond the death toll.


In the international community’s well-placed zeal to find a cure, the devastating impact upon two age groups is often overlooked. Because the vast majority of deaths occur in the young and middle adult population, AIDS leaves in its wake a destitute population of children and the elderly, which are now being referred to as “bookend” generations. A staggering 47.1% of Zambia’s total population is under the age of 15 compared to 21% in the United States. A study conducted by UNAID, UNICEF, and USAID reveal that 13 million children currently under the age of 15 have lost one or both parents to AIDS, with the majority of cases occurring in sub-Saharan Africa.


The task of caring for orphans falls upon impoverished and unprepared communities. Ignorance about AIDS within the region exacerbates the numerous challenges and hardships facing AIDS orphans. Children witnessing the suffering and painful death of their parents, and losing their source of security and comfort, suffer from depression, stress, and anxiety while simultaneously facing social isolation and stigmatization that often accompanies a family stricken with AIDS. Significantly at higher risk of HIV infection, emotionally vulnerable and financially desperate, orphaned children are more likely to be sexually abused and forced into exploitive situations –such as prostitution—as a means of survival. In Lusaka, the capital of Zambia, approximately 75,000 children live on the street. Children as young as 12 are left to care for their younger siblings. Orphans fortunate enough to have adult supervision by relatives are, nonetheless, the first ones denied education and, more often than not, work 40 hours per week. UNICEF reports that 68% of rural and 32% of urban orphans are not enrolled in school.


The health of orphans is greatly in jeopardy. The World Bank reports inordinately high levels of malnutrition and a 50% rate of stunted growth in South African children. Preventable illnesses are often untreated and immunizations are not administered to healthy orphans due to community assumptions that the children carry HIV. In short, millions of Southern Africa’s children suffer from stigmatization, sexual exploitation, and inadequate education. AIDS prevention education, medical care, supervision, and emotional and financial support are sorely needed.


The impact of AIDS on the elderly is of no lesser importance. Although the elderly have increased needs caused by aging, they now bear the primary burden of caring for orphans. Financially dependent upon their families, many elderly people not only face a loss of support due to the death of their children but are additionally burdened with the responsibility of grandchildren. A UNICEF survey confirms that the majority of caregivers are women, widowed and over 50 years of age. While capable of supervising children and providing desperately needed emotional encouragement, the elderly are incapable of supplying the necessary financial infrastructure to sustain themselves and children.


According to Dr. Peter Piot, former executive director of UNAIDS (the joint United Nations program on HIV/AIDS), the AIDS pandemic is also having devastating consequences on national economies in sub-Saharan Africa. The deaths of a majority of the working population have drained human resources at an alarming rate and this loss of workforces impedes sustainable development. A high percentage of the most able-bodied, motivated, and educated workers are no longer available, distorting labor markets and disrupting production and consumption. Ultimately, the lack of a healthy adult workforce diminishes national wealth, increasing the already high poverty rate.


An enormous effort by the international community is urgently required to resolve this ever-increasing crisis on all fronts. At present, efforts of governmental, intergovernmental, and non-governmental organizations have minimal impact on Southern Africa’s orphans and elderly. In Zambia, volunteer associations, churches, and NGOs are overwhelmed, reporting a lack of coordinated efforts and they’re only able to assist 7% of those children requiring aid. This is the largest crisis facing the world – an extensive and immediate response is needed.


Agathos International is currently involved in several programs with World Concern and others to assist local communities in these issues, providing pastors with training, medications as well as emergency food relief in areas affected by drought and famine.


Click here for a UNICEF report on the orphan crisis in Africa.

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