Africa Takes Small Steps To Help `AIDS Orphans'

UP a dirt path, past a banana field at the edge of this crowded capital city, is the small mud-walled home of seven orphans. Their father left the family years ago; their mother died in 1991. She had been diagnosed with AIDS.

The problem of ``AIDS orphans'' is acute in sub-Saharan Africa, where in recent years the disease has spread rapidly in a heterosexual population. More than half of all reported cases of AIDS - 8 million of 14 million worldwide - are in the region, according to the World Health Organization (WHO). Meanwhile, Africa's traditional ``social safety net,'' the extended family, is already strained from a declining economy.

Outside agencies and governments are just beginning to address the growing needs of healthy but abandoned children, as well as the more complex needs of orphans diagnosed as having contracted the AIDS virus from their mothers.

``It's getting worse,'' says Beatrice Uzamureba, a social worker here in the Rwandan capital, referring to the increasing number of AIDS orphans and the growing inability of surviving family members to take them in.

``Families are collapsing ... onto the [surviving] grandparents or brothers,'' says Neill McKee, a United Nations Children's Fund (UNICEF) official based in Nairobi, Kenya. In countries like Uganda, the problem ``is becoming a crisis,'' he adds.

Public-health experts from the United Nations, the United States, and Africa urge that families taking in AIDS orphans be given food, clothing, and money. Otherwise, the children may end up in overcrowded institutions or on the streets.

But the orphans living here by the banana field are being helped to stay together as a family. Caritas, an international Roman Catholic charity, pays the monthly rent, about $20, on their home and on several others.

Several of the older children have found casual jobs, and the money allows the younger ones to continue going to school.

``I'm doing a little business,'' Tereza, 20, says. She sells bananas and tomatoes at a local market. She is the second-oldest of the orphans, who range in age from 8 to 25 years old.

As Tereza talks, her brothers and sisters arrive and sit with her on one of the reed mats laid on the dirt floor. The tiny, two-room home has only two beds, so some of the children must sleep on the mats. The house, typical of many in Africa, has no electricity or running water.

Often, AIDS orphans cannot afford school fees. To help them, African schools need to provide ``cheaper educational programs and more practical training,'' says a recent report from Panos, a research institute in London.

Some churches and other private organizations are helping AIDS orphans, but their efforts are minuscule compared with the size of the challenge.

The Rev. Michael Decombes, head of the Kigali office of Caritas, estimates there are some 90,000 AIDS orphans in the greater Kigali area. The figure strikes Nairobi-based Bill Martin of the US Agency for International Development as plausible, given the high percentage of people in Kigali who test positive for the AIDS virus.

The Rwandan government reports that among pregnant mothers in contact with clinics, about 2 percent in rural areas and 27 percent in the Kigali area were diagnosed with the AIDS virus in 1992.

In Tanzania's worst-affected area, Kagera, UNICEF estimates there are some 30,000 such orphans. In Uganda's Rakai district, a 1989 survey found 25,000 AIDS orphans.

The AIDS Support Organization (TASO) in Uganda, a private agency, provides foster parents of AIDS orphans with food, clothing, and some financial support to enable the children to attend school.

Globally, about 30 percent of the children born to mothers who test positive for AIDS are themselves diagnosed with the disease, according to UNICEF. About 1 in 10 AIDS patients in East and Central Africa is a child under age 5, WHO reports.

To help a few such children in Kigali, Caritas bought six homes. In them they place destitute children - a few of them children with AIDS - and a housemother. ``We give them food, clothes - and a mama,'' says Agnes Icyizanye, a Caritas worker.

But the social workers are careful not to publicly identify the houses, or the children diagnosed with AIDS, to avoid negative reactions. Even the children who have AIDS are not told.

``To tell a child [that he has AIDS] is to discourage him,'' Mrs. Uzamureba says. Telling the child's housemates could also be counterproductive. ``They may ignore him,'' she says.

Teachers, likewise, are not informed. Casual social contact does not spread AIDS, according to doctors.

AIDS has spread in Africa primarily through promiscuous heterosexual sex, says UNICEF's McKee. With education, he adds, this pattern of behavior can change.