Africa shifts to 'whole village' approach for orphans

The war was almost over when 4-year-old Jose Castello Valentima showed up at the orphanage a few miles outside of this port city. It was 1991. He knew his father had died. He hoped that someone would soon find his mother.

Mr. Valentima spent the next 14 years at the orphanage run by the Association for the Children of Mozambique (ASEM).

"I learned so many things," he says of the orphanage. "We were always studying, they were always teaching us." He pauses. "But in the family you get the best education."

Valentima is just one of millions of children in southern Africa who have lost parents to war, AIDS, and hunger. But he might be one of the last to spend his entire childhood in an orphanage.

In recent years, faced with an overwhelming number of orphans, governments and aid organizations have shifted their response away from orphanages and toward a system they call "community-based care." This means that rather than giving a child a place to live, aid groups try to support them in their own villages – paying for school fees, for instance, or helping adoptive families with food aid. Organizations such as UNICEF say this is healthier and more culturally appropriate than moving children into institutions.

But, while orphanages may have their drawbacks, community-based care brings its own challenges – children who cannot find relatives, neighbors too poor to care for others, villages too strapped to give the necessary attention or support to traumatized youths.

"Everything revolves around the community," says Thierry Delvigne-Jean, UNICEF's spokesman in Mozambique. "If we are to succeed in dealing with this increasing number of orphans, it's really at the community level that it's going to happen. But it will have challenges. We're talking about huge numbers."

Although exact numbers are hard to come by – the United Nations estimates that at least 12 million children in Africa have lost one or more parents to AIDS – there are millions of others whose parents have died from war and hunger.

Mozambique is at the center of this crisis. With a population of almost 19 million people, UNICEF estimates that there are some 1.6 million orphans, and estimates the number orphaned by AIDS – now at 380,000 – will double within five years. Meanwhile, the HIV infection rate here is growing. In 1998, 8 percent of the country's adults were infected with the HIV virus, says Mr. Delvigne-Jean. Today, the infection rate is at 16.2 percent. Here in Beira the infection rates are some of the highest in the country – close to 30 percent of adults in the city are HIV-positive.

The only true way to manage the swell of vulnerable children is to prevent more parents from dying, say aid workers and experts. But in the meantime, groups trying to help have almost universally shifted to community-based care.

In Mozambique, there are hundreds of local aid groups who try to offer support to different neighborhoods, hoping that improved living conditions will make distant relatives and acquaintances more willing to take in orphaned children.

The government has also upped its monetary support to families caring for orphans. Few organizations are building orphanages, and many aid workers here now refer to the word "institution" with disdain.

Barbara Hofmann knows all about this shift. A former financier from Italy, Ms. Hofmann started ASEM as a soup kitchen in 1991 – her own personal response to the flood of orphaned and abandoned children coming to Beira in the waning days of the war. During the 1990s, the organization grew to include orphanages, schools, and community centers.

But after years of trying to make more space for orphans, she says, now she and her staff are working to move youths out of their centers. Of the 400 or so orphans they housed a few years ago, barely 100 remain, and Hofmann expects that number to drop further.

"The government and UNICEF don't like children in institutions anymore," she explains. "They want to have children in communities."

In ASEM's headquarters, in a faded concrete building on a dingy street in downtown Beira, Jorge Tarquino works to do just this. He manages the ASEM office here, and sits in front of bookshelves full of binders, which are all overflowing with documents related to orphans they are trying to reintegrate into communities. Each page gives a name, an age, and a few details about the child.

"Felipe Xavier, born in 1990. Had been living with a grandfather. Wants to be a doctor," reads one of the thousands of pages.

"Reintegration – it's the biggest difficulty," Mr. Tarquino says.

In addition to locating relatives or willing neighbors to take in an orphan, it is his job to make sure those families have the means to care for the child.

ASEM has set up a slew of projects to help with this support – vocational training centers, counseling groups, food assistance. But it is not easy to monitor an orphan's situation in the community, Tarquino says. He tells a story of how a group of colleagues spent four days looking for a family to deliver two days' worth of food.

This is a challenge across southern Africa, aid workers say. The most effective way for a village or town to absorb orphans is for locals to decide how and when to do it. But with the AIDS pandemic, the traditional support structures in villages are falling apart. With greater poverty and fewer caregivers – the life expectancy rate in Mozambique is now around 37 years – communities need help, aid workers say.

But what's right for one community might not be best for another.

"The challenge is that it actually has got to be the community that does the organizing," says Annabel Kanabus, director of AVERT, an HIV/AIDS charity and information website based in Britain. "And that requires not only money, but it requires resources and people encouraging them to organize themselves – as opposed to people coming along and saying, 'This is how you take care of orphans in your community.'

"This takes a lot of time and effort. But it can also result in something better."