Book Book

Children of AIDS: Africa's Orphan Crisis

BMJ 2002; 324 doi: (Published 26 January 2002) Cite this as: BMJ 2002;324:245
  1. Susan King, associate professor, division of infectious diseases
  1. Hospital for Sick Children, Toronto, Canada

    Emma Guest

    Pluto Press, £20, pp 192

    ISBN 0 7453 1769 3

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    Children of AIDS: Africa's Orphan Crisis is a collection of stories about children in South Africa, Zambia, and Uganda, whose parents have died from AIDS. Set within different cultural contexts, the stories introduce the reader to the diversity and complexity of life across Africa. They are deeply troubling and moving. They also show the remarkable resilience and hope of the children.

    The AIDS epidemic is ravaging sub-Saharan Africa and the incidence of HIV is highest among sexually active young adults. These women and men develop AIDS and die while in the prime of their lives. The children they leave behind are known collectively as “AIDS orphans.” The stories of these orphaned children closely reflect the societal response to AIDS. In particular the lack of resources to deal with the epidemic as a whole spills over into the crisis of these parentless children.

    The stories also describe the stigma the children feel before and after their parents' death. The children tell of their mixed feelings over support from foreign donors. They are grateful for this support but also impatient with donors' lack of understanding of their daily life. The book also describes the responses of grandparents, foster parents, and social workers involved in the care of AIDS orphans. Their generosity, determination, and commitment to the children and to Africa's future are remarkable.

    On one hand the stories provide hope. There are pockets of care and some orphaned children are thriving. On the other hand they show that the majority of orphaned children are falling through the cracks. Yet the resilience of these children has allowed them to survive, despite the many losses and instability of their lives. One wonders what will happen to them as they mature.

    Healthcare providers, educators, policy makers, and anyone whose work touches the lives of families from Africa should read this book. It provides a glimpse into the magnitude of the problem of AIDS in Africa. It also helps you understand some of the values and traditions that influence decisions and create dilemmas for African families affected by AIDS.

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    The link between poverty, social instability, and escalating rates of HIV infection is evident worldwide. Ensuring that the social infrastructure in Africa is rebuilt is the only acceptable, long term, global response to Africa's orphan crisis. In this way the thousands of children orphaned by AIDS may have a chance of adequate food, shelter, health care, education, and future employment.

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