AIDS in Zambia

Fales Mazyopa, a slightly built 11-year-old fourth- grader, misses her father, a nice man who once bought her a blanket and a dress.

She does not remember her mother. When she grows up, she wants to be a nurse and care for people who are ill. Fales knows well the kind of work nurses perform. Recently, her scalp broke out in sores that had to be treated.

Her parents died of AIDS, and she may have the virus, too.

No country in the world has a higher portion of its children orphaned than Zambia.

In 2001, almost one in five Zambian children had lost one or both parents, primarily because of AIDS, according to figures from the United Nations and the U.S. Agency for International Development. Only neighboring Zimbabwe had as high a toll.

The nation now has an estimated 600,000 to 700,000 orphans - children younger than 15 who have lost at least one parent - and there could be nearly 1 million by 2010. The number is expected to keep growing until 2020.

No one can foresee all the long-term social, criminal-justice and economic implications of the phenomenon.

Bishop Joshua H.K. Banda of the Northmead Assembly of God Church in Lusaka, the capital, runs an orphanage for 50 boys. He says the children are devastated by the loss of their mothers and fathers.

Some suffer from depression, anger, substance abuse - mostly alcohol - and withdrawal. Some are frustrated and aggressive, he says.

Those working with the children say many must quit school. Their life often becomes more difficult with less emotional stability, and they can run afoul of the law or the strong stigma associated with AIDS in Zambia.

The more fortunate ones, such as Fales Mazyopa, are being raised by relatives. Some wind up in orphanages, while many run the streets.

Fales is being raised by her grandmother, Esnart Nakazwe, a stoop-shouldered, 75-year-old widow who carries herself with as much dignity as the privation of her surroundings permits.

Each of Nakazwe's three children is buried in a different place. She says her belief in Christ enables her to cope with her sorrow. And she also has a strong reason to go on with her life: raising Fales.

Elizabeth Chisembele is a field officer with the CINDI-Kitwe Program, which monitors and assists some 14,000 children orphaned by AIDS in Kitwe, including Fales. Other programs do similar work in the area as well.

Many of the younger children live with a grandparent or other relatives. Many of the older ones, 14 to 21, look after themselves with assistance from CINDI, which stands for Children in Distress.

CINDI has a staff of 14. The program relies on neighborhood volunteers scattered around the city to help with the work.

Chisembele says there are 65,000 orphans in and around Kitwe, a city of 700,000 and the second-largest in Zambia. It is not known how many of the orphans have HIV.

The children can fall victim to many problems. Girls as young as 12 become prostitutes, and younger girls have been sexually abused by their guardians, said Dora Chizi, also with CINDI.

Lukama Imbuwa, a CINDI program coordinator, tries to keep the children in school: "Education is very important. You can feed and clothe a child, but if you don't send him to school, you won't achieve anything at the end of the day."

One Wednesday in July, CINDI officials took a load of used clothes to the small dirt yard of a home in the Kwacha. There, 88 orphans, most ages 2 to 7, had been gathered by volunteers for one of three weekly feedings.

The feedings were organized after officials realized that the food they were leaving at the homes of the orphans' caregivers was often eaten by others. The program and its volunteers now manage 24 such feeding centers.

When the CINDI van, a gift of Irish Aid, pulled up, the children broke into a song of welcome. The volunteers mixed among the youngsters, barely maintaining order. A hedge surrounding the small yard helped contain them.

They were happy to be with one another and hungry for positive attention as well as the food.

Some of those being fed were older. Sipiwe Mutakwa looked 10 or 11, but the small, thin woman is 20. Unlike the others, she did not smile or sing. She has tuberculosis and herpes and probably has AIDS, Chizi said.

"I'm not feeling very well," Mutakwa said. She complained of the sores on her head and said, "I'm always coughing."

Another tuberculosis patient was Mary Chisulo, 10, who proudly wore a jarringly fancy white dress.

The youngest child appeared to be George Chanda, just 5 months old. His mother died of AIDS two days after he was born. His grandmother now cares for him.

Because of privacy issues, the children cannot be made to take HIV tests, so it is difficult to determine their needs, Chizi said.

The children sat on the bare ground and grabbed handfuls of nshima, made from ground maize, and dipped it into beans and a dish made from small fish and peanut butter.

When volunteers brought out a bag of secondhand clothes for distribution, bedlam broke out. Each child got something, clutching it tightly. The clothes distributed, many of the children returned to their meals.
The CINDI staff then visited a rural community, Kakolo, of about 5,000 people and some 200 orphans. The incidence of AIDS was lower because the community has less contact with outsiders.

Many of Kakolo's residents live in mud-brick huts with thatched roofs. Others live in concrete homes topped by metal roofs, built with the help of an American charity.

The people of Kakolo make a living from agriculture and producing charcoal. Some assemble brooms for sale in town.

The CINDI staff checked on some of the orphans and met with Dainess Muamba, 29, who was widowed nine months ago when her husband, John, died of AIDS. Muamba has three children, ages 9 years, 7 years and 10 months.

Chisembele pointed out a rash on the baby. She worries he may also have HIV or AIDS.

Kitwe also has many "street children." Many of them are not orphans, but they run a great risk of winding up as AIDS victims.

Kenneth Kalichi, a "street worker" for the Piano House, a refuge for street kids, says many have one or two parents but have run away because they felt abused or because their parents were so destitute that they could not feed them.

Patrick Mukula, 13, says he ran away from a shanty slum because his mother was dead and his father beat him. He lived on the streets of Kitwe for two months before coming to the Piano House.

He said, through an interpreter, that while he was on the street, "we used to depend on the loose change that we begged and that we could also work carrying parcels for people who would give us money and then we could buy food."

Mukula, a third-grader, said he needs to get an education to have a brighter future. Kalichi said Mukula "is one of the fortunate ones. He's attending the government schools from here."

On a Saturday night last month, a group of a half-dozen boys and girls, as young as 10, hung out at a dimly lit street corner.

Sisters Carol Kunda, 13, and Bwalya Kunda, 12, were among them. They said they left home because their parents were very poor.

Many of them had been sniffing glue, a way to get high and defeat the nighttime cold, Kalichi said. The fumes hung over the group of children.

One girl had a pop bottle stuck up her sleeve. Inside the bottle was glue she had been sniffing. She and three girlfriends have been living in a drainage pipe with several boys, she said.

Kalichi said some had been having sex. He recently took them to a clinic, where they were treated for venereal disease. One of the boys was 9 or 10 years old, he said.

A group of policemen, some carrying rifles, came over. They demanded to see Kalichi's identification and wanted to know why he was talking to the children. Before they finished, they were interrupted by some belligerent drunks who staggered on the scene.

The officers confronted the drunks and forgot about the children.