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IV. Findings from Kenya, South Africa, and Uganda

In interviews with children and caregivers in Kenya, South Africa, and Uganda, Human Rights Watch found that governments had repeatedly failed to address AIDS-affected children’s extraordinary risk of school drop-out and poor performance.  Governments failed to intervene when parents fell ill and children left school to act as caregivers or breadwinners in the family; when parents died and children found themselves deprived of parental care and often completely on their own; and when children entered the care of extended family members, foster parents, and institutions, many of whom subjected them to abuse, neglect, and discrimination.  Often children experienced this cycle of sickness and death numerous times, as mothers, fathers, siblings, aunts, uncles, and other family members successively succumbed to HIV/AIDS.  When extended families proved unable to support orphaned children, community-based organizations often provided critical educational support, including paying for school fees, applying for government benefits, and advocating for their right to education before school authorities.  However, governments often failed to support or even recognize these local efforts, leaving the burden of safeguarding children’s right to education largely to already poor and overburdened private citizens.

Children as caregivers in the home

In every country visited, Human Rights Watch documented numerous cases of children dropping out or falling behind in school when their parent or guardian became ill and unable to care for them due to HIV/AIDS.  In Uganda, Martin P. said he lost his father to HIV/AIDS when he was twelve and his mother four years later.  When his mother was sick, he and his sister took turns leaving school to care for her:

When Mother was sick, it was us who were looking after her. . . . I left school for one term and then went back.  Then my sister left school for one term, and we traded back and forth like that.  But even when I was in school, it was not good, because my mind was back with my mother, and it was not easy to concentrate on my studies.⁵²

Martin P.’s story is not unique.  Moyo L., from Johannesburg , South Africa, said that when he was seventeen, his mother withdrew him from school because she was too sick to run the household. “Things started getting harder because she stopped going to work for weeks at a time,” he said.  “She started going to and from the hospital every day until she died.”  Moyo L. described the impact this had on his school performance:

I didn’t have time to study.  I would go home from school and find nothing in the house—no love, nothing.  I had to do a job my parents should have been doing.  I was a teenager, I should have been going out with my friends, playing soccer, dating.  I tried to make it work, but I couldn’t.  When I got my report card last December, I’d failed.⁵³

A persistent theme in children’s testimonies was the almost complete absence of government support as children struggled with the terminal illness of their parents.  In Kenya, Philip G., whose mother died of AIDS when he was thirteen, said that his mother’s sickness both forced him to miss school and distracted him in class.  “When my mother had the disease, it really affected her,” he said.  “I really took care of her—anytime she needed anything, I was around.  Sometimes in school, I could not even hear what the teacher was saying, because I felt the pain when I remembered my mother was sick.”⁵⁴

Children who were withdrawn from school to care for sick parents described performing long hours of difficult household labor.  “I would care for Mother and Father when they were sick,” said Nora P., from eastern Uganda, whose parents died when she was sixteen.  “I would prepare the meals for the family, I would help with the digging to get food, and I would do the washing.”⁵⁵  Asked how this affected her school performance, Nora P. said, “Once I got to secondary school, it was sporadic.  I could do a few terms and then drop out and then go back.”  In Kenya, Peter O. said, “I used to take care of my mother and father when they were sick. They needed water, porridge, and other things, so I used to stay close to them in case they needed anything.”⁵⁶  Peter O. dropped out of primary school in Standard Five⁵⁷ at age ten, and at age seventeen had not returned.

In some cases documented by Human Rights Watch, parents and guardians faced ostracization by extended family members for being HIV-positive, leaving the children to run the household completely by themselves.  Sihle S., from Johannesburg, South Africa, said when she was thirteen, her mother died and her sister became her primary caretaker.  When her sister was later diagnosed with HIV, their aunts and uncles rejected them:

They didn’t want to stay close to my sister, because they thought they’d also get infected [with HIV].  They kept a distance from her.  They would say, “Your sister is HIV-positive, we don’t want to get close to her.”   They’d go around the whole hostel and warn people she might infect them.  I knew better, because we learned in school how HIV is really transmitted.  They were so cruel about it.  I think they knew they wouldn’t get infected, it’s just that they were so cruel.⁵⁸

Sihle S. said she had to take care of her sister and her sister’s baby by herself.  Eventually, she failed a grade:

It was very hard, because I had to take care of my sister and her baby. Sometimes I would leave school for a whole week to take care of them. The baby was only six months old, so I had to wash the nappies, clean the house, everything. . . . I got my report card last December, and it said “Fail.” I was angry.  I asked myself, why do I have to fail?

Children left on their own

For many children interviewed by Human Rights Watch, the death of a parent to HIV/AIDS left them without any effective support for their education, least of all from their governments.  Attendance in school often declined as children found themselves without their primary source of support, encouragement, and financial assistance.  “My mom used to do many things to keep me in school,” said Henry M., sixteen, a child orphaned by AIDS in Johannesburg , South Africa.  “She used to try hard.  She’d sell clothing in the street, just like a small business, and pay our school fees with that money. . . . She’d sell things for other people—belts, trousers, gloves in the winter—and keep some of the money. When she died, that’s when I started suffering.”⁵⁹ 

For many, the death of a parent meant being chased from school because of an inability to pay school fees or other mandatory expenses, even in countries with policies of free primary education.  “We were going to school, but the teacher said to stop coming to school if we didn’t have money for exams,” said Marian A., eight, an orphan in Kenya who is also living with HIV/AIDS.  “So today, I didn’t go to school. I woke up, then I took my drugs and went to look for firewood.”⁶⁰  Pammy N., also from Kenya, said her mother could not afford to pay for secondary school fees since the death of her father to HIV/AIDS in 2002, when Pammy N. was sixteen.  “[The principal] agreed to allow us in, because my mother talked to her,” she said.  “But because we couldn’t pay fees, they retained our diploma until we paid them.”⁶¹  Anne Wanjiru, an employee of GROOTS-Kenya who was caring for numerous orphans in addition to her own children, said that the cost of education remained a major barrier to primary school access in Kenya.  “My kids stay out many days when I don’t have money,” she said.  “I’m still in debt to the school.  I have one who I haven’t paid a single cent.  He was chased on Monday, and I begged to let them stay until June.”⁶²

But losing a parent meant not only the loss of family income, but also the loss of an advocate, someone to defend children’s legal rights.  “After Dad died, we lost hope, there was often no food,” said Martin P., from Uganda, who lost his father when he was twelve.  “But mother tried very hard to keep us in school.  We didn’t lose our home, because mother fought the uncles.”⁶³  Martin P. dropped out of secondary school when his mother died four years later, but at age seventeen had re-enrolled in Senior 2.⁶⁴

Sihle S., from South Africa, said that before her mother died, she took great pains to pay for Sihle S.’s secondary school through donations and government grants.  Even when she ran out of money, Sihle S. said, her mother would ask the principal for a waiver of school fees.

When my mother was sick, she didn’t work. She got a grant of 500 rands every month [U.S.$2.60/day], so she used that money to maintain us. She spent the money on my school uniform, on school fees, and on something to eat. It wasn’t enough, but there was nothing we could do. If there was no money for food, we didn’t eat. If there was no money for school fees, my mother would go to the principal and ask him to let me stay in school.⁶⁵

The impact of parental death on children’s access to education was not always permanent.  In many cases, children dropped out of school temporarily only to return later; in others, the death of a parent concluded a period of instability caused by the parent’s sickness, particularly when extended family members offered to support the child’s education.  Too often, however, orphans were abandoned by their extended family members and left to support their own education.  “My aunts who were with me when my mother was alive, they all turned away from us,” said Philip G. from Kenya, who was thirteen when his mother died.  “Even sometimes when we ask for shoes, they say they don’t have any money.  So we wonder, what kind of aunt is that?”⁶⁶

Moyo L., from Johannesburg, said that when his mother finally succumbed to AIDS when he was seventeen, his relatives turned away from him.  “After my mother died, it was so bad,” he said. “People started looking at us in another way, even our relatives.  I hated it, I just wanted to be a normal person.”⁶⁷  Eventually an uncle gave Moyo L. a construction job so that he could earn money to attend a technical college.  “I failed there, too,” he said.  “I was too busy trying to make money.”  At the age of twenty-one, he was still trying to complete grade eleven.

Emotional burdens and AIDS-related stigma

Interwoven with all of the experiences described by orphaned children was the emotional hardship of losing a parent to HIV/AIDS.  Some children interviewed by Human Rights Watch found ways to express the psychological difficulties they experienced on the death of their parents, and the ways in which these difficulties affected their school performance.  Joseph M., fourteen years old and from Johannesburg, South Africa, said:

When my mother died, I started disrespecting my granny, and I didn’t want to listen to her.  I made funny faces and started hiding in the cupboards. . . . I’m not sure why I was doing it.  When I felt like crying, it was easier to act silly. . . . Sometimes in class I would sit alone, go to the back of the class, and cry.⁶⁸

For children who lost multiple family members to HIV/AIDS in succession, school may have been particularly difficult.  “After [my father] died, I lost other people in my family—my uncle, my grandfather, my granny, my auntie, and my sister,” said twelve-year-old Dipo L.  “Sometimes you don’t know how to work.  You remember your parents in class.  I don’t tell the teacher, and the teacher doesn’t say anything.”⁶⁹

Children orphaned by AIDS said that on top of the emotional difficulty of losing a parent, they were sometimes teased by classmates for being orphans or for “having AIDS.”  Charles W., who was orphaned at age eight and had his school fees subsidized by The AIDS Support Organization (TASO) in Uganda, said that his classmates and teachers nicknamed him “TASO Child” and treated him differently from other children:

My classmates, they knew my parents had died, they caused problems for me.  I was segregated.  I was known as ‘The son of AIDS,’ and teachers and students would call me ‘TASO Child.’ . . . When we were sharing desks, the kids wouldn’t want to sit next to me. . . . It would be terribly hurtful as a child to be called ‘TASO Child.’  It was only name-calling, no physical abuse, but still.⁷⁰

Charles W. went on to say, however, that things had improved for him since then, in part because his secondary school had an AIDS club that helped to break the stigma around the disease.  “When I reached S [Senior]-1 it changed,” he said.  “There was a club for AIDS, and there were activities at the school for learning more about the disease. . . . Also by that time, many of the students at the school were somehow affected by AIDS.”

Schools ill-equipped

Faced with an increasing burden of children affected by AIDS, many schools in sub-Saharan Africa are taking modest steps such as establishing “AIDS Clubs,” introducing HIV-prevention education, and providing occasional counseling to orphans and other vulnerable children.  However, in most cases documented by Human Rights Watch, schools proved ill-equipped to address the complex hardships faced by AIDS-affected children, other than to acquiesce to their need to miss school.  “I told my teacher my mom was sick, and he said it was fine for me to miss school,” said twelve-year-old Dipo L. from Johannesburg.  “So I stopped going to school and helped her.  I had to stay behind a year.”⁷¹  In Nairobi, Kenya, Florence N. said that her teacher did nothing when she explained that she needed to work to support her mother who was living with HIV:

I’d wake up in the morning and we wouldn’t have anything to eat. Our clothes would be dirty, and we didn’t have any soap to wash them. So I’d do casual work, maybe do some washing for someone and get 20 shillings [U.S.$0.25] to buy soap, or maybe some food. I’d stay home from school about two days a week. When I explained to the teachers why I wasn’t coming, they said nothing.⁷²

In many cases, schools showed needless inflexibility in the face of AIDS-affected children’s inability to meet certain administrative requirements.  Alfred D., sixteen and from Pretoria, told Human Rights Watch that his mother had tried to switch him to a school closer to home so that he could care for her more easily when she fell sick; however, the new school refused him entry because he could not produce a birth certificate.  “I stayed away [from school] for a year,” he said.  “I was just at home helping my mom. . . . When they started asking for the birth certificate, my mother said that until she could sort out the registration, I should stop going.”⁷³  Alfred D.’s mother died before she could obtain the proper papers.  “She died before she could get a birth certificate for me,” he said.  “She tried to get me in [without it], but the teachers wouldn’t accept that.”

A frequent response of schools to the needs of orphans was to provide free meals to encourage orphans to attend school.  But principals readily acknowledged that these measures were not enough, and that AIDS-affected children continued to drop out in large numbers.  “They disappear,” said one principal in Johannesburg. “They become truant, because there’s no one looking after them.”⁷⁴  Moreover, the government did not support feeding schemes in secondary schools, and secondary school teachers observed that AIDS-affected children frequently fell behind in school because of hunger.  At one Johannesburg school, counselor Nelly Hleza wrote to local businesses asking for food donations because her students were hungry in class.  “Most of our learners are orphans, others their parents are not working . . . and others are from the upbringing of elderly people who cannot provide for them,” the letter reads.⁷⁵  Hleza explained that it was very common among her students for AIDS-affected children to be cared for by their grandparents.  “A lot of them drop out,” she said.⁷⁶

Abuse and discrimination within extended and foster families

Following the death of one or both parents to HIV/AIDS, children interviewed by Human Rights Watch entered a variety of child-care arrangements, many of them grossly unsupportive of their education.  Most orphans were taken in by relatives or close family friends, many of whom were already caring for their own biological children.  Some entered formal or informal foster care arrangements—of the three countries visited by Human Rights Watch, only South Africa had a formal foster care system, but unregulated foster care arrangements nevertheless existed in all three countries.  A few children were living in child-headed households with no adult supervision.

Orphans’ access to education was often impeded by overt and unpunished abuse and neglect by their caregivers.  Seventeen-year-old Sipo M., from South Africa, said that after her mother died in 2003, she moved from Eastern Cape to Johannesburg to live with an aunt.  But her aunt refused to register her for school or pay for her school fees, instead subjecting her to difficult household labor and physical abuse.  “She was only looking for a helper,” Sipo M. told Human Rights Watch.  “She sent money to my relatives in Eastern Cape so I could come [to Johannesburg], but when I arrived, everything changed.  She didn’t want to pay school fees for me.”⁷⁷  Sipo M. registered herself in school, but her household responsibilities interfered with her studies.

I didn’t have time to sit and study at home, because I was always working.  I wasn’t even allowed to turn on the light late at night.  I didn’t have time to concentrate on my studies.  I had to wake up at 5:00 a.m. for school, and it was an hour’s walk.  I went to a different school from my aunt’s kids.  They were already in school when I arrived, so I had to register myself.  My aunt just didn’t want me going to school.

At times, Sipo M. said, her aunt physically abused her for not performing her chores properly:

She wasn’t really a mother to me.  She used to love her own children the right way, but she used to beat me.  There were four others.  She used a sjambok⁷⁸ to beat me.  Sometimes when I was washing the dishes and a plate fell, she beat me.  When I was late putting the washing up on the line, she beat me.

When Human Rights Watch met Sipo M., she had moved in with Elizabeth Rapuleng, a former school teacher who ran a drop-in center for AIDS-affected children in Soweto.  “[She] was going to school, but she wasn’t getting results,” Rapuleng said.  “She’d go irregularly.  It was so far away, and her aunt didn’t give her money for transportation or school fees.  We had to write a letter to the principal to let her continue going to school.”⁷⁹  Rapuleng noted that because Sipo M.’s aunt hadn’t paid any school fees, the school was planning to expel her.

In 2004, Sipo M. failed Grade Ten.⁸⁰  That same year, Rapuleng said, she tried to commit suicide.  According to Rapuleng:

She just vanished.  She didn’t show up [at the drop-in center] for her lunchbox one day, and we couldn’t find her at school or at home.  We had to contact the social workers in town.  She was trying to kill herself, because life was so tough.  We had to report it to the police. Her aunt couldn’t have cared less.

Rapuleng proceeded to take Sipo M. into her home, and as of June 2005 she was back in school.  She said school was easier now that she was no longer living with her aunt.  “I used to compare the way I was living with my cousins,” she said.  “I always had to ask for things.  When they stayed behind after school for extra help, I had to rush home to do the housework.”

Such cases of abuse and neglect by orphans’ own extended families were disturbingly common among children interviewed by Human Rights Watch.  Sixteen-year-old Alfred D., from Pretoria, South Africa, said that he resorted to living in the streets following his mother’s death:

When [my mother] died, I stayed in the house where we lived, but I depended on my relatives for food.  They took too long to bring the food, so I left the house and went to the park.  I spent two weeks there before coming to the shelter.  It was hard.  I had to wait for a long time before I could get any food.  I got it by begging.  I was alone.⁸¹

Asked whether he could have turned to his relatives for support, he said, “They didn’t even know I was living in the park for two weeks.  They told me they had their own kids, so they couldn’t cater for me.  They didn’t give me any advice on what to do.”

In cases where orphans moved in with caregivers who had their own biological children, Human Rights Watch consistently found among the small sample of children we interviewed that the orphans were less likely to be in school than the biological children.  Such differential treatment is reflected in population-based surveys: in a three-year longitudinal survey of 11,000 households in Kwa-Zulu Natal, South Africa, for example, children who lost their parents ended up having less money spent on their education on average than non-orphans living in similarly situated households.⁸²  In interviews with both children and caregivers, Human Rights Watch found that some caregivers would have liked to provide education for all children in the home but were simply overstretched, while others practiced overt favoritism.  Sixteen-year-old Henry M., from Johannesburg, said that he and his brother, Jacob, aged twelve, moved in with an aunt after losing their mother to HIV/AIDS in 2003.  He contrasted the treatment he and Jacob received from their aunt with the way she treated her own children:

My aunt treats us badly when we do things wrong.  It’s like James and I are always the ones making the problem.  I might come home late after visiting friends, so she’ll shout at me.  It’s not the same with her own son.  She treats her child better than she treats us.  She buys him clothes and gives him spending money.  We don’t spend anything.⁸³

Despite this mistreatment, Henry said that he and his brother were still able to attend school.  But his aunt got their school fees from a charity while paying for her biological children out of her pocket, making him feel discriminated against:

The social workers at the center pay our school fees, but my aunt pays for her son’s school fees.  We get our uniforms at the center, and all of our books.  For my cousin, my aunt buys his uniform.  It makes me feel bad.  It makes me remember my mother and how she never used to treat us badly.  She would treat all children the same way.

Joy T., from Mbale, Uganda, said that after she lost her mother to HIV/AIDS at the age of sixteen, she was sent to live with her biological father, whom she had never met and who had long since remarried.  She also had to rely on donations to attend school:

I was sent by myself as the only child of my first dad, to live with my dad and his wife.  It was not easy, because my stepmother didn’t like me and had other children of her own.  A friend in the church paid for me to continue schooling until S [Senior]-6.⁸⁴

In some cases, traditional practices such as polygyny and wife inheritance underpinned the discriminatory treatment of orphans within extended families.⁸⁵  Charles W., from eastern Uganda, said that when he lost his mother at age eight, his stepfather abandoned him in order to support the children of his three other wives. 

It was only after my Mom died, that the family split up and I went to live with grandmother.  [My stepfather] went to his other wives with the kids when my mom died.  His second wife also had kids and so they were all living together, but these aren’t really my siblings since they have a different mother and father.⁸⁶

Eight years old and in Primary Two, Charles W. was forced to leave school.  “From P [Primary]-3 to P-4, I stayed home for one year and interrupted school,” he said.  He spent that year living with his grandmother and hanging out in the streets. 

During that year when I was not in school, I played football and hung out on the streets.  The problems were there, it was food mostly, I could not get food. . . . I would say I was gambling with life, because during that time I was running around on the streets and it could have gone very badly for me.

Derrick D., sixteen, also from Uganda, said that when his father died his mother was “inherited” by her brother-in-law, Derrick D.’s uncle, who already had a wife and six biological children.  Derrick D. also had four siblings, bringing the number of children in the household to eleven.  Asked how many of the eleven children were in school, Derrick D. said,

Some are and some are not.  This is because of money.  For example, my sisters don’t have money to buy sanitary pads, so they can’t go to primary school even if it is free.⁸⁷  But some of [my uncle]’s kids are not going to school either.  It is really hard to have that many children in the house and not enough money.⁸⁸

He said that his uncle favored his biological children over Derrick D. and his siblings.  “There is a big difference in how the kids are treated in the house,” he said.  “For example, if [my uncle] brings home something, the step-mom and her kids don’t want to share.  They say we are orphans so they don’t have to share, then [my uncle]’s kids will get it.  Other times if [my uncle] is not there, we don’t have enough to eat and it is us orphans that don’t get the food.” 

Girls’ exposure to sexual violence and exploitation

For a number of girls interviewed by Human Rights Watch, being neglected by caregivers and dropping out of school contributed to their vulnerability to sexual violence and exploitation.  Josephine A., from Kenya, moved in with an aunt and uncle and their children after her mother died when she was nine.  She left school when her mother died and, even though her uncle was a head teacher with some influence, never returned.  “I went through a lot,” she said, adding:

I was beaten most of the time.  I had to learn how to do housework because I was forced to do a lot of house duties.  I was also frustrated by her children.  They were a little older—there were boys older than me.  They were in school.  They used to tell us, “We didn’t kill your mother, why are you coming to eat our food?”  Even my uncle used to beat me, even though he was a head teacher in a school.  He could have used his influence to get us into school.⁸⁹

After five years of being out of school, she said, she turned to sex work at the age of fourteen to support herself:

I went to stay with an older lady in Mathare who introduced me to selling illicit brew.  She also introduced me to commercial sex.  It was 2002.  She just said, “Make sure you satisfy the men, and don’t let me hear a bad report that you didn’t do what he wanted.”  She got the money, and the best she ever gave us was supper and a place to sleep.  We were with other ladies the same age.  Sometimes we’d be sent to three people a day.  I was treated like something that could be bought.  I never made any money, but sometimes the guys would buy me alcohol.  It made it easier.  But when somebody’s under the influence, they get very rough, and when I didn’t do what the clients wanted, the lady would get mad.

Josephine A. tested positive for HIV in 2004, at the age of sixteen.

Florence N., also from Kenya, moved in with an aunt at age twelve after losing her mother to HIV/AIDS.  She was able to finish primary school, she said, but could not attend secondary school because her aunt could not afford the fees.  “She used to send me into town to beg for money,” Florence said.  “And when I didn’t come back with any, she would chase me out of the house.”⁹⁰  In 2001 at age fifteen, Florence became pregnant:

I used to roam around asking people for money to help me, just like a street girl.  I’d make 20 shillings [U.S.$0.26], maybe 50 shillings [U.S.$0.66] in one day. . . . Boys would come up to me and say, “I’ll give you money, I’ll give you food if you come with me.” That’s how I ended up being pregnant.

When Human Rights Watch met Florence N., she was taking a weaving class from the nongovernmental organization GROOTS along with several other young women who had all dropped out of school following the death of a parent.  Another young woman in the class, Modiba A. also dropped out of school the year her mother died, when she was thirteen.  Like Florence N., Modiba A. had moved in with an aunt who favored her biological children.  “She didn’t treat me very well,” Modiba A. said.  “Sometimes she decided to leave the house without leaving any money for food, so I ended up going to sleep hungry.”⁹¹  On those occasions, Modiba A. found casual labor in the street—washing clothes, doing domestic work—so that she could buy clothes and food for herself.  The previous year, she was lured into an empty building by a group of boys and raped.

There are bad things that happen. . . . People can beat you if you don’t do what they want.  Earlier this year, a group of us were raped.  They have these video shows in the slums, and when we went to watch a video, there were boys there.  After the video ended, the boys asked us if we wanted to watch another one.  So we went back inside with them, and they shut the door behind us and raped us.  There were five of us girls.  They chased everyone else out of the room.  They said, “The video is over, it’s time to leave,” until we were all alone.

We reported it, and we were told that if we saw the person who raped us and can confirm it, we should bring them to the police. I haven’t seen them since. We didn’t go to the hospital, because then people will know we’ve been raped. The police didn’t ask us any questions or start an investigation.

School drop-out may not only be a contributor to sexual violence and exploitation; it may also result from it.  In Soweto, South Africa, Gladys Legodi, a primary school principal, told Human Rights Watch that she was familiar with numerous cases of orphaned girls who dropped out of school following an episode of sexual violence.  “Most of the girls who are sexually abused, they don’t have mothers,” she said, giving the example of an eleven-year-old girl who had recently been raped by an eighteen-year-old.  “The case went to court, and the perpetrator was acquitted because the child wouldn’t point at him,” she said.  “I asked her why she wouldn’t point at him, and she said he had threatened to gorge her eyes out.”⁹²

Abuses against parents and guardians that in turn harm children

In numerous interviews, Human Rights Watch found that the inability of AIDS-affected children to attend and remain in school was exacerbated by unremedied human rights abuses against their caregivers.  Among the people we spoke to, caregivers were typically women living in deep poverty, many of them widows, most of them also caring for their own biological children.⁹³  In some cases, their poverty had been exacerbated by violations of their property rights upon divorce or the death of their husbands.  The lack of an effective legal remedy for property grabbing was yet another example of how government neglect contributed to AIDS-affected children’s inequality in access to education.

In Uganda, Human Rights Watch met Barbara W., thirty, at an outreach center run by The AIDS Support Organization (TASO).  Herself HIV-positive, Barbara W. had been recently divorced and was caring for three school-aged orphans.  Her five biological children were in the care of her husband, who had since remarried and moved to a different village.  “He took all the property in the house,” Barbara W. said.  “We had 250 hens, ten pigs and two cows.  I took one cow to my village and I’m still there.”⁹⁴  The three orphans in her care started missing school, while her five children remained in school because of their father’s support:

My kids go to school because there’s a father who can take care of them.  But because I’m a poor African woman, I can’t raise enough money for the three orphans.  The one in secondary school, sometimes she misses first term because I’m looking for tuition.  The others miss school for two or three days at a time.  I had a cow I used to milk, but as time went on the cow died, so I can’t find any other income. . . . I used to get a ten liter jerry can of milk and raise school fees for the child in secondary school.  But now that the cow died, I have nothing.

Property grabbing affected not only divorced women, but also widows.  Thirty-five-year-old Prossy N., also from Uganda, said that her husband’s family abandoned her and her five children after her husband died, because she refused to surrender her property to them.  As a result, she could not afford to send any of her children to school.  She recalled:

As they were coming to get the property from me, I shouted, “I’ll burn you if you take my property!”  I wasn’t going to let them take everything my husband and I had built.  So instead of taking the property, they withdrew all the care they could provide for the children.  I have five children, and none of them is in school.⁹⁵

Other widows said that their in-laws successfully grabbed their property, leaving them destitute and unable to send their children to school.  Mary W., a Ugandan mother of six who is also caring for two orphans, said:

My husband died in 1996. All of my property was taken and I was left with nothing.  So I struggled to raise my kids. . . . It was the mother-in-law.  She took everything, including the bed and mattress.  I didn’t complain.  The mother-in-law was so tricky, she sometimes tried to beat me up.  At first the relatives thought my husband had been bewitched and that I’d bewitched my husband.  So I was neglected by all the relatives.  Now I’m taking care of all the kids without any help from anyone.  Many of my brothers and sisters died of AIDS, and now I’m left alone.⁹⁶

Herself HIV-positive, Mary W. aspires to start her own business.  “I try to get a little money from people,” she said.  “I dig for people.  There’s nothing, but if I had capital I’d be a businesswoman.”

Such cases of property-grabbing against widows or divorced women, combined with the lack of an effective legal remedy for this problem, are all too common.  In a 2001 survey of AIDS-affected families in two districts of Uganda, half of the adult respondents identified property-grabbing as a problem.⁹⁷  In Kenya, Human Rights Watch has documented numerous cases of widows sinking into poverty after having had their property grabbed following divorce, separation, or the death of their parents or husbands.⁹⁸

Dolphine A., forty-years-old and living in a slum of Nairobi, Kenya, said that she was caring for eight orphans in additional to her seven biological children.  The orphans, who were from two different sets of parents, did not inherit any property after their parents died.  “They left nothing,” Dolphine A. said.  “The children only had the clothes they were wearing.  The family of the children[’s father], they took everything.  They took everything the parents owned.”⁹⁹  With the money she earned from selling vegetables, Dolphine A. sent the eight orphans to an unregulated “informal school” in the slums.  The hardest thing, she said, was sending them to school on an empty stomach.  “I make 200 shillings [U.S.$2.50] a day,” she said.  “I buy two packets of maize flour and use the rest for vegetables. . . . If I give them one meal per day, I can save.”  One of the orphans, she said, had recently dropped out of school and run away, but she did not know where.

Child-headed households

As noted above, some AIDS-affected children interviewed by Human Rights Watch were living (or had lived) in child-headed households, cared for by a brother or sister under the age of eighteen.¹⁰⁰  Regular attendance in school proved next to impossible in these cases, unless the household was receiving significant charitable support.  Lisa W., the first-born of five children in Kenya, said she lost her mother to HIV/AIDS when she was seventeen.  Her mother had just given birth when she died, and she dropped out of school to care for her baby sister and three other siblings:

I was not able to make decisions, because I was still young and I didn’t have a job.  I was in Standard Seven, but I dropped out of school to get a job washing clothes for people so that I could feed my siblings and pay rent.  When I got some money, we ate.  When I didn’t, we stayed hungry. . . . I also enrolled as a vocational student.  I studied hairdressing, and after I finished I started looking for a job, and times if someone needed their hair done, I did it.¹⁰¹

Lisa W. said she did not even consider staying in school after her mother died, and that all of her siblings had to drop out as well.  She did not have any other relatives to turn to, and the community rejected her because her mother had been HIV-positive:

It was very difficult, because there was a lot of stigma.  People would say we were suffering because our mother was promiscuous, that’s why she died.  Our neighbors disliked us and didn’t listen to anything we said.  When our mother was sick, they wouldn’t even pass by the door or come into our house.  At school, the kids knew my mother was sick but we never told them she had HIV.  When she died, we just left school immediately.  I didn’t even find it important to stay.  Even if they had let me stay free of charge, I still needed to go and find odd jobs so I could feed the family and pay the rent.

When Human Rights Watch met her, Lisa W. was still working as a hairdresser and receiving support from Women Fighting AIDS in Kenya (WOFAK).  She said that her siblings never returned to school.

Peter O., also from Kenya, said he lost his mother to HIV/AIDS when he was thirteen and his father the following year.  The third of seven children, he was forced to care for his younger siblings from the age of fourteen.  “My older brothers are not so responsible, so they’re not taking care of us,” he said.  After burying his father in their village, Peter O. brought his siblings back to Nairobi and looked for casual work. 

When we got here, we looked for casual jobs.  If we earned 20 shillings [U.S.$0.25], we saw among us what we could buy, and we shared it.  We still live on our own, in a place in Mathare. . . . We have a neighbor who sells water, so in the evenings I go work for him, and he decides how much to pay me.  I also found work with a carpenter who takes orders for people.  I make about 30 shillings [U.S.$0.35] in the evenings, and on the weekends if there’s a job I can make 70 shillings [U.S.$0.50].  I work until about 7:00 or 7:30 every night.  My brother and sister sit next to the house where I’m selling water, so I can supervise them.¹⁰²

Peter O. said that while his younger siblings attended school, he dropped out when his parents were sick and never returned.  He had completed standard five and, when Human Rights Watch met him, was enrolled in a technical school learning carpentry.

Lettie L., from Mpumalanga Province, South Africa, was six years old when her mother died and she went to live with her older sister, then fifteen.  “My sister had trouble in school,” Lettie L. recalled.  “She had trouble taking care of us while she was still in school.  She dropped out at Standard Nine.  She didn’t work, she just stayed at home.”¹⁰³  Lettie L. said that when her sister was about seventeen, she became pregnant.  “He never gave us anything,” Lettie L. said of the father. “He does not support his child, but at least the child is still able to go to school.”

Child-care workers and school principals interviewed for this report observed that numerous children they knew were effectively being raised by their siblings.  “You have a grade nine learner caring for a grade three learner, and the parents are deceased,” was how Nelly Hleza, a school counselor in Johannesburg, described a typical case from her experience.¹⁰⁴  Experts said it was difficult to say whether a household was “child-headed” when adults in the home delegated significant household and child-care responsibilities to the children.  “To me, although there is a granny, this is a child-headed household,” said Dorah Mashita, a social worker in Johannesburg, referring to household in which three children under the age of twelve were staying with their grandmother.  “The granny is not old, but she leaves home at 6 a.m. while the kids are still sleeping and comes home after dark.  So this girl [the oldest, who is twelve] has to take care of her brother and sister all day.”¹⁰⁵

Orphaned and living with HIV/AIDS

At least six of the AIDS-affected children interviewed by Human Rights Watch for this report were also living with HIV/AIDS, infected either as infants or as adolescents.  Their testimony illustrated that infection with HIV, combined with inadequate support and accommodation from school systems, both contributed to poor educational outcomes (for example, if children had to miss school for long periods due to sickness) and followed from them (for example, if children were pushed into prostitution after dropping out of school).  It is important to reiterate that the HIV-positive children interviewed for this report constitute only a small and non-representative sample of the overall number of children living with AIDS in Kenya, South Africa and Uganda.

Daniel W., nineteen at the time he was interviewed for this report, described the impact of living with HIV on his education.  Orphaned by HIV/AIDS in 2003 at the age of seventeen, Daniel W. dropped out of Form Three and did not return to school for two terms.  He said he had already fallen sick by the time his mother died.  “I was not feeling well when my mother died, so I had to drop out to get proper medical attention,” he said.¹⁰⁶  A child-care worker at the NGO where Human Rights Watch met Daniel W., Women Fighting AIDS in Kenya (WOFAK), said that doctors diagnosed Daniel W. with tuberculosis and administered an HIV test.  After testing positive, he decided to remain in school.  “It was hard at first,” he said, “but now I have medicine.”  Although he had not yet fallen behind, he said he sometimes missed classes when he wasn’t feeling well.  The difficulty of discussing his illness with his teachers and classmates contributed to the problem, he said.

No one at school knows I’m HIV-positive.  Sometimes I have to miss days, maybe once a week. . . . I hope to go to college.  Maybe I’ll study hairdressing or catering.  It’s not easy to tell people in school [about my HIV status], but one day they’ll find out.

Ibrahim A., eighteen at the time of his interview, said that having access to antiretroviral medicines helped him resume his education following his HIV-positive diagnosis a few years earlier.  This was only after missing three years of school, however:

I stayed at home for three years without going to school and being sick. . . . Then I got TB, and I visited TASO [The AIDS Service Organization].  They treated me for HIV and then when I started getting better, they sponsored me for school.  This is good for me, because I came back to school and I am liking it. . . . The first time I had a CD4 count,¹⁰⁷ it was 106, and now my count is up to 675.  I have been on ARVs for one year.¹⁰⁸

Ibrahim A. said that despite his access to HIV/AIDS medicines, discrimination by his extended family members continued to disrupt his education.  His father had two additional wives besides Ibrahim A.’s mother, he said, and one of them discouraged his father from sending Ibrahim A. to school.

Even now with my siblings and step-mother, I am discriminated against.  They live in Kumi district, and they don’t want me to come there.  My stepmom says not to visit. . . . Even my siblings in Kumi don’t want me to visit, they don’t want to share food or cups with me.  The stepmom in Kumi didn’t want to let my Dad pay for my schooling, because she said “This boy is going to die anyway.”

Asked how he was treated by his classmates, he said:

Some students, they look at you and say that boy is HIV positive.  They don’t want to talk to you, they don’t want to eat with you. . . . They will be in a group and start talking about you in front of you, saying you are sick. 

In more severe cases, children may be effectively barred from school on the basis of their HIV status.  Until a landmark court victory in January 2004, certain government schools in Kenya refused to admit children from the Nyumbani Children’s Home, Kenya’s oldest and largest home for children living with HIV/AIDS, on the grounds that schools were full to capacity and the children could not produce birth certificates.¹⁰⁹  This was despite the fact that many schools were overcrowded in Kenya and that births were often unregistered.  Nyumbani’s victory in court marked an important milestone that resulted in greater access to education for children living with AIDS; however, it did not solve the ongoing problems of children living with AIDS having difficulty performing in school, or of parents placing pressure on schools to refuse admission to HIV-positive children.¹¹⁰

Many of the difficulties faced by children living with HIV/AIDS were not unlike those described elsewhere in this report.  Marian A., eight-years-old and from Kenya, said she lost her father to HIV/AIDS in 2001 and was living with her mother, twin sister, and four other siblings in a small rented house in Kayole, a suburb of Nairobi.  Although she was taking medication for HIV and was in good health, Marian A. could not afford to go to school on her mother’s salary from selling fish.  She said that she and her siblings tried to persuade the principal to let them learn, but to no avail.  “We went to school and asked our teacher if we could do the exams, and when our mother got a job, she would pay them,” she explained.  “But the teacher refused.  The teacher just said to stay home as long as we didn’t have any money.”¹¹¹

Lack of support to community-based organizations

Consistently among the children we interviewed, Human Rights Watch found that children’s first line of defense when their parents or guardians proved unable to support their education were community-based organizations, churches, and women’s groups that provided care and support to orphans on extremely limited budgets.  Often staffed by people who were themselves poor and AIDS-affected, these organizations were essentially meeting an obligation to protect vulnerable children that had been left unmet by governments.  While sometimes funded by governments or international donors, community-based organizations faced a range of burdens ranging from sudden suspensions of funding, arbitrary funding bottlenecks, and lack of legal capacity to make decisions on behalf of children in their care.

Numerous experts have described community-based organizations (CBOs) as “alternate extended families” for children who suffer abuse and neglect or whose extended families are strained beyond the capacity to care for them.  Individuals who staff these organizations often take responsibility for AIDS-affected children as though they were their own, paying out of their own pockets for basic items like food, detergent, and school supplies.  As one expert has described their role:

Faced with huge numbers of vulnerable children, communities are fighting back, providing care and support.  These small-scale, local initiatives can best understand the needs of children in their communities.  Indeed, in many countries in Africa, the most effective ‘aid’ currently consists of the poor helping the destitute.  Out-of-pocket spending on HIV/AIDS represents the largest single component of overall HIV/AIDS spending in most countries in sub-Saharan Africa.¹¹²

Another expert writes, “[w]hether outside bodies intervene or not, families and communities are going to be dealing with the impacts of HIV/AIDS, often with great difficulty.”¹¹³  The Committee on the Rights of the Child, the expert body responsible for monitoring implementation of the UN Convention on the Rights of the Child, recognizes the importance of CBOs when it calls on governments to “ensure that their strategies recognize that communities are at the front line of the response to HIV/AIDS and that these strategies are designed to support communities in their determinations as to how best to provide support to the orphans living there.”¹¹⁴

Human Rights Watch found that CBOs not only provided material support to AIDS-affected children such as meals and school uniforms, but also served a critical advocacy function with respect to the right to education—a function made all the more necessary by school systems’ lack of assistance to children in the greatest need.  A CBO in Soweto, South Africa negotiated with school officials to provide waivers of school fees to children orphaned by HIV/AIDS in their care.  (These waivers are guaranteed under the law, but many schools refuse to grant them.)  An organization in Kenya providing community-based support to AIDS-affected women and children paid school fees for children, provided vocational training to children who had dropped out of school, and urged principals to allow children who were in debt to the school to continue learning.  In Uganda, local branches of The AIDS Support Organization (TASO) and other groups subsidized the school expenses of orphans and conducted workshops in schools to fight AIDS-related stigma.  Each of these activities helped to ensure that AIDS-affected children could realize their right to education on an equal basis with other children.

Despite the existence of significant donor resources for HIV/AIDS programs, and despite the fact that governments are ultimately responsible for safeguarding the human rights of children, CBOs assisting AIDS-affected children in all three countries visited by Human Rights Watch operated under numerous financial and administrative constraints.  A CBO in Soweto, Sizanani Home-Based Care, told Human Rights Watch that although it had a contract with the provincial department of social development to provide home-based care to over 300 orphans, the government was five months behind in its payments.  The organization’s director of services for orphans and vulnerable children said that children were continuing to pour into the center seven days a week, and that she and her staff were working for free.  “If I don’t wake up in the morning and go and cook for these kids, who will?” she asked.¹¹⁵  An official with the department of social development said that there was “not necessarily a delay as such” in funding, and that government funding cycles meant that funds sometimes were distributed late in the fiscal year.¹¹⁶

Individuals and organizations caring for orphans in South Africa may be eligible for foster child grants worth Rand (R)500 (U.S.$78.00) per month per child.  Such grants require a formal foster care order, however, which deterred most CBOs from applying.  “It takes forever,” said Sizanani’s director of OVC services.  “A guardian can wait three to five years to get a grant.  By the time the grant comes, the kids are too old to qualify.”  A survey of 12,000 households in Kwa-Zulu Natal Province found that of children who had lost both parents, only 2 percent were receiving foster child grants.¹¹⁷

The result of this burdensome process is not only that orphans fail to benefit from foster child grants—it is also that their caregivers go unregulated by child welfare authorities, because (unlike grant recipients) they lack a court order recognizing them as foster parents.  When Human Rights Watch met Elizabeth Rapuleng, the director of a CBO in Soweto, South Africa, in June 2005, she had taken six orphans into her home because she felt their existing foster care arrangements placed them at risk of abuse and neglect.  One child had recently attempted suicide.  Others had been in the care of caregivers who were only interested in them because they were eligible for foster child grants.  Ironically, because Rapuleng was too busy caring for the children, she did not have time to apply for the foster child grant that would have given her legal recognition as a caregiver.  The result was that she was performing a parental function without either help or oversight from child welfare authorities. 

An attorney with the AIDS Law Project in Pretoria, Liesl Gerntholtz, told Human Rights Watch it was extremely common for orphans to “fall through the cracks” because informal caregivers such as Rapuleng were invisible in the law.¹¹⁸  Another group of children who were not part of the foster care system were those whose parents were sick.  Because their parents were alive and not abusing or neglecting them in the traditional sense, the children were not “in need of care” according to the statutory definition, and were ineligible for foster care grants.

In Kenya, Human Rights Watch interviewed officials from three established, grassroots women’s organizations that had been providing community-based care to women and children affected by HIV/AIDS since the late 1990s.  Staff members of these organizations described constantly having to take money out of their own pockets to provide basic needs to children such as food, rent, and school expenses.  “We get money from the government,” said Helen Ochieng, a home-based care worker with Women Fighting AIDS in Kenya (WOFAK).  “But they’re not reliable.  They don’t see our programs as sustainable, even though they’ve been funding us for twelve years.  Sometimes there are delays in funding.”¹¹⁹  Loreen Racho, also a home-based care worker with WOFAK, said that the government funding WOFAK had been promised for a vocational training program for orphans did not arrive on schedule.  “These are children who dropped out after primary school because they couldn’t afford fees for secondary school,” Racho said.  “They’ve dropped out because of their parents’ illness and probable death.  So we want to give them some skills.  We thought the money would come early this year, but it seems there was a problem somewhere.”¹²⁰

The availability of unprecedented international resources for HIV/AIDS programs should alleviate some of this burden, but often international funding fails to reach local CBOs in a timely or effective manner.  In “Bottlenecks and Dripfeeds,” a report commissioned by Save the Children-United Kingdom, Dr. Geoff Foster argues that many CBOs face chronic funding shortages as a result of artificial “bottlenecks” created by international agencies.  He describes these bottlenecks as follows:

[T]here are bottlenecks at all levels of disbursement, where money gets “blocked,” and much of it never reaches community groups.  The money flow is slow partly because of lack of staff and experience—from national level down to the smallest administrative level.  Conditions placed at all levels on spending make it hard for community-focused organizations to access funding.  It can be hard to apply for funding where there is little information about what is available, and where and how to apply.  The process for making applications is also often demanding and time-consuming.  Often donors and big international or national NGOs do not know how to “find” small local community groups.¹²¹

Two bottlenecks identified by CBOs interviewed by Human Rights Watch were the requirement of partnering with large “implementing agencies” in order to receive international funding, and having to tailor funding proposals according to the mandates of these agencies rather than the needs of the community.  Johannesburg’s Sizanani Home-Based Care, for example, said that in order to receive funds from the U.S. government’s five-year, $15 billion President’s Emergency Plan for AIDS Relief (PEPFAR), they would have had to enter into a contract with Nurturing Orphans of AIDS for Humanity (NOAH), an agency based in a wealthy suburb of Johannesburg that wanted to serve 100 fewer children and replace most of the Sizanani staff with unpaid volunteers.  Representatives of Sizanani said they had chosen to forego PEPFAR funding rather than to alter their program in this way.  Another CBO, which chose to pursue PEPFAR funding, said that NOAH required them to construct a new “resource center” for orphans rather than paying salaries to their staff.

The chief of the program services department at the Office of the U.S. Global AIDS Coordinator (OGAC) in Washington, D.C., Michele Moloney-Kitts, told Human Rights Watch that OGAC was committed to providing direct support to local CBOs, but that working through implementing agencies like NOAH was essential for administrative purposes.  Asked why implementing agencies could not allow CBOs to set their own priorities, Moloney-Kitts said that in many cases they did so, but that this depended on the strength of the CBOs in the country in question.¹²²

Governments’ failure to regulate and support CBOs’ responses to Africa’s orphan crisis is tantamount to abrogating their human rights obligations, ultimately leaving children’s welfare to the vagaries of charity.  Under Article 20 of the UN Convention on the Rights of the Child, when a child is temporarily or permanently deprived of his or her “family environment,” he or she is entitled to “special protection and assistance provided by the state,” consisting of “alternative care” such as foster placement, Kafala of Islamic law, adoption, or if necessary institutional placement.  International donors to AIDS-affected countries that have ratified the International Covenant on Economic, Social and Cultural Rights similarly have an obligation to assist local efforts to realize economic, social and cultural rights—including the right to education—to the maximum of their available resources.¹²³  Relying on CBOs to provide this assistance without providing them with adequate support not only exploits their goodwill, but also invites fraudulent or unqualified organizations to take advantage of the lack of government oversight and exploit children.  This is especially troublesome when CBOs are themselves staffed by individuals who are living in deep poverty and burdened by HIV/AIDS.