DATE=05/08/02

TYPE=BACKGROUND REPORT

NUMBER=5-51577

TITLE=AFRICA AIDS / CHILD MORTALITY

BYLINE=DELIA ROBERTSON

DATELINE=JOHANNESBURG

CONTENT=

VOICED AT:

INTRO: Loss of life from H-I-V and AIDS among children in sub-Saharan Africa has set back death rates to the higher numbers of the 1980's. And as V-O-A's Delia Robertson reports from our southern Africa bureau, the pandemic is creating a spiral of death and poverty that is ever more difficult to combat.

TEXT: One-and-a-half-million pregnant women in sub-Saharan Africa are H-I-V-positive. Most of their children either will be born H-I-V-positive or will be infected as babies through breast-feeding.

About 200 in every one-thousand babies will die before their fifth birthday -- wiping out 20 years of gradual reduction in child mortality in sub-Saharan Africa. In industrialized countries, only about seven babies of every one-thousand die before age five.

A chief reason for that death rate among children: the southern and east African regions have the highest rate of H-I-V infection in sub-Saharan Africa -- and the world.

The regional director of UNICEF for east and southern Africa, Urban Jonsson, says that there has never been another pandemic like it.

/// JONSSON ACT 1 ///

But the H-I-V/AIDS pandemic and crisis is significantly worse in east and southern Africa, and particularly in southern Africa. In southern Africa, we have prevalence rates that were unthinkable regarding any disease, any time in history. Botswana -- one-third of the adult population is infected. That has never happened in any country, any time in history.

/// END ACT ///

Mr. Jonsson says it is not only AIDS itself that is killing children under five. He says even more children die because of the impact of the disease on families and communities.

/// JONSSON ACT 2 ///

But that is a smaller contribution. The bigger contribution is of course those who are affected by H-I-V and AIDS. These are living in families which are getting very much poorer during an H-I-V/AIDS crisis in the family, whether it is the father or mother or both or relatives. So the overall impact is significant. We can say that in many countries now, infant and young child mortality rate is back to the values we had twenty years ago.

/// END ACT ///

Mr. Jonsson says that very few studies are being done into the reasons the infection rate of H-I-V/AIDS has exploded in east and southern African countries. He says one reason is the depth of poverty in the region, which creates the conditions in which the virus can flourish.

/// JONSSON ACT 3 ///

So, poverty is not just a cause, poverty is H-I-V/AIDS. Poverty is space in which H-I-V/AIDS thrives. And of course H-I-V/AIDS, when it develops into AIDS, the disease, contributes to poverty in many different ways, not only that adult people, who are the right age cannot work any longer, they also cost a lot of money -- hospital services and a long range of things. So I cannot separate the explosion of H-I-V/AIDS from poverty (in southern Africa). They are one and the same -- one cannot be understood without the other.

/// END ACT ///

South Africa has one of the highest rates of H-I-V/AIDS in the world, with as many as 20 percent of the adult population believed infected.

Eight years ago, the focus of one of the oldest children's homes in Johannesburg, Cotlands Baby Sanctuary, shifted from caring for disabled children to caring for children dying of AIDS.

Last year, nurse Stella Mahlanga took over as director of the children's AIDS hospice at Cotlands. Since then, she says, the number of children dying has increased from one or two each week to three or four. But she says it is not only at the hospice that she has seen children die.

/// MAHLANGA ACT 1 ///

There are so many children that are dying out there. We have a home-based care program here at home, we deal with people from Soweto, from Tembisa, and from KwaZulu Natal in Hlabisa. The number of children that are dying is appalling, and now recently we are faced with children that are dying and parents that are dying and children are left to take care of each other.

/// END ACT ///

/// OPT /// In addition to caring for the children, the staff at the hospice must also counsel and support their families -- and each other. Nurse Mahlanga says they comfort each other in laughter and gain strength from knowing that they have cared as best they can for each child.

/// OPT MAHLANGA ACT 2 ///

What we usually do -- we do a lot of counseling, we talk to the care-givers a lot, and our worry is always is their emotional state because with so much death around us we have to keep on talking about it. And what encourages us is we do the best we can. And when a child goes -- we know they are going to die but we never just neglect them and say they are coming to die here -- when the child goes, we know that we've done our best, we've offered our best.

/// END ACT // END OPT ///

This week, the Cotlands hospice staff is faced with the looming death of a seven-year-old boy whom they have named the Prince of Cotlands.

/// MAHLANGA ACT 3 ///

So he's faced with so many problems. And since he came here as a two-year-old, he's lived 'til seven and he's seen so much death he becomes anxious. He's oxygen dependent, he lives on oxygen 24 hours a day, and once there is anything wrong with his oxygen, he becomes so anxious and we all look after him. He's very charming and he also has a big heart because even if he's sick, he always has time to talk to his friends and tell them that they'll be well.

/// END ACT ///

When the life slips from his small body, the Prince of Cotlands will do more than add another statistic to the child mortality rate of sub-Saharan Africa. Nurse Mahlanga says he will leave behind an example of living with a big heart in the face of pain and weakness. (Signed)

NEB/DAR/JWH/RH