| By Matome Ramuelo,
on 14 February 2007
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 It is now an open secret that the AIDS (Acquired Immune-Deficiency Syndrome) crisis has been wreaking havoc in many of the Sub-Saharan African economies over the last 20 years. By and large, the response to the epidemic resembles a mop-up operation after a tsunami. Sadly, this tsunami has far deeper consequences, and it is relentless.
The sheer impact of the epidemic has left millions of destroyed families and orphans in its path. This has prompted a flurry of activity in civil society in an attempt to shelter vulnerable and orphaned children. Questions always arise about the best way to look after the little helpless victims of this deadly serial killer.
South Africa is not only the economic powerhouse of Africa it also has one of the highest incidences of HIV (Human Immune-deficiency Virus) in the world. This former pariah state provides fertile ground for activists to try out the best "HIV/AIDS orphanage" model. At this stage it is unnecessary to critique the intentions of these activists because there are just too many children who have been affected by AIDS.
AIDS has come to South Africa on the back of high unemployment and poverty levels. The double effect on children is devastating. Generally, the consensus is that no child should be institutionalised. Thus, community-based places are preferred; although they also have their problems.
The classic form of orphanage is where children are housed in a dormitory-type facility. Meals, accommodation, and sometimes medical care are provided on-site. Usually there will be a house manager or a child care worker who will perform general duties and provide basic care to the children. This is the most common model of care for vulnerable and orphaned children.
In this set-up it is usually common for the organisation to raise funds from individual donor agencies, rather than government-linked programmes. This is mainly because most state organs view these institutions as being removed from the community, and they are not keen to finance what they feel should be a measure of last resort.
There is still a stigma for children who are 'institutionalised', and this is compounded by the stigma attached to 'AIDS babies'. The ultimate goal of even these institutional orphanages is to place as many children in foster care 'in the community'.
Then there is the community-based orphanage, the most desirable form of child care. Normally this would involve placing the children with a foster parent in their community home. This might be a relative who has a family of their own and who is willing to look after the vulnerable child. Some of these are coordinated by social workers and community childcare committees. The committees have fieldworkers who are trained to find vulnerable children in their community and find surrogate families for them. The social-worker oversees this process and handles the legal requirements for the foster family.
The one major advantage of this system is that the community itself is involved in looking after their children, rather than rely on external resources. This community committee-based childcare model can be successful as long as the committees become self-sustainable. It is rather difficult to coordinate finances and to make sure that the children benefit from these.
Lastly, there is what has been dubbed the 'foster cluster homestead', a new idea pioneered by Heather Reynolds from South Africa's KwaZulu-Natal province. This is the province with the highest HIV/AIDS prevalence in the country and most of the vulnerable children are found there.
The cluster fostering model is a compromise between the institutional and community-based form. Funds are raised to build inter-linked cottages to accommodate a foster parent along with four or five children. Usually, the foster parents are destitute grandmothers who will then take on additional children at the cluster home. This essentially combines the institutional model, where the children are housed in a single facility, but includes a community aspect to it because they are each a family with their own house.
This form of childcare faces the same difficulties in raising funds because the children are 'removed from the community'. At the same time this might be a more effective way because it also benefits the foster mothers as well.
Nonetheless there may be some resentment in the community that the children housed in such institutions are better off, since they do not have to face the crime and squalor beyond the orphanage fences.
This feeling was very strongly expressed recently when pop star Madonna adopted a Malawian orphan. "How did she expect to solve Africa's problem by just adopting one child? Did she do it just for image? Why was she removing the child from his community?" was the exclamation.
This just goes to show that the problem of vulnerable and orphaned children is very extensive indeed. Whether enough is being done to address it and prevent it from escalating is the one issue that is still being debated.
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