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Missing generation: South African AIDS epidemic leaves elderly raising the children

SOUTH AFRICA (BP)–Children run wildly up and down the path — turning cartwheels and chattering along the way. Several steps behind, their granny walks stiffly, holding onto her oldest granddaughter’s arm for a steadiness she hasn’t had in years.

The contrast between youth and the elderly is drastic in this country. An entire middle generation is missing, creating the huge gap. HIV/AIDS wreaks its havoc in South Africa almost daily.

“People are dying and no one wants to talk about the cause,” a South African grandmother says as a bell tolls five times in the background. The ringing bell signals to the rest of the village that someone just died. “Every day that bell rings and every Saturday we go to funerals. Our young people are dying like never before.”

A South African survey published in March 2004 shows that South Africans spend more time at funerals than they do having their hair cut, shopping or grilling out. It found that over twice as many people had been to a funeral in the past month as had been to a wedding. It is estimated that about 600 people in South Africa die of HIV-related illnesses each day.

The missing generation can be found if you look hard enough. Many are buried beneath fresh graves. To find others, take a stroll to the backrooms of flimsy, tin shacks dotting the country. Emaciated and weak, this missing generation barely makes a wrinkle under blankets.

“I wouldn’t wish this fate on anyone,” says Margret Sithole, a young adult who volunteers as a home-care worker for HIV patients. “My peers are dying. Soon there will not be enough left in this age group to take care of the children or the elderly.”

Typically, half of the people with HIV become infected before they are 25. They then develop AIDS and die by the age of 35. They leave behind a generation of children to be raised by grandparents or left on their own in child-headed households.

AIDS is generating orphans so quickly that family structures are struggling to cope. Traditionally, aunts, uncles and grandparents absorb orphans into already existing family systems.

So far, the AIDS epidemic has left behind an estimated 15 million orphans worldwide. Around 80 percent of these live in sub-Saharan Africa. The most recent United Nations UNAIDS reports estimate that the number of children orphaned by AIDS will rise dramatically in the next 10-20 years. In South Africa alone, it is estimated that by 2010, there will be 1.5 million children orphaned as a result of AIDS.

“In the old days, the young took care of the elderly and children,” a South African grandmother says. “Now, there are only grannies and children left.”

This granny just returned from the hospital. Still weak from her almost deadly bout with high blood pressure, she came home early because there was no one to watch the children. The responsibility of this multi-generational family rests on her shoulders alone. In the old days, she could have depended on neighbors to help with the extra load orphans bring, but not today. Her neighbors and friends have their own orphans to watch over.

Nearly 90 million Africans could be infected by HIV in the next 20 years if more is not done to combat the epidemic, the UN has warned. Currently, some 25 million Africans have HIV, which causes AIDS.

While things might seem hopeless as a generation of providers falls victim to HIV/AIDS, International Mission Board missionaries Andy and Gay Wilkinson say there is still hope.

“If we can reach this younger generation before they become infected, then we can stop the cycle,” Andy says. “The hope is in the kids. They will have to break cultural barriers and not have sex outside of marriage. They need to know Christ and live godly lives.

“AIDS is a pandemic, but it’s also the greatest opportunity to bring people to Christ.”

HIV/AIDS Statistics (source: Unite Nations UNAIDS estimates 2003)

HIV/AIDS deaths in 2004:
Sub-Saharan Africa: 2.3 million
Worldwide: 3 million
All-time, more than 15 million Africans have died of HIV/AIDS.

Children orphaned by AIDS
Sub-Saharan Africa: 12.3 million
Worldwide: 15 million

South Africa
Estimated population: 40 million
Living with HIV: 5.3 million
Babies infected: 96,228
11.4% of population over the age of 2 has HIV/AIDS

Speed of the spread of HIV
High-income countries: 4 percent
Eastern Europe & Central Asia: 16.2 percent
Caribbean: 12.3 percent
North Africa & Middle East: 19.2 percent
Asia: 16 percent
Latin America: 15 percent
Sub-Saharan Africa 12.4 percent
Australia and New Zealand: 15.6 percent

Increase in HIV Infections (1999-2002)
North America: 16 percent
Caribbean: 53 percent
Latin America: 35 percent
Western Europe: 15 percent
Eastern Europe and Central Asia: 196 percent
East Asia and Pacific: 75.5 percent
North Africa and Middle East: 74.4 percent
South and Southeast Asia: incomplete data
Sub-Saharan Africa: 52 percent
Australia and New Zealand: 7 percent

Sub-Saharan Africa
People with HIV: 25 million
Percentage of world’s HIV cases: 66.1 percent
New cases in 2003: 3 million
AIDS deaths in 2003: 2.2 million