WORLD AIDS DAY - December 1, 2004
The Injustice of AIDS: Poor Africans Left to Die
Millions of Kids Losing Parents
March, 2004: 13-year-old Ester was heading home from school in her hometown of Naivasha, Kenya, the dust rising in clouds as she made her way down the dirt road with her youngest brother, 3-year-old Patrick, on her back (shown in picture below). Her two other brothers, ages 7 and 8 strode alongside as they approached the tin shanty where they lived with their mother who was dying of AIDS.
It was midday in the full March sun, but little light penetrated their small hovel that contained just a bench, a chair and a rough-hewn wooden bed where her mother lay, looking shriveled and well beyond her 34 years. Ester lit a charcoal fire in the corner, stooping to prepare the family's only meal of the day - corn meal mush and cabbage. Patrick took a seat on the dirt floor, a sad-looking boy with deep, lifeless pools for eyes.
Esther had become the primary caregiver in the family since her mother, Susan Andukais (in picture at left), had developed sighs of AIDS in the fall of 2003 and had been unable to keep up her work of tending cattle. Her husband left her and the four children behind. One can only guess his reasons - the stigma that weighs so heavily in African communities in the throes of AIDS. And so Esther became the head of her family, the responsibilities of an adult, falling upon her shoulders well before they had any right to do so.
Esther's family was among the poorest of the poor in Naivasha, a sprawling hardscrabble town northwest of Nairobi, best known for its lake, with thousands of flamingos. Tourists used to flock there, but they stopped coming after Sept. 11, and the economy has taken a tumble. For those fortunate enough to find work, the average wage is $1 a day. Esther's family had no income at all.
Esther spent her time dong the washing, helping her frail mother in and out of bed and scrounging for food. Days would go by when they had nothing to eat, and then she would fret. At night, she and her brothers slept on the cold, earthen floor, their mother's tubercular cough piercing the silence. Esther could not read and had never been to public school as she could not afford the $14 for a uniform, much less shoes or books. It was only through the generosity of the nuns at Upendo Village, that the family received food and the children were able to attend a local school.
Despite the lack of resources, Esther never complained. She spoke in a gentle voice; occasionally she might even smile. She was thin, and her short, braided hair had that reddish tinge common to those on the verge of starvation. She was neat in her appearance, gracious in her manner.
Her mother has since passed on. Susan died in April, as the complications of AIDS overcame her. As a poor African woman, she could never hope to get treatment for HIV - expensive, life-sustaining drugs that have long been taken for granted in this country. That she should be denied treatment seems outrageous, but like many of her fellow Kenyans, she had come to expect very little in life.
So Esther and her brothers are now official AIDS orphans among the 12.3 million in sub-Saharan Africa, according to the Joint United Nations Programme on HIV/AIDS. The U.N. agency now projects that 18 million children in the region will be on their own by this decade's end.
The four youngsters since have gone to live in an orphanage in the nearby town of Gilgil, where they are being well-cared for. It's not an ideal solution, but better than the alternative, which for most Kenyan orphans means a precarious life on the streets.
Today is World AIDS Day, which frames this reflection on Esther, on her lot in life and on the gnawing injustice of it all. While AIDS patients in the United States, most often have the benefits of antiretroviral therapy, most in Africa languish and die; less than 1 percent of the 25 million HIV infected patients in sub-Saharan Africa have access to this life giving antiretroviral therapy. And the United States continues to pursue a go-it-alone AIDS Policy that hurts rather than helps, those in Africa and around the world who are hardest hit.
For instance, U.S. Secretary of Health and Human Services Tommy Thompson recently argued for a delay in grants made by the Global Fund to Fight AIDS, Tuberculosis and Malaria, and it's likely the U.S. contribution to the fund will be cut next year - moves that could further impede access to treatment and threatens vital AIDS projects in countries throughout Africa.
And while some may feel we should be focusing our attention here at home, the current administration is equally cutting funding to AIDS support services here in the United States, an action that will likely lead to similar results here as are being seen in Kenya.
Surely we can do better. Susan Andukais and the millions around the world like her deserve more than an untimely, undignified death from AIDS. And orphans like Esther deserve more than a life without a parent to guide them.
Written by Ruthann Richter, the director of media relations at the Stanford University School of Medicine.
Photos by Karen Ande, who is documenting the HIV/AIDS crisis in Africa at www.andephotos.com.
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