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The statistics on AIDS orphans reveal that an estimated 15 million children under 18 have been orphaned by HIV/AIDS worldwide, with around two million of them living in India, the largest number for any individual country. Even if all HIV infections were to be checked today, the numbers orphaned will continue to spiral upward due to the time lag between contracting the HIV infection, death and orphanhood. Thus, while the situation of AIDS orphans is grave, the worst is yet to come.

In India, there is limited experience for implementing care and maintaining support systems for children orphaned by AIDS. Informal arrangements such as family or community-based care are very rare. Human Rights Watch found several cases in which institutions had turned away children because of their parent’s HIV+ status. Paradoxically, the potential harm to children from institutionalisation has been well documented.

Research has shown that the children in institutions lack basic and traditionally accepted social and cultural skills to function in their societies. They lack basic life skills, and parental skills. Therefore they have more difficulties with relationships after leaving an orphanage. It is recognised that compared to institutionalisation, community-based care is cost-effective and provides the children with a familiar, social, cultural and ethnic environment. Institutional care can be the option of last resort in this scenario.

Therefore, socio-economic assistance and psychosocial support to an AIDS orphan at all levels, i e, the family, community, national and international, is an urgent need at this crucial stage of the crisis. At the national level, the important role of the government is to formulate a national strategic plan to tackle the problem of children affected by AIDS, duly reviewing supportive policies and programmes. However, such a strategy should focus on (i) the provision of free education and vocational skill training to orphans and vulnerable children that would be a quintessential safety net for their future, (ii) educating, training and sensitising of the community and resource mobilisation to foster families, (iii) providing nutritional support in addition to anti-retroviral therapy and other medical treatment to HIV-infected households to enable the children and their parents to live together for a longer period of time, and (iv) protecting the legal and human rights of AIDS orphans – the inheritance rights of children and preventing land and property grabbing. International attention has a major role to play in developing an “enabling environment” that supports all levels of response. Unless an immediate coordinated and sustained effort with a holistic child-focused approach is initiated for addressing the psychosocial needs of the children affected by HIV, the “orphan issue” will remain “orphan” forever.

AVANJALI SATHPATHY

Chennai

(Continued on p 3736)

(Continued from p 3626)

Comments on RBI

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I would not like to give a rejoinder to Chandavarkar’s comments for the simple reason that the language employed in it is not academic in tone. I strongly believe that in the Indian guru-shishya tradition, it is the guru (that is how my generation sees Anand Chandavarkar) who should revel in joy when the shishya gets out of his/her shackles and explains his/her views.

Satyaranjan Sathe

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