Children of AIDS: Africa’s Orphan Crisis (Second Edition). Emma Guest. Durban: University of Natal Press, 2003. 176 pp.

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Emma Guest describes her book on children of Aids in Africa as ‘un-apologetically anecdotal’. Before her arrival on the continent, she was a marriage guidance counselor in Britain with limited exposure to the appalling human, social and economic consequences of HIV/AIDS in Africa. She was privy to personal stories from her close friend, an African woman living with HIV/AIDS. Upon her arrival in Africa she began to write about AIDS in Africa. Soon she discovered that there wasn’t a book on children who became orphans because of their parent’s death from AIDS. The result of that discovery lead to the birth of this book in which she documents the daily struggles as experienced by orphans and the heroic attempts of well meaning individuals who have tried to make a difference in their lives.

This second edition calls our attention to a number of discouraging aspects of the current fight against AIDS in South Africa. First, the fight against global terrorism has sidelined the spread of HIV as a global problem. Second, promises of free AIDS drugs have brought a new wave of hope to the millions of AIDS sufferers. But this hope may soon well be dashed as governments can no longer sustain an uninterrupted drug supply.  Finally, South African leadership failed the public and set the clock back in its fight against AIDS by characterizing the international AIDS program as racially motivated. The second edition provides updated statistics. Apart from this update, the core of this book remains intact from the first edition. In general, the book offers only a limited description of the orphan crisis through statistics. However, it offers interesting qualitative descriptions of the life of orphans as the author perceives it in three different countries; South Africa, Uganda and Zambia.

The book opens with a chapter on Zambian orphans under the care of grandmothers who have very little resources to take care of themselves. The Zambian Public Assistance program is supposed to provide support to these grandmothers. The organization is cash strapped, and therefore mostly ineffective.  The second chapter is the story of a woman who took under her care six orphans who lost their parents to AIDS. Child fostering is popular in Uganda as in many parts of Africa. In the age of the AIDS crisis, fostering extends beyond fostering children from blood relatives. The next three chapters provide vivid descriptions of the challenges faced by social groups: foster parents, child care committees, and cluster fostering homes where a group of mutually supportive fostering mothers live in close proximity to each other. Chapter six attempts to examine the orphanage as one of the solutions to the orphan crisis. New orphanages are expensive and many of them depend upon foreign donations and volunteers. Chapter seven highlights the characteristics of the Ugandan success story of HIV/AIDS prevention. Schools in Uganda provide factual information on HIV / AIDS and institutional assistance is often made in kind rather than in cash in order to avoid corruption. Chapter eight discusses the role played by international agencies such as UNAIDS. Here again, the author tells the story of an inspiring UN bureaucrat who has made a difference in the life of Zambian orphans. The last two chapters dwell on stories of children who live alone. In chapter nine we are told of children who have taken on adult family roles in a desperate attempt to stay together. The last chapter is a case study of a very unique individual, a caregiver to street children who are constantly exposed to street violence, sex and drugs.

Through skillful use of case studies, the author examines the role of state agencies, community level initiatives and Non Governmental Organizations (NGOs)  in providing solutions to the orphan crisis in Africa. These orphans will face high level mortality, morbidity and malnourishment as they grow up. As families collapse, agents of primary socialization disappear. As a result, crime and lawlessness are likely to enervate the strength of civil societies.

The crisis deepens as state agencies and community level initiatives fail to co- ordinate their efforts. As a result, a large bulk of orphan care is left to a few committed individuals in isolated communities and NGOs. Social workers employed by state agencies are constrained by rules and regulations which appear to be culturally insensitive to the African concept of child fostering. Consequently, social workers have limited ability to advocate for an expanded model which accommodates unrelated foster children within the African context of child fostering. The author focuses on “stigma” as a major problem limiting the solutions to the orphan crisis. She believes that politicians can play a major role in alleviating stigma through skillful use of mass media. The suggestions she offers are limited. The problem of stigma has to be resolved through programs and policies at the micro and macro levels.

In general the book is well written. It provides a journalistic account of the social, human and economic miseries suffered by African orphans. It alerts us to the formidable task of rebuilding Africa as millions of orphans born to HIV infected parents come of age. The book is a compassionate account of the orphan crisis in Africa to those who want to become familiar with issues of AIDS and orphans in Africa. In addition, this book also offers a critical view of selected initiatives of orphan care, all of which are small, diverse and vulnerable. The author provides very few suggestions on programs and policies to care for African orphans. I recommend this book without reservation to undergraduates, social workers, and any one interested in understanding the African orphan crisis.

Vijayan K. Pillai
University of Texas at Arlington