[pronut-hiv] PanAfrica: HIV/AIDS And the Children

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PanAfrica: HIV/AIDS And the Children

East African Business Week (Kampala)

COLUMN
July 31, 2006

There are many strategies used in responding to the impact of HIV/AIDS
on adults and children and I am going to consider a few. For our
purposes, I will consider the concerns that have been inscribed in the
Convention on the Rights of the Child (CRC).

First on the list is survival of children. For children who are living
with HIV, it is important to ensure that they are protected diligently
from any form of opportunistic infections such as malaria, cold,
intestinal diseases and pneumonia among others.

Children especially in their infancy cannot be expected to understand
what it means to keep clean, warm or to observe rules of hygiene unless
adults around them supervise them. It is important to note here that,
even children who may not be HIV positive face similar risks in their
infancy and need to be protected from infection of any kind.

As caretakers of children, we need to monitor their health status
regularly, especially if they are living with HIV. For the children who
are HIV positive, we should ensure that they are not struggling against
an unknown opportunistic infection quietly as we take care of them.
Medical check up would always ensure this.

If we can afford at some stage, we should check their CD4 count and
viral load to see whether they need to be put on some form of
anti-retroviral drugs. The drugs for children are still limited, but a
lot of research is going on to try and deal with this imbalance.

Related to health is nutrition. There is currently a lot of work being
done in the region on nutrition especially in relation to our
traditional foods, which are affordable and available.

Many of the regular vegetables we get even in the poorest homes are not
only nutritious, but may also be medicinal. Adults need to deliberately
give children the first priority in feeding, and healthy feeding at
that.

We also have to improve our knowledge of the kinds of easily available
and affordable nutritional foods we have among us. If in any culture,
the children feed after adults, this must be reversed; if they are given
mainly starchy and watery food, this should change.

The aim should always be to have quality before quantity. Past
assessments in certain parts of this East African region have shown that
because of cultural feeding practices, even in the midst of plenty of
food, some children have ended up becoming malnourished, often reflected
in a high number of children being underweight (weight for age), wasted
(weight for height) or stunted (height for age). Stunting is usually
considered chronic malnutrition.

In this region according to UNICEF statistics, the percentage of
moderate to severe stunting in infants (under-fives) between 1996 and
2004 in a number of countries are as follows: Burundi, 57%; DR Congo,
38%; Djibouti, 26%; Eritrea, 38%; Ethiopia, 52%; Kenya, 30%; Rwanda,
41%; Somalia, 23%; Tanzania, 38%; and Uganda, 39%. Many of the countries
that do not have figures for malnourished children are found in Europe,
North America and Australia. There also seems to be a close link between
instability, poverty and malnutrition.

For example, 54% of under-five children in Afghanistan between the
years 1996 and 2004 were stunted, while the figure for Iraq was 22% for
the same period compared to 15% for neighbouring Iran.

It is therefore not a big surprise that a big part of Sub-Saharan
Africa has children facing chronic malnutrition.

We have to however take this with "a pinch of salt" because even in the
countries that have had stability for years, we still see high levels of
stunting; Kenya and Tanzania come to mind when we consider this
contradiction.

If one compared the economies of Somalia and Kenya for example, it
would be quite unfair to say that they are in anyway close. Probably the
answer is not in whether one is poor or rich, highly developed or just
developing, but rather in what kind of feeding practices we have with
respect to our infants.

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The writer is a consultant on HIV/AIDS and development in the Eastern
Africa region based in Nairobi.