HIV/AIDS in Africa: Hope in the midst of tragedy

An Interview with one of the founders of Open Home Foundation International

The Open Home Foundation in New Zealand was started by a Wellington couple who were looking for a different way of helping children in need. Ewen and Gillian Laurenson set up the first small ministry in 1977 which aimed to provide support for children based on the idea that children fared best in families. Built on the promotion of 'families helping families', they became a national organisation in 1986 and their model of care has expanded throughout New Zealand. It is now one of the Ministry of Social Development's largest independent providers of social services for children and families (Troughton, 2013) with an emphasis on a child-centred and family-focused Christian approach.
After an invitation in 1991 to visit India and assist there, Ewen and Gillian started the Open Home Foundation International, which now works in India, Romania and Africa. The Nathaniel Report was pleased to be able to interview Ewen recently and asked him about the International Foundation's work in Africa with families and children who had been affected by HIV/AIDS.
----------------------------------------------------------------------------------------------
The Foundation was first invited to Uganda in 2000, and later to Zambia and Rwanda. The Foundation agreed that it would assist in these countries, by 'standing with them', but would not provide a New Zealand kind of service. Its work in Africa was to reflect the Foundation's vision, described by Ewen:
Every child, regardless of where they live, has the right to belong to a family and community where they are safe, loved, have enough to eat, that they can go to school, have access to health care and know they are loved by God.
In Ewen's words, the Foundation is non-denominational but is Christ-centred and prayer is at the heart of their work. While the basis of the Foundation's work is represented in its vision, the expression of its work differs from place to place depending on local circumstances. The invitation to be a partner in Africa came from a Ugandan pastor who saw the Open Home Foundation pamphlet at an Auckland church. He invited the Foundation to come and help with the enormous numbers of children who had been orphaned as a consequence of the deaths of their parents from AIDS.
HIV/AIDS has had a devastating impact on communities in Sub-Saharan Africa countries. The occurrence of the HIV virus in Uganda as well as other places was exacerbated by a number of local factors that led to appalling living situations for large numbers of families and especially for children. Polygamy was common and prior to the advent of cheap anti-retroviral drugs, once the husband had acquired the virus, all his wives would become infected. Upon the death of their parents, a common occurrence, children were often left to the care of an older brother or uncle, who was likely to have his own family to provide for. The children's care was often undertaken as an obligation, and the children "tolerated rather than loved". In these straitened circumstances there was little chance the children could attend school or receive adequate health care. The impact on families, and especially children, has had far reaching consequences for millions and will take generations to overcome: "A society suffering a profound unexpressed grief."
In 2012 there were 25 million people of this region living with HIV, of whom 2.9 million were children. There have been significant efforts to tackle the AIDS epidemic using a range of approaches, such as the ABC campaign, education about AIDS, the cheaper availability of anti-retroviral drugs and a global initiative (the United Nations Millennium Development Goal of 2000) to halt and begin to reverse the AIDS epidemic. The prevalence of HIV/AIDS in the three countries that the OHF first visited in 2000, Uganda, Rwanda and Zambia, shows that while there has been a concerted effort to reduce the rates of prevalence and to manage the disease, it remains a critical health and social issue.
While the number of new HIV infections continues to fall globally (declining by 50% across 26 countries between 2001 and 2012, and between 25% and 49% in an additional 17 countries ), HIV prevalence in Uganda has been rising since its lowest rate in 2006 , evidence that a degree of complacency has set in in some areas. In Zambia the prevalence rate of 13% (reported as being higher in urban areas) has not changed since the mid-nineties ; and in Rwanda, the relatively low prevalence rate of 2.9% masks the unequal impact of the disease as the prevalence rate for some of the most at risk groups is as high as 15% .
Overall the impact of HIV tends to fall unequally on women. For example, for Zambian women aged 15-24, the prevalence rate is twice that of men in this age group and in Uganda the prevalence rate for women is 5.4% compared with 2.4% for men. There are 170,000 children in Zambia estimated to be living with HIV and in 2009 there were 690,000 AIDS orphans3. In Uganda, in 2011, there were estimated to be 1.1 million children orphaned by the AIDS epidemic2, and in Rwanda in 2012 there were 120,000 AIDS orphans. The prevalence rates for women are higher for a number of reasons, including women's greater exposure to sexual violence, the refusal by their husbands or partners to use condoms, and the fact that women marry and become sexually active at younger ages than men, often marrying men who are older and may have already had a number of sexual partners.
Without doubt, the introduction of anti-retroviral drugs, and particularly the earlier access to and the reduced cost of treatment, has contributed to fewer AIDS-related deaths. These subsidised anti-retroviral drugs have meant that adults between the ages of 20 to 40 or more years, the 'provider generation' who had previously died or were incapacitated by HIV/AIDS, are not just surviving but are able to provide for their children. When the children are better supported and are freed from their caring roles, they are better able to access education.
Ewen's own experience of grief after his father died when he was 12 years of age, has enabled him to relate to the grief carried by these children, many of whom had lost both their parents and other close family and friends, as well as experiencing a 'loss of place' necessitated by a move to other areas. In the main, and in the absence of proper support, the children were simply expected to 'get on with it'. Their grief was often exacerbated by neglect, rejection and abuse and, for girls, by early sexual experiences not of their own making.
In the early 2000s, the focus of the Ugandan government's ABC (Abstinence, Be faithful, use a Condom) programme, was on the 'Abstinence and Be faithful' aspects, something that contributed to the drastic reduction of infection rates in Uganda when compared with other countries. Ewen, reflecting on how this approach conflicts with western notions of freedom, especially freedom of sexual expression, notes that many women, especially those who are victims of violence and rape, have limited control over their sexual relationships. Ewen has always been a strong supporter of the Abstinence and Be faithful approaches; they make sense in light of the evidence of reduced infection rates and have a particularly good chance in the places where Christianity is strong.
In addition, other measures have been introduced to resist the cultural forces which have exacerbated the HIV/Aids tragedy in Africa, particularly the domination of women by men . Ewen noted that girls are much less likely to be at risk if they are at school and being educated. He has also observed that 'women and girls are the cultural changers'; some education and a small amount of money can feed on their hope for a better life for their families. He believes that the education of girls is the key to lifting the family and community out of poverty. Meanwhile OHFI has conducted training seminars on the care and protection of young children, encouraging attendees to look beyond their own children, out to the needs of other children who are at risk.
In spite of the poverty and hardship suffered by the people of Uganda, Zambia and Rwanda, Ewen was constantly inspired by the expressions of hope there. He found the way the people expressed their love and hope through song exhilarating, and thought that their singing and their community orientation, as well as their openness to things of God were gifts they had that we had lost in New Zealand.
--------------------------------------------------------------------------------------------------------
In Rwanda the OHFI has partnered with a group called PHARP (Peacebuilding, Healing and Reconciliation Programme). PHARP members identify key women in a community, encourage the education of these women in a variety of life skills such as hygiene and diet, and assist them to develop small businesses. They also teach them about conflict resolution and reconciliation, focusing particularly on those who have previously harmed them. A number of the women had been grievously harmed by the genocide and the murder of some of their own families. As a consequence of the genocide, the rapes and the civil and political unrest for years afterwards, there are many orphaned, vulnerable children within every community.
PHARP asked if OHFI would come in and help them with training, talk to the people about the care and protection of children, and work with them to develop a programme for the children. They also asked if OHFI, working alongside local people, could help to develop a project that would create sufficient funds to support the schooling and health care for the children. As a result OHFI became involved with a community in Gicumbi.
The key contact they worked with there had lost his wife and children and forty members of his family to the genocide. He introduced Ewen to his small church where there were fifteen women who had HIV/AIDS, along with some of their children. Towards the end of the service another group of about fifteen women arrived from different churches. All were infected with HIV/AIDS and they came together once a week, spending some time together, praying, listening to one another, and providing support and encouragement to each other. Because of their impoverishment, none of the children was able to go to school or get the health care they needed.
Ewen described the scene in the church: "I always remember, these women stood and sang, actually they didn't just sing, they danced and sang. I asked for an interpreter, and it was really a song of love and hope and forgiveness and of a determination to make a better life as much as they were able to." Many of these women had contracted HIV/AIDS while being raped and had subsequently passed on the virus to their children. "So they'd been really traumatised. I was so taken by the suffering of these women, and yet by the faith and love and the hope that they were expressing." Afterwards, Ewen learned that they would love to be able to start a 'pig project' with the aim of breeding pigs.
When asked by the Wellington Cenacle Sisters for suggestions about a Christmas gift they could make, Ewen told them about the women of Gicumbi. The Sisters' then contributed to the purchase of eleven piglets – ten sows and a boar, and the OHFI undertook to pay a veterinarian to provide the local women with training in the care of the pigs. Subsequently 11 families were selected to receive the pigs; they were successful in caring for and breeding the pigs and handed on a quarter of each litter to another family.
The project was such a success that, when Ewen last visited, the group had grown to about 60 families, all owning pigs. Their children were all attending school and they were able to afford health care for their children, including the all-important anti-retroviral drugs which had been unaffordable before this project started. As this project has grown, again with money provided from New Zealand, the community has been able to purchase land, and they now plan to set up a communal piggery which will be used for the benefit of their more vulnerable children. Because of this project at least 200 children now have better lives and can look forward to a better future.