Children of a lesser god

A surfeit of funding, piety and programmes for children and HIV/AIDS and nothing much to show at the end

Akash Bisht & Trina Joshi Delhi

Saraswati, a nine-year-old girl, lost her parents and a younger sister to AIDS when she was only three. Labelled untouchable at that tender age, she was left to attend to her own bathing and feeding. She was not allowed to play with other children or attend school. "If you touch me you will die, that is what my grandma says," Saraswati would yell when someone tried to touch her. When she developed skin infections her grandmother brought her to Freedom Foundation, a Bangalore-based care home for HIV+ children, who gave her the necessary medical and nutritional attention. Saraswati was fortunate to be brought here. She is one of very few children in India able to avail of institutional assistance.

It is difficult to comprehend the impact of AIDS on children. According to latest figures given by UNICEF there are 5.1 million people living with HIV of which 2.2 million are children. Whereas UNAIDS figures indicate that more than 1.7 million children are HIV/AIDS affected. Rather than serving any purpose, these figures create confusion as every organisation brings out its own version of numbers of people living with HIV/AIDS. "Statistics can create controversies and everybody wants to play safe with them," believed an official in NAZ Foundation, an orphanage for HIV+ children, when questioned about the average number of HIV+ children in an affected family.

One prominent reason for this uncertainty is that AIDS is often assumed to strike only adults. HIV is commonly believed to be transmitted either sexually or through injectable drug use so people do not really think of it affecting children. "The world still thinks of AIDS as an adult illness," observed President Abdul Kalam while launching an AIDS awareness programme recently. These children are the missing faces of AIDS neglected by government and NGOs.

India's HIV/AIDS policy has glossed over children. UNICEF pointed out, "children are being overlooked when strategies on HIV prevention and treatment are drafted, policies are made and budgets are allocated. And investments in prevention continue to be pitifully inadequate." Government and internationally funded prevention programmes have been targeting adults such as sex workers, truck drivers and drug users. NGOs believe that the government has made little efforts to find out the true numbers of children living with or affected by HIV/AIDS, and state officials downplay the number of children living with HIV/AIDS in their states. The procedure for collecting these numbers is rudimentary.

The government has adopted sentinel surveillance, a method of trying to identify the prevalence of HIV with specific numbers within a specific period of time, and this includes testing the blood and trying to find out the percentage only among certain populations: sex workers, STD patients and truckers. In the general category, only pregnant women are being tested. This method has limitations and desperately needs a face lift in order to get the accurate figures. " We were asked to do the sentinel surveillance in Pondicherry. In the surveillance report we included already positive individuals and new infections. These already positive people were accounted for in the last sentinel surveillance and are again mentioned in the new report. So this does not give us an idea of the number of new infections reporting.