Ellen Rumhungwe doesn't need a 15-page report from UNAIDS and the World Health Organization to understand the devastating effects of the HIV/AIDS virus in sub-Saharan Africa. She lives the story every day in Mbare, a suburb of Harare in Zimbabwe. A widow over the age of 65, she alone cares for her eight grandchildren because their parents—her children and their spouses—have all died of AIDS.

• White House AIDS Summit
• Orphan Trusts in Zimbabwe
• The Uzumba Orphan Trust

A man in Zimbabwe who lost his wife to AIDS. Photo by Lowell Tindell.

The AIDS Epidemic Update, which was released by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) in November 2000, revealed dire statistics for sub-Saharan Africa. Of 36.1 million reported cases of HIV/AIDS worldwide, 25.3 million are in Africa south of the Sahara. That amounts to 70 percent of all the cases in the world. In addition, the report shows that, of the 5.3 million new cases of AIDS reported in 2000, 3.8 million of them occurred in sub-Saharan Africa.

"The AIDS situation in Africa is catastrophic," said Dr. Peter Piot, the executive director of UNAIDS, upon release of the report. "Sub-Saharan Africa continues to head the list as the world's most affected region. One of the greatest causes for concern is that, over the next few years, the epidemic is bound to get worse before it gets better. The region faces a triple challenge: providing care for the growing population of people infected with HIV, reducing new infections through more effective prevention, and coping with the impact of the 17 million deaths on the continent."

Lester R. Brown, of the Worldwatch Institute in Washington, DC, has taken the new statistics and projected what they will mean for Africa 10 years from now. "This year began with 25 million Africans infected with the virus," he said. "In the absence of a medical miracle, nearly all will die before 2010. Each day, 6000 Africans die from AIDS. Each day, an additional 11,000 are infected."

In contrast to most other epidemics and diseases in the world, which hit the elderly and the very young the hardest, AIDS claims young adults. Brown speculates that a number of African countries with high HIV-positive rates—such as Botswana at 36 percent of its population, Zimbabwe at 25 percent, and South Africa at 20 percent—will lose nearly a third of their productive working adults by 2010. This will greatly affect the economies of African countries and has already affected African businesses. But the grim statistics continue.

"The wholesale death of young adults in Africa is creating millions of orphans," Brown noted. "By 2010, Africa is expected to have 40 million orphans. Although Africa's extended family system is highly resilient and capable of caring for children left alone when parents die, it will be staggered by this challenge. There is a real possibility that millions of orphans will become street children, trying to survive by whatever means they can."

United Methodist churches across Africa have taken the lead as the church seeks to minister to individuals, such as Rumhungwe, and to families headed by children and young teenagers. Churches seek ways to educate their local communities about the causes and prevention of AIDS. But perhaps the hardest and most immediate task for the church is to create an atmosphere in which the stigma of AIDS is removed so that those most affected by the disease can receive care while their families receive the necessary support. On an international level, the United Methodist churches in Africa have pushed to have a voice in AIDS policy decisions.

White House AIDS Summit

The Clinton Administration and the US Agency for International Development (USAID) focused on the role religious leaders could play in the fight against AIDS at the White House AIDS Summit on World AIDS Day in November 2000. The White House hosted back-to-back conferences: "A Consensus From Conscience: Revealing the Role of Faith in Response to AIDS" and "Animating Theology: Turning Faith Into Action in Response to AIDS." Christian, Jewish, Muslim, and Buddhist leaders attended the summit, including two United Methodist bishops: Zimbabwe's Bishop Christopher Jokomo and Bishop Felton May of the Baltimore-Washington Conference.

Bishop Jokomo felt that the conferences were a breakthrough, describing them as "a major realization that the churches have a major role to play in the whole matter of HIV/AIDS." He believes that the churches will provide a more effective base for fighting the conditions that spread AIDS than large government bureaucracies. "You need to work with community-based groups," he said. "That's the message we have given to USAID."

Matilda Jambga with children of the Uzumba Orphan Trust. Photo courtesy Matilda Jambga.

President Clinton called upon religious leaders at the conference to work to end the silence about the causes of AIDS and to remove the stigma that victims of the disease often suffer. "Meeting both these challenges will be impossible without the moral leadership that in so many places only religious leaders, like those here today, can provide," he said.

Bishop May expressed support for the new approach to combat AIDS. "Heretofore, monies have been funneled through governments," he observed, "but now the US leaders are seeing the tie between strong faith, good health, and good social practices." Bishop May hopes that as much as $100 million will be available to support the work of faith groups globally in combating AIDS.

Orphan Trusts in Zimbabwe

Sandra Thurman, the top AIDS policy official for the Clinton Administration, traveled to Zimbabwe to visit some of the AIDS ministries of the Zimbabwe United Methodist Church. The Family AIDS Caring Trust, a program of several churches in Mutare, deploys 137 volunteers to help care for 4000 orphans. Thurman was introduced to Willard Tinet, 15, who has been raising his brothers, aged 14 and 12, since 1994, when their mother died of AIDS. The Zimbabwean church developed "orphan trust" projects in line with the traditional African methods of caring for orphans: in extended families.

AIDS orphans in Murewa. Some of them are already HIV-positive, while others risk getting the virus from the open cuts of infected siblings. Photo by Lowell Tindell.

In most African societies, when parents with young children die or are otherwise unable to care for their children, the extended family takes over. If the extended family is not able to take the responsibility, the whole village becomes the extended family. In the face of the AIDS crisis, it is possible that all of the young adults in an extended family may be infected with the virus. Those who are left may already be caring for children of their siblings or cousins. Orphan trusts make it possible for the children in a family to stay together within their household while receiving help from the people of the church in the community.

The Uzumba Orphan Trust

The Uzumba Orphan Trust began in 1995, with 15 volunteer caregivers and 815 orphans in the community of Uzumba, just outside Murewa, according to Matilda Jambga, Coordinator of HIV/ AIDS and Health Issues for the Zimbabwean United Methodist Church. The trust began after a group of pastors attended workshops that Matilda Jambga gave. The Ministry of Health in Zimbabwe, aware of the dire statistics overtaking the country, has enlisted the help of churches and service agencies to educate their constituencies about HIV/AIDS. One of the pastors, Passwell Chitiyo, introduced the idea of the orphan trust to his congregation.

The children remain in the community in their own households. Volunteer caregivers, many with families of their own, visit each such household, evaluate the children's living conditions, assess the availability of food, and look after the children's health, determining whether they are able to attend school. The children range in age from infants to teenagers. Today the Uzumba Orphan Trust has 198 volunteers and serves 4200 children.

"We have to register the children as AIDS orphans," noted Ben K. Jambga, Patron of the Uzumba Trust. "We need the death certificate, and one or both parents must have died from AIDS. This is required by the Ministry of Health." In order to support the children, the orphan trust sets aside farmland that the volunteers develop. Produce from the fields is for the trust. A portion is sold to provide income. A grinding mill and a chicken-raising project also provide income for the Trust. As the Uzumba Orphan Trust develops, the church would like to provide more services, such as transportation, daycare, other income-generating projects, and vocational training for the youths.

Child-headed households are becoming commom throughout sub-Saharan Africa. Orphan Trusts seek to care for children whose parents have died from AIDS by enlisting the help of the whole village. Photo by Lowell Tindell.

In Zimbabwe, children must pay school fees to attend the "public" school system. The United Methodist Committee on Relief (UMCOR) has provided grants to the Uzumba Orphan Trust to pay the tuition for 2000 primary school students and 2000 secondary students.

Leaders from other communities have asked Matilda Jambga how to start orphan trusts in their communities. They have asked The United Methodist Church to help them care for the growing numbers of orphans who live in their villages.

"We also care for children in difficult circumstances, for those who have been abandoned," said Matilda Jambga. "Although the Ministry of Health wants the AIDS orphans registered for the purpose of assessing the impact of the virus in Zimbabwe, we do not make a distinction when we offer care for the orphans."

Matilda Jambga also holds workshops for adults who work with the orphans and for those who care for relatives who are infected by the disease. "We have to teach them about the proper handling of blood, about washing, and about how to use latex gloves, which are hard to come by here," she reports. "We see the dear old grandmothers caring for the children, but they don't know about safe handling. They end up infected from a cut on a child that they don't know is infected, and they die as well."

UMCOR, in association with Interchurch Medical Assistance, Inc. (I.M.A.^®), is developing an infectious-disease-control kit that will help in the care of HIV/AIDS victims. The kit is designed to include some of the basic necessities for safe and effective care of the patients, while offering products to protect the caregivers, such as latex gloves. Churches in the United States and Europe will be asked to put the kits together for shipping, in much the same way that the Medicine Box kits or the Health Kits are done. The infectious-disease-control kits are designed to be used in the home but would also be quite useful in hospitals or clinics.

Although the problem is widespread and the statistics overwhelming, the solution, as Bishop Jokomo expressed it, may not lie in the decisions of the large government bureaucracies so much as it lies in the village homes and huts of the people who suffer. The ability of Africans to educate other Africans as to the causes and prevention of the disease will make the difference. In many African countries the virus runs its course unchecked. But in Uganda, a nation that was hit early in the crisis and had high HIV/AIDS statistics in the 1980s, the incidence of infected adults in the population has dropped from 14 percent in the early 1990s to 8 percent in 2000. With the mobilization of the health, education, religious, and industrial sectors of the society, it is possible to reduce the number of new infections. Only by stopping the spread of AIDS can we end the epidemic.

To support the work of UMCOR as it seeks to meet the challenge of the AIDS crisis, give to
UMCOR Advance # 982842-6: AIDS Orphan Trust.