Summary and Main Recommendations
When Mother died, I really lost all hope. No one bothers to look after you when you have no mother and no father.
—A seventeen-year-old boy orphaned by AIDS in Uganda
Governments in sub-Saharan Africa have failed to address the extraordinary barriers to education faced by children who are orphaned or otherwise affected by HIV/AIDS. An estimated 43 million school-age children do not attend school in the region. HIV/AIDS has caused unprecedented rates of adult mortality, leaving millions of children without parental care to ensure their access to education. While providing limited support to community efforts that support orphans, governments have failed to address the unique disadvantages faced by AIDS-affected children, with the result that these children are less likely than their peers to enroll, attend, or advance in school. This form of de facto discrimination places AIDS-affected children—whether orphans or those whose parents are terminally ill—at higher risk of sexual exploitation, unemployment, hazardous labor, and other human rights abuses, as well as at higher risk of HIV infection.
This report is based on detailed interviews with dozens of children affected by HIV/AIDS and their caregivers in three sub-Saharan African countries—Kenya, South Africa, and Uganda. Their testimonies revolve around a common theme: neglect and
abuse within families, in communities, and by schools and governments have hindered AIDS-affected children’s ability to enroll, remain, or advance in school. Children whose parents were terminally ill dropped out of school to act as caregivers to their parents and younger siblings. The successive death of multiple family members to HIV/AIDS led to the gradual erosion of children’s extended-family safety net, resulting in inadequate financial support for schooling. Parental illness or exploitation by subsequent caregivers led children to work long hours to offset lost family income or provide basic sustenance. The stigma associated with HIV led to taunting by peers, and made it difficult for children to communicate with their teachers about illness or death in the family. Children who were themselves HIV-positive experienced prolonged absences from school due to ill-health, poor access to essential medicines, and AIDS-related stigma and discrimination.
In the face of these hardships, the governments of Kenya, South Africa, and Uganda have turned their backs on the education of AIDS-affected children. In each country, it was official government policy not to deny education to any child who could not afford
to pay school fees and related expenses. Kenya and Uganda offered free and universal primary education, while South Africa had a system of school-fee waivers for children who could not afford to pay. However, AIDS-affected children interviewed by Human
Rights Watch in all three countries said that headmasters or teachers had prevented them from enrolling in or attending school because they were unable to pay school fees or other costs, or because they were unable to produce documents proving they were
eligible for free tuition. While the same could be said for poor children generally, the deprivation of parental care caused by HIV/AIDS—combined with the lack of an effective system of alternate care for all children who needed it—made it harder for AIDS-affected children to obtain these documents or to pay fees in the first place. In addition, few schools provided any support to children caring for sick parents or bereaving their parents’ death, and most simply acquiesced when emotionally scarred
children dropped out of school or fell behind. In Kenya, many AIDS-affected children had enrolled in “informal schools” established for children who could not afford government schools, but these schools often functioned with a single teacher, virtually no scholastic materials, and a complete lack of government support or oversight.
Ensuring equal access to education for AIDS-affected children does not require giving them “special treatment” in the provision of basic education, or singling them out as the only population at heightened risk of poor school outcomes. Some of the educational barriers associated with HIV/AIDS, such as difficulties paying school fees or having to provide household labor, also afflict children affected by diseases other than HIV/AIDS, as well as children living in extreme poverty or otherwise prone to
discrimination or social exclusion. In some cases, AIDS-affected children who are relatively wealthy may enjoy greater access to education than poorer children who are not AIDS-affected. At the same time, statistical surveys of thousands of households in
sub-Saharan Africa, illuminated by the testimony in this report, suggest that children who experience the sickness or death of a parent are more likely than their peers to fall behind or drop out of school, and that children affected by HIV/AIDS are at an even greater peril than children orphaned by other causes. By not confronting the special vulnerabilities of children affected by AIDS and extending basic protections to them and their families, governments create the conditions for de facto discrimination in access to education and undermine progress towards the goal of education for all.
As HIV/AIDS claims the lives of extended families, it is particularly incumbent on governments to ensure that children affected by AIDS have access to foster parents or an alternate form of parental care. In South Africa, the provision of formal foster care placements and cash grants to needy children (whether AIDS-affected or not) has made some progress towards this goal. However, these benefits were developed before the era of HIV/AIDS, and are reaching only a small fraction of children who need them. Government grants intended for foster children require a court order and a cumbersome bureaucratic process, with the result that few bother to apply and only two percent of orphans in one region were receiving them. A means-tested “child support” grant
reached more children but represented less than a third of the value of the foster child grant. The situation was even more dire in Kenya and Uganda, where there was no foster care or comparable system to ensure that children had access to alternate parental
care where needed. Instead, governments relied on overstretched extended families and community and faith-based organizations to fill this role, essentially delegating their human rights obligations to private citizens.
Wherever Human Rights Watch conducted research for this report, governments seemed content to let the poor help the poor, rather than assuming responsibility for children whose families had been decimated by HIV/AIDS. Churches and community
groups pooled meager resources to help children apply for school-fee waivers, monitor school attendance, and do home visits to ensure that sickness in the family was not interfering with access to education. They survived on shoestring budgets despite the
availability of significant international resources for interventions targeting AIDS affected children. Worse, community-based organizations encountered numerous obstacles such as sudden suspensions in funding from national and local governments
and donors, cumbersome bureaucracy in applying for social benefits on behalf of orphans or other needy children, and lack of monitoring and legal recognition from state authorities. This lack of government oversight further exposed children to abuse by
unregulated and ill-intentioned caregivers.
Unequal access to education is far from the only human rights challenge that AIDS-affected children face. The loss of parental care due to HIV forces children to become caregivers or breadwinners at a young age, leading to the risk of hazardous labor and
sexual exploitation. When AIDS claims the lives of multiple family members, children may be forced into a succession of sometimes abusive foster care arrangements. AIDS-affected children are at risk from factors both within their household and outside of it.
Too often, extended family members either subject AIDS-affected children to harsh labor or sexual abuse, or else discriminate against them in favor of their biological children. The stigma associated with HIV contributes to rejection and isolation by
family members, as well as to direct and de facto discrimination in access to government services. Property grabbing and other violations of AIDS-affected children’s legal rights are common, and the belief that these children are themselves HIV-positive may exacerbate these violations compared to children affected by other diseases.
In this context, it may legitimately be asked why education should be singled out among the range of human rights issues facing AIDS-affected children. Yet education is not only a basic human right; it is also essential to the enjoyment of a range of other human rights. Keeping children in school can help to safeguard them from abuses such as hazardous labor, sexual exploitation and discrimination in the workforce. Education increases children’s survival and development prospects, contributing to increased
employment opportunities, improved family health and nutrition, lower maternal and child mortality, and lower rates of unwanted pregnancy and sexually transmitted diseases. In the context of HIV/AIDS, schools may be the one place where children can obtain
accurate information about HIV prevention, as well as life skills that empower them to resist unwanted sex and early marriage. Education can be considered a “social vaccine” against HIV/AIDS: evidence suggests that HIV prevalence is lower among those with
higher levels of education.
It is part of the cruel logic of the AIDS epidemic that when parents become sick or die, it reduces their children’s access to education, which in turn makes them more vulnerable to HIV. Governments must do far more to break this cycle and ensure that
AIDS-affected children enjoy their right to education on an equal basis with all others. To date, governments have failed in this obligation by failing to adapt their education and child protection systems to the unique challenges posed by HIV/AIDS. Far from
addressing the specific educational disadvantages of AIDS-affected children, governments are simply letting them fail.
Human Rights Watch recommends that the governments of Kenya, South Africa, and Uganda1, as well as their international donors, take the following steps to ensure equal access to education for children affected by AIDS. More detailed recommendations, as well as more immediate steps governments can take, appear at the end of this report.
As noted below, the recommendations in this report are not intended to single out Kenya, South Africa, and
Uganda as the only countries where AIDS-affected children suffer disadvantages in access to education, and
other countries are urged to consider these guidelines as well.