Children fight back against Aids taboos

Africa's scourge: In face of formidable prejudice, a Jesuit priest is looking for foster parents

DAVID ORR

Nairobi

For Kevin Kamau, his mother's milk was not as nourishment it should have been. It was instead a poison potion which, after two years of breast- feeding, left him with HIV.

Today, the three-year-old orphan is one of 23 HIV-positive children living in a special centre on the outskirts of Nairobi called Nyumbani - Swahili for "home". Malnourished and ailing, Kevin was taken to the centre by an aunt shortly after the death of his mother from Aids in 1994. Thanks to Dr Angelo d'Agostino and his team, the child is thriving.

Despite the sentence of death hanging over Kevin and other children at Nyumbani, Dr d'Agostino, an American psychiatrist and Jesuit priest, has decided that the time is right to launch a fostering programme for his charges. Such a venture is new to Africa and is fraught with difficulties in a continent where so many taboos still surround Aids and HIV infection.

"It's not going to be easy to get these kids fostered," says the grandfatherly Dr d'Agostino in a Boston twang which has still not deserted him after 15 years in Kenya. "These children are undoubtedly stigmatised. We couldn't even get parents to accept them attending the local school. But with education and understanding, I think the difficulties can be oversome. Caring for these children can be very rewarding."

Dr d'Agostino is no stranger to challenges. He launched Nyumbani - Kenya's only specialist hospice for HIV-positive orphans - three-and-a-half years ago with little funding or support. The government's Aids prevention programme is at best half-hearted and few resources are made available to battle the epidemic. He somehow keeps the centre running on donations from institutions, gifts from individuals and grants from Unicef and the World Health Organisation. The fostering programme, to be launched in the next month, is modelled on successful schemes in New York and Glasgow.

Although the rate of HIV infection is slowing in neighbouring Uganda, regarded as the continent's worst-affected country, in Kenya it continues to spiral out of control. Some 15 per cent of Kenya's hospital beds are taken by Aids patients. There are more than 50,000 reported Aids cases but most researchers think the figure is three times as high. It is thought that as many as one million out of a population of 23 million have HIV.

"Somewhere between ten and twelve thousand children have been orphaned as a result of Aids in Kenya," says Dr d'Agostino. "If we had five centres like this there still wouldn't be enough room for them. By the end of the century, there'll be 120,000 children with HIV infection in this country."

All the children at Nyumbani have been abandoned. Most of their mothers came from slum areas and most, it is assumed, were prostitutes. Ironically, it is because they have been abandoned that they are now receiving such committed care.

All the children test HIV positive when they come to Nyumbani. A child born to an HIV-positive mother will automatically test positive, but not all inherit the virus. Between the ages of 8 and 12 months, three out of four of the children test negative and can lead healthy lives. Unfortunately, those who remain in the community, even though not infected, usually die of neglect because of their HIV-positive stigma.

As with adults, those who continue to test positive will succumb to Aids- related infections and die. The average life span of an HIV-positive child in Africa is between two and three years.

"We have a very good record," says Dr d'Agostino. "Initially, I thought we'd have a death every few weeks. But we've shown that with good feeding and care they can live much longer - and, more importantly, have a good quality of life. We have two 13-year olds who are getting on well."

Nyumbani has processed 115 children since it opened. Thirty of these are being cared for in a centre nearby. Those who have tested HIV-negative are in orphanages or have been adopted. Twelve children have died. Among the vegetable plots behind Nyumbani are three tiny graves marked with crosses.

But at Nyumbani they prefer to measure success in the smiling faces around them, not in the numbers of early deaths which will occur in Africa for as long as Aids remains the scourge of the continent.