- The Washington Times - Wednesday, March 22, 2006

KILEMA, Tanzania

Poking out of Patrice Mavia’s purple plastic sandals are toes dark and swollen with blood, ragged and infected as if chewed by jagged teeth.

His fingers seem to be in a similarly painful state.

Adella Kessy, a nurse at the Catholic hospital in the foothills of Tanzania’s Mount Kilimanjaro, said tiny sand fleas are to blame. Left unchecked, the insects form painful pustules and lesions, destroy fingers and toes, and eventually leave a victim crippled.

They come from walking barefoot on ground infested with sand fleas, drying clothes on the ground or poor hygiene. They are a clear sign of neglect, said Ms. Kessy.

Patrice probably doesn’t bathe with any regularity, nor is he likely to hand wash his thin clothes, or know that he has to destroy bugs and parasites with a heavy, charcoal-powered iron. He is, after all, only 8 years old.

Patrice was orphaned by AIDS maybe five years ago — he thinks he lost his parents in 2001 and 2003 — and he is the only one around to remind himself to wash behind his ears and scrub between his toes.

“No one is helping him care for himself,” said Ms. Kessy, shaking her head.

As communities across Africa struggle to cope with the growing number of children left parentless by AIDS — a number expected to reach 18 million by 2010 — the United Nations Children’s Fund (UNICEF) said recently that less than 10 percent of AIDS orphans receive any form of support.

“Most are in poor, poor, poor environments. They’re in poor houses, poor environments and have poor food,” said Anna Anselm, a clinical officer at the hospital’s patient resource center.

“They can’t afford everything that’s needed for the essentials of life. They’re so limited.”

Once a month, Ms. Kessy and her colleagues at the hospital’s HIV/AIDS counseling center invite orphans like Patrice to the hospital for “tea” — giving health workers a chance to know who the children are, where they live and who takes care of them.

More important, it gives them a chance to see the children. Are they skinny? Scraggly? Sickly?

Worrisome cases are followed up with a home visit, where volunteers will also drop donated food staples like beans, oil or flour.

Problem spans Africa

The problem of starving, orphaned children is not limited to isolated pockets of Africa. In the decades since the spread of AIDS, more than 100,000 children at 107 schools in six of Nairobi’s sprawling slums get their only meal — lunch — through the World Food Program.

At St. Philips School on the edge of Kibera slum, Wambui, 10, materializes at the clang of the lunch bell carrying a baby tied to her back with a brilliant pink scarf.

Skinny and stunted, with bony elbows and knees, Wambui carries a metal cup and a chipped black plate as she waits for her share of the mixture of corn and beans fried every day for the school’s 345 hungry children.

The baby on her back smacks her lips waiting for food as school officials confront Wambui.

They want to know why she’s not wearing her uniform, and whether she’s showing up for classes or simply arriving for the free food and then disappearing back into Kibera’s crowded, dirty alleys.

The feeding program is not simply about a free meal, they say. It’s a way to keep children healthy and in school so they can break the cycle of poverty.

“Words cannot explain how much this food has done,” said Louise Masese-Mwirigi, a monitoring officer from Feed the Children, which runs the program.

Before the program was in place, children were scavenging like goats, she said — looking for scraps in the garbage thrown out by their neighbors.

Adults could exploit them by luring some children with the promise of a piece of chicken or a plate of greasy chips.

“This is protecting them in a way you really can’t quantify on paper,” said Mrs. Masese-Mwirigi.

In soft Swahili, Wambui explains that she lives with her mother and helps care for five other children. Her father is dead, and her mother is dying of AIDS.

She was in class, she insisted. Teachers were simply looking for her in the wrong place: though she is 10 years old, she is still in the nursery class.

Taking food home

About 20 percent of St. Philip’s students are orphans. Some come from single-parent families. Almost all are destitute.

A few children snap a lid on their ration — a scoop and a half — and take it home to share with desperate parents and siblings.

“They cannot even have a meal. They will feed here today and they will come tomorrow and feed again. There won’t be anything to eat at home,” said Joseph Ndungu, a representative of the city education department.

A report issued last year by Human Rights Watch found that AIDS orphans are more likely to drop out of school, more likely to fall behind in their studies and less likely to see meager family earnings go to their education.

Dropping out means children are more likely to become trapped in poverty, exposing them to greater risk of abuse, sexual exploitation and AIDS.

Teachers at St. Philips say the offer of free food has turned that trend around.

Before the feeding program began two years ago, there were 212 students enrolled in the school. Now there are 346, about a 50 percent increase.

“It’s important for their academic work, and health-wise,” said the school’s head teacher, Jacinta Katheu. “The feeding program is helping their families very much. They are jobless — their guardians are often jobless — and at the end of the day, they won’t even eat a meal. There’s no food at home.”

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