HWANGE, Zimbabwe | When she looks at the exposed cinder block at the front of her house, Alice Sibanda usually thinks of her parents. Her father barely had a chance to finish the frame before he died of an AIDS-related illness several years ago. So the front remains largely as he left it -- unpainted, half exposed.
When Alice's mother passed away shortly thereafter -- also from AIDS -- she left her children with those four walls, some utility vouchers and little else.
"I'm the first born at 19 years old, looking after my four young ones," Alice said of her siblings. "Food, clothes, school fees -- those are a problem."
In Hwange, a town on the outskirts of a National Park where tourists enjoy game walks and four-star lodging, Alice's basic survival problem doesn't seem to have much of a solution. The same political unrest that sent inflation in Zimbabwe barreling past the 11-million-percent mark in recent years also isolated the government of President Robert Mugabe from the deep pockets of many western donors and international nonprofits. And that, in turn, further strained the nation's already unraveling safety net for about a million orphans throughout the country.
Certainly, not all international aid groups pulled out of Zimbabwe during the unrest. Among the largest that remains, the Global Fund to Fight AIDS, Tuberculosis and Malaria has supported nearly a third of AIDS orphans in the past several years with basics like food, medication, psycho-social support and school fees, according to Perry Mwangala, the Global Fund’s senior portfolio manager for the country. But more recently, as the organization has shifted its financial focus to putting more of the infected population on antiretroviral medication -- thereby helping adults survive to look after their children, Mwangala said -- direct support of current orphans was transferred back to the government.
And for now, no matter how many times Alice has applied for social services from the local authorities, the answer most days is no. There is no food. There is no money. There is no orphanage to help her care for her younger siblings.
"I have no one to help me," she said. "I am alone."
That's why the cinder block house on the outskirts of town is full most days. In one room are Alice and most of her siblings, who dropped out of school several years ago because they couldn't afford the fees. Occupying nearly every inch of the rest of the house are strangers -- tenants whose monthly payments keep the electric and water flowing.
And sometimes added to the mix is a local caregiver named Catherine Mathe -- who stops by when she can to check on the status of the children. She knows Alice and her siblings well enough to estimate that the little family is almost out of options.
"They need help," Mathe said, shaking her head. "If it gets worse, they must go look for a man. They will have to look for early marriages. And that is not all right."
For their part, government officials insist that such scenarios can be prevented -- that when police know of blatant abuse or coercion, children are taken to a safer environment.
"But we want to use the bottom-up approach, where we say that the communities should be at the center of identifying these children, and they should also be at the center of resource mobilization," said Macnon Chirinzepi, the provincial social services officer in Hwange. But the current economic situation in Zimbabwe also means the government can only do so much, he said.
"So, yes, I think the worst that can happen to such a family is sexual abuse or prostitution," he said. "And at the end of the day, HIV infection."
Alice herself has higher hopes for her future. She wants to be a teacher, pay for her siblings to finish school and live in the cinder block house without renters.
And there's plenty of time for all that, she says. After all, she's only 19 years old.
WASHINGTON | John Johnson was 19 when his mother died beside him.
By any standards, she was a sick woman: HIV, diabetes, gout, congestive heart failure. But John never expected her to go so quickly, on a random night in their home on 8th St. Northeast.
She was particularly quiet that evening -- didn't even ask him to change the channel once, which was unusual. "I felt her arm and it felt like she was cold," he said. "I knew that wasn't right."
And like that, she was gone. The woman who transmitted the HIV virus to him at birth, one of the few people he knew who could fully understand what it was like to live with all the medication, the sickness, the stigma; she was gone.
A year later, John's father died from cancer, leaving the 20-year-old and his two older brothers alone.
"It was scary when I lost both of them. When they're not there, or when you think they're calling your name and they're not. It's just kind of sad," John said.
Hear John tell his story in the video below:
John never imagined what it would be like transitioning into adulthood without either of his parents. The reality blindsided him. While he and his brothers scraped enough money together to stay in their town house, "it was hard living all alone. Really hard," he said. "That's when I first realized bills exist."
Still, John calls himself "fortunate." As the one HIV-positive sibling in the house, he had been part of a support group at Children's National Medical Center, a place where they would "check in, see how your life was going, do after-school exercises," he said. "So I received a lot of support growing up."
His brothers weren't so lucky. Like most "affected youth" -- those who don't have HIV themselves but have a family member who does -- the two didn't qualify for support or services. They were left alone to deal with the stigma, the emotional burden, the constant worry about their mother and brother's health. And at various points in their childhood, they were also the ones caring for both.
"It can all be very traumatic for these children," said Chris Norwood, the founder and executive director of Health People, a nonprofit in the South Bronx that provides support groups for HIV-infected and affected youth. "And often because of it, they'll end up having the post-traumatic stress levels of children living in war zones."
From a technical standpoint, very few children are "orphaned" these days in the United States. Treatment now allows those infected with the HIV virus to live for many years after diagnosis, and parents who know they're gravely ill usually transfer custody to another family member or a friend before they die. "So it's extremely rare to see a child become a dependent of the state," said Mindy Good, director of communications for the D.C. Child and Family Services Agency. "This is not like the African nations and what they're dealing with."
But there's another way to qualify someone as an "AIDS orphan," and that includes any child who has lost a parent to HIV or who has a parent sick with the disease. By Norwood's estimates, there are approximately 400,000 American "AIDS orphans" in that category.
"It's probably the highest number in the western world," she said. "But no one knows for sure because there's been no real effort to seriously count children in these terrible situations."
Why not? Norwood said she's been trying to figure that out for years. "It's like some blind, terrible thing," she said. "They come from poor communities where their parents are sick, where there isn't organization or advocacy for them. And one way not to pay attention to an issue or a group that may need some attention is simply not to count them."
While "AIDS orphans" in America hardly ever face the same desperate situation as those in a place like Zimbabwe, a little more attention and a few more resources would go a long way -- especially the establishment of support groups to help them work through their feelings, Norwood said.
In D.C., some children have access to that kind of programming through Children's National Medical Center. But for those "affected" and not infected by HIV, referrals to counseling services there are sporadic, leaving many "uncounted" and on their own with their emotions.
For them, John Johnson has some advice: "I would just tell them to get through it," he said. "Try to be strong."
Jason Kane travelled to Zimbabwe with the Global Fund to Fight AIDS, Tuberculosis and Malaria for these reports. Video of John Johnson produced and edited by Paula Rogo. Subtitles were added due to audio difficulties. Alice Sibanda's name was changed due to issues of stigmatization in Zimbabwe.