It’s a warm April day in Addis Ababa, and 11-year-old Gashaw is thrilled to be playing soccer with a half dozen friends at the AHOPE Orphanage. “I’m the best goalie,” she boasts, blocking kick after kick. But just five minutes into the game, the rail-thin girl is too exhausted to continue. She lets loose a rattling cough and, without a word, her concerned playmates call it quits.
Like most of the other 39 children sheltered by a high wall from the dusty roads of this busy capital of Ethiopia, Gashaw is HIV positive, forced to live in an orphanage because, like as many as 1 million other children in the East African country, her parents have died from AIDS. Gashaw’s father succumbed to AIDS-related tuberculosis as she slept by his side when she was 5. “I reached out and touched his arm, and it was cold, his arm was very cold,” she says through a translator.
Three years later her mother died while Gashaw was watching cartoons with a friend whose family owned a TV. “Before I went I asked her if she would like a cup of coffee to make her feel better. When I came back I couldn’t get the cup of coffee out of her hand and I couldn’t get her to wake up,” says Gashaw. Since then Gashaw, who is partially deaf because of HIV, has lived at the orphanage with her two brothers. “I want to go to school so I can be a doctor. But I don’t know if I will grow old enough to succeed. What will happen to us?”
Until recently Gashaw’s question had only one answer. HIV in Ethiopia – which has one of the most dire AIDS epidemics in all of Africa – was a death sentence, especially for a child. But in the last year, the government began dispensing the drugs, known as anti-retroviral “cocktails,” that have made HIV more manageable elsewhere since the early ’90s. Now a team of doctors from Columbia University, selected by the New York-based Worldwide Orphans Foundation, has begun to teach 40 pediatricians from throughout Ethiopia how to administer the powerful medications to children. “The drugs could change the kids’ lives in a matter of days or weeks,” says Dr. Marc Foca, pausing between examining sick kids at the orphanage and conducting classroom sessions with the Ethiopian doctors at the United Nations’ headquarters in Addis Ababa. “They will be amazed at the results, absolutely amazed.” Those with more experience in the country of nearly 70 million people – more than 2 million of whom are thought to be infected with HIV – know the challenges remain huge. To keep all 40 kids on the antiretroviral drugs for a year will cost about $150,000, an exorbitant sum by Ethiopian standards. But if the drugs can be administered regularly, they will likely bolster the children’s immunity while stemming HIV-related complications like tuberculosis and pneumonia. “This disease has killed an entire generation, and now it’s threatening to kill another,” says Dr. Desta Wondewosen, head of pediatrics at Empress Zewditu Memorial Hospital in Addis Ababa, where AIDS has hit hardest. “I feel hope for the first time in years.” Adds Dr. Fetwi Genet, from the country’s north: “At last we can make a difference.”
Certainly that was pediatrician Jane Aronson’s goal when she founded Worldwide Orphans in 1997 after focusing on the special health problems of foreign-born children adopted by couples in the U.S. That led her to tour orphanages in Eastern Europe and Latin America. “The kids were dying in droves, dying from simple diseases and serious malnutrition,” says Aronson, 51, the mother of two adopted sons, Desalegn, 6, from Ethiopia, and Benjamin, 5, from Vietnam. “We had to help.” With the aid of dozens of volunteers, many of them medical students, Aronson’s group has educated orphanage managers on nutrition and brought in grandmothers to play with the children. Last year volunteers taught doctors in Vietnam how to use ARV drugs on HIV-positive children there.
Aronson hopes to raise $1 million for drugs and training in Ethiopia, where fear and ignorance compound the difficulties of treating AIDS. “People here think HIV is a curse. Everyone in the neighborhood called the orphanage the house of the dead,” says Sidisse Buli, project manager for AHOPE (short for African HIV Orphans: Project Embrace). The organization, funded by private American donors, took over the orphanage last August after 25 children died there in the previous 12 months.
This year only one child has died at AHOPE, a success that Buli attributes to better medical care and more personal attention. But no HIV-infected child has ever been adopted from the orphanage, and some are shunned by their classmates at a neighborhood school. Still, Buli tries to make the children’s lives brighter. She walks through the compound handing out chocolates, and the kids clamor around her. Among them are 5-year-old Glegz, a burst of energy who proclaims himself “the best student in the whole school.” As if to prove the point, he proudly launches into the alphabet: “A-B-C-D-E-F-G . . . H-I-V,” he says. “See, I am the best student in the school.”
• By Steve Erwin in Addis Ababa