Struggling to cope with hunger and HIV/AIDS

Sixteen years of civil war, cyclic floods and severe drought have collectively caused much hardship in Mozambique. But the current drought, affecting about 600,000 people, alongside the devastating impact of the HIV/AIDS epidemic, are together pushing a growing number of families to the brink of survival.

About 13 percent of the pupulation is living with HIV/AIDS, although in some provinces like the northern province of Tete, an important corridor route between Mozambique, Malawi and Zimbabwe, the figure is over 20 percent.

"Before, we had drought in Mozambique, but without the HIV/AIDS," a UN Children's Fund (UNICEF) project officer Martine Le Fure told IRIN.

"But HIV/AIDS is increasing people's vulnerability. We don't know the number of HIV/AIDS hunger-related deaths in the villages. But we know there is no or little food in some of the villages. People in much of the province have been surviving on wild fruits and food aid.

"Undoubtedly, people living with HIV/AIDS have their lives cut short, as now with the drought they cannot even afford a nutritious meal. Sanitary conditions are inadequate and cholera poses yet another threat," Le Fur added.

The Mozambique News Agency (AIM) reported that cholera has claimed 33 lives since the first outbreak in September last year.

Emaciated with full-blown AIDS Campange tells a typical story of those sick in this current climate while his young teenage wife, Marita, nurses their baby.

After a prolonged stay in hospital, he has just returned to the family homestead. Like most of those living in Tambara district, in the central province of Manica, the family's maize crop has shriveled up and they survive mostly on wild fruits and maize handouts.

Campange is suffering from tuberculosis and has had severe diarrhoea. The homestead of five (they live with Campange's parents) has no latrine and they have had no soap for washing their clothes or even themselves for over a year. "We have no money to buy soap," said Marita.

At the end of January, cholera broke out in Tambara, and by mid February, 96 cases of cholera had been confirmed. Yet finding food, like wild fruits and working in exchange for maize is more on Campange's family's mind than the lack of a latrine.

Potable water is also a problem. Of the 32,000 people living in Tambara district, only a third consume potable water. It's a very difficult situation," said Eugenio Anselmo, the head of Nhacufula health centre, who has been taking care of Campange. "He is more at risk of opportunistic infections in this environment."

In their neighbouring province of Tete, 24-year-old Zaida Emilio, the head of a family of orphans, tells another story of day-to-day survival in this growing humanitarian crisis.

Her parents died of AIDS-related illnesses and now she is struggling to look after her four younger brothers and sisters as well as her six-year-old son, Elder. Emilio, who is a single mother, is also ill. On the day of the interview, Emilio looked tired and had a fever and coughed continuously. She has been sick for two years, but does not know what is wrong with her. She was even admitted to hospital for three weeks but she cannot afford continued medical care.

"I just put up with the fevers in the home," she told IRIN.

Some 40 percent of the population has no access to health services. Because of her poor health, Emilio depends more and more on her younger brothers and sisters for their survival. Ten-year-old Elma talked proudly about how she gets up before the sun rises (around 4am) to fetch water and clean the tiny wattle and daub hut, which has just a few mats on which to sleep and old pots for cooking.

Her 13-year-old brother, Joao, also talked about how he gets up at the same time, and besides household chores, he sometimes fetches water for other people to earn money to buy any available food. The maize plot they relied on has dried up. He received 3,000 meticais (less that on US cent) per journey to fetch water.

"I can manage three trips before I start school," said Joao. "But I arrive at school tired and hungry."

Despite their situation, Emilio has tried to encourage her siblings and her son to attend school regularly. The only time they occasionally missed school was last year when their mother was dying of AIDS. "They were just feeling too sad to go to school," said Emilio quietly.

Countrywide, it is estimated that almost 300,000 children are orphaned by HIV/AIDS. Many orphans drop out of school, especially the girls, to care for the sick, to perform domestic chores and, now with the drought, to look for food. They are also especially susceptible to exploitation and sexual abuse.

UNICEF has supported the NGO, Help Age International, to reintegrate orphans into school. They work with local authorities at provincial and district level as well as with community leaders and teachers. So far in Tete they have reintegrated 359 orphans into school.

WFP and UNICEF are also supporting a supplementary feeding programme for children between six months and five years, and pregnant and lactating women in the drought-affected areas. UNICEF is also working to train community members to identify serious cases of child malnutrition to send to hospital for therapeutic feeding.

"We are trying to prevent a grave situations," said Le Fur, a medical doctor, who was running one of the training sessions.