Grandmother Anchilalo Ejigu was distraught when her daughter died from an HIV-related illness two years ago, leaving behind two children under five; the family’s other relatives refused to take in the children, so at the age of 50, Anchilalo became a parent all over again.
"I was really struggling; my business selling beer was not doing well and I had to pay 300 birr [US $22] in rent every month and to find food for the children as well," she told PlusNews in the Ethiopian capital, Addis Ababa.
Ethiopia is starting to recover from the food price shocks of 2008, but the prices of cereals such as white maize remain 55 percent higher than the 2005-2009 average.
Rapid construction happening across the city stands in stark contrast to the extreme poverty evident among the large number of people living on the street and the crowds of beggars hanging around the city's highways.
Anchilalo and her two grandchildren, both of whom have tested HIV-negative, survived potential destitution when a local community worker introduced her to the Hiwot HIV/AIDS Prevention Care and Support Organization (HAPSCO), which - through the UN World Food Programme's (WFP) urban HIV/AIDS programme - started to provide her with food for the children monthly.
While the food support has been a life-saver, Anchilalo says more than anything, it has allowed her and the children to remain together.
Keeping families together
"I have such a strong bond with these children now, I can't imagine life without them," she said. "If there was no food support, I would have had to give them up to someone who could feed them, but now we can remain together as a family."
Thousands of orphaned Ethiopian children live in orphanages, often taken there by family members unable to support them; thousands more spend their days and nights living wild on Addis Ababa's crowded streets. Close to 40 percent of Ethiopia's 77 million people live below the poverty line, and taking in an additional child is an expense few families can afford.
|I have such a strong bond with these children now, I can't imagine life without them|
With an HIV prevalence rate of 7 percent - far higher than the national average of 2.3 percent - Addis Ababa is home to thousands of families affected by the loss of loved ones to HIV/AIDS.
A 2009 report by the NGO Save the Children noted that children in institutions are at increased risk of abuse and neglect due to the poor standard of care found in many of these facilities; it recommends every effort be made to keep children in family-based care.
According to Judith Schuler, public information officer for WFP Ethiopia, food is often the draw to the urban feeding programme, but the benefits of the programme are far wider than just food.
"Food support enables families to remain together, it allows orphans to remain in school; it allows people once facing social exclusion to gain acceptance in society once again; it allows people living with HIV to continue taking their drugs," she said.
WFP's programme feeds three categories of beneficiaries: people living with HIV on life-prolonging antiretroviral medication; orphans and vulnerable children; and pregnant and lactating mothers undergoing prevention of mother-to-child transmission. The programme, which works through local NGOs, has more than 125,000 beneficiaries in 23 urban centres around the country.
Beyond providing food, HAPSCO also runs a community support system for its beneficiaries, teaching them how to prepare the food they are given and how to supplement it to get the best nutrition. Orphans also get school materials and have their progress in school followed-up.
The feeding programme is not permanent; people living with HIV are expected to “graduate” from the programme after nine months, as long as their body mass index exceeds (BMI) 18.5, or they achieve a healthy weight.
"At six months, if they have achieved a BMI of 18.5, we put them on half-rations and start to prepare them for income generating activities," said Tsegazeab Bezabih, programme assistant at WFP Ethiopia. "We teach them different skills - petty trading, sheep rearing, metal or wood work and so on."
Tirunesh Tefera is raising two children alone after her husband died of an HIV-related illness; she and her eldest child, a 12-year-old boy, are both HIV-positive. While she still receives some food for the children, who are separately enrolled at HAPSCO as orphans, she has “graduated” and recently started a successful business with seed money from the NGO.
Photo: Keishamaza Rukikaire/IRIN
|Mulumebet Adugna is doing everything she can to get off food support and start a successful business|
"I sell tea, bread and meals for daily labourers in my neighbourhood. I have even employed a young woman to help me," she said. "I can buy books for my son, who is doing very well in school and wants to be an engineer."
Some are less successful the first time round. Mulumebet Adugna “graduated” from the programme about a year ago, but is back because her business failed and she fell ill, her weight and her CD4 count - a measure of immune strength - dropping to dangerously low levels.
"I was selling charcoal, but the authorities kept chasing us away from our spot, saying we were there illegally - I couldn't make the business work; I also do embroidery, but one piece that takes three days to make sells for just 8 birr [60 US cents] and my rent is 120 birr [$9]," she said. "I got so stressed by it all; that's why I fell sick again."
According to Zenebech Asfaw, a social worker with HAPSCO, there is a need for more intensive training in business in order to register more success in the income generating activities.
"Some people want to go into food preparation, but sometimes people find out you are HIV-positive and they may not be willing to buy food from you. People need to be made to understand what can work and what can't," she said.
She said successful businesses served as an example to others in the programme, helping to prevent "dependency syndrome".
"I really don't want to continue getting food support," Mulumebet said. "I will do everything I can to get healthy again and make my business profitable."