AIDS Infects Education Systems in Africa

Teachers in Zambia nearly went on strike a few years ago because they weren’t paid on time.

Neither of the two government officials responsible for the payroll had reported to work as the salaries came due. One was out sick, almost certainly from an AIDS-related illness. The other was attending to the death rites of someone who had died of the disease.

A strike was averted only when the funeral had taken place and the second official returned to work.

The Rev. Michael J. Kelly, a longtime professor of education at the University of Zambia until his recent retirement, tells this story to bring home the point that the AIDS pandemic raging across sub-Saharan Africa doesn’t stop with personal carnage. It also threatens whole systems, including what is arguably the most critical for the region’s future—education.

“For countries that are not very rich in managerial personnel, the loss of a few managers can be very deleterious,” Father Kelly said.

Similarly, the loss of teachers in the region can sink the quality of education as classes are combined and teachers with fewer qualifications are hired.

“In many African countries, we are talking about educational systems that are already fragile in many ways—they may lack materials; teachers are poorly trained, especially in rural areas,” said Cream Wright, the chief of education for UNICEF and a native of Sierra Leone.

In such a situation, any reversal—the death of a teacher, the bereavement of a child, a reduction in budget—can more easily do harm.

The injury goes deeper than it otherwise might because AIDS is destroying families, which undergird the education system. Families are the mainstay of schooling in any country, but in African nations, the family is often the only social safety net that can keep children in school. Now, even that net is seriously frayed by the AIDS-related illnesses and deaths of men and women in their most productive working years.

“Both on the side of schools and of homes, AIDS destroys those coping mechanisms that are in place,” Mr.Wright said.

Where rates of HIV infection are high, as they are in much of southern and eastern Africa, experts warn, the effects on social stability and education are so great that young people are being robbed of hope, and national development is being stunted.

And in a final merciless twist, declines in education reduce the chances of arresting the pandemic, since schools may be the best way to reach uninfected young people with the information, skills, and attitudes that ultimately protect them.

11 Million and Counting

Of the estimated 39 million people worldwide living with the human immunodeficiency virus, for which there is no vaccine and no cure, some 70 percent are in sub-Saharan Africa.

Yet the prevalence of the virus that causes AIDS varies enormously even in this hardest-hit region. In several West African countries, including the most populous, Nigeria, the infection rate is less than 5 percent. But in Botswana and Swaziland in southern Africa, more than 35 percent of the adult population is infected, and the rate continues to rise, according to UNAIDS, the United Nations AIDS coordinating group.

Widespread Pestilence

SOURCE: UNICEF

Millions of Africans have died of the disease in the past 20 years. The bereft include 11 million sub-Saharan children who have lost one or both parents to the disease, making the total number of orphans in the region more than 34 million. The number of AIDS orphans is expected to rise to 20 million by the end of the decade.

The loss of parents affects school enrollment and learning. Families with fewer workers are less likely to be able to afford the costs of school or be able to forgo the labor of a child who is enrolled. Sick relatives make further demands on children, especially girls, who in many African countries devote hours a day to household tasks.

Juliet Chilengi knows firsthand that orphaned children are likely to lose their chance for an education. To save some of them from that fate, Ms. Chilengi founded the New Horizon orphanage in Lusaka, Zambia, where she lives. One teenage girl now with Ms. Chilengi arrived after the aunt with whom she lived judged the girl a handful and “chased her away.” Another succumbed to a sexual liaison with an older man because she had no one else to pay for her education, which was cut short anyway when she got pregnant.

Many extended families in her country are breaking under the strain of poverty from unemployment and AIDS, Ms. Chilengi explained.

“There is such a drastic change,” agreed Lucy Barimbui, who coordinates anti-AIDS activities for the Kenya National Union of Teachers. “It’s no longer the Africa where a child belongs to everyone, and the teachers have to deal with that.”

Even where children’s material needs are met, grief and insecurity all too easily interfere with learning.

“We try to talk to them and encourage them, so they don’t feel the absence of the parents,” said Bartholomew Njogu, the head of Nkubu Primary School in Nkubu, Kenya. But that is a tall order for a school that has no paid counselors and where classes number around 40 children.

Taking Action

Meanwhile, the pandemic has sickened and killed thousands of trained school employees. At one point, experts identified male teachers as being a particularly at-risk population because many are posted to jobs away from their families and have the money for extramarital sexual partners—including readily available female students. In the absence of convincing evidence, however, many experts now believe that teachers are no more likely than others of their area and background to be infected.

Still, classes already swollen by recent guarantees of free primary education in, for instance, Kenya, Malawi, and Zambia, are doubled up when teachers are absent. Rural schools, which are harder to staff, particularly suffer.

To try to preserve its teaching force, Zambia has recently begun offering free antiviral therapy to infected teachers, and a pilot project of several South African teachers’ unions will do the same.

Education bureaucracies are generally ill equipped to project manpower needs, and in many countries, internationally imposed fiscal constraints, as well as internal economic ones, have kept hiring of additional school staff members to a minimum. A decline in school quality going back to the 1970s that had begun to be arrested in the 1990s has once again taken hold, many experts say.

In fact, the creeping nature of the crisis erodes improvements just when education needs to be making quantum leaps. Schools should be humane and supportive environments, for instance, free from sexual harassment of girls, who far outpace boys in their rate of HIV infection. Gambia has taken a step in that direction by passing a national law prohibiting male teachers from allowing female students as visitors in their homes. Schools in Zambia, for their part, have been fostering compassion for people with AIDS by distributing AIDS emblems to be worn by all teachers on a certain day of the month. And Kenya has produced a pocket-size AIDS-in-education policy that is to go to all teachers.

On new fronts, some education thinkers are proposing a massive resurrection of boarding schools, which had largely fallen into disfavor with aid donors as expensive artifacts of the colonial era. Though day schools are cheaper, boarding schools might provide orphans with a nurturing community as well as an education. Policy experts also envision more flexible forms of schooling tailored to the needs of youngsters who are caring for family members, bringing in income, or themselves heading families.

“This generation is being forced to take on adult responsibilities earlier than any generation in our historical record,” said the Rev. Gary Gunderson, the director of the interfaith health program at Emory University’s public health school in Atlanta and an expert on AIDS.

Education can literally be a lifesaver for children who must grow up quickly—especially girls, whether by enabling them to learn how to make a living or to protect themselves against the virus, Mr. Gunderson added. “The crisis of HIV/AIDS,” he contended, “has way more to do with people in schools than physicians in hospitals.”

‘Low-Grade Charity’

At the very least, some experts say, schools in sub-Saharan Africa could do a better job of helping children and teenagers avoid the virus. The infection rate among people younger than 15 is low, but then soars, especially for girls. So programs must start early—and go beyond simple awareness. In Cameroon, for example, more than nine in 10 teenagers were aware of AIDS, but fewer than 30 percent knew how to avoid contracting HIV.

Research strongly suggests that the lessons must impart both understanding of the disease and so-called “life skills” for risk management, such as negotiation with a sexual partner and identifying the ways in which a particular social environment poses dangers.

“So far, a lot of resources have been wasted in terms of money, material, and training that don’t work,” said Mr. Wright of UNICEF. “We’re looking to revise [ineffective] programs.”

The hurdles to pushing back the pandemic and minimizing its personal and national costs are high but not insurmountable, according to people such as Dr. Peter Piot, the UNAIDS executive director. Anti-AIDS efforts continue to be hampered by prejudice and discomfort because the disease is transmitted mostly by sex and results in death, according to Dr. Piot. He argues that empowerment of people infected by HIV and those most vulnerable to it are among the best antidotes.

No one doubts that millions of Africans have mobilized to try to meet the needs, from compassionate groups operating on members’ small contributions to education ministers convening policy and planning groups.

But inadequate funding must be reckoned with. Dr. Piot estimated that the $6.1 billion allocated for response to the pandemic in low- and middle-income countries in 2004 is half of what is needed for the current year. Moreover, the worst-affected African countries, he contended, would gain more from the cancellation of international debts, new trade practices, and better prices for pharmaceuticals than even from increases in rich nations’ aid.

“The response already made to AIDS [by Africans] is quite unprecedented,” said Mr. Gunderson of Emory. “What has not changed is our response [in the developed world]: We’re acting as we’ve always acted, which is with relatively low-grade charity.”

The public-health professor called on educators to add their voices to those of people living with AIDS and their advocates, who played an important role in putting drug treatment within the financial reach of more Africans. Educators in the United States and the rest of the developed world, he said, can grasp the challenges facing African children who have little and have lost much.

“This is an unprecedented crisis, in scale, and nature,” Dr. Piot said in a speech in London last month, “and we have no choice but to act in exceptional ways.”