Posted November 1998
Guideline 8 of the 1998 "HIV/AIDS and Human Rights International Guidelines" declares: "States, in collaboration with and through the community, should promote a supportive and enabling environment for women, children and other vulnerable groups by addressing underlying prejudices and inequalities through community dialogue, specially designed social and health services and support community groups". This is then elaborated upon in a section of two paragraphs (see Annex 1) on the Human Rights of Children, which needs to also be seen in relation to the entire document.
In Sub-Saharan Africa, the vast majority (see Chart 1) of the population is still rural and will continue to represent over 50% of the population in three sub-regions out of four well into the twenty-first century. Not only do a greater proportion of children live in rural areas but also, due to higher rural than urban fertility, the number of children in rural households is greater than in urban ones.
In the same region, per caput agricultural production had remained stable or even declined during recent decades (see Chart 2) and has not yet caught up with the 1961 level. Future food requirement scenarios fuelled by population growth and changes in structure and life style project generally tremendous challenges to the food production systems.
1. Are rural children living in absolute or relative "exceptionally difficult conditions"? What are the possible future prospects?
2. If so, do rural children receive the special consideration they need on the basis of available resources? Have they been discriminated?
3. Although the rights of a rural child are the same as those of an urban one, does the fact of being rural raise specific difficulties in ensuring the rights are recognized and enjoyed by the child? These difficulties are due both to the fact that rural children are often invisible to outsiders because of remote access, poor road or transport infrastructure, and lower attendance at school and to the fact that a rural child cannot be isolated from the context he or she lives in. A rural child is not just "rural" by opposition to an "urban" child. He or she lives in a specific agro-ecological zone in which a farming system is embedded and interacts with socio-cultural and economic factors. The environment is varied and complex and requires adaptation by human rights programmes in order to increase their impact. The complexity of the environment of the rural child is often poorly understood or overlooked which reduces the effectiveness or relevance of the programmes. For example, are the "International Guidelines" referred to sufficient or appropriate to assist rural children?
Chart 1. Percentage residing in rural areas by region, 2000-2030
Source: adapted from World Urbanization Prospects: the 1996 Revision,
Chart 2. Food production and calories supply in sub-Saharan Africa
Source: FAO Stats, 1998
The objective of the present paper is to focus mostly on the first questions raised and to present some of the information extracted from FAO studies which can help in providing elements for the response to some of the other questions.
Generally, data on the incidence and prevalence of HIV/AIDS in rural populations are even less satisfactory than for urban ones. Information of prevalence and incidence rates by sex and age for rural populations is not generally available. It is thus not possible to present a statistical picture, but only a picture of the types of problems encountered. One does not know their frequency or distribution, but one knows that there are considerable variations between households, communities and regions. Besides the lack of data on HIV/AIDS for rural populations at the macro level, the corresponding data at the household level is also lacking. The consequence of this lack of data is that rural populations can be short-changed in the attention they receive and in the allocation of resources available in HIV/AIDS programmes. This can be even truer for rural children. To what extent is one really aware or knowledgeable about the situation of rural children, especially at the household level? How can one ensure their rights are protected if the knowledge is so insufficient?
Differences in rates of infection do not, of course, affect the nature of the rights of adults or children, but the higher the rates of prevalence, the greater the needs and the more thinly distributed might be the resources available. This can result in rights being recognized, but with little practical results. The design of more effective rights programmes is therefore related to knowledge of the situation. This goes beyond data on rates to include other information (e.g. cultural practices).
Data is also important because there are threshold effects after which household, community or sector responses and coping mechanisms break down. For example, the fostering of one or several orphans in a household at subsistence level is not at all the same thing in practice: it might be able to host one or two orphans, but hosting four or five can lead to all the children going hungry, dropping out of school, etc. In a similar way, a community in which only a few households are affected by HIV/AIDS can provide support, but beyond a certain point, the community itself can no longer cope. Even cases of neglect or abandonment have to be viewed within the context of harsh realities and survival strategies of households and communities rather than with sanctimonious judgements and pious wishes.
The studies in East Africa placed considerable emphasis on exploring the types of impacts which could be encountered in various systems (small farms, commercial farms, pastoralists, etc) and in establishing the vulnerability of farm-household systems. The studies in West Africa focused more on the impacts related to migrant labour. Besides identifying impacts, the studies also, to some extent, attempted to identify the types of coping mechanisms and responses the farming systems set up to mitigate the impacts felt. The results have been published and a synthesis prepared. As will be shown in the next section, the direct focus was with the production units, not with the individuals. However, a certain amount of information was collected which can be used to discuss the rights of the child within the farm-household system.
It should be kept in mind that these studies were small ones, through purposeful samples and with an emphasis on qualitative methods. It is interesting to note, however, that many of the results of the FAO studies have been corroborated by the papers presented at the Conference on "Responding to HIV/AIDS: Technology Development Needs of African Smallholder Agriculture", held in Harare in June 1998.
At a macro level, rural households are located in agro-ecological zones (AEZ) which have certain physical characteristics, which influence household behaviours and strategies. For example, in semi-arid zones where yields can vary considerably migration can be much more intense than in other zones where rains are more predictable and better distributed. Therefore, one will find linkages between different AEZ and migration, and between less well endowed/poor zones to better endowed/wealthier ones. The interrelations between such zones can have an impact on the spatial distribution and level of HIV infection.
At the more micro level, i.e. the farm-household, the questions looked into are not related to the health of the individual, but to their role in the unit of production. This means exploring the total labour available and its reduction; the impact of changes in labour on production; the division of labour by sex and age, etc.
Looking into coping mechanisms is important but complex. Farm-household units are designed to be resilient in view of the vagaries of agriculture. However, the assets available affect the degree of resilience: a poor household is less able to cope with disaster than a wealthy one. There are also limits to resilience because after varying levels of thresholds there can be drastic changes (rather than collapse), e.g. abandonment of cultivation of more distant fields, crop substitution. Resilience is also influenced by the more or less favourable agro-ecological conditions (which can impact on the level of assets of the farm): marginal ones limit the range of crops grown and their nutritional value.
One of the contributions of the framework used by FAO is that the farm-household is viewed as a system, as shown in figure 1. When a component is affected, it can have repercussions elsewhere. This is crucial because in such a system, the objective of the survival and development of the system normally overrides the interests of the individuals in the system. In good times, all can benefit, but not necessarily equally, and vice versa in bad times. The child is but one element in such a complex system. Although there should be no opposition between the system and human rights, this may not necessarily be so. At times of crisis, how can the concern for human rights, and more particularly the rights of the child, be respected or promoted if these rights are perceived by the decision-makers to be in conflict with the interests or survival of the production unit?
Source: "The effects of HIV/AIDS on farming systems in Eastern Africa", FAO, 1995
As can be seen in Figure 1, the farm-household system is basically composed of three interrelated components. In a fully subsistence system, there would be no "off-farm" component, but this is rarely the case nowadays: on the contrary, the off-farm component is increasing in importance and such a trend can have considerable impact on the epidemic. The framework shows that AIDS can impact on multiple components at the same time. It is also clear that the poorer the system, the greater the impact and the less capable it is to absorb shocks and disruption. In poor households, labour is the essential and last remaining asset and one can see how precarious the rights of the child can become when there is a need for labour, which cannot be found elsewhere.
One should also recall that agriculture is extremely complex: ensuring food security with few assets (land, tools, etc) requires feats of organization, management and a variety of skills in the face of considerable uncertainty. The farm-household system is therefore extremely vulnerable to the disruptions introduced by AIDS and children consequently suffer the consequences directly and by being dragged into the coping mechanisms.
What does emerge is the problem of orphans. It should be kept in mind that orphanhood of the father or of the mother is not symmetrical: due to polygyny, the death of a father can lead to many more orphans than the death of a mother. In the FAO Burkina Faso study, the death from AIDS of 56 married farmers corresponded to the death of 32 wives and the survival of 33 widows as well as of 151 orphans. On average, the surviving widows had 5 children to bring up (their own as well as orphans from co-wives). Such data is provided as an example and cannot be generalized.
There are also a number of widowers, but if they are polygamous, the other wives look after the orphans. The situation of widows can be much more difficult: when it is suspected that they could also be infected, the practice is appearing to wait for a year or two before they can remarry. Another practice is remarriage to an economic tutor or to a male child of a relative (both forms normally exclude sexual relations) in order to permit the support of the widow and children. An added issue about which little is known as yet, is the question of the survival of the widower or widow as a temporary situation rather than a permanent one. The exit can be through remarriage, but often through death due to differences in timing of HIV infection (and/or duration of incubation) between husband and wife.
Widows are frequently victims of land grabbing and generally live in poverty, which affects their ability and time to look after their children and to feed them, both in quantity and in quality. In particular, meat and fish tend to disappear from the diet of children, except for some presents from the family. In such circumstances and in poverty, attendance at school is generally impossible: the work of the children is necessary or they have to fend for themselves.
As is known, fostering of children is a common practice in many regions. It is expected that orphans be redistributed within the extended family accordingly. The downside is that brothers and sisters can be separated and that the fostered children are vulnerable to exploitation. The rights of fostered children need monitoring and protection. It has also been found that farms, in which the parents have died, are run by a teenager with the siblings. This has raised the question of whether they have been abandoned which is not always clear because it has been asserted that children are left on the farm in order to protect their claim to it, which claim would be lost if they were fostered.
Finally, children can be abandoned; especially if AIDS hits the communities they belong to hard and the capacity to assume extra burdens is reduced.
When this happens, food security is affected. It has been systematically observed that, in these situations, both the quantity and quality of the food diminishes and children can often go hungry or are malnourished. In this connection, when a family has to host the widow of a relative and her children, the number of mouths to feed can suddenly increase considerably without any increase in the availability of food, with the result that all go hungry, especially the children.
A drop in production or a loss in remittances also means that resources are no longer available to pay for school fees, uniforms or books which leads to children dropping out of school or never starting to attend. The work of children on the farm and in the house can become indispensable; this also jeopardises their possibility of attending or benefiting from schooling. Traditionally, rural children learn many of their farming skills through working together with the parents. When this learning process breaks down due to illness or death of the parent, there does not appear to be replacement mechanisms for the child who remains on the parental land.
As mentioned, the farm-household has developed coping mechanisms in the face of adversity or disaster. It can attempt to compensate the loss of labour through recruiting casual labour, especially for peak seasonal needs, or increasing the labour inputs of the household members, including the children. Another strategy, especially for poorer households, is to adjust downward the standard of living and food security by giving up the cultivation of cash crops or certain fields, etc. In this case also the children are affected because the assets necessary to keep them in school are no longer available. Older children can migrate to other rural areas to work on plantations or to the cities in order to relieve pressures and attempt to send remittances: here again it implies giving up any form of schooling.
It is important to note that there are thus different options open to farm-households in their coping mechanisms and this opens a window of opportunity for interventions in order to protect or promote the rights of children. A study of ways in which to reconcile the interests of the children with those of the farm-household would be useful, but this has not been undertaken.
A possible indirect consequence needs to be flagged and deserves to be studied: the children who become victims of tuberculosis through the HIV/AIDS of the parents. As is known, tuberculosis can be the immediate cause of death for adults infected with HIV. In such cases when farm-households sink into poverty and the level of nutrition declines, the children living in close contact with parents with active TB, can often be expected to become more susceptible to TB infection and vulnerable to its impact. It is thus possible that the children will become victims of TB at a later stage.
Another issue raised at the beginning of this paper is whether it makes sense for the rights of the child to be promoted or implemented ignoring the context in which they live? Would this not lead to stressing principles, but at the risk of being ineffective? It could be very useful to identify what is really feasible in the farm-household context? This is all the more necessary since the epidemic is expected to continue to spread to rural populations and therefore both an increasing number of children, and perhaps proportions of children infected or affected by HIV, would be found in rural areas.
Are the existing Guidelines sufficient?. Besides Guideline 8, which explicitly refers to children, a number of other guidelines are directly relevant. For example, Guideline 1 (see Annex 1) recommends an "effective national framework…across all branches of government" however neither agriculture nor food security are mentioned in paragraph 21 which elaborates on it and lists major activities of relevance to HIV/AIDS. Guideline 2, which elaborates on it and stresses the need for community consultation, begs the question of whether rural communities have been consulted on HIV and children? As to Guideline 8, it specifically mentions children as a vulnerable group, and recommends to "promote a supportive and enabling environment", but then falls short of expanding on this by stressing questions more related to issues like prejudice, than drawing the survival or developmental consequences of the guideline. Guideline 8 is elaborated upon in paragraphs 94 and 95 which flesh it out (see Annex 1), but in the same kind of direction which does not measure up to the magnitude of the problems of the children. However, in paragraph 95 there is a very interesting idea, which could be usefully explored: i.e. the idea of the rights of the children to be actors in their own development. It could be extremely beneficial to consult rural communities and the children themselves on the problems, priorities and necessary programmes which could lead to the development of more appropriate guidelines for rural children: after all, if teenagers can be de facto heads of farm-households, they can and should be consulted!
Following such a first step, it could then be appropriate to consult rural communities and children on the problems and possible solutions as mentioned in the previous section. The difficulty in this case is that, due to the different environment contexts of farm-households, there is probably a much greater degree of heterogeneity between rural areas than between urban ones: this requires tailoring of rural programmes to the situations encountered. Another difficulty is that the epidemic can evolve rapidly and some kind of monitoring is necessary to avoid programmes becoming obsolete.
The various situations of rural children. It has been pointed out already that the coping mechanisms set in place can vary significantly. These mechanisms need to be analyzed in order to identify the options desirable or feasible for intervention: the selection of one option over another needs to take into account various factors such as the farming system and cultural factors which are generally of great importance where children are concerned. As the example given on leaving orphans on the land to preserve their rights to it (at least when it does not correspond to a pretext for abandoning them) or fostering them out to relatives showed, it is often very delicate to identify the best option.
A related and thorny issue is the question of work of the child especially at younger ages. The question is sometimes examined in the absolute, disregarding the fact that work for a child, even at a young age can be "a passport for survival" (expression heard a number of times at the Harare conference). What should be the strategy when the survival of the child is at stake? How does one reconcile banning or restricting work with survival of the child or should the primary issue be translated into ensuring the child is not exploited or abused? In such circumstances, the concern should perhaps focus more on ensuring that the child is not exploited or abused.
The role of the formal and informal rural institutions. FAO has highlighted the role of rural institutions in assisting farm-households respond to the impacts of the epidemic. As far as formal institutions are concerned, extension services have to adjust to dealing with a new clientele (children instead of just adults) and a new situation. This is quite a challenge; especially when at the same time they face internal adjustments due to the thinning of their own ranks. It is thus advisable that in such circumstances resources be utilized in an optimum manner, which implies an evolution in the modes of working. Partnerships with informal rural institutions appear as a very rational response to such situations, besides having the added advantage of contributing to the empowerment of the civil society and of the children themselves. Such partnerships are very important, for example in the case of abandoned orphans: an issue where NGOs play a crucial role.
95.Many of these rights are relevant to HIV/AIDS prevention, care and support for children, such as freedom from trafficking, prostitution, sexual exploitation and sexual abuse since sexual violence against children, among other things, increases their vulnerability to HIV/AIDS. The freedom to seek, receive and impart information and ideas of all kinds and the right to education provide children with the right to give and receive all HIV-related information needed to avoid infection and to cope with their status, if infected. The right to special protection and assistance if deprived of his or her family environment, including alternative care and protection in adoption, in particular protects children if they are orphaned by HIV/AIDS. The right of disabled children to a full and decent life and to special care and the rights to abolition of traditional practices which are prejudicial to the health of children, such as early marriage, female genital mutilation, denial of equal sustenance and inheritance for girls are also highly relevant in the context of HIV/AIDS. Under the Convention, the right to non-discrimination and privacy for children living with HIV/AIDS and finally the rights of children to be actors in their own development and to express opinions and have them taken into account in making decisions about their lives should empower children to be involved in the design and implementation of HIV-related programmes for children.
Guideline 1: States should establish an effective national framework for their response to HIV/AIDS which ensures a coordinated, participatory, transparent and accountable approach, integrating HIV/AIDS policy and programme responsibilities across all branches of government.
Guideline 2: States should ensure, through political and financial support, that community consultation occours in all phases of HIV/AIDS policy design, programme implementation and evaluation and that community organizations are enabled to carry out their activities, including in the field of echics, law and human rights, effectively.
Guideline 8: States, in collaboration with and through the community, should promote a supportive and enabling environment for women, children and other vulnerable groups by addressing underlying prejudices and inequalities through community dialogue, specially designed social and health services and support to community groups.