Tuesday, December 2, 2014

Ebola's Other Victims: The Orphans the Epidemic Left Behind

by Nomad

As the Ebola epidemic continues to claim lives in West and Central Africa, one of the indirect effect has been the children orphaned by the humanitarian crisis.

What does the future hold for these children? The answer lies in how much help they receive now.

Meet 8-year-old Lamin Borbor, one of the hundreds of orphaned children in Ebola-ravaged Sierra Leone. After losing both parents to Ebola, Lamin's new home is the Interim Care Centre (ICC) in Kailahun town, in the east of the country.  
In a recent news article, Lamin told a reporter for IRIN:
"I was brought here because I had nobody to take care of me. My parents died of the Ebola virus. but I have no fear [because] the people are taking good care of me at the centre."
Meanwhile Sierra Leone's Ministry of Social Welfare, Gender and Children's Affairs (MSWGCA) and international agencies struggle to find solutions for the orphans of Ebola. Although the Kailahun ICC is being managed by the government. the funding comes from organizations such as Save the Children and UNICEF

At this time it is the only center in Kailahun but a second facility for Ebola orphans has been opened last month in Port Loko, in the north of the country. Most doctors consider this to be ground zero for the epidemic in West Africa. At the moment, at least.

So how many children like Lamin are there? The exact numbers of Ebola orphans from all of the stricken countries is hard to place. (That's also true of the actual number of Ebola victims.) Three days ago, one UK charity, Street Child, released a report that estimates that in Sierra Leone alone it has left 7,000 children without parents. They also admit that that's probably a very conservative estimate.

A revised survey paints a far grimmer picture. Accounting for the current death toll, under-reporting of cases within the population, and data reports from local teams, the organization estimates there are at least 20,000 children in the region who have been effectively orphaned by Ebola – left with no-one to care for them. 
It is simply impossible to know. Many children living in rural areas may be unaccounted for, while many others end up on the street or are living with neighbors temporarily. Some parentless families are being raised by older siblings.

In contrast to the aid organizations' estimate, the IRIN news report:
Nationwide, more than 3,400 children have been directly affected by the virus, including at least 89 children who have lost one parent and more than 795 who have lost both parents to Ebola, according to the MSWGCA/UNICEF-led Family Tracing and Reunification (FTR) network. There are no accurate figures for the number of separated children, a spokesperson for FTR said.
Whatever the true figures, it is clear that the Ebola orphan crisis will become a long term social problem for a nation that already has more than its share of problems.

Fear and Ostracization
When children arrive to such centers they are put under a 21-day surveillance to ensure they are infected. Many of the caregivers are actually Ebola survivors with natural immunity from the disease. While watching for any signs of the disease, the staff also give them the attention and affection that many others are too afraid to. 

One teenage girl says that after the loss of most of her family, she had little left but memories and fear. She told an interviewer, "I'm always in constant fear. I'm afraid to sleep at night." 

Dr Unni Krishnan, head of disaster preparedness and response for Plan International told a BBC reporter:
"Children are sent off to extended family outside affected areas, but extended families don't want to take care of orphans of affected parents or other vulnerable children any more out of fear of being contaminated or stigmatized in the community."
Krista Armstrong, a humanitarian information and communications officer with Save the Children. explained that the problem involved thousands of children who have been left without family or any kind of support. She added:
"Because of the nature of the virus, orphaned children are also at risk of being ostracized from their communities at the most vulnerable time in their lives."
Although the authorities make every effort to reunite the children with relatives, it is often an impossible task. 

Amy Richmond, a child protection specialist also with Save the Children, explains the kinds of problems agencies face:
"It can be hard sometimes to trace their roots. There are children that go into the ETUs [Ebola Treatment Units], who survive and come out, but now they are in big cities, hours from their village, and their parents have passed [away] and they don't actually know where they came from or are afraid to talk."
According to November reports, 520 children have received psycho-social support services in Sierra Leone and 200 have been either reunited with their families or placed in foster care, in accordance with the international Guidelines for the Alternative Care of Children.

Once families can be found and the children are certified as Ebola free, the agencies work to reintegrate the children into their new homes and communities. Families are given professional advice to help them deal with the normal problems. 
In addition, social welfare assistance is provided along with reintegration kits, that include "household items, such as a mattress, bedding, small food items, clothes and dishes to help ease the burden of taking in an extra child during, what is for many families now, an already difficult time."

With the high levels of poverty in the country, the burden of suddenly having a new child or children to care for will simply be economically impossible with some kind of direct assistance.  

Children Left Behind
Those children that cannot be immediately placed or reunited, are sent to an ICC where they are given a safe place to stay and psychological support until a better solution can be found. 
Although ideally it is a temporary solution. Some children may stay just a few days at the ICC, while others a few weeks. Some even longer. 

Fatu Falma, a 14 year old who lost both her father and grandmother and whose mother remains in the treatment center, explains that her life in the facility is very different to her past life.
"But I eat good food. and the people talk to me very nicely. I normally spend most of my day playing with the toys and games with the other children here."
One survivor/volunteer is Fanta. She has been working in the Kailahun ICC since September. She told the IRIN interviewer that it was not easy for young children to lose their loved ones so early in life. 
"Most of them saw their parents die. Others are too young to know. But for all of them, seeing someone that cares for them, plays with them and talks with them, is all they need."
Sailfulai Bah, the coordinator of Sierra Leone's Ministry of Social Welfare in Kailahun District, that games and toys can provide much needed distractions and can reduce the frustrations and worry about their loss.
In addition, the centers are looking to hire teachers to give lessons during the day. 

Another agency is constructing a boarding home in Kailahun for children who face a long term stay at the ICC as they wait for foster care or local adoption. 

At the present time, international adoption is not an optional for these children. Matthew Dalling, a chief child protection officer for UNICEF in Sierra Leone explains:
"The Ministry doesn't have the capacity to do [international] adoption investigations and it's a risky endeavor. So right now we're focusing our efforts on family tracing and foster care."
Many of the children expressed the appreciation for the centres but really just want to return to their normal lives. Said Augustine Turay, an 11-year-old orphan:
"I want to see my friends and other relatives I used to play with. And I want to be with someone like my mother who can take care of me. but she's very sick. I don't know if I can see her again."
Looking toward the future, without a plan, these abandoned children may soon become easy prey to radical ideologies of groups like Boko Haram, whose main message is a rejection against Western education and all of its influences.

Allegations Against Aid Workers
Against this desperate background, there are the inevitable allegations of misuse of funds. 

For example, a UK tabliod reported the claims of Julia Duncan-Cassell, the minister in charge of saving the orphans in Liberia. she has charged that Western aid agencies have misused funds and have used the funds to pay for a "lavish lifestyle in $800-a-night hotel while the children are left to fend for themselves.
'Millions of dollars might be coming into the country but it is going to international organisations that are running their own institutions and their own organisations, not understanding the dimension of what needs to be done.'
She also told reporters:
'They [the agencies] are using the situation to raise money for their organisations. The money is paying directly for the NGOs - their per diem, the money they get per day, is even more than I make as a minister, the kind of cars that they ride, the best hotels. How many of them do you need to do that? We do not need an army of them.'
How valid Duncan-Cassell's claim actually are cannot be verified. One organization responded to the allegation by noting that the numbers of foreign aid workers in Liberia can hardly be considered an army. They also point out, that more than half a million people in West Africa have been helped through the work of aid agencies.
Most of those delivering aid for us in Liberia are Liberians and the small minority of international aid workers working for Disaster and Emergency Committee (DEC) agencies live in conditions that tend to range from pretty basic to adequate.
However, these claims by Duncan-Cassell need to be put into the proper perspective. Corruption claims in African countries are nothing new, whether they involve foreign aid workers or not. 
Cynical Liberians from the beginning of the Ebola outbreak have looked upon the crisis as just another government scam. As one source explains:
When Ebola first appeared in Liberia, many of the people in the country thought it was a scam crafted by the government to attract funds from international donors. This meant that Ministry of Health messages on precautions to avoid transmission fell on deaf years.  
After neglecting its health care for decades, the government minister's claims strike many as unhelpful and hypocritical. After all, there are only 50 doctors in the public health system in Liberia, a country of 4 million to 5 million people. Despite the fact that Liberia is among the largest aid recipients on the continent, its population still has no public provision of clean water, sewerage or electricity; and over 76% of the population still lives on less than $1 a day. 

Clearly, it is this kind of neglect of basic public health that has contributed to the spread of Ebola and other diseases, not frivolous aid workers living it up in fancy hotels.

Nevertheless, even the suggestion of aid organization corruption can have an impact on the amount of donations these organizations receive.

For those who are not inclined to charity or who feel that the Ebola children are not their concern, the minister's complaints provide the excuse to ignore the problem altogether.

America's Lack of Focus and Myopia
In the other hard-hit countries, such as Liberia and Guinea, the World Health Organization says infection rates are stabilizing or declining.

In contrast, the rates in Sierra Leone are soaring. Whether that's because more there is more accurate accounting of the victim numbers or whether it is an actual increase is unclear. Whatever the reason, the country has been reporting around 400 to 500 new cases each week for several weeks. 

Treatment centers are simply being overwhelmed by the numbers along with the difficulties in finding experienced staff. For every death, there is likely to be a family left in chaos. 

Furthermore, even as new treatment centers are being built in Sierra Leone to deal with this surge, UN admitted this week that it would not be able to meet its ambition targets for curbing the spread of Ebola. 

Last month, President Obama asked Congress to approve of a $6.18 billion emergency funding bill to fight Ebola worldwide. ($4.64 billion for immediate needs and $1.54 billion in contingency funding.)
The White House provided a fact sheet that detailed the outline of the plan. Some key point show that U.S. Agency for International Development would receive $1.98 billion for emergency assistance and humanitarian needs, the Department of Defense would receive $112 million to develop new technologies, and $25 million for the Food and Drug Administration to quicken efforts to approve medicines and vaccines. The funds would improve state readiness in the U.S. as well as help combat the disease in West Africa.
While none of the senators have said openly they would oppose the spending bill, given the climate in Washington, it is questionable whether such an initiative has any chance at all. The Congress has until Dec 11 to make a decision. 

In October, Congress slashed a similar effort in half. The White House had asked for $88 million for Ebola but House Republicans, led by House Appropriations Committee Chairman Hal Rogers (R-Ky.), agreed to spend a total of $40 million to fight the epidemic in the 2015 spending bill. 

At that time, Louisiana Republican Sen. David Vitter told fellow senators at that time that they should not approve the $1 billion dollar Ebola eradication plan because Obama's plan to tackle Ebola at its source. 
The problem with Obama's plan, said Vitter, was that it "focuses on Africa and largely ignores our own borders." 

While Vitter's excuses are not only selfish and anti-humanitarian and poorly thought-out, they are so extremely myopic.

The Harvest of Neglect
If Mia Bloom the author of the book “Small Arms: Children and Terror" is correct, any refusal to help these abandoned children now will come back to haunt America in years to come. 
Bloom points out that many terrorist movements have actually "institutionalized the recruitment and indoctrination of children." The Taliban in Pakistan and Afghanistan, as well as others, have set up schools and training camps to indoctrinate children, with an aim to create the next generation of terrorists.  

That's not a hypothetical possibility. Before Ebola there was the AIDS epidemic. 
By 2010, AIDS epidemic created 40 million orphans and for them becoming child soldiers, (as well as slave workers or prostitutes) was simply one means of survival. An article in Fordham International Law Journal says:
Many children who have lost their parents and siblings due to the scourge of AIDS are especially susceptible to the lure of child soldiering. Many orphans have actually watched their parents die and were forced to fend for themselves at a very young age in an unusually dangerous environment. In this context, the structure of an army setting can provide orphans with the false sense of belonging to a community, an escape from loneliness, and the hope of more security and stability in a country at war.
Despots, religious extremists and warlords regularly use children as effective, cheap, and expendable fighters. 
By indoctrinating them early, these children can easily become radicalized and  with a vow to exact revenge on a world that failed them when help was needed.