-Caveat Lector- > Aids Analysis Africa vol 10 No2 aug/sep 1999 > > AIDS and age: SA's crime time bomb? by Martin Schonteich > > AIDS and age will be si&ificant contributors to an increase in the rate of > crime in South Africa over the next ten to twenty years. There will be a > boom in South Africa's orphan population during the next decade as the > AIDS epidemic takes its toll. Growing up without parents, and badly > supervised by relatives and welfare organisations, this growing pool of > orphans will be at greater than average risk to engage in criminal > activity. Moreover, in a decade's time, every fourth South African will be > aged between 15 and 24. It is within this age group where people's > propensity to commit crime is at its highest. > > AIDS, orphans and crime > . Between 1995 and 2065 South Africa is expected to have the highest , > number of deaths attributable to AIDS of all African countries - 7.4 mil > Unlike other; diseases!. HIV/AIDS targets young adults in their . prime - > the parents and workers of the nation - leading to a loss of human > resources and an unprecedented wave of orphaned children. In South Africa > the majority of HIV infections occur between the ages of 15 io 25 for > women, and 20 to 30 years for men.2 > Nearly one million South African children under the age of 15 will > have lost their mothers to AIDS by 2005. This is estimated to increase to > over two million by 2010, according to the Department of Health (Figure > 1).3 > > As the AIDS epidemic progresses, an increasing number of children > will lose their parents to the disease, and there will be fewer adults of > parent age to care for them. The burden of care will increasingly fall on > other children or upon the grow-ing proportion of elderly people. In > Zimbabwe, for example, 43% of orphan households are headed by > grandmother.4 > A number of studies have been conducted on the plight of orphans and > their care in various African countries. It has been shown that families > which foster children in Kenya usu-ally live below the poverty line, and > that orphan households in Tanzania have more children, are larger, and > have less favourable dependency ratios.5 > Children who lose a parent to AIDS suffer loss and grief like any > other orphan. However, their loss is exacerbated by prejudice and social > exclusion, and can lead to the loss of education and health care.6 > Moreover, the psychological im-pact on a child who witnesses his parent > dying of AIDS can be "more intense than for children whose parents die > from more sudden causes. HIV ultimately makes people ill but it runs an > unpredictable course. There are typically months or years of stress, > suffering or depression before a patient dies. And in developing > countries, where the epidemic is concentrated, effective pain or symptom > relief is often unavailable to alleviate a parent's suffering."7 > For a child living with a parent who has AIDS, the disease is > especially cruel, as HIV is sexually transmitted. Consequently, once one > parent is infected, he or she is likely to pass it on to the other parent. > Children who lose one parent to AIDS are thus at considerable risk of > losing their remaining parent as well. > > Ashraf Grimwood of the National AIDS Coalition in South Africa > argues that the increasing number of AIDS orphans, who grow up without > parental support and supervision, will turn to crime. "Crime will increase > because of the disintegration of the fabric of our society. It will be > made worse by the lack of guidance, care and support for HIV-positive > people, including children. Children orphaned by AIDS will have no role > models in the future and they will resort to crime to survive", Grimwood > said.B > > A review of the backgrounds of a large sample of children who have > killed or committed other grave (usually violent) crimes in the United > Kingdom found that 57% had experienced the death, or loss of contact, of > someone important such as a parent9 > A 1998 interview study of young men serving jail sentences, or > involved in crime, by the Centre for !he Study of Violence and > Reconciliation (in South Africa)found that most of the interviewees were > "abandoned or kicked out of their homes, or had to live with a stepfather > or mother who rejected them. Many expressed feelings of being unloved."10 > The absence of a father figure early in the lives of young males > tends to increase later delinquency." Moreover, such an absence will > directly affect a boy's ability to develop self control. "The secure > attachment or emotional investment process [a father figure provides] > facilitates the child's ability to develop and demonstrate both empathy > and self-control. By extension, an insecure attachment will lead to lower > levels of empathy and self-control, and to an increase in violent > behaviour."12 > Another research group completed an exhaustive review of family > factors as correlates and predictors ofjuvenile con-duct problems and > delinquency. They found that, interalia, poor parental supervision or > monitoring and low parental in-volvement with the child (factors which > would obviously ex-ist with an orphaned child) were important > predictors.13 An-other study found that poor parental supervision was the > best predictor of violent and property offenders in later life.14 > > Age and crime > The relationship between age and crime has been the subject of much > criminological analysis. It has been suggested that "probably the most > important single fact about crime is that it is committed mainly by > teenagers and young adults':15 > Conviction, offending and arrest rates, as well as other information > on criminal offenders, show that throughout the world juveniles and young > adults tend to commit crimes far in excess of their proportion of the > general population. > > In comparison with many other countries -especially developed > countries - South Africa has a relatively youthful population. According > to the 1996 census results, 34% of the South African population is under > the age of 15. The numerically largest population segments are those aged > 5 to 9 and IO to 14, each of which make up 11.5% of the total population > (Figure 2)'" > > AIDS, age and crime > During the next ten to twenty years the number of juveniles and young > adults as a proportion of the general population will peak. This will > exert an upward pressure on the crime rate, as juveniles and young adults > are proportionately more likely to commit crime than children or adults. > At about the same time South Africa will also experience a rapid increase > in the number of children growing up with no or only one par-ent because > of the effects of AIDS. [to page 41 > 15(Z) Atig/Sep 1999 3 > > > > Most of these orphaned children will grow up without adequate parental > supervision, guidance, or discipline. It is probable that most orphaned > children will be cared for by their extended family. This will, however, > place considerable financial pressure on the relatives of such children. > In rural communities it is often the grandmother who would take on the > responsibility for such care. This will further impoverish South Africa's > older generation and the economically marginalised rural poor. As a result > many such orphaned children will grow up under impoverished conditions > which will increase their temptation to engage incriminal activity at an > early age. > AIDS will have a minor effect only on the mortality rates of those > children (currently aged 5 to 14) who will create the population bulge of > crime-prone juveniles and young adults over the next 20 years. According > to UNAIDS, of the 2.9 mil-lion people who were infected with HIV at the > end of 1997, only 80 000 (2.8%) were children under the age of 16-17 > Governmental policy makers would be well advised to brace > themselves. for an increase in juvenile-related crime as the number of > orphaned juveniles increases. over the next two decades. > > Notes > > > > 1. Haldenwang, B.B. (1999), "The demographic impact of HIV/AIDS in > Africa", Social Issues, 4(1): > > 2 Myslik, WD, Freeman and J Slawaski(1997)Implications of AIDS for the > Southern African population age SA Journal og Gerentology > 3. Kinghorn, A. and M. Steinberg (undated), HIV/AIDS inSout Africa The > impact and priorities > Department of Health, p.14. > > 4. Myslik et al. op. cit. (1997) p.6. > > 5: Myslik et al. op. cit. (1997) p.6 > 6 UNAIDS (1999a), The Orphans of AIDS: Breaking the Vicious Circle, > http://www.unaids.org/unaidslevents/wad/l 997/orphansofaidshtml, 12 May > 1999. > 7. UNAIDS (1999b), Children Orphaned by AIDS, > http://www.unaids.org/unaids/events/wad/l997/orphan.html, 12 May 1999. > 8 Mackay, M.M. (1999), "AIDS will spur on crime, say ex-perts': > Saturday Argus, 9/1/1999, Cape Town. > 9. UNICEF (undated), "Why do children become violent?'lnnocenti Digest, > Children and Violence, no. 2. UNICEF International Child Development > Centre, p.15. > 10 Segal, L., J. Pelo and P. Rampa (1999), "Asicamtheni Magents - Let's > Talk, Magents", Youth Attitudes To-wards Crime and Conftict, Autumn 1999, > University of Natal, Durban, 15:24. > 11. See, for example, Bowlby, J. (1947) forty-four Juvenile Thieves: Their > Characters and Home Life, Lon- > don: Bailliere, Tindall and Cox; and Gabel, S.M.D. (1992) "Behavioural > problems in sons of incarcerated or otherwise absent fathers: the issue of > separation", Fam-ily Process, 31:303. > 12. Katz, R.S. (1999) "Building the foundation for a side-by side > explanatory model: a general theory of crime, the age-graded life-course > theory, and attachment theory': Western Criminology Review, l(2). > 13.Loeber, R. and M. Stouthamer-Loeber (1986) "Family factors as > correlates and predictors of juvenile conduct problems and delinquency", > in Ton-y, M. and N. Morris (eds.), Crime and Justice, Chicago: University > of Chi-cago Press, pp.29-149. > > 14.McCord, J. (1979). "Some child-rearing antecedents of criminal > behaviour in adult men: Journal of Personality and Social Psychology, > 37:1477-l 486. > 15. Smith, D.J. (1995), "Youth crime and conduct disorders'; > in Rutter, M. and D.J. Smith (eds.), Psychological Dis-orders in Young > People: Time Trends and their Correlates, Chichester: Wiley, p.395. > > 16. Statistics South Africa (1999) The People of South Af- rica Population > Census, 1996: Census in Brief report > > 17. UNAIDS (1999) Epidemiological Fact Sheet on HIV/ profile': Southern > African J. of Gerontology, 6(2):3. AIDS and sexually transmitted diseases > - South Af rica, UNAIDSWHO Working Group on Global HIV/AIDS South Africa: > the Impact and the Priorities, Depart-and STD Surveillance . > http:l/www.who.ch/emc/diseases/hiv, p.3 14 May > . > Martin Schonteich is Senior Researcher at the Institute for Security > Studies in Pretoria. > > > > HIV/AIDS and small-holder agriculture in Zimbabwe > > Zimbabwe, like most of its Southern African neighbours, is facing > devastating cross-sectoral effects from the HIV/AIDS epidemic. A study of > agriculture in 1998 revealed that this sector is experiencing setbacks in > its efforts to contribute to-wards stabilising the social and economic > development of the country. The study was conducted in particular to > deter-mine the extent to which small-holderfarmers, based mainly in rural > settings, are affected by HIV and AIDS in their agri-cultural enterprises. > Zimbabwe has a population of 10.4 million according to the 1992 > census, comprised of 5.1 million males and 5.3 mil-lion females. Average > population density is 27 persons per square km, 70% of the population > living in rural areas. There are about 2.1 million households, 67% of > which are male- > headed. The population is youthful, with 45% below the age of 15 and only > 3% aged 65 years and above. > The country is divided into five agro-ecological regions. > The Gweru and Shurugwi districts, which are the focus of this article, are > found in the Midlands Province, with an average annual rainfall of 550mm. > > The agricultural sector > The agricultural sector in Zimbabwe is divisible into four sectors: > large-scale commercial areas, small-scale commercial areas, resettlement > areas, and communal areas. The reset-tlement and communal sectors > constitute the small-holder agriculture producing areas. The farming > systems in these areas are mainly crop production (especially maize and > groundnuts), and livestock production (cattle and goats). In these sectors > farmers produce both for home consumption and for sale. The annual > off-take of cattle is about 5%. Al-most all agricultural operations depend > on family labour, which is therefore an indispensable asset of all > households. The income derived from cattle and surplus from crop > pro-duction is used for developmental activities such as home improvement, > and sending children to school. > > After independence in 1980, government support for small-holder > agriculture saw about 60% of maize, the country's stable food being > produced by resettlement and com-munal areas. Gweru and Shurugwi districts > have been among the highest producers of maize. The small-holder sector > therefore plays a very important role both at house-hold and national > level in terms of food security. This sector > is, however, both susceptible and vulnerable to HIV effects. > > The impact -of HIV/AIDS > HIV/AIDS has reduced agricultural productivity by an estmated 15% in the > communal and resettlement areas, and as a result a significant proportion > of average household in-come is being lost. This situation is observed at > the begin-ning of the serious effects of the epidemic in these areas, and > may increase with time as the epidemic takes its toll. > According to a survey carried out in Gweru and Shurugwi districts in > May 1999 ,95% of agricultural extension workers and farmers said that the > negative impact of the epidemic has worsened in these areas since a > baseline survey in May 1998. Lands are lying idle, more input providers > have died, more time is being spent caring for the sick, and more > live-stock and farm implements are being sold to cover HIV/ AIDS- related > expenses. All this has significantly reduced productivity, with a > consequent loss of income to both the families directly affected and to > the State. > > Ability to cope with the impact of the epidemic vanes between > families and communities. Coping mechanisms have included the withdrawal > of children from school, children be-ing sent to scout for income, > reduction of land area under cultivation, and diversion from cultivation > of big crops (such as maize) to small crops (such as sweet potatoes). The > majority of affected families have had to divert most of their resources > towards household maintenance for survival. > > Reduced labour > HIV prevalence is naturally highest among those aged 20- > 50, the country's reproductive age group. This is also the age group that > contributes towards effective farming and the building of wealth. Families > lose labour through debilitating > long-term ill-health and death. This results in poor crop and livestock > management, and consequent reduction in yields and the overall > productivity of the sector. > > Reduced cropping areas > Because households are weak and unable to crop bigger areas, some lands > are left idle, and as a result production from this sector is reduced. > Some input providers either fall sick and leave employment or die. This > leaves households with no agricultural inputs, which results in reduced > yield pro-ductivity of the sector. > > Sale and slaughter of livestock > Livestock, especially cattle and goats, are sold to cover HIV/ AIDS > related expenses. Oxen are most commonly sold, which results in families > having no draught power;'consequently, smaller areas are cropped, using > hoes. Although families may borrow draught power from their neighbours, > they usually have to wait till they have finished. This results in late > planting and associated loss in yields > ------- > > > > The HIV/AIDS burden on Swaziland's health care sector > > In 1998 a baseline HIV/AIDS survey was conducted in Swaziland's four > regional hospitals in two urban and two ru-ral areas.' This found that > 49.5% of in-patients were infected with HIV, and reaffirmed the serious > threat posed by HIV and AIDS to the Kingdom of Swaziland. > Trends in HIV prevalence in 1986 Swaziland realised the presence of HIV > when the first AIDS case was seen. It was a case of 'just one person" out > of an estimated total population of 800 000. Life expectancy during this > period was 65 years for females and 61 for males. It seemed that Swaziland > was moving along a sound development trajectory. Then in 1992 the first > sentinel sur-veillance on pregnant women found that 3.9% of women were > HIV-positive; by 1998 this had risen to 31.6%. > It was believed that this situation would have a significant impact > on the country's health services. Partly as a result of the sentinel > surveillance data, therefore, in 1998 the Ministry for Health and Social > Welfare conducted the baseline survey at the country's regional hospitals, > > The purposes of the survey were: > > to determine the prevalence by age, sex and rural-urban residence; and > ? to establish a baseline for monitoring future trends. > , > The method used was to test and complete a questionnaire for all > patients being admitted to non-maternity wards for the first time during a > 30-day study period in June/July 1998. > There were a number of other significant findings. HIV prevalence by > hospital ranged from 45.7% in Mbabane (the capital) to 53.4% in Good > Shepherd Hospital. Indeed, the two rural hospitals reflected higher HIV > prevalence rates than the urban ones. In addition, patients at all > hospitals were asked whether they were urban or rural residents Overall > HIV prevalence was 45.5% for urban dwellers and 53% among rural residents. > > This finding is counter-intuitive, as we would expect to find higher > levels of HIV in urban populations. What it may point to is that people > who fall ill are returning to their rural homes. If this is the case then > itwill have serious implications for rural poverty - not only are the > homesteads having to cope with increased demand for resources, but they > also face the loss of income from remittances. > HIV prevalence rates by age are shown in Figure 1 > There are no surprises in these data -although it is assumed that the > majority of those infected in the 1 O-l 9 age band are at the upper limit, > otherwise it might point to a problem of child abuse. It is, however, > extremely worrying to note that two-thirds of patients aged 20-39 are > HIV-positive. > 1 Figure 1 HIV prevalence.by age among inpatients (%) > > 0-9 40% > 10-19 21% > 20-29 63% > 30-39 60% > 40-49 55% > 50-59 40% > 60+ 15% > > > > > > > The impact of HIV Levels of ill health and rates of mortality have shown a > marked increase during the past decade. This has been assumed to be linked > with rising HIV prevalence, although in the absence of HIV testing of > patients and death certificates reflecting the cause of death, there has > so far been no proof of this. > > The survey found a huge burden of disease as a result of HIV. Of the > total number of patients tested, 49.5% were infected. The breakdown of HIV > infection levels by ward ofad-mission is detailed in Table I, > > Table 1 HIV prevalence by ward (%) > I > Medical 55.8 > Paedratric 44.6 > Surgical 37.6 > Private 35.9 > > > > The report notes that there has been an increase in mortality among > hospital patients, which was assumed to be due to HIV infection. It is > clear that this is indeed the case. > The SNAP is to be congratulated for this study. Not only does it > provide a baseline but also provides directions for future work. > References > > 1 Swaziland National AIDS/STDs Programme (1998), Report on HIV > Prevalence among In-patients in Selected Hospitals, Mbabane: Ministry of > Health and Social Welfare > DECLARATION & DISCLAIMER ========== CTRL is a discussion and informational exchange list. Proselyzting propagandic screeds are not allowed. Substance—not soapboxing! 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