Isabel, 14, sits quietly in a room surrounded by other children chatting and running around at the orphanage.

She lives here with a dozen or so other children with HIV in a 2-story apartment with eight bedrooms in Kwabenya, a densely packed neighborhood on the outskirts of Accra, Ghana. Her last name is omitted to protect her identity as a school-aged child.

A good Samaritan brought her to the home when she was just 5. Her parents died of AIDS in 2013. Extended family members had rejected her and feared contracting the virus from her.

She said life has been good so far at Motherly Love Orphanage, a home founded by Rev. John Azumah 14 years ago. The pastor, who also has HIV, founded the orphanage to provide hope and fight stigma faced by orphans living with HIV.

Here, Isabel gets her basic needs met by the orphanage. She also completed her basic education and hopes to enter high school next year.

“I want to be an air hostess,” she said. “I want to see how other countries are doing so that I can compare it to my country and maybe see if we can also improve our country too.”

Globally 2.7 million children are living with HIV. The infection in children occurs most often during pregnancy, labor or breastfeeding. Without effective treatment, more than half of all babies born with HIV will die before their second birthday.

Close to 15 million children worldwide have lost one or both parents due to HIV/AIDS-related causes. Three quarters of these children live in sub-Saharan Africa, where communities often refuse to accept these orphans, especially if they are HIV-positive. The majority of HIV-positive orphans end up living on the streets and sometimes die due to hunger and lack of proper treatment.

In Ghana, there are over 230,000 children orphaned by HIV/AIDS while close to 29,000 children live with HIV.

Sixteen-year-old Rejoice also lives at the orphanage. She lost both her parents to AIDS at the age of 10 and is also HIV-positive. She plans to attend high school next year and hopes to be a nurse one day.

“I want to help those who are sick and give them medicine and take care of them,” she said.

Opening doors for children with HIV

Rev. Azumah opened his doors to orphaned HIV-positive children 14 years ago.

Azumah himself has been living with HIV for 22 years. His personal journey with living with HIV has been met with enormous suffering, resilience and tenacity.

When he received his HIV diagnosis in 2000, he thought he was going to die. He felt the need to confide in his senior pastor.

“That was the biggest mistake I made in my life,” he said.

Azumah said he was excommunicated by the church after his head pastor announced his HIV status to the entire congregation. His family experienced a great deal of stigma in the community. Shopkeepers wouldn’t even sell to his children.

“Those days, whenever my children went to even buy foodstuff, people said there was AIDS on the money because it’s being handled by an AIDS patient. So you see, the stigma was very bad,” he said.

Azumah became a pastor when he was 19. Life became tough after he was sacked from his church and his HIV status became public.

When Ghana’s Aids Commission reached out to him in 2010 to do advocacy work as an ambassador on a nationwide campaign, his life’s mission changed. The campaign against stigma and discrimination gave him the chance to be a public-facing figure with HIV.

People started reaching out to Azumah about HIV-positive orphans who were abandoned by their relatives. That’s when he made the decision to take these children in and create a home for them.

“Motherly Love Orphanage exists to give these children hope and to help them get empowerment to be able to overcome their self-stigma and community stigma,” he said.

One-of-a-kind care

There is currently no other center or orphanage that takes care of HIV-positive children in Ghana, making Motherly Love one of a kind.

“Many people keep knocking at our door but we have limited accommodation,” he said, adding that it’s harrowing to reject children who may otherwise die on the streets without their care.

But their care comes at a huge cost. He gets antiretroviral drugs from the government for free, but as a nongovernmental organization, he still has to pay for food, housing and everything else.

Donations have been irregular during Ghana’s economic downturn, he said. Even the home they live in is a rental.

And school fees present a significant cost. The children all attend private schools with required fees for books and uniforms.

“Another key thing is medication,” he said. “They don’t take only antiretrovirals. We take other essential medicines like immune boosters, vitamin C, blood tonics … So these medicines are expensive.”

State obligation to care

Today, due to the ongoing COVID-19 pandemic and the war in Ukraine, many high-income countries are cutting back on aid and resources for HIV/AIDS.

Ghana’s AIDS Commission said it has serious financial challenges and continues to engage partners on how to provide better support to orphaned children living with HIV.

Child rights advocate Lilipeaarl Baaba Otoo lauds Azumah’s intervention.

“If you look at it critically,” she said, “it is the state that’s supposed to be responsible for these children.” She said the neglect enrages her and is pushing for better policies to complement Azumah’s efforts.

“The painful reality is that there are more of these children on the streets. Yet, most orphanages in this country often don’t want to accept them after knowing their HIV status. I believe this is discrimination [and] it is unacceptable…” she said.

Human rights advocate Richard Mawutor Dzikunu said the state must do more to create better conditions for children affected by HIV/AIDS, citing Ghana’s 1992 constitution as well as the Children’s Act and other international conventions to protect children.

“Clearly, you can see that these children are being violated. And  it is critical at this point that some legal action is taken against the state to compel the state to perform its functions toward these vulnerable children,” he said.

Penelope Mawuenam Agbai, who works with the West Africa AIDS Foundation, said she is most concerned about the impact of the nutrition crisis on children with HIV.

Children who begin treatment when they are malnourished are three to five times more likely to die than those who are not, she said. HIV-positive children have higher energy requirements and often experience more weight loss, she added.

“ARVs are powerful drugs that need to be taken with nourishment,” she said.

Agencies worldwide have formed a global alliance to ensure that no child living with HIV is denied treatment by the end of the 2030, among other aims.

UNAIDS Executive Director Winnie Byanyima said the global alliance must work to ameliorate the inequality that children with HIV experience.

“With the science that we have today, no baby should be born with HIV and no child who has HIV should be without treatment. … We will not allow this shameful and avoidable injustice to continue,” she said.

Hope for acceptance

Back at the Motherly Love Orphanage, the children continue to thrive and hope to contribute to a society that will embrace them.

Rejoice, 16, said she is full of gratitude for Azumah’s work. “He has really done a lot,” she said. “So God bless him, we love him so much.”

Azumah said he wants Ghana to intensify their efforts to eradicate stigma through HIV education and prioritize the needs of HIV-positive children so that they can realize their fullest potential.

But he really has just one wish:

“My joy will be that if tomorrow, I am no more, a home will be built for these children,” he said. So they’ll one day be able to say, “This is my home … I am going to where no one will stigmatize me and I am accepted.”

Source: Ghana/ Ridwan Karim Dini-Osman