CHAHA comes to an end and with it hopes of HIV+ children

Surjakanta Ngangom *

Sarju knows very little about HIV, even lesser about the medicine she takes every day to keep the virus in check. Her widowed mother, Mala, also HIV positive, always tells her to take her medication in time so that she grows up to be a strong and beautiful lady.

The rest of the world, unlike Sarju, is not oblivious to the worry lines on her mother's face that betrays the beautiful world Mala painstakingly builds for her daughter. Her resolve to shield her daughter from her loss and the vagaries of life received a severe blow when she was recently told that CHAHA—the programme which provides her monthly ration of rice, dal and other domestic necessities has come to an end.

Children Affected by HIV and AIDS—Health and Happiness for All popularly known as CHAHA is an initiative supported by the India HIV/AIDS Alliance and funded by the Global Fund for AIDS, TB and Malaria—6 (GFATM-6). The initiative providing care and support to children infected and affected by HIV and AIDS was launched in six districts of Manipur in June 2007. It came to an end in March 2011. The initiative has components like Education Support, Household Support, Nutrition Support etc through which various needs of a child were met.

The programme was implemented by Social Awareness and Service Organisation (SASO), Sneha Bhavan, Dedicated People's Union (DPU) and Manipur Network of Positive People (MNP+) in Imphal East, Imphal West, Chandel, Ukhrul, Thoubal and Bishnupur district. Altogether 4242 children under 18 years belonging to 3,102 households benefited from the programme. 899 children enrolled in the programme are HIV positive, 1782 have single parent and 373 are orphans looked after by their close relatives.

Besides taking care of children infected and affected by HIV and AIDS, the initiative also looked after concerns of the immediate families of these children. Support came in various forms—mosquito net, school uniform and stationary items, food, medicine, ambulance fare in case of medical emergencies etc. Under the income generation component of the programme, 424 families were provided a soft loan of around 2000 rupees to start small business like silk reeling, aggarbati, vegetable vending, poultry etc.

During monsoon last year when Rani and her three children, one of them HIV positive, were trying in vain to plug the leaking roof of their two room house, CHAHA had come to their rescue by providing corrugated tin sheets to protect them from the rains.

In another case, CHAHA has been supporting Victor's education since he enrolled in the programme in 2007 admission and monthly school fees, uniforms and stationery items. Currently studying in seventh standard, Victor's mother may have to consider putting him in a Government school, a cheaper option, or stop sending him to school altogether.

The programme implemented by four NGOs in the State has ensured that the benefit reaches those who are in urgent need of support. Most of the children enrolled under the programme are single-parent family, mothers in most cases, or orphans living with close relatives.

Preparing for an eventual pull-out of the Chaha initiative the NGOs from the beginning have tried their best to link up the children and their families to existing Government welfare schemes like SSA, AAY, MGNREGS, widow pension scheme, Indira Awas Yojana etc. However, access to these schemes are hard to come by. For instance no parents want their children to attend Government schools as they are non-functional in most places. Those who attend have one thing in mind—a mouthful provided under the mid-day meal scheme and not regular classes. "We can't help if the parents don't want to send their children to Government schools, and they have good reasons to do so", says Bangkim Chingshubam, Joint Secretary, SASO.

Sister Teresa Karot, Sneha Bhavan, who looks after 2,075 such children in Imphal East, Chandel and Thoubal district has a similar story. Subsidised rice meant for BPL and AAY card holders enrolled in the programme are difficult to access. "Most of the time I'm told rice is finished or I'm late".

In all CHAHA districts, the NGOs have had several rounds of meetings with Government heads of districts, Pradhans, Anganwadi workers, and ASHAs so that certain service components of the programme can be sustained. ASHAs, in these districts were sensitised so that they can replace the outreach workers (ORWs) engaged under the CHAHA initiative. However, with ASHAs already burdened with the task of ensuring hundred per cent institutional delivery and other responsibilities, it is difficult to say whether they will be able to reach out to these children effectively.

While the ORWs engaged under the programme were trained and entrusted with specific responsibilities the ASHAs with their myriad responsibilities will not be able to do justice to children infected and affected by HIV and AIDS. To make matter worse, there are no specific Government welfare schemes for such children and their families. "Referral and linkup is difficult as there are no care and support system specifically designed for these children. Existing schemes are most of the time accessed by those who are well connected", Basanta, Programme Coordinator, CHAHA, Manipur.

To address some of these issues, the one-year pilot CABA Scheme (Protection Care & Support for Children Affected by AIDS) was launched in mid 2010 in Imphal East. However, with an estimated 10,000 children infected and affected by HIV and AIDS in CHAHA districts alone, it's a case of too little too inappropriate. The scheme provides Double Nutrition to children infected and affected by HIV and AIDS in Imphal East. The benefit is being provided under the Integrated Child Development Services (ICDS) through Anganwadi centers.

Besides parents, a number of people working in the development sector feel that CHAHA should continue or similar programmes introduced to support these children. While existing Government welfare schemes were designed not taking into consideration specific needs of women and children affected by the epidemic, the current National AIDS Control Programme - III (NACP-III) has no care and support component to address issues like children's education and nutrition.

The two decade old epidemic has widowed hundreds of women and orphaned even more number of children. Though Manipur has 2,578 HIV positive children (Jan 2011, MACS) and even more affected by the epidemic, there is very little to ensure that they do not go to bed hungry or attain basic education.