WASHINGTON -- Largely because of the AIDS crisis, nearly one-quarter of all children in Zimbabwe are orphans, a figure that approaches historic levels set in Rwanda after the genocide in 1994, according to a new national survey.
The study, specialists said, shows the accelerating devastation of families in a region that has the highest HIV-prevalence figures in the world. Zimbabwe is the second southern Africa country, after Lesotho, in which a recent national survey has found that roughly a quarter of all children are orphans, which is defined as having lost at least one parent.
"You have to wonder what does this mean for a generation of children growing up as adults," said Christopher Dell , the outgoing US ambassador to Zimbabwe, in a telephone interview. "You wonder what it does to the future of the country."
The 2006 survey, conducted by the government Central Statistical Office in collaboration with Macro International, a Maryland-based organization that conducts health surveys around the world, found that 22 percent of children under the age of 18 in Zimbabwe had lost one or both parents, up from 9 percent in 1994 and 14 percent in 1999. Overall, Zimbabwe recorded an 18 percent HIV-prevalence rate among adults, said the survey.
In 2004, a Lesotho national study found that 26 percent of its children were orphans. The only other comparable figure in recent history in Africa is from Rwanda; a national survey found in 2000 -- six years after the genocide left an estimated 1 million people dead -- that 27 percent of its children were orphans. As the country has stabilized, the percentage of orphans in Rwanda has declined, to 17 percent in 2005.
AIDS specialists said the number of orphans in Zimbabwe is linked to the long economic and health crisis in the country, starting from the 1990s and spurred in part by President Robert Mugabe's policy of seizing white-owned farms. The country's annual inflation rate now tops 4,000 percent.
The country's healthcare system, which Mugabe had helped build into one of the best in the continent, has disintegrated.
Children, the survey found, often have been hurt the most.
Basic immunization coverage for children ages 12 to 23 months declined to 53 percent in 2006, down from 75 percent in 1999. Stunting, caused by malnutrition, increased to 29 percent in children, up from 21 percent in 1994.
"The numbers on immunization reflect the broader economic decline and the consequent meltdown in the public healthcare sector," Dell said. "Thousands and thousands of healthcare workers have left the country."
Zanele Sibanda-Knight , a Zimbabwean and advocacy coordinator for Firelight Foundation, a California-based organization that gives grants to groups helping orphans, said the death rate from AIDS is higher in Zimbabwe than surrounding countries because fewer people have access to antiretroviral drugs. Those drugs, called ARVs, can extend for years the life of someone with HIV .
"When you are there, one of things you find is that those who are well-off, or well-connected, can get the drugs," she said. "But for the majority of people, the access is very limited."
Still, several analysts said, Zimbabwe's orphan figures are not expected to be that different from other countries in southern Africa, the epicenter of the AIDS pandemic. Several nearby countries with high HIV prevalence rates, including South Africa, Botswana, and Swaziland, have not recently conducted a demographic survey.
But Vinod Mishra , a director of research at Macro International, said the spread of antiretroviral drugs would almost surely slow or reverse the percentage of orphans. "It depends how fast ARVs come into play," he said.
Jennifer Delaney , executive director of Global Action for Children , an advocacy group partially funded by the Jolie/Pitt Foundation, said the Zimbabwe figures show the need to expand AIDS programs throughout Africa.
The Bush administration is on track to spend $18 billion to battle AIDS in the five years ending in 2008, with the bulk of funds in 15 countries. In fiscal 2006, it spent $213 million on orphan care.
The US government also funds AIDS programs in Zimbabwe and 107 other countries, although less generously. For example, Zimbabwe, which has an estimated 1.7 million people living with HIV, received $22 million in US funds to fight AIDS last year. In contrast, Guyana, one of the 15 focus countries in the US plan, received almost exactly the same amount, even though it has an estimated 12,000 people living with HIV.
"What the US is doing now is a great start," Delaney said, "but I worry because orphans have been on the radar with the US public in a way that it looks like the US and other countries are taking care of the problem. And they're not."
John Donnelly can be reached at firstname.lastname@example.org.