It has traditionally been said that there is no such thing as an orphan in Africa: children who lose their parents are normally incorporated into a relative's family and treated in the same way as their own biological children. Many go to considerable lengths to keep orphans in school, including borrowing money through informal networks and selling their own assets. But with increased numbers of orphans, reduced numbers of caregivers and weakened families, the extended family is no longer the safety net it once was, though it remains the predominant source of care for orphans in Africa.

Families and local communities have shown remarkable resilience and creativity in addressing the needs of children affected by HIV/AIDS. Across Africa, religion is both integral to community life and ubiquitous – over 85% of the population is involved in some sort of religious association. Religious communities offer the most extensive, viable and best-organised network of institutions at both local and national levels. Many are now addressing the multi-dimensional impact of AIDS, particularly on children.

Yet, religious groups have sometimes been perceived as responding to HIV/AIDS in negative terms. Furthermore, in the past, religious support for orphans led to the establishment of developmentally unsound residential institutions, rather than maintaining children in their families and communities. In recent years, however, there has been a remarkable proliferation of community-based support programmes for orphans and vulnerable children (OVCs) by faith-based organisations (FBO).

Most faith-based congregational and personal responses are small scale, and it has been difficult to measure their cumulative impact compared to the more visible NGO programmes. Lack of awareness of community coping mechanisms is a major blind spot of most development organisations. In many places, even the poorest and most vulnerable people have set up resilient and ingenious coping mechanisms such as self-help groups, burial associations, grain loan schemes and rotating credit-and-loan clubs. These coping methods are positive, successful aspects of everyday life that are non-sensational and almost invisible to outsider and insider alike. Due to the lack of documentation of the work of religious groups in supporting OVCs, their activities remain unappreciated and under-supported. A recent study documented FBO responses to OVCs in East and southern Africa. Preliminary results suggest that most congregational responses are informal voluntary initiatives of a religious leader or the laity, rather than projects by governing Religious Coordinating Bodies (RCBs). Most congregation responses are established because of growing numbers of OVCs within communities. Support activities include household visits, spiritual support, counselling, provision of food, clothing and medical care, school fees, shelter construction, helping with household chores and agricultural assistance. Most initiatives offer care and support to vulnerable children irrespective of their faith. Many involve volunteers who visit affected households several times per week, care for preschool children and HIV-positive babies, or feed, educate and train children at day-care centres or rehabilitation centres for street children. Volunteers are highly committed and offer their services for free, though they often lack skills and require training, particularly in HIV/AIDS and counselling. Few congregation responses receive external funding; most rely on support from their members and other well-wishers within the community, which is frequently inadequate.

In Kenya, of 164 congregations interviewed, 85% had developed an OVC-support response, with 145 congregations supporting some 27,500 OVCs. In Uganda, of 68 congregations surveyed, 48 congregations supported approximately 7,500 OVCs. Of 79 Ugandan RCBs interviewed, 52 supported more than 16,000 OVCs, either directly or indirectly through their congregations. Similar results were found in Malawi, Mozambique and Namibia. Most initiatives want to expand the scope and scale of their activities, but they are limited by lack of administrative capability and finances.

Scaling up: the need to build on existing local initiatives

In order to expand OVC responses in sustainable ways, it is vital to consider community responses, rather than focusing on grandiose schemes to scale up initiatives implemented by government or international organisations. External support can easily undermine local efforts, change the nature of the community solidarity and distort the motivations driving grassroots initiatives. International and national agencies must realise that the orphan problem is not primarily theirs, but rather belongs to affected communities, many of which are already developing context-appropriate solutions. From this perspective, the primary responsibility of outside agencies is to first understand, and then strengthen the programmes, activities and endeavours initiated by communities. RCB responses have the potential to expand their support to vulnerable children because most have formal structures through which they deliver support, paid staff, office premises, and systems and procedures to guide their operations. Enabling RCBs to provide technical support, and material and financial resources to congregations should become a major strategy of agencies seeking to address the orphan crisis. 

The scale and duration of the AIDS pandemic present a fundamental challenge to the world. Long-term commitments are necessary to prevent the spread of HIV infection and mitigate the impact of AIDS. Religious organisations have proven their sustainability through continuous presence in human communities for centuries. They have withstood conflict, natural disaster, political oppression and plagues. Members of religious groups have demonstrated commitment to respond to human need based on the moral teachings of their faith, voluntarily and over long periods of time. As the AIDS epidemic continues to create a "caring deficit" – eroding the capacity of communities to care for those affected – religious organisations will be critical to sustain community coping and address the impact of the disease.