Flattening Need and Steepening Responsibility: Navigating Access to Islands of Care for Children Living with HIV in Uganda

Abstract

In this chapter, I look at an organization providing care for children living with HIV in Uganda as an example of how NGOs define childhood in particular ways, which in turn determines which children are able to access care and what kinds of assistance they receive. I use the metaphor of landscapes to explore the ways in which responsibilities become overlaid onto needs to create islands of care—alternately placing children on these islands, or leaving them stranded with no way to access them. The tensions between vulnerability and responsibility, and dependency and entitlement manifested at a treatment center for children living with HIV as children and caregivers attempted to navigate the terrain created by both on-the-ground service providers and distant donors. I wish to complicate the responsibilization of children and young people, not denying their agency, but recognizing the circumstances which constrain it. I evoke a Kiganda ethics of interdependence, to demonstrate that dependency is not necessarily irresponsible nor disempowering but can be a viable strategy for accessing resources. In brief, I join the many scholars who have criticized the dominance of sustainable development rhetoric and I call for a reconsideration of the viability of unconditional aid.