Best Practices for the Care of HIV/AIDS Orphans
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When we say practices and care, what really comes to your mind is
holistic care. We other words, we are referring to the ATTENTION and
PRACTICES of "caregiver" (mother, father, and sibling, child
care providers) to provide the food, health care, stimulation, emotional,
academic, shelter and spiritual SUPPORT necessary for children’s
healthy survival, growth and development within a given environment.
Speaking of practice, we are talking of the actual performance or
application. The systematic exercise for proficiency of the caregiver
toward the child. This is something the caregivers does or work at
How many Orphans are we talking about here and where
The issue surrounding this topic is a very interesting one, especially
now that the world leaders are giving their attention to the pandemic.
It will be nice to take few minutes to call our attention to the recent
global statistics of AIDS as at December 2004. We need to point out
that the range around the estimates in the following table define
the boundaries within which the actual numbers lay, based on the best
Number of People living with HIV in 2004
Total 39.4 million ( 35.9 - 44.3 million)
- Adults 37.2 million ( 33.8 - 41.7 million)
- Women 17.6 million ( 16.3 - 19.5 million)
- Children under 15 years 2.2 million ( 2.0 - 2.6 million)
AIDS Deaths in 2004
Total 3.1 million ( 2.8 - 3.5 million)
Adults 2.6 million (2.3 - 2.9 million)
Children under 15 years 510,000 (460,000 - 600,000)
Young Women - An Endangered species
Women make up nearly half of the 37.2 million adults living with HIV.
In Sub-Saharan Africa the proportion rises to almost 60%. In the same
region, three-quarters of all 15 - 24 year olds living with HIV are
female. In some sections of Sub-Saharan Africa, Young women have no
access to education or job. They are often economically dependent
on men and have not the power to resist sex or ask their husband or
partner to use protection.
Innocent Victims of Silent Killer - AIDS - CHILDREN
HIV/AIDS Orphans statistics
Global: Over 15 million children under the age of 15
have lost one or both parents to AIDS
Region Sub-Saharan Africa: 12.3 million
May I point out here that the AIDS orphan crisis is not restricted
to sub-Saharan Africa. There are an estimated 1.8 million orphans
living in South and South-East Asia, 85,000 in East Asia and the Pacific,
330,000 in Latin America, 250,000 in the Caribbean, and 65,000 in
North Africa and the Middle East.
Countries at High Risk
Already there are, for example, an estimated 1.5 million orphans living
in Nigeria, 890,000 in Kenya and 780,000 in Zimbabwe. These numbers
will increase as the pandemic develops. It has been estimated that
the number of children orphaned by AIDS will rise dramatically in
the next 10-20 years, especially in southern Africa.
The scale of the problem
As the number of adults dying of AIDS rises over the next decade,
an increasing number of orphans will grow up without parental care
and love and will be deprived of their basic rights to shelter, food,
health and education. In African countries that have already had long,
severe epidemics, AIDS is generating orphans so quickly that family
structures can no longer cope. Traditional safety nets are unraveling
as more young adults die of AIDS related illnesses. Families and communities
can barely fend for themselves, let alone take care of the orphans.
Typically, half of the people with HIV become infected before they
are aged 25, developing AIDS and dying by the time they are aged 35,
leaving behind a generation of children to be raised by their grandparents
or left on their own in child-headed households.
The deep-rooted kinship systems that exist in Africa, extended - family
networks of aunts and uncles, cousins and grandparents, are an age-old
social safety net for such children, and it has long proved itself
resilient even to major social changes. But capacity and resources
are now stretched to breaking point, and those providing the necessary
care are in many cases already impoverished, often elderly and have
often themselves depended financially and physically on the support
of the very son or daughter who has died.
Almost throughout sub-Saharan Africa, there have been traditional
systems in place to take care of children who lose their parents for
various reasons. But the onslaught of HIV slowly but surely erodes
this good traditional practice by simply overloading its caring capacity
by the sheer number of orphaned children needing support and care.
HIV also undermines the caring capacity of families and communities
by deepening poverty due to loss of labour and the high cost of medical
treatment and funerals.
Having given the about statistics and the plight in which the AIDS
orphans find themselves, the following then is the seven (7) best
practices for the care of HIV/AIDS orphans.
Adequate living environment - Shelter
Child Counseling/Support Groups
Academic Stimulation - Schooling
Vocational and Artisan Training
Sustainable Development Program
Advocacy & Preventive Empowerment
Adequate living Environment - Shelter:
There are various kinds of shelter when it comes to care. However,
the best preferred type of Shelter for HIV/AIDS Orphans are:
- Extended Family Network
- Foster Families
- Child - Headed Household
We have found out that the above system have proven to be the best
especially due to the old cultural traditions of the Africans, Asians
and those from South America.
Institutionalized system is the less preferred type of shelter. Institutionalization
stores up problems for society, which is ill equipped to cope with
an influx of young adults, who have not been socialized in the community
in which they have to live. UNICEF believes that whenever possible,
children who are orphaned should remain in their communities to be
raised by their extended family. Recognizing that family care is far
better for children and far less costly than institutionalized care
is also very vital.
Children who grow up in families also develop better social skills
and are psychologically better adjusted than those who grow up in
institutions because they receive more affection and attention and
develop a better sense of personal identity. Children growing up in
communities disrupted by the epidemic, orphans are more likely to
cope if they can live in surroundings that are familiar, stable and
as nurturing as possible. Many believe that orphans should be cared
for in family units through extended family networks, foster families
and adoption. At the very least, siblings should not be separated.
Botswana government encourages communities to provide extended family
care for AIDS orphans and encourages institutional care only as a
last resort. In Swaziland, as many as one in 10 households are run
by orphans. In Zimbabwe, the Farm Orphan Support Trust (FOST) was
set up as a community response to the situation of orphans in commercial
farming areas. FOST aims above all to keep sibling orphans together,
within a family of the same culture, and in a familiar environment.
FOST promotes five levels of orphan care:
(1) It's preferred care is within the extended family.
(2). Orphans are placed within substitute families.
(3). The third choice is for small groups of orphans
to live together on a farm, looked after by a caregiver employed by
the farm for this purpose.
(4). The next most preferred type of care is an adolescent
child-headed household with siblings remaining together, preferably
in the family home.
(5). FOST will arrange for temporary care in an orphanage,
until a better solution can be found.
Keeping orphans at school is crucial for their future. It can provide
education that can work as a safety net in the child's life. Schooling
can also help to break the cycle of poverty.
Sustainable Development Program:
In Uganda, UNICEF supports the Uganda
Women’s Effort to Save
Orphans (UWESO), which helps communities start income-generating
projects such as beekeeping or sustainable farming. It also provides
micro-credit to help women start small businesses.
Vocational / Skill Acquisition Centre:
Orphans who are unable to complete even primary or High School, usually
due to the need for them to be at home to care for their siblings
are provided Artisan Training such as job experience in bicycle repair,
radio repair, carpentry and tailoring among others. The skills attained
help them to earn a living.
In Nigeria, government approved vocational training institutions such
as fashion design, secretarial and computer skills, and home economics
has been established with the AIDS orphans in mind.
Empowering affected children first of all means regarding them as
active members rather than just victims. Many children already function
as heads of households and as caregivers. They are a vital part of
the solution and should be supported in planning and carrying out
efforts to lessen the impact of HIV/AIDS in their families and communities.
We strongly recommend working in partnership with States nutritionists,
women affairs directors, social workers, community developers, educators
and child care providers in prescribing a balanced but very cost effective
diet for care givers regardless of their social status.
Child Counseling/Support Groups:
Relief oriented support such as distributing food, blankets,
Being in contact with traumatized children who have
had the unfortunate experience of seeing their parent’s fall sick
and die, a child-counseling centre are & should be developed to
specifically offer emotional treatment for such children.
Regular visitation to their homes by care providers
has helped reduce the rate of stigmatization & marginalization.
Through centres like this, identification of abused children is noted
and prevention of child abuse in schools and families carried out.
Enemy of the practices:
Poverty is a huge problem in the developing nations. In Malawi, it
is estimated that 65% of the people live below the poverty line. "Communities
who want to help but are living on the edge of starvation, have run
out of ways to feed orphans. Farmers say, 'we cannot get food to feed
them'." In Zambia, one of the countries hit hardest by the HIV/AIDS
pandemic, research shows that the traditional mechanism for the care
of vulnerable children that is the extended family, has started to
break down under the twin pressures of poverty and disease. Mismanagement
of resources and abuse of authority is another enemy of these practices.
Although we have visibly the enemy of the recommended practices, we
have not doubt that the practices are be the best. We are gradually
eliminating the enemy of the practice by empowering the grassroots
community and even the orphan communities. We would encourage all
the various Community Development Organizations working with AIDS
orphans and their caregivers to make a conscientious effort to apply
or integrate the practices in their programs.
Food for Thought
"It’s not enough to give the child all he need monetarily
but also to create an enabling environment which would protect the
life, dreams, future of the world’s child . . ."(Young Man, 21,