Abstract

The World Health Organization (1995) estimates that HIV has infected more than 15 million people by the end of 1994, of whom 1.5 million are children. Furthermore, 70 % of these infected adults and 90% of the children live in sub-Saharan Africa. Malawi and Uganda are two of the most affected countries in this regard. It is estimated that there will be more than 10 million unaccompanied (orphaned, abandoned, runaway) children in sub-Saharan Africa due to HIV by the turn of the century, three times the current estimate from other causes.
One of the great challenges facing these African countries is the lack of indigenous human resources, or national capacity, to effectively respond to the basic developmental, psychosocial and health needs of children orphaned by AIDS. The project responds to this challenge. It will develop, implement, and evaluate a research and training program addressing the issue of community-based support for AIDS orphans in four Malawi communities. Specifically, it will build community-based child care capacity targeting the psychosocial and health needs of AIDS orphans, first by identifying local need and capacity for this support, and then developing and evaluating an appropriate community-based support training program.

Post-Project Summary

The researchers used a participatory action research methodology grounded in the United Nations Convention on the Rights of the Child (CRC), of which Malawi is a signatory. They selected 12 communities across the country based on cultural and economic variation. In each community, they carried out focus group discussions with young people, families, traditional leaders and community representatives, interviewed key informants from nongovernmental organizations (NGOs), social welfare offices and educational institutions, and gathered a number of case studies of orphans. The findings were summarized and presented back to the community. A second series of focus group discussions were held to identify actions that could be taken to address the needs raised in the research. In framing the issues, the facilitators often referred to the guiding principles of the CRC, especially "best interest of the child."

Orphans have traditionally been adopted by members of their immediate or extended family but, as the number of orphans increases, traditional support systems are showing strain. Among the many problems faced by orphans, one practical and one psychosocial problem merit particular mention. First, since children's inheritance rights are either limited or non-existent, orphans are vulnerable to property grabbing by relatives. There is a need to sensitize members of the community to the importance of making wills. Second, all focus groups identified problems in addressing the grief of a child whose parent is dying or deceased. Young children were not told about the death and older children were thought to have forgotten about it after a few months, although it was also noted that children were often seen crying and showing signs of social withdrawal for much longer than that. There was some evidence that attitudes are beginning to change, for example some churches and NGOs were beginning to offer counseling and social support, but in there is still a need for broader awareness of child grief.

The research prompted a number of community-based actions, including: orphan guardians organizing themselves into a self-help group; skilled artisans providing vocational training to teenaged orphans; youth groups helping elderly guardians to cultivate their vegetable gardens; chiefs donating land for food production by orphans and their guardians (seeds and watering cans were provided by World Vision Malawi); community leaders and clergy groups sensitizing people to the need to give love and affection to all children; communities requesting training in home-based care of people with HIV/AIDS and dealing with orphans; elders counseling orphans after the death of their parents; and setting up nursery schools for young orphans while their older siblings attend school.

Recipient Institution(s)