You are here: |
| |
What is in this guide?
This guide looks at ways of supporting children affected by HIV/AIDS. It covers children whose parents are ill or have died as well as children living with HIV/AIDS.
It has the following sections:
- Introduction
- Important principles
- Community child care committees
- Children whose parents are ill
- Children who are orphaned
- Children who are living with HIV/AIDS
This web site also contains the following guides on HIV/AIDS
Important things to know about HIV/AIDS
Introduction to community projects on HIV/AIDS
How to run HIV/AIDS prevention and education projects and campaigns
How to care for people living with HIV/AIDS and their families
How to care for children affected by HIV/AIDS
The fact that there is a stigma around HIV/AIDS that prevents people from being open increases the isolation of people in families affected by HIV/AIDS. Not only do they have to deal with their own grief and emotional suffering but also this is made worse by the way that the community treats them.
The greatest impact of HIV is on young people. The same generation whose parents are ill now are likely to be the ones who will themselves be ill in later years. In their childhood, they get little emotional and material support and they often have to start playing roles that are usually expected from adults. In many families, they play the adult role of maintaining the house and sometimes even trying to provide an income. Most of them play some nursing role and directly look after the parents who are ill. Older children also play the parent role to their younger siblings.
When parents die, very small children are often taken in by relatives. The survival of older children is often neglected and they are more vulnerable. In many cases, older children drop out of school to look after younger siblings. When they are not provided for by relatives, some end up living on the streets or barely surviving in very impoverished homes.
There are three categories of children who need special care:
Children whose parents are ill
Children whose parents have died
Children with HIV/AIDSMost of the affected children (and the people who care for them) do not get the grants they have a right to get. See page 24 for foster, care dependency and child support grants. The main reason for this is ignorance, lack of access and lack of the right documents.
Target all children in need
There are many different models of community childcare projects. The main principle should be that all children in need should be identified and supported in some way. A project that deals with children affected by HIV/AIDS should be integrated in other efforts to help children in need.
This will also help to deal with the stigma and secrecy surrounding HIV/AIDS. If all children who have ill parents are supported, it will be easier for children to ask for help than if a project only helps children whose parents are ill with AIDS.
Keep children in their communities
Children should be supported in ways that help them to stay part of their community and family. For example, the common old-fashioned idea that children who are orphaned should be put in institutions like orphanages is no longer popular.
Orphanages are expensive and are not very healthy places for children to grow up. It is much better to keep the children in the communities they come from and to make sure that they get adult supervision and support in a familiar environment.
Adoption is also not easy to organise, especially for older children. It is even difficult to find adoptive parents for babies if there is a chance that they may be HIV positive.
It is not good to separate children from their siblings when they have lost their parents. It is much better to keep them as close to their natural support groups as possible. If there are other members of the family who can take in children this is often better than fostering them out to different families or letting different families adopt different children.
Coordinate services and use volunteers
Support must be well coordinated and reach down to the ground. This means that all services and organisations should work together to identify children in need and to make sure they get the right help. Welfare and health workers should work with churches and schools to identify children whose parents are ill or have died.
At a local community level, volunteers should be used to visit families, help child headed families and monitor foster care and other projects.
Community childcare committees are an option that has been used very successfully in different countries. A group of adults work together to take responsibility for organising support for vulnerable children in an area. Childcare committees can be set up by social workers, the community can elect volunteers or they can be appointed by various organisations. It is important that they have community support and some official status so that they can be effective.
The volunteers usually come from different organisations and religious groups. They find out children in need and try to ensure that they are either linked to welfare services or that members of their family look after their needs.
The community childcare committees can also take responsibility for helping all children in need to get access to social workers and to child support or foster grants. They should also take responsibility that all births and deaths are registered so that children can get IDs and therefore access to social grants when they need them.
Community childcare committees can also help to screen foster parents and to monitor them to make sure that they treat children properly. Children in need are very vulnerable to exploitation and abuse. Some people take in foster children just to get the foster grants.
Community childcare committees should be linked to social workers from the government Welfare Department or the Child Welfare Society. They should get some training and report regularly to professional supervisors to ensure that they are doing their work properly.
In many families, children become the main caregivers for people who are ill with AIDS. Older children also often play the parenting role for younger ones. Home-based care and childcare volunteers should target these children for training and support. Here are some of the things that should be done:
Educate children about HIV/AIDS and teach them basic methods for washing and looking after patients.
Make sure they are in school and are able to survive – get food parcels and clothes to them.Help them to get access to grants and to things like parent’s bank accounts.Talk to them about their fears and answer their questions.
Make sure they are registered with Home Affairs and apply for ID books.
Invite older children to family support group meetings
Make sure the ill parents make memory boxes and have all their documents in order.
Talk about the future and help make arrangements to look after the children after their parents death – most children are terrified by the uncertainty of what will happen to them when their parents die.
Children who have lost one or both parents need a lot of support. They have to deal with grief as well as survival. Most orphaned children are supported by relatives. They are usually older women and are often unemployed or on pension. The family will become poorer and will need food and financial support.
A large number of orphans stay on alone in the family home when their parents die. Older children look after young ones and try to find ways to survive. Thousands of children are living in desperate poverty in these child-headed homes. Many of them drop out of school and some turn to sex work or crime to survive.
Some children are taken in as foster children whilst others go to orphanages or other institutions. In this section, we look at the different options and the role child care committees can play.
Child-headed homes and care by relatives
We must find ways to support children who are looked after by relatives or by older siblings in child-headed homes. Community child-care committees are best to reach and support these children. Here are some of the things that community child care volunteers should do:
Make sure that they get the government grants they are entitled to receive and help them get access
Make sure they get food parcels and benefit from poverty relief programmes
Try to keep children in school as long as possible and work with schools to organise support for children who cannot afford books, fees or clothing.
A volunteer should visit the family at least once a week to check that children are coping, going to school and eating.
Check that children are healthy and help them get healthcare, vaccinations and medicine when needed.
Support children who are HIV positive and get them into medical and other support programmes.
Work with churches and welfare organisations to collect clothes, bedding and building materials
Help children get documents like death certificates and IDs
Counsel children to help them deal with their feelings of loss and grief.
Be an adult they can trust and come to with their problems
Foster care
Foster care is provided by a family that takes in orphaned and other vulnerable children and looks after them. They do not adopt them and the state remains responsible for the welfare of the children. A court has to officially appoint foster parents – this is usually organised by social workers.Foster care parents receive a grant for doing the work and should use it to provide material and emotional support for the children and to ensure that they attend school. (see page 23/4 on grants)
If foster parents do not fulfill these obligations, the children will be moved to another family. Foster care is better than orphanages because it provides a family life for children. It is still not always an ideal situation and many children in foster care can be neglected or even abused and exploited.
It is important for foster parents to be trained and monitored by social workers. Childcare committees should also visit foster families and talk to the children to check that they are receiving proper care.
Group housing
In some communities group housing has been provided for children. This means that a number of different children who are orphaned will live in a house or homestead with one adult to look after them. These adults are often older women who no longer have their own children to look after. This option has been tried on farms and in rural villages where orphans have become a big problem and the traditional leader or farmer has taken responsibility for setting aside a house for this purpose.
Adoption
When you adopt a child it is a formal legal process and the child becomes yours. You have full responsibility for the child and the law treats the child as it would treat your own biological child. There are no special grants for adopted children and they family will only qualify to get the child support grant if they are poor.
Orphanages
There are very few orphanages available for the thousands of orphans who need care. Orphanages are a very expensive way of looking after children since the building, staff and services are costly. Orphanages are also not very good for children since they are impersonal and often there is too little contact with adults. Many children are abused by older children in orphanages. Families are the best place for children to grow up. When that is impossible it is better to get one adult to look after a small group of children than to put a children in an institution.
Some orphanages use a house parent system and instead of one large orphanage, they have a number of smaller houses in one place. Each house will have 5 -10 children with one adult to act as their "parent".
Children living with HIV/AIDS will have special needs that are different from those of adults. They are not able to get access and help themselves in the same way. Usually they depend on their mother or another caregiver. If they are very young, they will not understand the disease and the steps they have to take to stay healthy and to protect other people.
Most children with HIV/AIDS get the disease from their parents who can become ill or die when the child is very young. Home-based care and childcare volunteers should make sure that children with HIV/AIDS are properly supported.
It is best for children to be looked after by those they know and make them feel safe. If possible, children with HIV/AIDS should be left in the care of their families and relatives. In some areas, there are hospices or homes for children who are ill or dying. Social workers should work with clinics, home–based care and childcare volunteers to identify children who would be better off in hospices.Most ill children are too small to care for themselves in any way. The caregiver has to be the main target for support and training to make sure the child receives proper care.
HIV/AIDS Prevention | Care for Children | Care for People with HIV | HIV/AIDS and Municipalities | Community Action | How to coordinate work around HIV/AIDS | How to set up Support Groups |
This material may not be used for profit without permission from ETU