Orphans and Other Children Made Vulnerable by HIV/AIDS

4.0 OVC Research Priorities

Workshop participants identified the following "knowledge gaps" or "research needs" in program approaches to orphans and other children made vulnerable by HIV/AIDS.

• Mechanisms for maintaining community care giver's motivation and performance
• Sustainable community nutrition programs particularly addressing HIV/AIDS
• Effective psychology approaches
• Mainstreaming gender in OVC issues
• How do we emphasize and develop community-owned programs as opposed to community-based?
• How do we address special needs of HIV orphans, without targeting them for fear of "stigma"?
• How have other programs dealt with this issue?
• Use of community dialogue to absorb OVCs
• Effectiveness of approved schools in responding to needs of orphans and vulnerable children
• Operations research on community care of OVC
• Infant feeding options
• Documentation of best practices in orphan support
• Evaluation of interventions for OVC
• Baseline studies on the situation of orphans
• Research and mapping of current partner and their interventions
• Research to develop measurable indicators for monitoring and evaluation for OVC programs
• Community response to OVC
• Alternative feeding for infants born of mothers who are HIV/AIDS
• Developing linkages to existing community structure and initiative that support and integrate OVCs in the society
• Designing child friendly curriculum sensitive to the time needs of the children
• Upgrading of the inventory of OVC, widow, and widowers
• The socioeconomic impact of cultural practices
• Strengthening care structure in communities
• Operational research on the outcome of OVC
• Community research/diagnosis on the impact of OVC programs
• Knowledge, Altitude and skills of psychosocial influence on OVC, families and PLWHA
• Community response to fostering, inheritance and legal issues on OVCs
• Mother to child infection during breastfeeding
• Growth and development of grandparent fostered OVC
• Impact of HIV/AIDS on the social unit
• Psychosocial impact of HIV/AIDS and related illnesses and death on OVC
• Equitable distribution of NGOs working on OVCs countrywide
• Community coping mechanisms with their OVCs – Use best practices and replicate elsewhere with cultural implications having been considered
• Research on simple GAs that OVCs can be involved in OVC care and support
• How effective is it in ensuring adoption of non-risky behaviour by those affected
• The feasibility and sustainability of foster home programs
• Factors that influence access to education, retention and completion by an orphan and other children made vulnerable by HIV/AIDS
• Quality of care in children's homes
• Nutritional care by foster parents to OVC
• How does being born unwanted affect children's ability to adopt safer sex practices later in life as adults?
• How does parental HIV status affect children's personality development as relates to deviance/truancy?

5.0 Way Forward

During the closing ceremony, the Director of Family Health International (FHI), Mr. John McWilliam highlighted FHI's work in the area of orphans and vulnerable children. He emphasized that FHI was aiming at integrating home-based care with OVC issues and noted that he was hopeful that the guidelines would prove to be helpful with this task. He reiterated that FHI was ready to work in partnership with other organizations, as it has always done.Before concluding the meeting, participants were given an opportunity to reflect and comment on the fulfilling and frustrating moments that they have experienced through their work or personal involvement with orphans and vulnerable children.

Appendix 1

Orphans and Other Children Made Vulnerable
By HIV/AIDS Guidelines
Workshop at Ndallas, Matuu

Appendix 2

Speech By Dr. Margaret Gachara, Director National Aids Control Council

During Official Opening of Workshop to Develop National Guidelines on The Care And Support Of Orphans and Other Children Made Vunerable by Hiv/Aids At Dallas Hotel, Matuu On 18^th December 2001.

THE ORGANIZERS, DEVELOPMENT PARTNERS, LADIES AND GENTLEMEN

IT GIVES ME GREAT PLEASURE TO JOIN YOU TODAY IN THIS VERY IMPORTANT WORKSHOP TO DEVELOP NATIONAL GUIDELINES FOR THE CARE AND SUPPORT OF ORPHANS AND OTHER CHILDREN MADE VULNERABLE BY HIV/AIDS PANDEMIC.

I WISH TO THANK THE TASK FORCE MEMBERS FOR THE GROUNDWORK, WHICH CULMINATED TO THIS WORKSHOP, WHICH IS A MILESTONE IN THE CARE OF ORPHANS AND VULNERABLE CHILDREN IN KENYA.

I ALSO WISH TO THANK THE DEVELOPMENT PARTNERS (UNICEF, FHI AND POLICY PROJECT) FOR MAKING THIS PROCESS A SUCCESS. OUR JOY IS TO SEE THE COMPLETION OF THESE GUIDELINES AND THAT CHILDREN IN KENYA GET WHAT IS RIGHTFULLY THEIRS.

HIV/AIDS IS ONE MAJOR DISEASE KENYA HAS COME TO FACE IN POST INDEPENDENCE HISTORY CLAIMING ABOUT 700 LIVES DAILY AND LEAVING MANY CHILDREN HELPLESS AND WITHOUT BASIC NEEDS.

SO FAR, WE HAVE AN ESTIMATED 2.2 MILLION KENYANS LIVING WITH HIV/AIDS AND MORE THAN 1.5 MILLION ORPHANED CHILDREN. THE FIGURE OF OTHER CHILDREN AFFECTED INDIRECTLY BY HIV/AIDS IS EVEN MUCH HIGHER.

LADIES AND GENTLEMEN:

THE NUMBER OF PEOPLE DYING OF HIV/AIDS CALLS FOR PARTNERSHIP IN THE PROVISION OF CARE AND SUPPORT TO THE CHILDREN AND THE AFFECTED MEMBERS OF THE FAMILY. THE CURRENT NUMBER OF PEOPLE LIVING WITH THE VIRUS SENDS A TERRIFYING MESSAGE OF THE LIKELY NUMBER OF ORPHANS WE ARE BOUND TO HAVE IN THE NEAR FUTURE. EVEN IF HIV/AIDS INFECTION COULD LEVEL OFF TOMORROW, THERE WOULD STILL BE AN INCREASE IN THE NUMBER OF ORPHANS AND CHILDREN AFFECTED BY HIV/AIDS FOR THE NEXT 20 OR MORE YEARS

LADIES AND GENTLEMEN:

AT THIS JUNCTURE, I WOULD LIKE TO CALL UPON ALL OF YOU TO WORK TOWARDS DEVELOPMENT OF GUIDELINES THAT WILL ENHANCE THE CAPACITIES OF OUR COMMUNITIES TO IDENTIFY AND ADDRESS THE NEEDS OF OVCS.

THE SOCIO-ECONOMIC AND CULTURAL PROBLEMS FACED BY OVCS IN KENYA CANNOT BE DESCRIBED BY STATISTICS OR WORDS. KENYAN COMMUNITIES HAVE RESPONDED IN VARIOUS WAYS TO THE NEEDS OF OVCs. HOWEVER, WE DO NOT HAVE WRITTEN GUIDELINES TO GUIDE PROGRAMMING FOR THE CARE OF ORPHANS AND CHILDREN MADE VULNERABLE BY HIV/AIDS.

THE GOVERNMENT, NGOS, DONOR GROUPS AND PRIVATE INSTITUTIONS HAVE CONDUCTED SEVERAL RESEARCHES ON OVCS. THESE FINDINGS WILL COME IN HANDY IN DEVELOPING THE PROPOSED GUIDELINES.

SEVERAL NGOs AND CBOs HAVE INITIATED PROGRAMMES ON CARE OF OVCs. THIS GIVES AN ADVANTAGE TO THIS WORKSHOP, WHERE YOU ARE EXPECTED TO SHARE EXPERIENCES OF WHAT EACH IS DOING AND ADOPT THE BEST PRACTICES.

LADIES AND GENTLEMEN:

THE GREATEST CHALLENGE IN PROGRAMMING FOR OPRHANS AND CHILDREN MADE VULNERABLE BY HIV/AIDS IS THE STIGMA ATTACHED TO THE SCOURGE. THEREFORE, THIS IS AN AREA THAT NEEDS TO BE ADDRESSED BY THE PROPOSED GUIDELINES. INVOLVEMENT OF CHILDREN IN ADDRESSING THE NEEDS OF OVCs IS CRUCIAL SINCE THEY BEAR THE BLUNT OF THE SCOURGE WHEN THEIR PARENTS AND CAREGIVERS GET INFECTED AND DIE OF HIV/AIDS.

STRENGTHENING PARTINERSHIP AT ALL LEVELS AND BUILDING COALITIONS AMONG KEY STAKEHOLDERS WILL ENSURE ACCELERATION IN LEARNING AND INFORMATION EXCHANGE.

LADIES AND GENTLEMEN:

AS WE GIVE OUR CONTRIBUTIONS TOWARDS THE DEVELOPMENT OF THE GUIDELINES ON THE CARE AND SUPPORT OF THESE VULNERABLE GROUPS, IT IS MY HOPE WE WILL GIVE VIEWS THAT WILL NOT UNDERMINE COMMUNITY INITIATIVES ALREADY IN PLACE. THEIR CONTRIBUTIONS ARE CRUCIAL AND SHOULD BE SOUGHT WHEN COMING UP WITH THE FINAL DRAFT OF THE GUIDELINES. SO LONG AS THEIR IDEAS ARE SOUGHT THEY FEEL PART OF THE PROCESS AND LONG TO PARTICIPATE DURING IMPLEMENTATION.

IT IS ALSO MY EXPECTATION THAT THIS WORKSHOP WILL ENHANCE ACTION TOWARDS CHILDRENS' RIGHTS AND CREATE A FRAME WORK, WHICH WILL SERVE AS A BRIDGE FROM A NEEDS BASED APPROACH TO A RIGHTS BASED APPROACH TO CHILDREN AFFECTED BY HIV/AIDS. LET PARTNERS IN THE AREA OF OVCS ASSEMBLED HERE SHARE LESSONS LEAARNT AND EXPERIENCES AND IDENTIFY PROCESSES CONSTRAINTS AND CHALLENGES. BEST PRACTICES WILL EMERGE FOR REPLICATION ELSEWHERE.

LADIES AND GENTLEMEN:

FINALLY I HOPE AT THE END OF THIS WORKSHOP, GUIDELINES WILL BE DEVELOPED WHICH WILL GIVE INTERVENTION STRATEGIES ON THE CARE AND SUPPORT FOR OVCS AS OUTLINED IN THE NATIONAL STRATEGIC PLANS' PRIORITY AREA OF INTERVENTIONS.

THANK YOU

Appendix 3

Participants Presentations

Response To The Needs Of Orphans, Programming, Achievements And Constraints: Presented By St. Rita Nanga Women Group

In 1993, I took the first HIV/AIDS infected orphan to my house. His name was Ferdinand Ochieng. At that time, Ochieng was 7 years old. We lived with Ochieng for the next 8 years and he died on 30.01.2001 at the age of 15 years. During the years we lived with Ochieng, it was a journey that prepared the birth of St. Rita Nanga women Group.

In October 2000, I moved from Nairobi to Kisumu and formed a community-based groups registered under the name of St. Rita Nanga Women Group to provide continuum of care for orphans. The group straight away embarked in horticulture activities. One of the members donated a farm and thereafter followed by paultry farming. Currently the farm has sukuma, spinach, cabbages, onions, tomatoes, watermelon and cassava. The group has also sunk two boreholes to enable effective farming. We still do not have water pumps but are able to water the farm manually. From this farm we are able to sell the produce and use the proceeds to take care of the orphans.

Our group has recruited from our immediate community 40 orphans. From the total number, only two orphans have mothers who are very sick with HIV/AIDS infection. Our orphans are all in formal schools. I need to mention here that our memberships of 15 are volunteers, working with the children. Each member in this group has an Income Generating Activity (IGA) which is supplemented by the farm in assisting the orphans.

• For clothing, we appeal to our friends to donate to us all items in their houses not in use by their family members.
• We also request our friends to miss their lunches at least on Fridays together with their members, at least twice a month so that they contribute the same to our group. This has worked well so far, but can only subside the food.
• Currently we are in the process of raising money for school activities. The plan is to organize a chain fundraising where we start off with 15 people (members) at a contribution of 100/- and each person recruits the next equal number for the same amount and the chain continues. If it works, we should be able to:
  1. Pay school requirements
  2. Buy zero grazing cow, to sell milk
  3. Set up small Revolving Loan Scheme (RLS) for bigger orphans to start Income Generating Activities (IGA)
  4. Establish medical subsidy
• For orphans whose land has not been grabbed and sold, the group intends to farm it out for the family to supplement our contribution constraints.

CONSTRAINTS

• FAMILY HOSTILITY

  Where younger orphans are driven out of their mother's houses by older orphans from stepmother, deprived of home comfort. Orphans in this situation often run to the street.

• CHILD LABOUR

Misuse of younger orphans by guardians.

• SALE OF PROPERTY

Very often orphans left have their parent's land grabbed and sold by uncles left.

• Lack of medication to affected orphans and finance to attend to the infected one. As a result even cases that are minor get out of hand.
• Lack of community education especially those living with the infected orphans to be able to know how to handle the situation with infections and to avoid infecting oneself.
• Counseling for the children following death of parents and for those taking care of them.

CNSP/OVC; CHALLENGES FACING IMPLEMENTING AGENCIES

Presented by: Mr. Ouma Otieno, SAOLA
SAOLA is a vocational training and rehabilitation Centre.

• Establishment of SAOLA – It has been a rough riding journey by SAOLA. SAOLA has been started three times and brought down just as many times due to lack of funds and training facilities.
• Beneficiaries – The age group between age 12-22 years cutting through young married mothers and men, to school dropouts.

THE CALL

Mr. Ouma Otieno the initiator of SAOLA is a person of 42 years old, who grew up and experienced one of the hardest times during childhood and teenage. When he grew up he decided to help others who are suffering like him before (when he was a child). Mr. Ouma has now worked for and with CNSPs in different capacities for the last 10 years or 11 years.

CONSTRAINTS

First there are the presenting problems, very touchy ones indeed, like idleness by the youth, drug abuse, child labour, child sexual exploitation and so forth. But there are the hidden and on understood ones like bad parental care and up bringing, abuse of children from family members, lack of food at the homes and houses, drunkenness by the guardians and foster parents, human greed and so forth that makes close relatives disinherit the orphans of their birth right or even constitutional ones. These complicates the problems and constraints the care givers experience.

Shelter – Some CNSPs go to the street or do all they do, due partly to the fact that they lack shelter and hence security and the life in the streets and the other children already living in there, provide just the excitements and a becoming environment for security and well being.

• There are few or no trained child handleers leading to failure in rehabilitation and placement of OVCs.
• Lack of enthusiastic support or networking from other stakeholder's e.g. the communities, NGOs, NGIOs, or even individual due to either rivalry between agencies, or community apathy, or NGOs disinterest/fatigue.
• There is the lack of interest or disinterest on the part of CNSPs/OVC themselves due maybe to various premises like shock of loosing their dear close kins, stigmatization from the members of the society or just the trauma resulting from the loss of parents, or extreme poverty at their homes.
• Difficulty of penetrating the donors, individual donors or bigger agencies by the upcoming and lesser known agencies.
• Label the community, attaches to the agencies working for or with CNSPs/OVC.
• Poor public relations due to lack of proper and appropriate marketing strategies on the part of the implementing agencies creating as a result misunderstanding and distrust and or hostilities from the communities and society in general within which we work and exist.
• Rivalries between the agencies and the tendencies by the bigger and better entrenched organizations to keep the heads of upcoming ones below the water level.
• Poor or no fundraising skills by the agencies dealing with CNSPs/OVC or just ignorance on their part of the funding or donor agencies needs and areas of operations.
• Conditionalities (inappropriate) by the donor agencies that are solely and largely at variance with the reality on the ground.
• Erratic and or vague vision, mission and objectives resulting into unachievable and unrealistic goals.
• There is the question of over ambitious indulgences by some CBOs mostly and a few NGOs or NGIs.
• Lack of ownership of responsibilities by the implementing agencies raising the question of authenticity or sincerity and lastly but not least, there is the question of appropriateness of some programmes.

In essence these are the summarized constraints practically experienced by SAOLAs members in the period of their work n the field of OVC/ CNSPs.

The other constraint is the question of the children becoming sexually wise at tender ages more so in the slum areas of the urban centers as at early as 9 years. This has a big impact on the concerned pupils as they become disorganized and disoriented unless they are being engaged in sex discussions. More often than not the female children would rather admire their male handlers and the male ones would look at their female handlers as any other lover or one fit to engage in sexual relationships.