Introduction
1.1 Who should use this manual?
Frontline workers involved in the provision of support to orphans and vulnerable children (OVC), especially in Sub-Saharan Africa and other developing countries, will find this manual useful. We take frontline workers as those persons who implement interventions that directly influence the nature and kind of support orphans receive. Policy makers and evaluators may find it relevant, but not adequate for their work.
1.2 Purpose of the manual
The manual provides a synthesis of good practices based on a review of 16 community-based orphan support projects in Zambia and Kenya and experiences of 29 frontline workers from Germany, Kenya, Uganda, Ethiopia, Rwanda, Malawi, Zambia, Namibia and South Africa. The good practices were synthesized during a regional workshop held in Nairobi, Kenya in March 2003. The purpose of the manual is to enable frontline workers undertake sustainable and effective community based orphan support interventions. Application of the good practices is illustrated using case studies1.
1.3 HIV/AIDS and Orphans
While the sense of common purpose in the worldwide struggle against HIV/AIDS has intensified, inadequate attention has been paid to the time bomb of children orphaned and made vulnerable by HIV/AIDS. In 2003, the estimated number of children globally who have lost one or both parents due to AIDS was 14 million. Approximately 70% of these children live in sub-Saharan Africa. Forecasts indicate that the number of children orphaned by AIDS will rise dramatically in the next 10-20 years, especially in sub-Saharan Africa.
As the number of adults dying of AIDS rises over the next decade, increasing number of orphans will grow up without parental care and love, and be deprived of their basic rights to shelter, food, health and education. Trauma to orphans starts way before, during illness: selling of assets for medicines; role reversal when children nurse parents, and assume domestic and child care responsibilities beyond their years.
The danger to orphans may not be orphanhood, but the way communities deal with parentless children. Several studies have shown that, more than the loss of one or both parents to disease, it is the stigma attached to AIDS that makes life hard for orphans. Orphaned children face discrimination within their families, communities, churches and schools before and after the death of their parents. Stigma may undermine efforts to provide safety nets for orphans because families may not come forward to benefit. Other problem areas include quality of life, care arrangements and psychosocial support. Many children worry about going to school and leaving their parents to die alone. Yet, quite often children are excluded from discussion of the imminent or recent death of a parent because death is a topic for adults.
The future cannot be ignored and preparations must be made now. The United Nations declaration of commitment on AIDS and orphans reads, “By 2003, develop and, by 2005, implement national policies and strategies to build and strengthen governmental, family, and community capacities to provide a supportive environment for orphans and girls and boys infected and affected by HIV/AIDS, including by providing appropriate counselling and psychosocial support, ensuring their environment in school and access to shelter, good nutrition and health and social services on an equal basis with other children; and protect orphans and vulnerable children from all forms of abuse, violence, exploitation, discrimination, trafficking and loss of inheritance (paragraph 65) (United Nations General Assembly Special Session on HIV/AIDS, June 2002, New York). This declaration needs to be translated to action the soonest possible, especially in sub-Saharan Africa.