Integrated Regional Information Networks - September 30, 2009

"We need to heed the cry of a child's heart for an adult who will care for them and be crazy about them," said Monica Woodhouse, who runs the South African NGO, Give a Child a Family.

According to the UN, there are more than 34 million orphans in sub-Saharan Africa today, 11 million of whom lost parents to the AIDS pandemic.

Traditionally, orphans in Africa are raised by the extended family, and while many families continue to take in orphaned relatives, conventional family structures are buckling under the pressure of caring for additional children; a 2006 study in Korogocho, a Nairobi slum, found that more than half the 436 people surveyed were caring for at least one child orphaned through HIV/AIDS.

Too poor to cope, many families now reject these children, leading to a proliferation of institutional childcare facilities across the continent; in Uganda, for example, government statistics show that the number of children in orphanages nearly doubled between 1998 and 2001.

Separation is hard

"There are plenty of studies which show that raising children in institutions as opposed to families affects their cognitive, social, emotional and even intellectual development," Philista Onyango, regional director of the African Network for the Prevention and Protection against Child Abuse and Neglect (ANPPCAN), told IRIN.

"In Africa, people are not trained to work with these children and often don't know what they are doing, so orphaned children in institutions can wind up being physically or sexually abused," she added. "Many are not even registered and those that are, are not properly regulated."

According to the National Council for Children Services in Kenya, there are 417 charitable children's institutions registered, while another 800 are estimated to be operating unregistered.

"Separation from the family is harmful to children; it doesn't matter if I have grey hair on my head, my mother is still my mother, my family is still my family - children need that sense of belonging," said George Nyakora, regional training director for the SOS Children's Villages, which places children who cannot be connected to their biological families in family environments.

Cost issues

Speakers also said the cost of supporting families to raise orphans was significantly lower than keeping a child in an orphanage; a study from South Africa showed the cost of residential care can be as much as six times that of providing care to children living in poor families.

"All the money donors are pouring into institutions should instead be invested in enabling families to raise these children," Onyango said.

Even HIV-positive children on life-prolonging anti-retroviral medication do better growing up with family, according to Protus Lumiti, chief manager of the Nyumbani Children's Home in Nairobi.

"We run a home with about 110 HIV-positive children, but even we realise this is a last resort," he told IRIN. "We have another facility in Nairobi caring for 3,500 children who are based with their families but come to a centre for drugs and nutritional support - community-based care has worked very well in our experience."

"There are some extreme situations, for instance, where a child's disability is so difficult that it can only be properly managed by professionals in an institution, but there is certainly no need for as many childcare centres as we are seeing on the continent," ANPPCAN's Onyango added.

Protection factors

However, steps - including legislation, screening of families, training of child welfare professionals and setting up monitoring and evaluation mechanisms - are necessary to ensure children are successfully placed with relatives.

"We tend to focus on the moral issue of homeless, orphaned children, but we need to look at the economics of it, and to create minimum standards that families must meet in order to care for children," said Nyakora.

Onyango noted that it was not unheard of for children to be abused within their own families, so mechanisms needed to be in place to ensure families were assessed for suitability and monitored to ensure they were giving children the best possible upbringing.

"Sometimes the relatives are only interested in the deceased's property, and not the child's welfare, when they offer to take in orphans," she said. "Setting up child welfare committees at the community level who can monitor a child's progress would be an excellent idea.

"The people left to care for the children - often their grandparents - also need support beyond ensuring the children are fed, clothed and educated," Onyango said. "They need community support in parenting these children, and structures that will ensure the young children will not wind up looking after their old grandparents instead of living a child's life."

"As long as they have the financial capacity and social support to raise children, a family is the best place for a child," Nyakora said.

090930
IR090938

Always watch for outdated information. This article first appeared in 2009. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980 – 2009. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .