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Informed policy decisions based on realities of children
Sonja Giese, HIV/AIDS Programme
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It has often been said that key to the realisation of children’s rights is the need for children and caregivers to know their rights and to be aware of the mechanisms that exist to enforce these rights legally. It is however of equal importance that law-makers and implementers understand the realities of children and families to ensure that legislation and policy are relevant to local contexts, and are sufficiently resourced and sustainable.
Drawing on Children’s Institute research* into the experiences of children and caregivers in heavily AIDS-affected communities, the paper presented at the Fourth World Congress on Family Law and Children’s Rights highlighted key issues for consideration by the State and civil society in drafting policies and legislation aimed at mitigating the impact of HIV/AIDS on children. The relevant issues are contextualised through the following narrative, which typifies the experiences of many AIDS-affected households:
Mantoa – aged somewhere in her forties, but looking much older – lives in a dusty village in Limpopo Province, one-and-a-half hour’s journey from the nearest town. She has eight vibrant though undernourished children, of whom the youngest six live with her: Thabo (14), Solomon (12), Wunda (10), Lefa and Refiloe (8), and Thabang (2). Her eldest daughter lives with her mother’s sister and her second-born with her mother, some distance away. The children’s father is not contributing to their maintenance, having thrown Mantoa and the children out of his house in 1999 in order to live with another woman. The household is desperately poor. Thabo and Solomon earn the only income – R100 a month for herding a neighbour’s cattle each day. Although some of the children are eligible for Child Support Grants, they don’t receive it because they don’t have birth certificates, while Mantoa was left without an identity document after a shack fire. A local, erratically-funded faith-based organisation provides the household with a small food parcel once a month – that is when such parcels are available.
When we met her and her children, Mantoa was frail and ill with AIDS. Her youngest child Thabang had also tested HIV-positive and is a weak, sickly child whose breathing is laboured and wheezing. The local clinic staff has treated Mantoa well, she says, but she struggles to get to the hospital for her check-ups because she doesn’t have any money for transport. When food runs out – as it frequently does - she hates having to beg her mother or the neighbours for help. Her mother is already supporting a number of other persons on her meagre farm worker salary. Thabo and Solomon are not attending school. Mantoa has not been able to get transfer letters from their previous school and besides, the boys say, “they would chase us away without the fees”.
Mantoa’s story illustrates how the impact of HIV/AIDS on children is exacerbated by poverty. Poverty-related issues – and in particular hunger – emerged as the primary concern of children and caregivers who participated in the CI research. Children, caregivers and teachers spoke about how hunger impacts on children’s abilities to attend school and to concentrate while at school.
Other poverty-related struggles for households included: struggles to pay school fees; lack of school uniforms, clothing and other material possessions; inadequate housing; difficulty accessing water and not having money for transport or health care when sick. Current poverty alleviation mechanisms remain grossly inadequate and, given the urgency of need, require immediate review.
Mantoa’s circumstances also illustrate the vulnerability of children living with a sick caregiver. Programmes and policies aimed at addressing the impact of HIV/AIDS on children have tended to focus on children who have been orphaned by, for example, targeting services and support at children only after the death of their biological parent(s).
However, in a country where antiretroviral treatment is not available to the majority who needs it, AIDS-related illness in caregivers renders children extremely vulnerable long before the death of a parent. The limited support available to biological parents to care for their own children is therefore a major gap within current policy, as is the absence of support for children caring for the terminally ill.
To download the paper, click here.
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*Giese S,
Meintjes H, Croke R & Chamberlain R (2003) Health and Social Services to
address the needs of orphans and other vulnerable children in the context
of
HIV/AIDS in South Africa: Research Report and Recommendations. Report
submitted to the HIV/AIDS Directorate, National Department of Health,
January 2003. Cape Town: Children's Institute, University of Cape Town.
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