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8th SWAA Conference updates
Post conference Report
SWAA PMTCT Report
8th SWAA Conference report
KEY PRESENTATIONS
SWAA Particpants
SWAA Report 2
PMTCT Programme
Adresses
French AnnouncementMember Countries
SWAA Branches|
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| Children and AIDS in Africa: Challenges and Strategies to cope |
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| LESSONS LEARNT |
| What Children said: Children orphaned at tender age miss parental love and care. They experience hardships as they are deprived of breadwinners and income. They cannot get basic needs and so most resort to street life. Children miss education, shelter, and health facilities. It was their feeling that these needs be addressed immediately. There must be programmes and resources to assist them. Empowering Young Aids orphans Young people require positive changes in knowledge and attitudes towards HIV/AIDS, they should be empowered to develop survival skills, assertiveness and maturity. Adolescents need continuous support to change their sexual behaviour. Parents are a critical group for effective sustainable prevention of reproductive health including HIV prevention among adolescents. Inadequate information on sex and sexuality In some societies sex-related issues are considered confidential and a taboo for open discussion even in a parent/child relationship. This inadequate information on dangers associated with unprotected sex and related issues increases the prevalence of HIV/AIDS among adolescent women. There is need for them to be made aware of their sexual rights and dangers of unprotected sex. Raising awareness among the youth HIV/AIDS is a problem that affects communities. Preventive programmes usually exist in cities and not rural areas where the number of orphans is increasing because there are no specific sex and health education programmes. Teaching rural communities (youth and Adults) how to deal with the epidemic helps increase awareness and preparedness because people are no longer afraid to live with HIV/AIDS. Variations in children Needs Needs of children differ by age and where they reside so it is important for children to be open about their needs so that strategies are laid out to meet them. To prevent stigmatisation, awareness should be created within the communities and children made to feel secure and loved. Reference to them as `those’, `these’ and not `our’ children discriminates them and increases stigmatisation. For the sake of participatory planning there is need to seek the views of children themselves in form of counselling. Children should be empowered through skills training. Counselling affected children and their guardians is vital in identifying the very needy children, Treatment, Provision of scholastic materials, fees and follow-up visits, training and counselling and Training communities on needs and rights of children. Most important was the need for extended families and Communities leaders to be involved in providing foster care for victims. Children Rights Children counsellors should be specifically trained and children prepared and not manipulated. They should be taught sex and sexuality. Their rights should not be violated, should be heard and a consensus reached before children are exposed to public fora. Children should not be exposed to media attention especially when they are least prepared for its implications. It was critical to interprete children rights to communities. There should be responsibility in using children to articulate messages on AIDS. The press must be careful not to dehumanise them. Vulnerability Children live on streets not by choice but because society does not offer them alternatives to obtain basic needs. They choose streets because of the feeling that urban areas provide solutions to their predicament. Sometimes they do so for lack of attachment to families into which they were adopted or because their relatives had extra responsibilities and fewer resources than they would cope. Most have suffered the traumatic experience of seeing their parents suffer and die. On the streets they are sexually exploited, experience brutality, violence and insecurity. They are at risk to STDs and exposure to HIV/AIDS. Drug-use of a common practice, they lack health-care, suffer low self-esteem. They are vulnerable and live in constant fear of loosing power over their lives. Street girls as women are even at a greater risk of getting HIV/AIDS since they have no control over their sexuality. The social and cultural circumstances make them dependent on men. These beliefs and expectations encourage risky sexual behaviour. Therefore, programmes that focus on affected children should be gender sensitive. Affected and infected children should not be marginalized and intervention programmes should be developed for all those in schools and communities where they live. There should be improvement in cultural practices, an element of Gender sensitivity and Mainstreaming introduced, and a holistic approach in addressing needs of affected children. Child support programmes should not remain in urban areas alone but spread to rural settings. The plight of orphans is worsened by prejudice and social exclusion, which makes them live with the stigma long after the loss of their parents. The isolation can create a vicious cycle that places children even at a greater risk of contracting HIV/AIDS themselves. Distress, fear and uncertainty can be overcome through open discussion. Community intervention should include establishment of low cost schools for orphans so that they are able to improve their knowledge and promote their talents. Orphans should assist fellow orphans in counselling, teaching. They are numerous constraints in care for orphans such as the law on adoption of children. Guardians and caregivers cannot assume total ownership of orphans. Communities have a role to play in supporting vulnerable children through provision of shelter, clothing, and love. In so doing, it is important to use available to use available resources rather than depend on donors. These policies should not remain unimplemented, it is important for mothers to be trained and children sensitised. Resources should be mobilised and targeted at affected and infected parents and children. All this vital information and use of best practices can be shared through networking. Interventions Governments should have national programmes to respond to the crisis. There should be commitment by individuals to care for the orphaned children. An advocacy campaign should be launched to lobby governments establish programmes and administrative structures to offer direct support to orphans as a priority. Prevention of HIV/STIs Transmission Many people still lack conviction of attendant risk of unprotected sex, lack of condom negotiating skills and have doubts about efficacy of condoms or cannot afford them. Supply of free condoms and counselling on condom use could enhance regular use of condoms. With increasing urbanisation, there is danger of spreading HIV and other sexually transmitted diseases to young girls and boys. Child counselling should be encouraged for children to survive. What Women said concerning their options for HIV Prevention: The rights of Orphans and Widows Inheritance practices affect widows and orphans and limit their ability to ensure their future. Many victims experience property grabbing which threatens their socio-economic well-being. Women bear a disproportionate burden in caring for orphaned children, besides most women are reluctant to disclose their sero-status. Therefore there is need to increase community awareness about property rights of women and children. Leaders and communities should be mobilised to safeguard these rights. There is need to reduce stigmatisation and discrimination against HIV-positive parents to enable them plan for their children. Reduction of stigma and support to Victims by Communities Grass root women through linkages in communities have responded to HIV/AIDS epidemic through sensitisation, advocacy and lobbying. Other activities include counselling, home based care and orphan support. Cultural practices like polygamy, wife inheritance and circumcision contribute towards the spread of HIV. It is important to work to reduce the stigma, support affected families, increase knowledge on HIV and empower women to be able to negotiate preventive skills and build strong networks to provide these services. Women are vulnerable to HIV infection and traditionally care takers, make an impact in prevention and care. It is necessary to mobilise such groups of women (infected and affected) and from different social economic and professional backgrounds to work to reduce the impact of HIV and stigma among orphaned children. Income and Health improvement To generate sufficient knowledge in development needs, and skills for appropriate development interventions, it is necessary to mobilise leaders and communities to train in modernisation of agriculture, and support widows and orphans with improved crops and seed varieties, train them in business skills, provide social services including water, public health and care for children. Appropriate health education and training in Health care for HIV infected women and children, is a critical part of building infrastructure and capacity to manage HIV/AIDS epidemic. It is also leads to tangible benefits for HIV-infected women and children. What People Living with AIDS said: Communication Illness and death in families have a major impact of development of children and their future, therefore there should be proper counselling of people living with AIDS on communicating with their children, To fulfil their responsibilities as parents. Children need to feel responsible in life to be good citizens. Their role in promoting Positive Behaviour PWAs go public and target audiences as a strategy to influence behavioural change. They use drama techniques to sensitise, teach and educate communities. In so doing attitudes of people towards PWAS changes gradually. Their participation in awareness sensitisation and education is important in promoting behavioural change. Children need medical treatment and social security, it is important for HIV- infected parents to use cultural and traditional training to teach their children to start doing things appropriately because failure to pass information to children (youth) has disastrous effects on their development. It is important to start by counselling PWAS to fulfil their responsibilities as parents and for children to work to become responsible citizens. Observations by Civic Leaders Inadequate community Involvement Responses to HIV prevention care and support while evident are slow in some communities, because of the level of mobilisation and sensitisation. There is need to increase in awareness about HIV/AIDS STD education and involve stakeholders in HIV/AIDS prevention and care programmes. Children cannot be left alone to face life without parents. For material and psychological needs, medical care and education the better and sustainable way to support orphans is in a family context, because they feel part and parcel of the effort and value care given. Nursing Aids patients is very demanding and distressing and so there is need for control of AIDS pain and symptoms at home. Aids carers need support, counselling and respect in the community. In empowering communities to reduce the impact of HIV/AIDS and effect home based responses, there should be home visits by individual teams, families or community members who assess, identify needs of orphans and infected people and offer care, support and health education. In this way communities are mobilised to take responsible roles. Impact of HIV prevention Initiatives In assessing impact of initiatives it was found out that communities are reached through education, meetings and home care visits. These initiatives have increased knowledge on HIV/AIDS transmission preventive behaviour and risk perception. Condom use has significantly risen among non-regular partners, there is increase in voluntary HIV testing which is a positive development among students although it remains low among women and children. Role of Non-governmental Organisations Non-governmental organisations have played a fundamental role in prevention of spread of Aids, care, support and counselling of infected women and children all through various initiatives including training of vulnerable children in vocation skills, training in counselling and reproductive health income generation sensitising communities on rights of children. These initiatives have had a positive impact in that most children have acquired skills for self-sustenance and can support other members of the family. School health education Programmes Many school programmes have an element of being sensitive to needs of affected children. There is significant contribution to traditional efforts in fighting literacy, providing AIDS care, support and preventive services. Health education programmes in schools aim among others to establish a framework for voluntary counselling and Testing and increase of risk perception among students have yielded results which show increase in awareness, assistance and use of condoms which are means of prevention of HIV transmission. Radio and newspaper campaigns besides health education, activities have disseminated information to a wider public. Specific health education sessions are necessary and should be included in school curricula and teachers trained and motivated on these aspects. CONCLUSION ________________________________________________________________ CONCLUSION It is important to realise that constant public statements may increase rather than reduce HIV/AIDS stigma. There is need for positive attitude among Africans and collective action in the fight against AIDS. Africans should work within the resources they have, as assistance from international partners for care and support for infected and affected children may be inadequate. Such assistance from international partners should be directed to the needs of respective communities and reach grassroots where it should reach intended victims. Parents should give information about their sero-status to their children since it is more terrifying to have them in the dark and adolescent children should be mobilised counselled and trained for prevention, care and support of their peers. Peer education should be enforced whether in or out of school. All stakeholders should participate in mobilising resources to be used in the fight against HIV/AIDS and implementation of recommended strategies. RECOMMENDATIONS The following recommendations emerged out of the presentations and discussions: Information and communication. The plight of children is worsened by social exclusion and stigmatisation at the loss of parents. To help them cope, communication between them, peers and adults should be strengthened through open discussion and counselling. Failure of parents to disclose their sero status and lack of communication on sexuality hindered change of attitudes and promoted discrimination. It was recommended that parents should teach their children about sex and sexuality as a means to protection of their rights, making proper choices and taking charge of their lives in the future. Information from parents about their sero-status to children was needed to help them avoid shock, traumatisation, stigmatisation and destitution when the former finally succumbed to Aids. Parents should also teach their children basic morals, discipline and values that shape their behaviour in society. Adolescent Empowerment For children to be open about their needs, it is important for them to be counselled and trained to participate in care and support programmes and mobilisation of resources to be used in implementation strategies. Children as adolescents should be empowered through counselling and training to openly discuss their sero-status to encourage behavioural change, and adopt preventive strategies. They should be taught prevention, care and support of peers. Responsibility for Infected and Affected children Extended family systems should take responsibility for care of orphans because they survive best in a home environment. Community leadership should be involved in care and support of infected and affected children, for they can coordinate and share resources. Protection of street children Street children should be protected from sexual exploitation, brutality and insecurity. They should be counselled, given material support for basic needs such as shelter, food and clothing, and empowered through training in vocational skills so that they provide for themselves. Promotion of Awareness Information flow through the media, drama groups raises awareness among adults, parents and children. The media should be used to publicise activities on HIV/AIDS reporting should be done with responsibility to eliminate stigmatisation and discrimination. Spiritual Guidance and use of Traditional Healers Partnership with spiritual leaders and traditional healers in central responses to HIV is important since a large part of the population in rural communities seek their services. Churches and traditional healers should be trained to counsel victims and get actively involved in prevention programmes. Mobilisation and use of Resources Care packages for HIV-infected parents should be used to stem their lives as well as give children support. Resources should be mobilised and targeted to assist infected and affected children and parents and used sparingly. For communities it is not only important to identify needs but also their inherent capacities to address them using the little they have. Gender sensitisation Education, Counselling and training programmes and activities whether in or out of school, should be gender sensitive to provide for both the girl and boy child, men and women. Informed decisions by HIV-positive persons People living with Aids should be given information to enable them live positively and responsibly. They should enjoy their sexual and reproductive rights without compromising the lives of their children or their partners who may be discordant. Mothers should seek early information on their sero-status to avoid vertical transmission of HIV to their born or unborn children. If infected, they should be given a choice to use available preventive drugs such as Niverapine, that reduce the viral load, and formula foods instead of breastfeeding their infants. For such a programme to succeed there should be a comprehensive multi-sectoral approach involving the entire community. WAY FORWARD ____________________________________________ WAY FORWARD 1. SWAA will up to the year 2003 continue to direct concerted energies in the following areas: i) advocacy ii) training 2.The major strategies will focus on improving the well being of children affected and infected with HIV/AIDS and in this connection two groups have been identified: a) Those infected and living with HIV/AIDS b) Those affected by HIV/AIDS i.e. - pre-orphans, and orphans. 3. In recognising that the health and well being of children depend on the health of mothers, it is also agreed that: a) Women infected and affected with HIV/AIDS should be a target population. Strategies for Children 1. Advocacy for human rights of children 2. Ensure their access to treatment and anti-retroviral drugs 3. Social support and care including food, shelter, security, education, love and parental care 4. Ensure access to information by the children whether in or out of school 5. Ensure that children’s voices are heard by involving them in planning and implementation of interventions and projects that concern their health and welfare Strategies for Women 1. Advocacy for Human Rights of women for reduction of stigma and discrimination 2. Ensure access to voluntary counselling and testing 3. Ensure prevention of mother to child transmission by supply of breast milk supplement and provision of anti-retroviral drugs 4. Ensure access to anti-retroviral |
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