The difference AIDS makes to vulnerable children

New South African research shows that AIDS-affected children struggle with educational and mental health issues more than their peers, who are vulnerable for other reasons.



The research, which authors said was the first to measure the effects of AIDS-related illness among care-givers on children, was conducted by Oxford University and South Africa’s University of the Witwatersrand and presented at the Orphaned and Vulnerable Children (OVC) Conference in Johannesburg on 1 November.



Led by Oxford’s Lucie Cluver, the study followed 730 vulnerable children from three South African provinces – the Western and Eastern Capes as well as Gauteng – over four years.



Researchers found that having a care-giver suffering from an AIDS-related illness almost doubled the chances of a child not being enrolled in school compared with a child whose carer experienced other illnesses. Children whose care-givers were battling opportunistic infections were also more likely to miss school days and have concentration problems.



A July 2010 report by Statistics South Africa (StatsSA), estimated that AIDS-related illnesses accounted for 43 percent of all deaths in the country over the past decade.



According to StatsSA, there are two million children who have lost one or both parents due to AIDS in the country.

I don't concentrate at school. I am worried about my mother. She looks like she is going to die like my father. - 12-year-old study participant

Different vulnerabilities



Cluver said the findings may point to a higher demand for care associated with AIDS-related opportunistic infections than with other illnesses.



About a third more children cared for by adults with opportunistic infections reported doing at least three hours of housework daily compared with children whose carers had other ailments.



“We asked children about this increased care work,” Cluver told IRIN/PlusNews. “A lot of it is what we might call intimate healthcare – they’re cleaning wounds, washing people, toileting people, they’re responsible for giving medication ... but a lot of it is also sibling care, housework...”



Big problems, small shoulders



Cluver also said that in a linked study of 850 OVCs, those whose carers had AIDS-related illnesses said they felt responsible for that person's well-being and guilty about leaving them to go to school - creating high levels of anxiety that adversely affected the children’s mental health.



“[AIDS-related] sickness is impacting on concentration both because of the care work they are doing – so the kids are worrying about what they need to do – but also through increased levels of psychological disorder… which would be issues that, in the west, would be seen by a doctor or psychologist.”



Children with a care-giver who suffered from AIDS-related illnesses had heightened levels of anxiety, depression, problems with peers and post-traumatic stress disorder, according to Cluver.



Cluver said that in addition to programmes commonly aimed at OVCs, such as feeding schemes and fee waivers, schools could respond to the needs of children in such households by offering psycho-social support or perhaps introducing flexible time-tables for children with heavy care work burdens.



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