2.7 The challenges experienced by AIDS orphans and vulnerable children
2.7.3 Social impact
As Moletsane (2003) mentions, one apparent effect of the illness and death of an adult due to AIDS may be the huge numbers of young adults who grow up without adult supervision, love and attention (as AIDS orphans and/or in child-headed households), making them vulnerable to abuse (emotional, sexual and physical) from extended household members and other community member. With South Africa being a patriarchal society (Dorrington and Johnson, 2002), girls especially are vulnerable to sexual abuse.
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(Kelly, 2002 and Leach, 2002). Many girls willingly get involved in relationships for economic and other reasons as found in studies by Hepburn (2002), Kelly (2002) and Leach (2002) and/or as a result of illness and/or death of economically active members of the household. The loss of a breadwinner leads to a reduction in the family’s earnings and the ability to care for and protect its children, who become prey to neglect and abuse (Ebersohn and Eloff, 2002). With widespread sexual activity in conditions of intimidation, harassment and in some cases rape (Leach, 2002:) and young girls not always being able to negotiate safe sex (Kelly, 2002), they are exposed to possible HIV infection, the risk of falling pregnant or being infected with other sexually transmitted diseases. They may be further deprived by becoming excluded from school or by dropping out as a result of pregnancy (Moletsane, 2003).
Extended family networks of relatives and grandparents are an age-old safety net for such children. But the capacity and resources have been stretched to breaking point and those providing the necessary care are in many cases already needy, often elderly and have often themselves depended physically and financially on the very son or daughter who has died.
Many children are left on their own in child-headed families (United Nations Children’s Fund, 2003).
The vulnerability of young adult orphaned by AIDS commence before the parent died.
The emotional suffering of young adult usually starts with their parent’s progressive illness and distress. This is compounded as the disease causes drastic changes in family structure resulting in heavy economic toll, requiring children to become caretakers and breadwinners and fuelling conflict as a result of stigma, blame and rejection (United Nations Children’s Fund, 2003).
Finally the children suffer the death of their parent and the emotional trauma that results.
Then they have to adjust to a new condition, with little or no support. Children orphaned on account of AIDS are often at a higher risk of abuse, illness and sexual exploitation.
They may be denied the health care that they need and sometimes this is because it is presumed that they are infected with HIV and their illness is incurable. They often run a greater risk of being malnourished and underdeveloped. Children grieving for their deceased parents are stigmatized by the community through their association with HIV
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and AIDS. The social isolation and distress experienced by these teenagers is strongly worsened by the fear, shame and rejection that borders people affected by HIV and AIDS.
Teenagers may be denied access to health care and schooling. They are also denied their property and inheritance (United Nations Children’s Fund, 2003).
Children may not only become victims but also perpetrators of crime. Growing levels of poverty, the emotional trauma associated with AIDS-related parental death, reduced levels of parental guidance and control and loss of positive role models may encourage delinquency and criminal behaviour (Schonteich, 1999). In a study conducted in South Africa, Moletsane (2003) found that there are rising numbers of children living on the street and other destitute and abandoned children in care centers and other homes who are vulnerable to abuse (physical, emotional and sexual) from extended family members and other members of their communities.
The abuse and neglect of children in AIDS-affected households is an indicator of the reduced ability of adults to cope (Ewing, 2002). Children will be abused because they lack shelter and protection or because selling sex is their only means of survival. Abused children are more likely to take greater sexual risks or find themselves in abusive relationships in adulthood. The trauma of rape can destroy a person’s self-esteem.
Orphaned girls are particularly vulnerable to sexual abuse because they assume adult responsibilities, such as caring for dying parents or raising siblings, without the maturity to understand quite what has happened to them (Ewing, 2002).
McKerrow (1999) (cited in Smart, Pleaner & Dennil, 2001) agrees that young girls’ abuse within households is on the high rate highlighting three myths or theories apparently linking child sexual abuse and HIV and AIDS. (The prevention theory, the cleansing theory and the retribution theory). As they grow up without parents, and being poorly supervised by relatives and welfare organizations, this growing pool of children orphaned on account of HIV and AIDS would be at above average risk to engage in criminal activity (Schonteich, 1999).
Schonteich (1999) further points out that the absence of a father figure early in the lives of boys is likely to increase later delinquency. Such an absence will directly affect a boy’s
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ability to develop self-control. An insecure attachment will lead to lower levels of empathy and self-control, and to an increase in violent behaviour. Institutional care may be needed on a temporary basis to offer children a temporary home until a more permanent solution can be found. But as a long-term solution, this intervention should always be seen as being the last resort for vulnerable children. Should the extended family not be available for any reason then the community could provide a better alternative than an institution (McKay, 2002; McKerrow, 1999). This would be discussed in detail later in this chapter.