The views of children on who should care for them, and how, if they become orphaned are very different from those of care givers, a recent Save the Children study in Malawi 1 shows.
Malawi is one of the countries worst affected by HIV/AIDS and, as in South Africa, the burden of care for those who are sick and dying, and for the more than 400 000 children left behind2, falls mainly on families living in dire poverty. Donors and, increasingly, governments in affected countries, are making provision for orphaned children a priority in welfare programmes. However, the views and experiences of children are rarely sought when decisions are made about their care and protection. As in many other spheres of life, it is widely assumed that adults in authority will naturally act in the best interests of the children concerned.
A recent case study, commissioned in Malawi by the Save the Children Alliance as part of its Care and Protection of Separated Children in Emergencies project (CPSC), directly involved children in exploring the care options for orphaned and vulnerable children. The objective was not to make children responsible for deciding on those options but to see how childrens views might inform choices about which options best meet different childrens needs. A total of 165 informants, in two rural communities and one urban township, were involved, including children from the age of 8, caregivers and community leaders.
The recently published report on the study Family Matters: the Care and Protection of Children Affected by HIV/AIDS in Malawi reveals what the author, Gillian Mann, describes as a remarkable discrepancy in the views of adults and children about care options. While adults tended to believe that children should play no part in the decision making around their care, children themselves expressed clear and well-considered opinions on the characteristics of the most suitable care arrangements, and these vary significantly from those of adults.
One might argue that children's views should be expected to diverge strongly from adults but the remarkable aspect is how far the children's experience of alternative care differs from adults assumptions or even stated intentions.
Most children orphaned by AIDS remain within their (extended) family. The scale of premature deaths of adults, due to untreated HIV/AIDS, means that the resources of families already living in poverty are often stretched beyond their limits by taking in relatives children. In such circumstances, any option for care of an orphaned child is unlikely to be ideal. However, the Malawi study showed that, while adults emphasised the material capacity of a family to care for an orphaned child, children were much more concerned about being cared for by adults who would love them and respect the honour of their deceased parents. This led to a strong preference for care by grandparents, even if this meant living in extremely poor material and economic circumstances.
One of the consequences of these different priorities was the perception of adults that orphaned children were not sufficiently grateful for the care they provided, while the children felt they were unloved and mistreated. In fact, the children's descriptions of how orphaned children are treated reflected a failure, or inability, of guardians to meet both the basic material and emotional needs of those children.
All but one of the orphaned children in the study areas were living with relatives. All the children and adults interviewed agreed that it was best for orphaned children to live with relatives and that staying with an unrelated adult was not an appropriate option. The main reason for this was that unrelated adult caregivers were more likely to abuse or exploit a child. However, orphaned children revealed a startling pattern of abuse and discrimination at the household level, and some quite gross examples were cited.
Among the many examples of discrimination and harsh treatment reported by children in all three research communities were:
Child is treated as an unpaid domestic worker while the guardian's biological children are able to rest and play at leisure.
Child is the only one in the household who does not attend school.
When eating, child is asked, “Did your dead parents buy this food for you?"
When child requests assistance with a task or problem, s/he is told, “We are not the ones who killed your parents, so don’t ask us for help".
Child is made to cook and serve food to the family, then told to wait in the kitchen until the family has finished eating to see if there are any remainders.
Child is made to sleep outside, often without a mat or blanket.
Girl is sent out to find a husband so that “someone else will be responsible" for her care.
Girl is told to “go and find some soap" (a euphemism for becoming a prostitute) so that she “can earn her keep".
Biological children give the orphaned child all of the work that they have been personally assigned. When the guardian returns home, these children claim responsibility for the completion of both their tasks and those of the orphan. The orphaned child is then beaten for being “lazy and doing nothing”.
According to the report, Many orphans recognise that their guardians expected them to be grateful for even the most negligible assistance. But children do not feel that they should be held responsible for the death of their parents. They do not want to be made to be thankful for a situation which they view to be both dreadful and entirely not of their own making.
Given the insistence of both adults and children, in all three communities, that orphaned children would be more vulnerable to ill treatment if living with adults who were not related to them, it was ironic how readily guardians seemed to tolerate, or even encourage, orphaned girls from the age of 12 becoming prostitutes, or being married off to much older men. Female youths told the researchers that guardians often encouraged girls to sell sex or to find a Sugar Daddy. And one 14-year-old girl commented: ... As long as families can't meet the needs of their children, girls will have to marry young, even before they have breasts.
All the children reportedly felt that an orphaned child's best hope of adequate care was with a grandparent. When asked about their preferred care options, the children cited five. These were, in order of preference:
With their mother
Nearly all felt that their mother was the one who loved them most and could best care for them, regardless of her economic, health or HIV status: No one will ever love you like your mother; she gave birth to you so you are part of her.
With their grandmother
Boys and girls would prefer to live in this situation even if their grandmother was elderly and they therefore had to perform a number of time-consuming and arduous tasks on her behalf.
Grandmothers will try to care for you as they would their own children.
Many of the children involved in the study were living with their grandmothers and felt that they were living with the best person possible, even if other family members were materially better off.
With unmarried older sister or brother
In this context, children felt that their siblings loved them and would treat them fairly:
They will not ill-treat you because you are the same blood and there is nowhere else for you to go.
The study also found that boys and girls in Area 18 [urban township] also commented that in sibling-headed households, they had a say in family decisions and were able to work together to share ideas and solve problems.
In the two villages, it was found that girls often married by their late teens, and sometimes especially orphaned girls as young as 12 or 13 years old.
With married brother or sister
However, siblings spouses were seen as potentially problematic:
Your brother's wife and your sister's husband love to beat you.
With a young aunt
In most cases, children said that their young aunts were closer to them in age and would sympathise with their difficult and painful situation:
She won't beat you if you are tired from gardening or collecting water.
One of the villages was close to two orphanages and children had strong views about the unacceptability of this care option.
Staying in (an orphanage) is temporary, but your grandmother or sister will never leave you.
They can chase you from there at any time. When you are too old, they make you leave, but you have nowhere to go.
Considering the negative experience of many of these children, one might wonder why relatives had ever taken them in. The Malawi study explored this question in some depth. It found that many guardians had taken in orphaned children out of consideration for them. Some felt they had no choice (due to obligation or lack of an alternative caregiver) and others said it was simply because the child was related to them, because they were concerned for the child's welfare, or because the child was in an abusive environment, or couldn't go to school.
However, some of those interviewed admitted to more selfish motivations. These included: securing a share of the deceased parents wealth such as a pension, property, or belongings; gaining from the child's labour; getting registered for assistance (from a government or welfare agency); using a female orphan as the wife of the male guardian; or hoping to benefit from the man a girl may marry later.
The main reason given for some guardians choosing not to take in a child was poverty/lack of resources.
The study report shows that children in all three communities had not been involved in the decision making around their care. Most adults had never considered child participation in decision making; in any case they felt that high levels of poverty and illness meant there were rarely any real options. One elderly male guardian said that choosing a place for an orphan to live does not depend on who is who but on who has what.
One prominent member of a Village AIDS Committee told the researchers, who asked about the role of children in stating their care preferences,
Children play no part in the decision making about their care. This question is about the democracy thing and rights but things in this community are different. We don't go by that. Children are getting confused by these things. They have no choice, nor should they.
In contrast, the study found that orphaned and other vulnerable boys and girls in all three communities felt strongly that they should be consulted on such matters. An 11-year-old boy commented:
It is your life and you know who will care for you. You can see for yourself who will love you and who will treat you like a slave.
Adults perceptions of children's preferences for care
AIDS committee members, guardians and other community members in Ngawo, Mpinganjira, and Area 18 were all asked with whom orphaned children most preferred to live. In two areas, most adults said that they did not know children's preferences, aside from staying with relatives. One woman said:
Children only care what they eat, not where they stay.
In one of the rural areas, adults believed children preferred to stay with their grandmothers.
Life is easier with a grandmother children can do their own thing and never get disciplined for it.
But they also cited many of the reasons given by boys and girls, especially with respect to children's desire to be well treated and to have their mothers honour and character defended.
Parents, guardians and other adults did recognise that orphans and other vulnerable children did not just have material needs. They highlighted the importance of parental guidance and the need for love and support.
However, the report notes -
It was rare for guardians or other adults to articulate support in an overtly affectionate way, particularly for children over the age of 9 or 10. Rather, love was seen as providing for the basic needs of a child. Giving food when hungry, buying school supplies and involving the child in family life were all considered ways of showing love and support to orphaned children. The large majority of guardians interviewed had never spoken directly to the child in their care about his or her sense of loss and the process of grief and adjustment.
Orphaned and vulnerable children interviewed identified three areas in which they felt their lives were notably unlike those of children with parents. These were: unconditional love and forgiveness, which only parents could give; freedom of expression, which orphaned children did not have; and discrimination and stigmatisation, which was worse for orphans.
Boys and girls of all ages shared examples of how their parents would have treated them with love and kindness, but their guardian did not. These included not being allowed to rest when sick; not being provided with medical care even when it was freely available; being punished harshly for small mistakes, such as dropping a piece of laundry; and being made to feel like a burden for merely existing. All the children and young people agreed that orphaned children in their communities experienced enormous amounts of discrimination and harsh or cruel treatment mainly by their female guardians. However, the report noted,
Many guardians reported that orphans often feel victimised to such an extent that they are unable to differentiate between discrimination and the inability of their guardian to meet all of their needs.
The study also investigated children's coping strategies in these adverse conditions. It found that, as well as approaching other families or neighbours for specific needs, and dropping out of school in order to work to meet their basic needs, children also sought help and support from each other. Adults believed that children's friendships consisted entirely of play but children identified many ways that they did and could help each other. The views of children and adults were also sought on how to reduce the vulnerability of children to HIV/AIDS, especially that of orphans and those boys and girls whose parents are disabled or not in good health. These proposals are detailed in the study report.
Many people working with orphans and vulnerable children in the southern African region will find the report a rich source of questions and ideas about appropriate responses to the impact of HIV/AIDS on children. As the author says:
Through the use of appropriate, child-focused and participatory methods, we can learn from children different things from those we learn from adults. In so doing, we can gain a fuller picture of their lives and thus improve our capacity to assist them to assist themselves.
1. Mann, Gillian. Family Matters: the Care and Protection of Children Affected by HIV/AIDS in Malawi. 2004. Save the Children Sweden. ISBN 91- 7321-063-3. The study focused on the work of COPE in Malawi, a programme of Save the Children USA, which mobilises communities to respond to a range of issues stemming from the AIDS epidemic.
2. Ibid, citing UNAIDS estimates for 1999.
This feature: ChildrenFIRST, May-June 2004.