Children Corners or Warehouses? The Quest for Psychosocial Support

to OVC’s

Eric UmarCollege of Medicine

Community Health Department

Orphan Care Models

Community BasedInstitutional Based

Program Evaluation

Surrounding the childHealthEducationPsychosocialLivelihood

Orphan and Vulnerable Children situation in Malawi

650,000 AIDS orphansRepresenting 65 % of Orphans

Vulnerable childrenOrphans and children on the

brink Adolescents living with HIV

Adolescent Living with HIV

The roll-out of anti-retroviral treatment programs has made it possible for perinatally infected infants to live through adolescence and adulthood

Worries about illness revolve around:Disclosing their HIV status to friendsPeople finding out that they live with HIVLiving situationsSexualityinfecting someone else with HIV

Emotional impact

Children on the brink – experience negative changes start to suffer neglect, long before they are orphaned

Suffer the death of their parent(s) – leading to emotional trauma

Adjustment challenges new situations - with little or no support

may suffer exploitation and abuse

Studies have found high levels of psychological distress in OVCs Anxiety, Depression, Anger Suicidal - wish they were dead (12 % vs 3 % in Uganda)

Psychological problems more severe when child is forced to separate from their siblings > half of orphans no longer live with all of their siblings (Zambia)

Psychosocial SupportThere is a huge need for emotional

support and counselingHelp them deal with loss, traumaAdjust to new situationsSupport them become resilientSet goals for their livesTake up new roles

Looking after siblingsTake their medication – ARVs etc

Deal with family – property grabbers

Children’s Corner

Support children cope with psychosocial problems

Establish children problems that might affect them psychosocially and intervene where possible

Limitations

Huge numbers of childrenboth orphans and non orphans come to

the corners

Disorderly nature of the activitiesDifficult to identify children with problems

Weekly meetings

Few poorly trained “facilitators”Two facilitators

Communities unable to provide food etc

Conclusions

Children corners provide some form of psychosocial support

The support is too inadequate

The End!Sikomo

Recommendations

There is need for attention to mental health problems faced by OVCs

Need for well designed and monitored psychosocial support research interventions in resource-poor settings.