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7 HIV/AIDS, Children, and Sub-Saharan Africa Dealing with Bereavement Susan Fox and Warren Parker My father died quickly, but my mother was ill for a long time so it was a different pain because I cared for her and washed her. It wasn’t difficult though because I was the only one who could give her that care. My mother had relatives but they didn’t help and refused to care for children that aren’t theirs. We have to act like adults because no one else treats us like children and we have to do what adults do. Now I wake up at 4 a.m., do the housework, cook, bathe the younger ones, and then I walk about five kilometers to school. When we go to school it’s our happiest time because we are away from our problems. I want to finish school and get a good job. I will care for my own children and give them what I have missed. —Sarah, a sixteen-year-old girl from Zimbabwe whose parents died of AIDS Sarah’s parents died two years ago. Today she and her four younger siblings live with a foster father on a farm in Bindura, Zimbabwe. As Sarah’s story illustrates, the death of a parent from AIDS generally follows a prolonged period of illness, 119 You are reading copyrighted material published by Ohio University Press/Swallow Press. Unauthorized posting, copying, or distributing of this work except as permitted under U.S. copyright law is illegal and injures the author and publisher. triggering many changes in the household that disrupt the child’s sense of security. While the financial burden of HIV/ AIDS is highly visible in families, its psychological impact on children is more difficult to identify. Addressing the psychosocial health of bereaved children is a critical part of the response to the AIDS pandemic. While adults spread their love among several meaningful relationships—with a spouse, at work, as a parent, and with friends—a child invests almost all of his or her emotional love in parents and thus has a difficult time dealing with a parent’s absence. The consequences of bereavement on a child depend greatly on the child’s age and social environment. Children suffer more from the loss of parental support than from the actual death itself.1 Children’s responses to bereavement are in- fluenced by their relationship with the person who died; the nature of the death; the child’s own personality and previous experience with death; the child’s chronological and developmental age; the availability of support from family and community ; and the attitudes, behaviors, and responsiveness of parents and other significant adults in the child’s environment. The effects of bereavement on individuals vary, but whether or not they appear to be affected, the death of a parent always has some impact on children. Psychological damage can manifest at any time, even years after the event, and can greatly hamper a child’s ability to acquire skills and knowledge.2 Strategies for Dealing with Bereavement Long-term studies of children in difficult circumstances have shown that they cope in different ways with traumatic and stressful situations.3 The context in which the traumatic experience takes place is often more important than the experience itself. With AIDS, if favorable conditions can be created both 120 / The Children of Africa Confront AIDS You are reading copyrighted material published by Ohio University Press/Swallow Press. Unauthorized posting, copying, or distributing of this work except as permitted under U.S. copyright law is illegal and injures the author and publisher. before and after the parent dies, then chances are that a child, over a period of time, will effectively overcome the trauma of separation from a loved one. Helping Parents to Talk about AIDS and Death Disclosing one’s HIV status means dealing with a number of social obstacles, including stigma and discrimination. The decision to disclose often depends on the individual, their family, and community support structures. Whether or not parents disclose their status, it is important for them to focus on living positively with the virus rather than on dying. The best way to assist children is to prolong the quality and duration of a parent ’s life, especially through a healthy diet, access to health services, and a positive attitude. While positive living makes the family’s current situation easier, the issue of death cannot be avoided...

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