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10: How Communities Help Families Cope with HIV/AIDS in Zimbabwe
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10 How Communities Help Families Cope with HIV/AIDS in Zimbabwe Gladys Mutangadura In Zimbabwe, an estimated six hundred thousand children have lost their mothers or both parents to AIDS since 1985.1 The National AIDS Co-ordination Program (NACP) in Zimbabwe estimates the orphan population to be growing by sixty thousand children per year. This situation demands feasible program interventions. The extended family as a safety net is still by far the most effective community response to this crisis.2 Traditionally it is assumed that the extended family and the community at large will assist orphans socially, economically, psychologically, and emotionally. This is a common practice in most parts of eastern and southern Africa. In Zimbabwe, traditional strong family ties have been the best social insurance against starvation.3 These ties include regular urban-rural interhousehold income transfers. When crops fail, family members from the town bring cash and purchased food to rural areas. When a family member in town loses a job, a family member from the rural areas sends food to town for them or welcomes them back to the rural homestead.4 In an orphan enumeration study in Mutare, all 340 orphans identified were 159 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. absorbed into extended family structures.5 In a UNICEF study in Masvingo Province, relatives in the community were found to be caring for more than eleven thousand orphans. Most of the caregivers were grandmothers who were more than fifty years old and widowed.6 Community coping responses take the form of different organizational groupings—informal (or traditional) and formal. In hard-hit areas of Zimbabwe, Zambia, and Tanzania, traditional community initiatives such as savings clubs, burial societies , grain-saving schemes, and labor-sharing programs are playing a major role in helping households cope with the HIV/AIDS pandemic.7 The major activities carried out by these community initiatives include assisting with burial ceremonies , communal farming, provision of food, supporting sick patients, and rebuilding dwellings. Besides providing material support, these informal groups are a major source of psychosocial support. However, as the number of AIDS-related deaths grows, these existing local strategies are under increasing pressure, and policies and programs must be designed that are capable of providing support when existing community mechanisms become inadequate. Formal initiatives have come from community-based organizations and AIDS support organizations that rely, to some extent, on external support from NGOs, governments, or other development institutions. Their mitigation activities vary from country to country, but include agriculture and off-farm incomegenerating activities. In Zimbabwe an NGO called Families, Orphans, and Children under Stress (FOCUS) assists orphans in Mutare. The main activities of its program include the recruitment of volunteers from the community to identify, register , and visit orphans who live within a two-kilometer radius of their homes. Orphans are supported materially with agricultural inputs (such as maize seed and fertilizer), primary 160 / 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. school fees, food, and blankets. Though help from NGOs is reported to be effective,8 the number of NGOs and their coverage is very limited. Therefore only a small portion of the orphan population benefits from their activities.9 Methods In 2001 I conducted a study of 215 households with orphans (eighteen and younger) who had lost their mothers within the last five years, selected from Mutare, an urban site (n = 101), and Marange, a rural site (n = 114). The two sites are in Manicaland Province, Zimbabwe, where 1995 HIV surveillance data indicated a provincial antenatal clinic HIV rate ranging from 14 percent in the rural area of Rusitu to 34 percent in the province’s capital, Mutare. Both sites are within the FOCUS operating area. FOCUS volunteers helped identify households that were fostering maternal orphans. Qualitative methods entailed focus group discussions with members of the communities at each site and key informant interviews. Quantitative methods entailed administering a household questionnaire to the selected sample. The respondent was the foster parent, who in many cases was a relative. Results A total of 700 orphans were being fostered in 215 households. The 101 urban...