A Study into the Political Economy of AIDS Orphans and Vulnerable Children in Swaziland
Year of Submission: 2009
Word Count: 19,478
Advisor: Richard Gibb
A Study into the Political Economy of AIDS Orphans and Vulnerable Children in Swaziland
Victoria Higgs
346092
2009
MA International Relations
Project Advisor: Richard Gibb
The content of this dissertation is entirely the work of the author
Abstract
HIV/AIDS is threatening the stability of many countries. The affects of the pandemic can be paramount on all sectors of society and can leave families torn apart and struggling to survive. The affects of this on children can be enormous, in terms of risk of infection themselves, the trauma of losing loved ones, the poverty and lack of education, guidance and support to know how to survive, all have huge affects on these young people.
The aim of this dissertation is to examine the affects of HIV/AIDS on children in Swaziland. Swaziland has the world’s highest HIV/AIDS prevalence and currently has 120,000 orphans in the country, with this figure set to continue to rise for the next decade at least. It is critical to investigate what is being done for these children and whether the work currently undertaken is enough, while also proposing alternative ideas for the future.
The results have shown that Swaziland faces a huge challenge in how to support and manage the vast numbers of orphans and vulnerable children but that there are many organisations working towards achieving this challenge. The conclusion of this dissertation was that in all sectors of Swazi society: organisations, the government, the community and each individual all need to ensure they are helping in the fight to combat HIV/AIDS. Once Swaziland has overcome the pandemic the country will then have a strong generation who have learned from the past and want to ensure that they do not return to it, this is reliant on people’s behaviour changing which currently is not happening in Swaziland. It is crucial that the awareness campaigns are scaled up, but also done in a way that people will relate to as currently there are many campaigns but behaviour change is limited as people still do not appreciate the real danger of HIV.
The orphans and vulnerable children need adequate love, support and guidance to ensure that they can grow into educated and civilised adults. They are the future of Swaziland and it is important that the work of all organisations working with children is scaled up so that a noticeable difference is apparent. The results were divided into four chapters, all investigating different areas that children are affected and need support. The majority of the results showed a positive future and that people were working on improving the situation but the main problem was the speed at which this was happening.
The research concluded that it would be naive to predict a bright future for these children as much more needs to be done, although with work and all the different organisations working together, results would be more likely to be seen. Time is important here though as everyday the number of orphans and vulnerable children in Swaziland are increasing.
List of Contents
Section One: Introduction
Chapter One - Introduction
Section Two: Literature Review
Chapter Two - The Socio - Political Economy of HIV/AIDS in Sub-Saharan Africa
Chapter Three - The Current Situation for OVC in Swaziland
Section Three: Methodology
Chapter Four - Methodology
Section Four: Results and Discussion
Chapter Five - Encouraging children into Education in Swaziland
Chapter Six - NCP - SWOT Analysis
Chapter Seven - Awareness, Education and Challenges for the Future
Chapter Eight - Provision of Psycho – Social Care and Support to OVC
Section Five: Conclusion
Chapter Nine - Conclusion
Section Six: References and Appendices
Chapter Ten - References
Chapter Eleven - Appendices
List of Figures
Figure 1.1: Map showing Swaziland in the region of Southern Africa
Figure 1.2: Map of Swaziland
Figure 1.3: NPA’s criteria for being defined as a vulnerable child
Figure 2.1: Map showing adult HIV/AIDS prevalence
Figure 3.1: ARVs Cartoon
Figure 3.2: NCP Wishlist
Figure 5.1: Pie Chart – Main Problems Facing OVCs
Figure 5.2: Ministry of Education Main Aims
Figure 5.3: Bar Graph – Is There Any Help to Encourage Children into Education
Figure 6.1: Pie Chart – What is Your Opinion of NCPs?
Figure 6.2: Bar Graph – Food Provided at the NCPs
Figure 6.3: Bar Graph – How Could NCPs be Improved?
Figure 7.1: Bar Graph – Are Children and Young Adults in Swaziland Well Educated on HIV/AIDS?
Figure 7.2: Controlling the Spread of HIV/AIDS
Figure 7.3: Doughnut Diagram – The Future for OVCs
Figure 7.4: Pie Chart – Impact of OVCs
Figure 8.1: Bar Graph – Main Problems Facing OVCs
Figure 8.2: Pie Chart – How Could NCPs be Improved?
List of Plates
Plate 3.1: One Love poster on the side of a bus
Plate 3.2: Sex Can Wait Campaign
Plate 6.1: Children Eating at NCPs
Plate 6.2: NCP Children at their Garden
Plate 6.3: An NCP with limited shelter
Plate 6.4: Children playing at the NCPs
Plate 7.1: Sign in Manzini town centre advertising acceptance of HIV/AIDS
List of Tables
Table 1.1: Aim and Objectives Table
Table 4.1: Objectives Table
Acronyms
AIDS – Acquired Immunodeficiency Syndrome
ANC – African National Congress
ARV – Antiretroviral
FPE – Free primary education
FLAS – Family Life Association of Swaziland
HIV – Human Immunodeficiency Virus
MDG – Millennium Development Goal
MOEd – Ministry of Education
NCP – Neighbourhood Care Point
NERCHA – National Emergency Response Council on HIV/AIDS
NPA – National Plan of Action for OVC
OVC – Orphans and Vulnerable Children
UNICEF – United Nations Children's Fund
WFP – World Food Programme
Acknowledgements
I would like to thank Richard Gibb for his advice, guidance and support throughout this dissertation. This has been greatly appreciated.
In order for this research to have taken place the finances were needed to visit Swaziland, I am very grateful to the Gilbert Murray Trust and The Devon Educational Trust for their kind financial assistance in order to make this trip possible.
This project would also not have been possible without the support provided by ALLOUT, who not only provided me with somewhere to stay while in Swaziland, but worked so hard to help with my research wherever possible, providing directions, translations and general advice and support.
The NCPs, NGOs and Clinics were all so welcoming and happy to talk to me, this made the research enjoyable and informative and this dissertation would not be here without this help from you all.
I would also like to thank all my family and friends who have provided such valuable support, advice and encouragement throughout the duration of this project.
Thank you!
Chapter One
Introduction
This dissertation will investigate the effects of HIV/AIDS on the country of Swaziland, specifically considering how the pandemic affects children in Swaziland. Swaziland is a small landlocked state in southern Africa, bordered by South Africa and Mozambique; Figure 1.1 shows a map of Swaziland in the region of Southern Africa. Swaziland has a population of 1.1 million and the country is only 17,364 sq km (6,704 sq miles) (BBC 2009). Figure 1.2 shows a map of Swaziland, highlighting the urban and rural areas of the country. Swaziland is one of the last remaining absolute monarchies in Africa.
HIV/AIDS is increasingly becoming a threat to many countries, but it is sub – Saharan Africa (SSA) in which the pandemic is at its highest and the effects of HIV/AIDS are creating huge strains on all areas of society. The situation in Swaziland follows this pattern and with 42.3% of adults being infected, Swaziland has the highest prevalence rate of HIV/AIDS in the world. It is for this reason that this dissertation will focus on the effects of HIV/AIDS on this tiny country. A lot of research has been done into the HIV/AIDS pandemic, looking at a variety of issues. HIV/AIDS in Swaziland affects almost everyone in some way, whether directly or indirectly, but for some of the most vulnerable children in Swaziland some of these affects are appalling. This dissertation will focus on how the pandemic in Swaziland affects these children, looking at the political economy impacts. There are currently 120,000 orphans in Swaziland with numbers increasing daily. The NPA (2006) predicts that the total number of OVC by 2010 will be 198,000, which equates to nearly 20% of the total population, this addresses the importance of this dissertation in identifying potential solutions to ensure that these children get the love, support and guidance that is needed to ensure that they can get through the trauma and have a possibility of a decent life in the future.
The definition used for an orphan in this dissertation follows the definition from the National Plan of Action for Orphans and Vulnerable Children (NPA), which is “a child (less than 18 years) who has lost one or both parents”. A vulnerable child is a child under the age of 18 years who lacks access to any of the basic needs, highlighted in Figure 1.3.
This research will investigate HIV/AIDS in the region of SSA to set the scene of the pandemic, followed by an investigation into the current situation in Swaziland. The findings of this research will then be addressed looking into education plans and proposals, the work of Neighbourhood Care Points (NCPs), an analysis of the social support available for orphans and vulnerable children (OVC) and an investigation of what the future holds for the OVC in Swaziland and what the impact of that number of OVC in Swaziland is and the affect it will have on the country. This research was undertaken following the Aim and Objectives highlighted in Table 1.1.
Aim: “to examine the political economy of AIDS orphans and vulnerable children in Swaziland”
Objectives:
- To understand the current situation of orphans and vulnerable children in Swaziland
- To see what is in place to help orphans and vulnerable children receive an education
- To outline what emotional support and guidance is in place for orphans and vulnerable children
- To assess what the future holds for orphans and vulnerable children and to propose potential a solution
Chapter Two
The Socio - Political Economy of HIV/AIDS in Sub-Saharan Africa
Introduction:
Sub-Saharan Africa (SSA) is the region most affected by the HIV/AIDS pandemic (see Figure 2.1). “AIDS is the leading cause of death in sub-Saharan Africa and the fourth leading cause of death worldwide” (Stover et al 2002), SSA is also home to “24 out of 25 countries with the world’s highest levels of HIV prevalence” (UNICEF 2004). Barnett and Whiteside (2002) describe how in 2001, there were approximately 36 million people infected with HIV/AIDS – if all of these people’s condition affected four other individuals it would mean that “a total of more than 150 million people are being affected by HIV/AIDS” worldwide. Many of these people will be children, the pandemic is affecting them in a number of ways, for example: “In 2003, 12.3 percent of all children in SSA were orphans” (UNICEF 2004) but there are other children who are also very vulnerable as they have parents who are ill or dying, putting their family under enormous pressure.
It is clear that “Africa bears the burden of the epidemic” as nearly three quarters of the people living with HIV/AIDS in 1999 were in SSA, as well as “the 13.7 million Africans claimed by the epidemic” (Barnett and Whiteside 2002). UNAIDS (2009) most recent statistics are that an estimated 22 million people in Africa were living with HIV/AIDS in 2007.
HIV prevalence in Africa varies across the continent; “there is a great geographical variance across Africa regarding levels of HIV prevalence” (Poku and Whiteside 2004), this can be seen in Figure 2.1. The reasons for this unequal distribution are unknown; however it is clear that southern Africa has a much higher prevalence than west or east Africa. This dissertation aims to investigate the impacts of HIV/AIDS on OVC; this will be addressed throughout this chapter, while looking at the political, economic and social influences of HIV/AIDS.
Economic factors:
HIV/AIDS presents huge threats to African economic development, for example the loss of labour is apparent, particularly in agriculture and the mining industry. Waal (2003) states how there are increased staff absences “due to illness, attending funerals and caring for the sick.” HIV/AIDS is more common in people aged 25-30, this is just as they are trained up in their job, at the peak of their careers, meaning the most productive members of society are in some cases lost. Many companies, including the mining sector have started providing free antiretroviral drugs (ARVs) as “it is more efficient to treat infected employees than to train replacements” (Waal 2003). Potter et al (2004) define African people’s labour as their only resource and so for many in Africa when they cannot use their labour, they cannot earn a living. This can put a large strain on families and mean that finances are lost that would have funded school fees, uniform and equipment. Not only then is a wage lost meaning that many children need to find employment, so they are often missing school but there are also the costs that are incurred for treating a sick family member or paying for funerals, which traditionally are very elaborate, although funerals are becoming less extravagant in SSA due to so many deaths.
People are dying younger meaning that they never reach the highest levels of their career which also means that older people with often older views stay on in job roles, rather than having new fresh ideas brought in. The lack of farmers leads to a risk of food insecurity, farmers are dying or are too ill to farm, yet “in low-technology agricultural systems the most important input is human labour” (Potter et al 2004) and without this no food can be produced. It is important to educate young people into the dangers of HIV/AIDS so that a new generation of healthy individuals can replace the generation that have been lost. If adequate education and awareness is not provided to the young people in SSA then this situation threatens to continue.
Political factors:
The role of governments has played a crucial role in the management of the HIV/AIDS epidemic. Many governments have been criticised for not taking the pandemic seriously, “there has been a full measure of denial” (Barnett and Whiteside 2002). For example, the ANC (African National Congress) have been accused of delaying lifesaving ARVs access into South Africa and trying to refuse that unprotected sex and AIDS are linked. It is now clear that “slowly and belatedly we are awakening to the full implications of the HIV/AIDS pandemic in Africa” (Waal 2003). Yet there are arguments by many that African governments are not capable of managing the pandemic (Waal 2003, Chazan et al 1999) and that the pandemic is another problem in a long line of problems facing the “cash-starved African governments” (Potter et al 2004). Stover et al (2002) state how it is crucial that governments and societies admit to the true scale of the pandemic and start acting upon it. Not only have government’s reactions been delayed but their understanding of the disease has been non existent. Health Ministers in South Africa have advertised “garlic, African potatoes and olive oil as alternatives to ARVs” (University of Pretoria 2004) whereas other reports suggest that eating beetroot can cure you. The Guardian (2008) spoke to a South African man who believed that by mixing a herb for TB, another for diarrhoea and one for headaches would cure AIDS. This does not set a good example for young people who will not understand the true threat posed by contracting HIV. This could be because of the use of ARVs, as people cannot see people getting sick, meaning that people do not see the negative effects of HIV/AIDS and so they are less concerned about contracting the disease, as they can just take ARVs.
This naivety towards the epidemic by governments means that citizens of sub-Saharan African countries are often misled, as a lot of trust is put on governments. This lack of acceptance of the scale of the pandemic has meant that action has been slow and education into the pandemic has been minimal. Governments now have the chance to educate the new generation of children and young adults into the dangers of HIV/AIDS and to provide these people with the knowledge of how not to contract the disease and the consequences it could have if they were to contract it. Myths need to be dispelled and health education needs to be put into school curriculums as well as passed around to those children who are not in regular attendance at school.
It is not only African governments that have a responsibility to combat HIV/AIDS, it has increasingly gained a lot of international response “International and domestic funding for AIDS has grown from 'millions' to 'billions' in the last decade” (UNAIDS 2009) and many initiatives have been introduced to try and halt the spread of HIV/AIDS. AIDS is the “only disease to have a dedicated United Nations organisation – UNAIDS” (Barnett and Whiteside 2002). It has become clear that “overcoming the pandemic is a precondition for achieving goals such as poverty reduction” (Waal 2003) and the Millennium Development Goals (MDGs). Many governments have agreed to work towards achieving the MDGs and so have a commitment to fighting against HIV/AIDS. This will have an increased effect on OVC as the MDGs do not only aim to combat HIV/AIDS as in goal 6, but goal 2: to achieve universal primary education, goal 4: to reduce child mortality and also goal 5: to improve maternal health, will all have an effect on the future of OVC in Swaziland (UN 2009).
It is clear that more needs to be done, even though international attention appears to have increased, relatively new initiatives such as NEPAD (New Partnership for Africa’s Development) which many believe could be Africa’s best answer to development, are failing to adequately address HIV/AIDS. HIV/AIDS is mentioned only four times in NEPAD, which for a pandemic that is threatening almost every aspect of African life, is clearly not enough, much more attention to HIV/AIDS is needed if any development proposal is going to be successful.
Many of the effects of AIDS have reversed the development work, that has taken place since independence in Africa, meaning that AIDS needs to be drastically addressed, “there is no area of development policy which can omit to take HIV/AIDS into account” (Desai and Potter 2002). It is clear that AIDS plays a detrimental role in the development of countries and that more attention needs to be paid to this as currently many countries are going backwards in development, “It would be no exaggeration to say that development will falter and could be reversed” (Poku and Whiteside 2004). This for the countries of SSA, within which many citizens are facing dire poverty, would be devastating and would create an even bleaker future for the many OVC.
Social factors:
It is important to outline that it is not only political and economic factors that influence the lives of OVC in SSA, social factors play an important role in the lives of these children, as shown by Chazan et al (1999), “as people with AIDS turn to their families and communities for care, the social and economic fabric of many countries has been acutely strained, especially in rural areas.” The economic costs of having a sick family member have already been addressed, but the social costs to a child with either a sick parent or a deceased parent are paramount. This could be in a variety of ways, such as the strain of having a sick relative in the house, often families have one main room and so the rest of the family have to respect the needs of the one sick relative, while in a small space. Barnett and Whiteside (2002) address how the emotions of a child cannot be quantified, for example “what is the cost of a cuddle foregone?”
Family and community ties in Africa are very strong and so the effect of increased numbers of orphans in Africa has not been as bad as many had expected due to extended families or the community taking them in, UNICEF (2004) state that “extended families have assumed responsibility for more than 90 percent of orphaned children” but due to the scale of the pandemic and the amount of OVCs, this is becoming more difficult. Many houses now have elderly relatives looking after lots of children as so many of the family have died. Although the child is physically looked after, often they do not have the mental and emotional support that they need and there are cases where these children are abused and not allowed the basic human rights that all children should be granted.
There are now a reported 120,000 orphans and vulnerable children in SSA, this is stretching the communities further than ever before and many cannot cope. This threatens the culture of many African countries as many OVC are looked after by Non Governmental Organisations (NGOs) and so rather than have African knowledge and culture passed down by elderly relatives they are gaining western mindsets imparted by western NGOs.
The stigma that is attached to AIDS can deter people from gaining medical treatment. “HIV/AIDS is predominantly a sexually transmitted disease” (Barnett and Whiteside 2002) and so often people are embarrassed to talk about it, never mind to actually admit that they are infected. The Guardian (2008) found that people associated test centres with “shame and fear” and that people were put off going as you could tell who received good news and who did not. It is crucial that stigma is “reduced to remove barriers to accessing services” (Stover et al 2002) as currently many more people could be treated if they would get tested. The Guardian (2008) describes how support groups are held outside as “an emblem of their most urgent aspiration: to take the virus and those it afflicts from their secret places of shame”. This is increasingly apparent with children whose parents do not want to admit that their child is ill and so do not get the child tested, meaning that eventually the child dies an unnecessarily premature death. This shows how not only do OVCs face an uncertain future in terms of their parents and education, but they are also at risk of contracting HIV/AIDS themselves and many studies have highlighted how OVC are more at risk due to the lack of support and structure in their lives.
How the factors interlink:
It would not be possible to undertake this study without investigating all the factors investigated here, but although in a variety of ways the factors appear very separate, they are very much interlinked. For example, when studying education it is apparent that political factors play a key role by ensuring that all children should have access to education, economics plays a key role as if governments cannot afford to implement policies on education then there is a problem, or in the case of many African countries if parents cannot afford to send their children to school. Social factors also play a key role as some children have to stay home to care for sick parents or younger siblings or go out and work to subsidise a lost income. It is clear that to create a full picture of the problems facing OVC, many factors have to be investigated.
Conclusions:
It is clear from this chapter that there are many factors that will affect the lives of OVC in SSA; this is stated by Barnett and Whiteside (2002) “the epidemic of HIV/AIDS would affect not only the health of individuals but also the welfare and well being of households, communities and in the end, entire societies.” HIV/AIDS cannot be seen as just a health problem, there are many other ways that it affects people and one the most vulnerable groups in any society, is children.
Children are not only losing parents to the disease, but are also growing up in a society that is struggling due to the impacts of HIV/AIDS, as well as being at risk of catching HIV/AIDS themselves. Adequate education, support and guidance are needed for these children to ensure that they know how to minimise their risk of infection and do not suffer from a lack of education or support due to the disease. This support should be granted in a number of ways, not only from the community, but also from the government.
The next chapter will focus on the country of Swaziland which is one of the worst hit countries for HIV/AIDS in the world, there is currently a prevalence rate of 42.6% of adult Swazis being infected (Robinson 2005). This creates a huge number of OVC that need caring for and educating, currently Swaziland has 120,000 orphans, but this number is rising rapidly. Some key issues will be highlighted about the pandemic in Swaziland, such as awareness and knowledge of the virus, including investigating some awareness raising campaigns. Some initiatives will be studied to gain an idea of what is currently in place to support OVC; these initiatives are the work of the Indlunkhulu Fields, the Lutsango Mothers and Neighbourhood Care Points (NCPs). Education is also investigated as this is seen as empowering children and giving them the vital skills and knowledge they need for life.
Chapter Three
The Current Situation for Orphans and Vulnerable Children in Swaziland
Introduction:
It is clear from the previous chapter that “HIV/AIDS is recognised worldwide as a threat to children and their families” (UNICEF 2004) and that this is specifically a problem in SSA. This chapter will address the situation in Swaziland, a country which has “the world’s highest rate of HIV infection”, with “an astonishing 42.6% of adult Swazis (being) HIV positive” (Robinson 2005). Since the first case of HIV was diagnosed in Swaziland in 1986, the disease “has spread at an alarming rate” (Progress Report 2008) and was declared a national disaster in 1999 by King Mswati III (Whiteside et al 2003). A lot of research has addressed the problems that the pandemic causes for children and this is especially apparent in Swaziland, due to 23.3% of children being orphans (Progress Report 2008).
UNICEF (2004), state that the number of children orphaned by AIDS in Swaziland will continue to rise for at least the next decade. Phaladze et al (2005) investigated the quality of life of people living with HIV and AIDS and describe it as “a complex constellation of disease, poverty, stigma, discrimination and lack of treatment” which is the quality of life that many children now face in Swaziland, a life that has been described by the NPA (2006) as “conditions typical of disaster situations.”
The NPA (2006) estimates that there are over 130,000 OVC which includes over 70,000 orphans and 60,000 vulnerable children who, although their parents are still alive they are too unwell to support their children without intervention from the community and/or government. The number of orphans is now estimated by 2010 to reach 130,000 orphans alone, not including the many vulnerable children in the country (UNICEF 2004).
The NPA (2006) describes how the full impact of the pandemic “is being experienced by every sector of our society” so the effects of the pandemic on children is paramount - medically through possible infection themselves, socially through the stigma of having a parent with or who has died of AIDS, psychologically through the trauma of having lost parents and economically through having no support from parents for school fees, uniform, food and medical expenses. This situation is even worse for the 15,000 child headed households in the country, who often have no responsible adult ensuring their wellbeing.
The focus of this dissertation is to understand the current situation for OVC in Swaziland and to assess what the future holds for these children. This chapter will investigate what is being done for these children and study the initiatives in place to try and minimise the impacts of the high number of OVC as well as creating a brighter future for the children of Swaziland.
Awareness and knowledge of the virus:
The Swaziland Central Statistical Office (2007) found that the proportion of people who had heard of AIDS was high, exceeding 96 percent, although it was clear that actual knowledge of the virus was lower. For example, many people believed it was possible to catch HIV from a mosquito bite. The majority of people are aware of the main ways in which the disease is spread and how to protect themselves, but many are confused about certain aspects of the disease (Whiteside et al 2003).
Education into the disease is crucial and especially for the younger generations, Buseh et al (2002) believe that “prevention must be the focus of our efforts” as there is no cure for the disease. Swaziland has many prevention efforts under way, for example NERCHA’s “One Love” campaign (see Plate 3.1) promoting the advantages of having just one sexual partner and the “Sex Can Wait” campaign promoting abstinence until young people have gained their education (see Plate 3.2). This shows that young people are growing up in a country surrounded by information on HIV/AIDS. In order to ensure that it reaches a diversity of people, Whiteside et al (2003) suggest that the material should be available in SiSwati. Campaigns such as these and the efforts of organisations such as the Family Life Association of Swaziland who are a “major source of information on this fatal disease” (Buseh et al 2002) mainly through the medium of doing discussion groups in schools, are challenging in “a country where sexuality is not openly discussed” (Mkhabela et al 2008) and talking about these issues can often “prompt controversy” (Buseh et al 2002). This needs to change though if the pandemic is ever to be controlled, it should not only be that schools are able to provide this information, but it should also come from parents who in Swaziland are often shy about talking to their children about these issues.
A problem that seems to remain apparent is that even with the introduction of voluntary counselling and testing which encourages people to know whether they are infected or not and to act accordingly (see Mkhabela et al 2008), this is not being used to its full advantage as people are too scared to get tested due to the stigma that is attached to being HIV positive. Robinson (2005) describes how “prejudice and stigma remain powerful barriers in Africa’s fight against AIDS”.
Another barrier to fighting the pandemic is the lack of behaviour change exhibited by much of the population, for example “in spite of the good supply in Swaziland, the use of condoms remains controversial and unpopular” (Avert 2009). Possible reasons for the lack of behaviour change, is that with the introduction of ARVs many people who are diagnosed with HIV then appear healthy and fit and appear free to enjoy a normal life. For example, a publication by the Institute for Health Development Communication “ARVs and your life” contains a cartoon about how ARVs work showing the individual as healthy after the introduction of ARVs (see Figure 3.1) - this could make HIV seem less severe. It is hard to get the balance right, as it is crucial to advertise that AIDS does not mean a death sentence, but how can this be done without advertising ARVs in this way?!
It is a hard task to find a way that teaches about prevention in a manner that people will listen to and abide by, but this is crucial in preventing the spread of HIV and creating another new generation of orphans in the future.
Initiatives in Place to support Orphans:
The government of Swaziland have recognised the “urgent need to find a rapid, cost effective and sustainable way of providing OVC’s with access to food as well as adequate care and support services” (NERCHA 2004), the pandemic rates very high in the government’s priorities. The first legislated OVC policy was released in 2006 and calls “for the protection of inheritance rights; medical care; nutritional support; and the endorsement of community based care” (Rosenberg et al 2008). The NPA (2006) “represents practical steps to ensure that the rights of OVC are met in the country” showing that the government have a commitment to fighting for a better future for the many OVC in the country.
It is crucial now that even though “the country has made some great progress in a number of areas” (Progress Report 2008) that the government uses the work of the many NGOs in the country to help in their quest for a brighter future; a multi pronged approach including all sectors of society working together has been called for in the NPA (2006), which should also include the work and involvement of children in finding the way forward.
There are many ways that the government has provided help to OVC in Swaziland and some of these are now outlined.
Indlunkhulu Fields:
Traditionally in Swazi culture there were never any orphans as when a child’s parent’s died, the children were taken in by an aunt, uncle, grandparent or someone in the extended family. Due to the scale of the pandemic the extended families cannot cope with the pressure as there are so many orphaned children (UNICEF 2007). The community and government are now required to step in - a child is never orphaned, they become “bantfwana bendlunkhulu (children of the community)” (NPA 2006). They then become the responsibility of the Chiefs who are responsible for the poor people in their communities and “’Indlunkhulu’ is a SiSwati term that refers to the provision of food from the Chief’s fields for members of the community that are unable to support themselves” (NERCHA 2004).
All children who need assistance are helped; although they have to “assist in tilling the Indlunkhulu fields to enable them to obtain practical experience in subsistence farming” (NERCHA 2004) and this will also stop the worry that the children will become dependent on people giving them food. The Indlunkhulu fields are a sustainable option for OVCs to access food. This then allows children to attend school in the mornings and learn subsistence farming skills at the fields in the afternoon as well as providing them with food meaning that there is not so much pressure to leave school and gain employment.
Lutsango Mothers:
The Progress Report (2008) has described the impact of HIV/AIDS on the physical and emotional wellbeing of children as “extreme” often it is forgotten that these children have had such traumatic experiences and are now in situations that they are unable to cope with. This situation makes them highly at risk of being taken advantage of and leaves them open to abuse. The community initiative of the Lutsango Mothers, which involves “assigning local women to care for OVCs will enable them to stay on their parental land” (NERCHA 2004), and also provides the emotional support and a watchful eye for the children.
Phaladze et al (2005) discuss how the magnitude of the pandemic means that often “the plight of individuals – particularly their quality of life – might be overlooked” if the needs of the actual sufferer are likely to be overlooked, what is the likelihood that their children will receive adequate care, love and attention. The NPA (2006) highlights the importance of love to a child, in order for them to grow into decent human beings, “what all children need is love, without love, children have minimal hope for the future, which no provision of basic services can replace”. The work of the Lutsango Mothers provides these children with someone to go to with their worries and someone to watch over them to ensure their safety and development.
Neighbourhood Care Points (NCP):
NCPs are centres set up for OVC, they are described as “an innovative project that provides food, psycho-social care and other support” to OVC (Dlamini 2007). The number of NCPs is rapidly rising and there are hopes that all neighbourhoods will benefit from them in the future, “as of December 2005 at least 33,000 vulnerable children (were) benefitting through 435 community run NCPs” (NPA 2006), but this number has risen to more than 625 NCPs which serve “more than 40,000 children” (Progress Report 2008).
The NCPs have many functions, as can be seen in Figure 3.2 and they are divided into those NCPs that are excellent, very good, good, functioning, poorly functioning and non-functioning from a point scoring system for which the maximum points is ten (UNICEF 2006). There are other functions that are not so clearly highlighted but that are vital for the OVC, for example, they highlight the “children who fall outside the formal education system” and are a way of “directing children into formal school education” as well as providing “a safe environment for older siblings to leave younger brothers and sisters so that they may attend school” (Progress Report 2008).
NCPs are run by volunteer caregivers who are chosen by the Chief, they provide at least one hot meal for the children at least five days of the week; the food is provided by the World Food Programme (WFP) and is cooked by the volunteer caregivers. Some of the NCPs also have gardens which provide a wider variety of food for the children at the same time as teaching them new life skills.
NCPs are one of the main focus points of this dissertation due to the support they offer to children and the informal education that they provide. This dissertation will question whether the idea of NCPs works, how they can be improved and what other alternatives may be available in the future.
Education:
With such huge numbers of OVC and with numbers expected to rise, the chances of keeping children in school are slim. Many will remain home to look after sick relatives, some may get jobs to keep an income for the households and others may simply not be able to afford the fees. For this reason the Ministry of Education (MOEd) have been working hard to come up with a solution, for example in 2005 they “provided support for all school aged children affected by HIV/AIDS in the NCP’s to attend school” (Garcia et al 2008). Hall (2004) states how the “government says it will start paying the tuition fees of all AIDS orphans, many of whom would not be able to attend school otherwise” this could then create tensions for poverty stricken families as AIDS orphans get more help even though poor families struggle with school fees just as much. This initiative in 2005 agreed to pay half of the fees for OVC and their families were expected to find the other half as well as pay for the school uniform. Many children do not have family to put up the other half of the fees and so were still unable to attend school. The MOEd, are now bringing in a policy due to start next year (2010) where all children can attend grades one and two for free, with the hope of extending this to being all primary education as aimed for in the MDGs, where Goal 2 is to “ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling” (UN 2009) This addresses the problem of other poor children who are not orphans coming off worse and so all children should attend grade one and two for free next year.
Hall (2004) questioned how with such high levels of unemployment and people being absent due to illness leaves very few tax payers in the country and so questions where the money for this comes from. The government faces a challenge as they have minimal funds and need to focus on all aspects of society not just HIV/AIDS. The importance of education has clearly been recognised as it is this new generation that needs to halt the spread of the pandemic and get Swaziland back on the right tracks for development.
Conclusion:
There is clearly much help out there for the OVC in Swaziland and only some have been mentioned here but with all the initiatives in place, as well as the work done into the prevention of mother to child transmission, meaning that more children are born without being infected (Robinson 2005), means that the future appears brighter for OVC in Swaziland. In the words of the NPA (2006) “There is no doubt that HIV and AIDS have brought suffering to many children in Swaziland” but it is now time to start working towards minimising the spread of the pandemic and in turn the effects of the pandemic on not only the children of Swaziland but the whole population. There is clearly some way to go but at least the government and NGOs are working towards finding a happier, safer and brighter future for these children.
The next chapter outlines the research methods that were used for this dissertation. The different research methods are discussed and the reasons for using them are highlighted. Problems with the data collection are outlined and the methods are critiqued to allow for development in the future if the research was to be repeated.
Chapter Four
Methodology
Introduction
The aim of this dissertation is to examine the political economy of AIDS OVCs in Swaziland; four objectives were identified from the research and investigated to find out what the current situation was and what could be done in the future to create a better future for these OVCs (see Table 4.1). In order to understand the many different opinions it was vital to conduct a large and varied sample of research methods and to understand how different situations may have affected people’s opinions.
Ethics
When conducting research it is important to ensure that the participants will not be negatively affected in any way. This is especially apparent when conducting research into such a sensitive topic; HIV/AIDS has affected almost everybody in Swaziland in some way and so it is possible that people may not wish to talk about the pandemic. The interview questions were written in a way that was not asking about personal experience and participants were free to stop the interview at any time if they became uncomfortable. The researcher applied to the ethics committee prior to conducting the research to ensure that the data collection methods passed ethical approval from the University.
Data Collection Methods
A variety of research methods were used, including semi structured interviews, basic observations and an analysis of the Swazi Times newspaper.
Semi – Structured Interviews:
A semi structured interview approach was chosen because Barbour (2008) discusses how they have “become almost the ‘gold standard’ approach” and are widely used within social science research; this could be due to the wide exchange of knowledge that can be achieved. It is crucial for the researcher not only to ask the relevant questions but to also listen to the replies! (Barbour 2008).
Berg (2009) describes how in a semi-standardized (or semi structured) interview, “the interviewers are allowed freedom to digress” this is beneficial as something may come up in an answer that is of use to the researcher and elaboration would be useful for the research. Some questions were planned in this research (see Appendices 1-4) and the interviews were guided by the researcher, although when other information came up the conversation was allowed to drift, while still staying relevant to the aim of the research.
Observations:
Observations of the country and the way of life were conducted while in Swaziland. It was possible for the researcher to write down key bits of information that were observed while travelling in the country or visiting any of the participants. The researcher did not conduct a formal field diary although always carried a notebook and so could note down anything relevant during the research. Observations allow the researcher to observe the way of life in a natural setting and so gain a true understanding of the situation. Although, it must not be forgotten that observations can pose serious questions, for example as a lone researcher there is only one perception and as a western individual for example the education received at the NCP may not appear adequate. It is crucial that the researcher maintains an open mind and does not compare what is being observed as different to a western way of life, but sees how it is benefiting Swazi people and how if it was not there, to understand what the situation would be instead.
Observations and interpretations can easily be affected by the researcher’s opinions and experiences, it is hard to avoid this, but it is important to approach the situation with an open mind and to maintain an unbiased viewpoint of the situation. The situation of HIV/AIDS is clearly a sensitive issue and so this is even more paramount, for example if a participant was to talk about traditional medicine being able to cure AIDS, trying to not impose a western viewpoint onto the participant could be hard.
Analysis of newspapers and Academic Literature:
Analysing newspapers allows the researcher to see what the current arguments are around certain topics, as well as allowing the researcher to work out how often the issue of HIV/AIDS is discussed in the newspaper. Newspapers are a valuable resource although must be read with care as they may not always be factually reliable. Academic literature allows the researcher to see what research has been conducted previously and aim to fill gaps in the research and compare findings.
Sample
Interviews were conducted with eleven NCPs; the schedule included asking about the daily running of the NCPs, for example “do you provide food to the children?” Questions about the problems that OVC face were also asked, for example “what do you think the future holds for OVC in Swaziland?” (See Appendix One for all the interview questions). The literature review highlighted areas that needed to be addressed and so the questions asked in the interviews were structured around the findings of the literature review in order to fill current gaps in the research into OVC in Swaziland. The first three interviews worked as pilots, it was important to see whether the interviews were going to be successful or whether questions needed changing. After these first interviews some of the questions were dropped or reworded due to confusion from participants.
When arranging interviews it would usually be important to get interviews at a time to suit the participant and to arrange this in advance as this gives the participant time to prepare as well as setting aside time to be interviewed. Although, due to the nature of the NCPs set up and the lack of contact details available, the best way to arrange an interview was to visit the NCP, it was then possible to interview the participant or to return at a later pre-arranged time if this was more appropriate. All the NCPs were happy to answer the questions on arrival at the NCP and were welcoming and helpful. It is hard to imagine that there are over 600 NCPs in Swaziland because finding them is very difficult, originally more NCPs were going to be interviewed but the researcher then focused on interviewing more of the many NGOs that are easily found in Swaziland and cut back the sample of NCPs from fifteen to eleven.
Twelve NGOs were interviewed to investigate the work that they undertake into helping OVCs and to assess what the future holds for OVC (Appendix Two). The pilot interviews worked the same as for the NCPs; it was possible to see what questions needed changing from the first three interviews. It was again possible to turn up and either speak to someone then or arrange a time to return, the majority of NGOs had someone available to interview on the first visit. A variety of NGOs were visited, including NGOs focussed on care, treatment, sponsoring of OVC and others focusing on a whole variety of issues that affect the lives of the many OVC in Swaziland. The NGOs were easy to find as most are situated near the centre of Mbabane or are well sign posted from main roads.
Five clinics were also interviewed to gain a professional view of what the situation is like for OVC in Swaziland, (Appendix Three). The clinics were usually able to speak without an appointment; although some clinics did not want to be interviewed without permission from someone in authority, but there was a wide enough sample of clinics that were happy to answer the questions, that this was not a problem. Clinics were also a valuable place to see some of the campaigns that raise awareness of HIV/AIDS and some literature was gathered.
After all the interviews had been conducted an interview was arranged with a representative from the Ministry of Education (MOEd). The telephone number was gained from an NGO and so arranging a meeting was not a problem. The MOEd is situated in the centre of Mbabane and so a visit there was possible. A variety of questions were asked which can be seen in Appendix Four.
These interviews were designed to give an insight into the work that is being conducted for OVC in Swaziland. It was then possible to investigate whether what is happening is enough or whether more needs to be done. These participants were chosen as they are all aiming for the same thing, a stronger future for OVC, but they are each very separate organisations. It will then be possible to see what support is in place, the different attitudes to this support and whether the attitudes correspond between the many players involved with OVC in Swaziland.
Observations were conducted in Swaziland; the researcher carried a notebook and recorded important facts or information that became apparent during the research. For example, it was possible while at the NCPs to conduct observations, this allowed a greater idea of what happens within different NCPs, the standard of the building, whether the children were enjoying themselves and receiving food while in a safe environment. It was also possible to see the variety of awareness raising campaigns and to notice the availability of information on HIV/AIDS.
While in Swaziland the ‘Swazi Times’ was read regularly, this gave an insight into how often the issue of HIV/AIDS is discussed and could give an indication into people’s awareness of the disease. A content analysis was conducted and shows on average how many times the HIV/AIDS pandemic was mentioned in each issue of the ‘Swazi Times’. The researcher was not looking at solely awareness raising campaigns but also at general articles discussing anything related to the pandemic.
It was important for this research to look at other past research, partly for ideas of how to collect the data, but also for an understanding of the AIDS pandemic, the country of Swaziland and of the past and current situation. Academic research can then be compared to this research to compare the results and recommendations. Having looked at the past research it was possible to detect where there were previously gaps in the data and to focus on those areas. For example even though NCPs are widely in use around Swaziland, there is limited literature on the true value of them; the same is true for education in Swaziland. This dissertation fills the gap of a general overview of what is currently being done and what the future needs to focus on in order to help the many OVCs in Swaziland.
Critique of Methodology
Many questions are raised about conducting overseas research, for example there are some positives such as being immersed in the country and the way of life, hence gaining a better understanding of the country. Although, it is important to ensure that the research is not affected because it is conducted by an outsider to the country. The ideal situation would be to have two researchers working together on a joint project, one being a citizen of the country being researched, the other being an outsider. That way the idea that bias, patriotism or an acceptance of the culture could affect research is balanced out by the idea that the other researcher may look on the situation and not have a true understanding; see it as wrong or unethical as it may be elsewhere in the world.
Although, when undertaking research into another country, it is vital to visit that country rather than research it from home, how can a true understanding of the country of Swaziland have been gained from an office in a western country? It is important to remember though, that however well disguised, the researcher is, they are “always the elephant in the room” (Pearson 1993) which raises the question of whether observations can reach the stated aim as are the settings being observed really naturally occurring? For example the attitude of the NCP staff towards the children may be very different when the researcher is not there, than when the researcher is present. By not pre-booking an interview, on arrival the researcher was able to observe the setting as naturally occurring even if just for a short while. The researcher also had the added advantage of having volunteered at an NCP previously and so understood the general set up and running of an NCP.
Focus groups although could provide important and interesting data were avoided in this study; this was due to the sensitivity of the study and the time that would have been taken up advertising the focus groups. Barbour (2008) discusses how “the logistics involved in bringing individuals together in a set place and at a specific time should not be underestimated” and to try and conduct this in a country that the researcher is not that familiar with would have been hard. Johnston et al (2000) describe how focus groups are a way for “participants to share and test their ideas within the group” and Barbour (2008) states how often this can “give rise to a lively debate.” The researcher felt that although some valuable information could be gained from focus groups, the limited time available in Swaziland and the sensitivity of the issue meant that it was better to focus on the other research methods.
The issue of HIV/AIDS is a sensitive subject and so needs to be approached sensitively and answers must not be forced from participants who may have had bad experiences associated with the pandemic. The questions that were asked were tame and were written that way in the hope that people did not feel uncomfortable answering them.
Achievement of the Objectives
Objective One was achieved through the interviews conducted with the professionals who work with OVC and the caregivers at the NCPs to gain an understanding of the current situation for the OVC. It is also possible from just being present in the country and visiting the NCPs, NGOs and reading the papers to understand a small part of what life is like for an OVC in Swaziland.
In order to achieve Objective Two participants were asked the following questions ‘Is there any help to encourage orphans into education in Swaziland? What plans have you heard of?’ This gave an insight not only into what help there was for the OVC but also how aware people were of this help and what they thought about any proposals. The interview conducted with a representative from the MOEd was held on the last day of the research so that questions could be written that highlighted and hopefully answered any uncertainties the participants or the researcher had picked up on during the course of the research.
Objective Three was achieved by visiting many NGOs while conducting the research, many were offering emotional support to orphans and so it was possible to see what was in place to support them. Many NGOs and NCPs could also stress the importance of emotional support and guidance for OVC and how not having parents affects you more than just financially.
To achieve Objective Four many ideas were gathered and collated from the different interviews, with the researcher’s own views and by combining the results it will be possible to propose what the future holds for these children, the research will assess what works well and what does not, as well as whether the initiatives are currently sustainable. It will then be possible to state what will work well in the future and to try and propose a way forward to help these OVC.
Analysing the data
The interview results were coded and then put into a spreadsheet, it was then possible to highlight what the key areas of importance were to be able to address these in the research. Many quotes, arguments and ideas were taken from the participants and focused on within this dissertation.
Observations were recorded and then written into the report where appropriate. A percentage was worked out of how many times HIV/AIDS was mentioned in the Swazi Times, while also highlighting what a valuable resource the Swazi Times could be if used to its full advantage.
The analysis undertaken on this research structured the results chapters based on the key findings of this research.
Chapter Five
Results and Discussion:
Encouraging Children into Education
Introduction:
It is currently a good time to research this topic as there are many plans and proposals in place by the government that aim to improve education for all children in Swaziland, these are not just specifically for OVC but the effect that they will have on OVC’s access to education means they are relevant for this research. This chapter will investigate the importance of education for young people and look into how the new proposals offer hope to many children, while also discussing the controversy about the time it is taking to put these policies into action.
Importance of Education:
The research undertaken highlighted that public perception of the importance of education is very high. NGO 3 stated that when children are educated, they are empowered “so that they can be better people in the future” and NGO 6 echoes this by saying that “it’s the education that is going to give them a future”. Education gives children the knowledge they need to succeed in life, not only in employment but in protecting themselves and knowing what is right and wrong - “teaching is a way to protect the children” (NCP 3). The interview with the MOEd recorded that without adequate education, children will not be able to communicate with the world “that means they will remain blind.”
Teaching about HIV is a good example of how to protect children and this will briefly be addressed here as it is one of the main aims of the MOEd, more information on teaching about the pandemic can be found in Chapter Seven.
Many of the OVC in Swaziland are alone and have to find their own way in life, without parents to guide them; they also face a series of barriers to education, meaning that their chances of succeeding in life are slim. It is crucial that the government allows these children access to education so that they can have a brighter future as well as creating educated people which will be beneficial for the future of Swaziland. Some of the barriers to education will now be examined.
Barriers to Education:
Money is an enormous barrier to education for many people in Swaziland and this is even more pronounced for the many OVCs. NGO 6 discusses how “the fees in Swaziland are very high so most people cannot afford them” and states that for many children it is easier and makes more sense for them to leave school and find a job. This is a problem that these children should not have to be concerned with; if education was free for all then they would not feel pressurised into leaving school due to not affording fees. The results showed that 6/28 participants - who were free to state as many answers as they wished, said that poverty or a lack of money was one of the main problems facing OVC in Swaziland, see Figure 5.1.
It is not only the school fees that pose a problem to the OVC it is the “constant stream” of monetary requirements, “now we have a building fund to pay and now we have a school trip to pay” (NGO 12). The school uniforms can also be extremely expensive and especially on top of all the other fees. School uniforms vary but some of the participants stated prices of about R300 (approx £23) which is a lot of money for someone who cannot work. Many of the schools are very strict on the uniform being correct, NGO 12 reports how “it was the wrong sweater and so they would get sent home.” There are reports where children are skipping a year of their education because parents cannot afford to send both children to school and so they alternate between the years (IRIN 2009). This is in situations where the parents cannot afford the fees, so for those children who do not have parents, what hope do they have of finding the money, often this leaves them very susceptible to abuse as they are so desperate for money, three of the interview participants stated that one of the main problems facing OVC is abuse, see Figure 5.1.
Getting into the schools is not the only problem faced by children, having a proper school structure and a teacher to teach the class are often also barriers. The MOEd (2002) describes how “more and more teachers left classes unattended” due to being sick with HIV, this situation is only set to get worse as the infection rate in Swaziland keeps rising and the true effects of what this will do to the country are yet to be seen.
Government Actions to Ensure Access to Education:
The government has had a number of strategies to help OVC into education and are working hard towards achieving the goal FPE for all by 2015 (MDG 2, UN 2009). The MOEd (2002) outlines their main aims in Figure 5.2.
Parents and families have always had a responsibility to pay for school fees for their children, but in order to help parents, the government currently provides textbooks (as of 2004), stationary (as of 2006) and provides grants to help OVCs with school fees (IPS 2009a). This initiative started in 2003 when the government “allocated R18 million (US $2.7 million) to keep children already attending school in class when they became financially endangered” and then in 2004 the government added R20 million ($3 million), which was to go towards allowing “children who have dropped out because of AIDS in the family to re-enrol” (IRIN 2004).
IPS (2009a) describe how the grants provided to OVC consist of $32.50 and it is expected that the child’s guardian find the rest, the fees vary depending on the school but this amount works out as approximately half of an average schools fees. This still leaves families and often children with the challenge of finding the rest of the money, this is often too hard and as mentioned above, children get frustrated and end up leaving school or are left desperate and open to abuse.
It is clear that the government is working hard to try and improve the situation for these OVC, but there are “quite a number of restraints” (NGO 6). There are a lot of OVC in Swaziland and the number continues to rise, financing half of the school fees for 120,000 children is quite a challenge. This initiative may also be disapproved of by poverty stricken families who even though they have parents, it is still a struggle to find school fees.
The second aim of the MOEd (2002) was to “stem the rising tide of the epidemic and mitigate its impact” and so it is not only getting OVC into school that is a challenge, it is also the job of the MOEd to find an effective way to teach school children about the dangers of HIV/AIDS as well as educate those that are not in school. As shown in Chapter Seven, there are a lot of plans and campaigns teaching about HIV/AIDS. This is crucial in order to stop the spread of the pandemic into this next generation, it is also important to start educating the children when they are young to ensure the message is clear before they are engaging in sexual activity.
IRIN (2004) state how 25% of the government’s budget goes on education, whereas 44% goes on paying the government workers, police and the army, this is shocking when it is education that is really going to turn the country around, in terms of halting the pandemic as well as creating an educated generation to work for the country in the future. Where will Swaziland be when the current workers retire or die and the next generation are too uneducated to take over?
Free Primary Education (FPE) for All:
When the researcher arrived in Swaziland there was a lot of excitement about the government promising free education for all children in grades one and two next year (2010). Having researched this while in Swaziland it was possible for the researcher to gain an understanding of this, although on returning to England and researching further it became clear that there had been some controversy about when the new proposals were due to start.
The research highlighted that almost all the participants knew about the government’s plans to bring in free education, see Figure 5.3. In Swaziland’s constitution written in 2005, it was stated that primary education would be free in three years time. IPS (2009b) states how four years later this is not the case, the reasons that the government are giving for this is that “it lacks sufficient financial resources to implement the initiative” (IPS 2009b). The MOEd (2002) stated that “funding is the main constraint” to all the initiatives they would like to bring in.
Parents were angry that although they had been promised free education from this year, they were given three days notice that the fees were not going to be paid, many parents argue that they had not budgeted to pay the primary school fees and so were now stuck. A court hearing was held and “Swaziland's High Court has ordered the government to adhere to the constitution by providing free education to primary school children (IRIN (2009). The Swazi Times (2009) reported that “while the government would not disregard the court’s judgement, it was impractical to introduce this benefit this year” and have said that as of 2010, grades one and two pupils will not need to pay fees. IPS (2009b) report that FPE will happen gradually, “covering one grade each year until all the grades are included by 2015” this date has been set due to the constitution being influenced by the MDGs and this is a stipulation of UNMDG 2 that all children will receive a FPE by 2015.
The interview with the representative from the MOEd, highlighted that the plans were on track to come in next year for free education for grades one and two and that “free education is one thing we are very happy about”. The representative also stated that “eventually all primary school children will receive free education, by 2015.”
This new policy will not be cheap for the government and means a lot of work as the “government needs to employ 200 new teachers, build 160 new classrooms and 200 new teachers’ houses” (IPS 2009b). The interview with the representative from the MOEd voiced the fear for this stating that they have high demands to reach the standards needed to cater for the extra children. The MOEd are also “looking forward to a time when there will be a law enforcing everybody to send their children to school” it is to hope that this will create a greater future for all children in Swaziland and especially OVCs who will have the chance to receive this education without worrying about how to pay the next set of school fees.
This is clearly a start and the MOEd interview highlighted that the government are intending to carry on working towards FPE for all by 2015, but for some Swazi residents this is not enough. NCP 9 states that the government has not addressed education when they are only talking about FPE, ”you can not provide the primary and then forget about the university and high school you haven’t even talked about education” (NCP 9). It is clear that the government still have work to do to provide FPE but they are committed to this and are working hard to achieve their goals.
Conclusion:
It is clear that work is being undertaken towards achieving MDG 2 and having FPE for all by 2015 and a great start has been made, education is seen as the key for a child’s future and so this is crucial. The government still have some way to go though and they need to ensure that once they reach FPE they do not stop and think their work is complete. Many children will still struggle to pay for uniforms and the question of who can go onto secondary education is also raised. It is important for Swaziland to start rebuilding their foundations that have been damaged by the HIV/AIDS pandemic and focusing on educating this new generation is surely a step in the right direction for the future of the children, as well as for the future of the country.
The next chapter investigates the work of NCPs; the chapter is conducted using a SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis looking at the variety of activities that are provided at NCPs, including provision of food to OVC, informal education, games and interaction as well as the uses that are often not so obviously highlighted, for example being a way of monitoring children and highlighting those that are in need.
Chapter Six
Results and Discussion:
NCP SWOT Analysis
This chapter will examine the results gathered from the research into NCPs. The chapter is written using a SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis, while looking at opinions gained from this research as well as comparing these to ideas already present in previous literature and research.
STRENGTHS
The research highlighted many strengths demonstrated by the NCP initiative, for example Figure 6.1 shows how 24/28 participants stated that NCPs were a good idea, only 1/28 said they were not and 3/28 said they had mixed opinions. Many of the participants liked the fact that the NCPs were “community based” (Clinic 5) and saw the importance of starting at the “grassroots level” (Clinic 2).
The NCPs are run by volunteer caregivers, although the research highlighted that 3/11 of the NCPs had some staff that were paid or given incentives such as soap or travel expenses. The issue of caregivers will be addressed in the opportunities section, but they needed to be mentioned here as they keep the costs of NCPs low and clearly have “good hearts” (Clinic 1) for the time and effort that they give, NGO 12 stated how “a lot of energy” was put into the NCPs.
The main aims of NCPs were highlighted in Figure 3.2 and it became clear that not many NCPs actually achieved high enough scores to be classed as excellent. Although this research has shown that 12/28 participants said that they believed NCPs achieved what they were aiming to, 9 said that there were still many problems that needed addressing and 7 did not know. The most important and main aim of NCPs is to provide the children with food.
The research has shown that all of the 11 NCPs interviewed provided food to the children, Figure 6.2 shows how 4/11 NCPs only provide one meal a day whereas 5 provide two meals, one NCP said that it depended on whether the food was available to provide breakfast and lunch but if possible then they would provide two meals a day. Plate 6.1 shows children eating at NCPs. NGO 4, described how “the children rush from school to the care point to get food” and NCP 4 stated how for many of the children “if they are not here then they don’t take anything” and so if they are unable to attend the NCP they will go hungry. NCP 9 describes how very few children are ever absent, “they are always here because they are hungry”. There are still improvements that could be made though, by ensuring food is always present but also by providing “a variety of food” (NCP2) so that the OVC are getting a balanced diet as opposed to just beans, maize and porridge everyday. One NCP has vegetables donated from the local supermarket so the children have a variety of food to eat.
NCP 8 showed the true value of providing food to the children while stating that at times the NCP shuts down and if they close for two weeks, when the children come back you can tell they have lost weight and that they have not been eating enough, but then “once they start eating here they become fresh again”. This shows the situation that many of these children would be in if the NCPs were not there and that NCPs are a good way of monitoring the children. NGO 3 states how NCPs “can hopefully identify if a child is abused” and they are also able to tell if a child needs medical attention or they can just be there to support a child. Certain NGOs, for example Young Heroes reported using NCPs as a way of getting into local communities and highlighting those children who need help.
It is hard to say that NCPs are not achieving great things, as there are clearly many strengths associated with them, although this is not to say that there are not problems.
WEAKNESSES
The caregivers although being a great asset to the NCPs are often criticised as they are not trained and many people believe that an NCP should not be treated as a substitute for going to school, for example the MOEd representative stated that “surely we cannot allow learning to go on at NCPs”. NGO 11 states how children who show up at the NCPs who are of school going age should be “routed into school”. With the introduction of FPE as discussed in the previous chapter this will be more feasible. The standard of education received at the NCPs varies vastly, it is not possible to say that it is all inadequate but it is true that they should be attending school. Five of the eleven NCPs interviewed had lesson plans for the OVC and two of the NCPs relied on volunteers to create the lesson plans. The NCPs that had lesson plans were the NCPs who had paid caregivers or those that received help from organisations such as Children’s Cup. The fact that two of the NCPs were reliant on volunteers to provide lessons to the children, shows the importance of organisations that supply volunteers, for example ALLOUT who currently provide support to three NCPs and aim to open one of their own soon. It is crucial to ensure that the lessons can continue once these volunteers have left, in many cases the volunteers are not only teaching the OVC, they are also teaching the caregivers into how to conduct effective education themselves.
NCPs are criticised for not providing more life skills training to the children and not making the children work for what they receive at the NCPs, many participants fear that because they “are not trained, everything is done for them, they cook for them, they give them food” (Clinic 3), that this will create a generation of children who are spoilt. Many of the NCPs solve this by having small gardens or allotments that the children are responsible for, this can be seen in Plate 6.2.
The standard of care and education that is received at some NCPs creates worries about whether they do fulfil the purpose, as previously said, all NCPs are different but there have been “reports of NCPs running out of food” (NGO 6) which is unacceptable when the main aim of them is to provide food to the children. This was apparent when conducting the research as many of the NCPs visited were not running due to a lack of food. The results show that 5/28 interview participants stated that more reliable food was needed to improve the standard of the NCPs (Figure 6.3). By asking in the local area when an NCP was shut, it was possible to interview some of the caregivers for the NCPs that were not running but others were just empty buildings. This raises the question of putting money into these NCPs, as some of the buildings are of a high quality and are being wasted due to a lack of food or teacher. Again this shows the inequality between NCPs as NCP 11 states “we have no shelter for cooking when it’s raining and you see in the classes here, when it’s cold there are no windows” and the NCP in Plate 6.3, clearly has no enclosed space for the children when the weather is bad, just a store room for storing the food and a non wind proof shelter.
A large weakness that was noticed in the research was that even though OVC are at an incredibly high risk of contracting HIV and carrying on the pandemic that has got them in the dire situation they are currently in, there is limited teaching about the pandemic at NCPs. Four out of eleven NCPs reported teaching about HIV at the NCP, NCP 10 declared “yes, once in a while” while two of the others said that it was covered briefly in bible class. Only one NCP had a specific time set aside to talk about the issues of HIV and even that was not currently happening due to not having a teacher! Another four NCPs plan to start teaching in the future but currently there is nothing. One NCP said that they get taught about it at school, but for the younger children who do not attend school, or those children who currently cannot afford the fees, where are they going to learn how to protect themselves? The dangers of HIV/AIDS need to be taught to children as early as possible because “now they are indulging in sexual intercourse at a very tender age” (Clinic 4).
OPPORTUNITIES
The future of NCPs was widely discussed during this research, some participants, for example NGO 8 believe that NCPs were “an emergency response to an emergency situation” but that now “a more systematic approach” is needed. With the number of OVC still on the increase it could be argued that Swaziland is still in a state of emergency and so this emergency response is still needed. However, it is clear that to allow these OVC a future, then education is important, with the introduction FPE the role of the NCP could be changing. There are suggestions that the centres could be used as pre schools for pre-school aged children during the school hours and then life skills lessons, homework clubs and extra curriculum lessons could be developed for all OVC in the afternoon. Primary education in Swaziland is from 6 -13 years old and so in an ideal situation all children between the ages of 6-13 (at least!) would be in formal education and then gain extra skills and collect food from the NCP. This way the NCPs could compliment the formal education system as opposed to being an alternative to it. This is a very idealistic viewpoint, as the government are currently only offering free education to grades one and two but where are the children then going to go once they reach grade three and cannot afford the fees?!
Six out of twenty eight participants believed that better education was needed at the NCPs, “they need to educate the people that are taking care of the kids” (NGO 3) so that they can provide more in depth and appropriate lessons for the children. At many NCPs the caregivers do not know how or what to teach the children and so often the children go without any education. Many of the NCPs are good at playing games with the children, singing songs and interacting with the children, see Plate 6.4. By training the caregivers it would be an incentive and give them further motivation to be there “then they could do a greater job than they already are” (NGO 5). Many participants stressed the importance of paying and training staff to “make them feel valued” (NGO 7) as “the caregivers often complain that they get nothing” (NGO6). NCP 9 describes that this is why they lose caregivers as they too have needs and they need money to live, they believe that “if we care for these children then government must care for the caregivers”. The MOEd representative stressed the importance that NCPs should not be for formal education and that these children should be in school gaining education from “qualified people, who can teach quality education.”
The children attending the NCPs are only there for a few hours and so NGO 1 questioned where the children are for the rest of the time and who is watching out for those children. Many of the participants voiced the idea of having a big house for all the children to live in, similar to an orphanage so that they had support and guidance all the time (NCP 7, NCP 8, NCP 9, and NCP 10). This would provide care for administering medicines and protection against people who may wish to take advantage of these children. Chapter Eight will address the issues of full time support for the OVC of Swaziland.
It is clear that there are many ways that NCPs could be improved but it all comes down to the capacity of the government and the NGOs to be able to make these improvements. Everything that has been mentioned here as an opportunity for improvement will cost money, but the biggest challenge is where will this money come from? Many of the NCPs are being funded by external donors or NGOs and this is not sustainable because if they withdraw that funding then the NCPs will struggle to survive. NCP 9 states how “we live to donors in Swaziland, it is a small country; it’s not supposed to live to donors.”
THREATS
There are a number of key threats to the NCPs, as just mentioned the NCPs rely on donors for everything and as soon as there is a national shortage of food then the NCPs will have to go without, Clinic 1 described how “today the food is there, tomorrow it is not”. The Red Cross described in an interview with them that they were supporting thirty three NCPs last year but they recently had a report to say that ten are no longer functioning due to a lack of food.
Stigma also poses a threat to the NCPs, NGO 12 describes seeing children “who would rather starve than go across to the orphan care point to get lunch” as it means being branded as an orphan. On the opposite side to this there are many children who attend the NCPs who are not OVC and should not be using the NCPs for food; Clinic 4 stresses how “the children must be well deserving to go there.”
The NCPs are not monitored by a central body, they are set up by different organisations and receive funding from different donors; this makes it impossible to keep track of the NCPs. One NGO that supposedly works very closely with NCPs could not even give directions to any NCPs when approached by the researcher. It is not surprising that people feel the NCPs are not managed when the experts who are responsible for overseeing them do not conduct regular visits or even have any idea where there are NCPs locally! If the structures were all overseen by someone they could be standardised, so that everyone knows what they are meant to be doing and how to do it. Currently there are areas that do not have any NCPs and there are many children “who still go to bed hungry” (NGO 6) but it is crucial if more NCPs are to be built that they are monitored and not wasted.
Conclusion:
It is clear that there are many strengths, weaknesses, opportunities and threats to NCPs, but the main finding is that the role of the NCPs is set to change. It is clear that a lot of energy is put into the running of the NCPs and so it is imperative that this energy is used to its full advantage. NCPs are seen as an important initiative for children to get food but it is clear that they could also be developed for school age children to come and receive extra curriculum activities. It is easy to say that NCPs should not be an alternative to school but for the children who at the end of grade two, the end of free education, who have nowhere else to get any education, attending an NCP may be their only option - surely an informal education is better than no education? The standards of lessons are not adequate for this age range though and it is to hope that the government can find funding to send all children for FPE.
The aim of this dissertation is to examine the political economy of OVC and NCPs are clearly very involved with this. This chapter has addressed all of the objectives as it examines the current situation, investigates the education that many NCPs provide to the OVC as well as looking at the support and guidance and highlights that the NCPs if used correctly could be very beneficial to OVC and continue to address all the factors stressed as important to OVC during this research.
It is those NCPs that have volunteer organisations, such as ALLOUT, working with them or have private sponsors such as ‘Children’s Cup’ that are working well, but many are not so well off. More NCPs are always appearing but it seems as if the ones already in existence should be standardised or at least be monitored to ensure that all are running instead of just pumping money into building more, which as this research has shown could then end up being left empty and the buildings being wasted. It is also crucial that the organisations responsible for overseeing the NCPs are thorough and do undertake regular checks, unlike what was found by the researcher while conducting this research where many NCP experts seemed completely unaware of what NCPs were running or even where the NCPs were.
It is to hope that NCPs in the future are for pre-school age children and can then be used as food centres and social centres in the afternoon. This idea is reliant on the MDG 2 being achieved and having FPE for all children. If this is to be achieved then NCPs need to compliment the formal schooling system rather than try and be an alternative to it.
The next chapter will highlight education initiatives and awareness campaigns present in Swaziland and see what the challenges are for Swaziland and the Swazi OVC in the future. Swaziland needs to address the pandemic and accept that it is happening and also the extent that it is happening to, it is going to take hard hitting awareness campaigns and a true acceptance of the scale of the pandemic before it can be adequately fought against.
Chapter Seven
Results and Discussion: Education, Awareness and Challenges for the Future
Education and Awareness:
The research demonstrated that awareness of HIV/AIDS in Swaziland is high, with seventeen participants believing that young people knew about HIV/AIDS, six more participants thought that it depended on the area; three thought that there was a good start but more needs doing and only three said that they were not educated at all (Figure 7.1).
Clinic 5 discussed how there were a lot of awareness campaigns that educated young people for example “via print and electronic media and at school” many of the participants stated that information about HIV/AIDS is everywhere and is always taught about in school (NCP 1, NCP9). There were some participants such as NGO 5 who stated that the focus is in the towns and not in the rural areas and so people who do not have access to the mediums that HIV/AIDS is educated through are very unaware of the dangers, for example in the rural areas “some of them do not even have the radio.” It is crucial that awareness campaigns get to all members of society, “either in terms of language or things that they really relate to” (NGO 6). This is especially important for children as it is so vital that they get the education that they need to know how to maintain their negative HIV status, “many are unclear about where the danger lies” (NGO8). NGO 11 suggests getting the youth involved “they need to come up with the solutions not us coming up with the solutions” for them so that the campaigns will be done in a way that relates to youth.
The content analysis of the ‘Swazi Times’ highlighted that on average HIV/AIDS is mentioned only 2.63 times in each issue; this is shocking in a country where 42.6% of adults are infected. Many of the times HIV/AIDS was mentioned were not even awareness raising campaigns, some were merely job adverts for roles working with HIV/AIDS related issues! Some of the issues only mentioned the pandemic once and it was actually rare to see awareness raising information in the paper. A lot of the Swazi population have access to the Swazi Times and it is a great way of getting information to people; so it seems senseless that in every issue there is not some form of awareness raising campaign.
It is important to really tackle the issues that research has shown to be the ways that HIV is spread, for example multiple concurrent partnerships are still common in Swaziland and even amongst the youth. Campaigns such as the
‘One Love’ campaign address this but are they really getting through to people? NGO 11 says that “the messages are not really talking to the people” and unless people go out and find out for themselves and want to know more about the disease then the messages do not say anything. Maybe a hard hitting campaign showing people what HIV/AIDS has done to Swaziland and showing them why Swaziland needs to change the current situation is the way forward. NGO 10 states that “they need a model to say HIV is real” and NGO 8 agrees saying that if a famous Swazi stood up and said – this is real, we need to act on it, then Swazi people would be more likely to listen.
Education into the pandemic is occurring not only through awareness raising campaigns but also in schools and youth clubs across Swaziland. The Family Life Association (FLAS) organise presentations and discussions with children and it is a way for the children to voice their concerns and ask questions. NGO 7 discusses how “children still have a lot of unanswered questions, they don’t have a chance to have an open discussion” and so initiatives like this are key to driving forward young people’s awareness. It is absolutely imperative though that the facts discussed during these presentations are true and that the discussions are used to their full advantage. It also needs to become a large part of the school curriculum and be taught to children of all ages, this is an aim of the MOEd as discussed in Chapter Five. Organisations such as FLAS and any other trained organisation that wants to deliver HIV/AIDS education should be embraced and used to its full capacity.
It is crucial to really understand what the drivers of the pandemic are and to find ways to stop those drivers, in ways that people will listen to and respect.
Challenges for Controlling the Disease:
The majority of participants, expressed concern over the lack of behaviour change exhibited by people in Swaziland, there were many comments such as “you cannot change a person’s personality” (Clinic 4), “it all boils down to behaviour change, the information is available” (NGO 1) and “people are educated but they choose to act ignorant” (NGO 4). This is a worrying situation; even after the work of organisations to educate people into the dangers of HIV/AIDS, people do not seem to be taking it seriously, for example Clinic One told a story about people coming into the clinic and describes how they can tell you everything about HIV, but when asked so “are you are doing this and this and this to prevent it?” they often answer “you know sometimes I do, sometimes I do not.”
This is why the proposal of a really hard hitting advert, which could be publicised through as many forms as possible, could make a big difference. For example some current driving safety adverts on English television often leave the viewer shocked, yet this shows that the message has been understood. The current Swine Flu pandemic had not hit crisis stage in the UK before every household had a leaflet through the door educating them into how to protect themselves. This may take time and money but someone needs to create a hard hitting advert, even if this goes against Swazi culture and prompts controversy, the issues need to be addressed!
Another large problem that needs to be overcome in Swaziland is the stigma attached to HIV/AIDS, “it’s still a taboo and people don’t want to talk about it” (NGO 7) and there are cases where young people are too scared to get tested because their “parents think that HIV is a bad thing and that people who get it are promiscuous” (NGO 7). The Swazi Times (9th July 2009) reported how a girl was beaten up by her brother because she was HIV+ and he believed he would catch it from sharing a toilet seat with her. This shows not only the lack of awareness into the disease but also the way that people can turn against their relatives because of the stigma attached to HIV. It is not surprising that people are too scared to get tested, although it was promising to see the Swazi Times add that you cannot catch HIV from sharing a toilet seat. Stigma was recognised as a barrier to controlling HIV/AIDS by the participants, with 5 of them stating that stigma and openness about the pandemic needs to be combated (Figure 7.2). Clinic 4 believes “we need to come out and just take HIV like a condition like any other” as well as NCP 9 stating that people should know their status as they then do not have to wonder whether they are infected or not. There are organisations working towards tackling the stigma associated with HIV/AIDS, see Plate 7.1.
People need to accept that the pandemic is happening and until they do no initiatives in place can work, NGO 7 believes that “until people just accept it and can be open about it, then it’s quite hard to challenge” (NGO 7). The question now is how to get a true understanding, knowledge and acceptance of HIV/AIDS, this has been attempted and although has reached some people clearly not enough people are aware and so it is vital to go a step further to really ensure everybody is aware of the pandemic and it’s consequences.
What the Future Holds for OVC:
There were mixed opinions as to what the future holds for OVC in Swaziland, figure 7.3 shows how the majority of participants believe that with work, the future of OVC would improve, only 2/28 participants thought that OVC faced a good future yet 12/28 believed that the future was not positive although 14/28 participants believed that with work the future prospects could be improved. This shows that it is crucial to ensure that work is undertaken into ensuring a more positive future for these children, Clinic One stresses that “not really enough is being done to make a bright future for these children” and NGO 11 believes that “the future is very bleak for orphaned children” yet there is hope that work will be undertaken and that in the future “they can be a great resource for a country because they have lived through the tough times” (Clinic 2).
NGO 11 stated that there were many gaps “where government is not supporting” OVC, although NGO 1 stated that the new government have already made changes” and so the future is looking more hopeful.
One main point that came out of the research was the lack of people who knew about the NPA even though the majority of the participants work with children. No clinics had heard of the plan, only one of the NCPs and 6/12 of the NGOs. NCP 9, even though having heard of the plan stated that they had not seen any of it, NGO 1 commented how everybody is “doing things in their own corner” which is not the multi pronged approach that has been called for during this research. This could mean that work, resources and finances are being wasted as people are not communicating about who is doing what. NGO 7 stresses their lack of hope of the NPA as “they have these meetings and then you kind of wonder how much action will come from it”. It is worrying when there are so many different partners working towards a better future for OVC in Swaziland that the results here cannot be more positive, maybe this lack of communication highlights why. NGO 11 also shows frustration at the way the pandemic is being managed, stating that “I’m just an officer; I’m not one of the decision making players”, people really want this situation to change and even some professionals feel helpless.
It is clear that many people are working to help these OVC and so it is to hope that this will create a positive future for them, but this is not only the responsibility of NGOs and the government, some responsibility lies with each individual child, NGO 4 states that the children need to decide, it ends with me, “I want to put a stop to this”. This will not be easy though, as NGO 12 states “the saying goes ‘what you do to a child today is what they will do to society tomorrow’” so it is so vital now that work is done to help the children not follow in the current pattern, the children need to think I am an OVC but do not want my children to be and so this is what I will do. All the factors discussed in this research will be needed for this to happen, for example the children need the education and awareness of the disease before being educated enough to make that decision and they then need the emotional love and support as well as food, care and guidance into how to become a decent adult. This cannot happen overnight but work is needed to ensure that in time all of this support is offered to all children in Swaziland and in the future with the right support, the children can lead “a great and bright future” (NGO 12).
People have hope that this may happen, NGO 3 states that “as long as we still have people with negative status who are being encouraged to maintain their status then we can defeat HIV.” Swazi people are also encouraged “to stand up and give love to these children” (NGO9) and to “have a heart and help them”, gradually people are realising it is important to “cradle and nurture these kids” (NGO 12) to create a brighter future for the OVC and the country.
Impact of OVCs:
Many of the participants had concerns over what impact 120,000 OVC would have on the country. Many of the participants believe that the true impacts of the number of OVC are yet to become apparent. Swaziland has already hit crisis point with the current number of OVC but this number is increasing rapidly with 8000 children orphaned monthly, (New Hope Centre 2006). It is believed that “the proper impact on society will come at a later stage” (NGO 8), meaning that the true scale of the pandemic is not yet clear and it will take time to see the effect of this large number of OVC.
There were a variety of impacts that the participants discussed, but the main impact was that of the economy, (Figure 7.4). NGO 4 describes how “we will keep on pumping money into helping these OVC that could have been used for other development in the country” the number of OVC has already threatened many development successes that Swaziland had achieved and threatens to put development back further as the pandemic and it’s effects increase. Due to the many barriers to education that have been discussed in Chapter Five there is a threat of an uneducated generation and how then can the country strive towards development even once the pandemic is controlled. NGO 11 describes this as “a certain percentage of the population that the government did not work fast enough to make sure that, that generation grows well and is taken care of”. Not only will this generation be uneducated, “they have grown up without anybody and so they don’t like anybody to come in and tell them what to do” (NCP 8) and so they could struggle to remain in employment as well as potentially being unruly and unmanageable.
NGO 6 questions what the long term results of people not working will be Hall (2004) describes how a lack of people working equates to a lack of tax payers which in turn means the government have less capacity to fight the pandemic. This does not provide reassurance for a positive future.
The impact of the number of orphans, which equates currently to 10% of the population of Swaziland - not including the many vulnerable children and the increasing numbers of orphans is hard to predict. Many participants stated that they do not think Swaziland is “seeing the impact yet” (NGO 8). NGO 9 states how they can “see Swaziland collapsing full of young people dying of HIV/AIDS” this does not pose a very bright future for the country but with work there is hope that this can improve.
Conclusion:
A multi sector approach is needed where all organisations and the government work together, NGO 8 calls for “a multi-pronged approach” that is led from within government while also having faith groups and NGOs involved to really pull their resources, talents and finances together to conduct a countrywide approach to combating the spread of HIV/AIDS. There is a need for something hard hitting and shocking, something that stands out and due to the culture would probably be very controversial but that is the only way to get people’s attention and raise their awareness. Many of the campaigns are promoting good messages although they are doing this in a way that does not address the true scale of the pandemic and to all sectors of society in mediums that will be available for all to see!
The future for OVC in Swaziland is currently unknown, this makes it hard to successfully address Objective Four investigating what the future holds for OVC, but it is crucial that the impacts are predicted and so that work can begin to try and reduce the scale of the impacts. With work, guidance and support it is hoped that the OVC in Swaziland can develop into a healthy and hard working generation who strive to ensure Swaziland gets out of the current crisis, but without help these OVC could follow on the pattern of HIV/AIDS creating an even larger percentage of infected people and OVC in the future. The impact that OVC has on the country has arguably not become clear yet and is due to get worse, Swaziland needs to ensure they are ready for this increase.
It became apparent during the research that there was a need to investigate the idea of institutions for OVC in Swaziland and the trauma that a child feels when they have lost a loved one. This trauma is discussed in the next chapter and the need to ensure that all children are supported through the trauma is considered. Residential institutes are investigated and whether this could be a possibility for the future is discussed.
Chapter Eight
Results and Discussion:
Provision of Social Care and Support to OVC
Originally the aim of this dissertation was not to investigate social institutions and psychological support for OVC, although during the research this theme emerged as important. Many participants stressed that protecting the OVC went a lot further than just providing food and education and so the researcher felt it was important to discuss that here.
The scale of the pandemic in Swaziland has created a huge number of OVC, meaning that the traditional network of extended family and community ties in Swaziland has become stretched. Swaziland now faces the challenge of what can be done to protect the many OVC. The multi pronged answer is again suggested here, where communities, the government and the NGOs need to come up with an answer as to how best to care for these OVC. It is here that all these partners need to consider all the objectives of this research in order to ensure they are creating a safe and positive future for these children.
The research highlighted that many OVC are not getting adequate help to overcome the trauma that they have been through losing a loved one to AIDS. NGO 12 states how this is the biggest problem facing OVC and that anyone can provide food for them, but questions who will help these OVC through the grief, anger and depression of losing a loved one? NGO 4 also stressed that psychological support needs to be provided by “every organisation that is supporting those children” to enable them to succeed.
It is widely recognised that every child needs love and guidance if they are to grow into decent human beings, but how can the cost be measured of not only losing a parent, but in many cases losing all members of your family. Barnett and Whiteside (2002) question “what is the cost of a cuddle foregone?” For many children losing a loved one would mean they needed love and comfort from those close to them, but for many OVC there is no one left to provide this. NGO 12 states how “you can see it in their eyes, the way they’re walking you can say that one is an orphan” but the future of Swaziland is in the hands of these children and could depend very much on how they are comforted and helped through these times.
The support does not stop with helping them get over their grief but guidance and advice are also needed for these OVC through all of their childhood. NGO 11 questions who will take care of all the issues that should be a parent’s job “all the social issues that are supposed to be taken care of, that me as a parent would take care of for my child are not being taken care of for those children.” This is even more apparent when the child themselves is sick, NGO 8 describes how a child on ARV treatment has to have “a pretty dedicated caregiver” or the child’s chances are “slim” due to formulas constantly changing with the growth of the child. NCP 10 also states the importance of having someone who you can talk to whether happy or sad, for example “even if you’re excited ‘oh Mum, I passed my test’ you need someone just to tell that” (NCP 10).
Many of the participants expressed a worry as many of these children are vulnerable to abuse, there are 15,000 child headed households in Swaziland and more so than any, these are the children that are most vulnerable to abuse from older members of society (NGO 7, NCP2, NCP8). See Reza et al (2009) who discuss the health consequences of sexual violence for young girls in Swaziland. NGO 8 states how Swaziland has a lot of sexual abuse and childhood violence which causes a worry for those children who are alone and this can also contribute to the spread of HIV. Three of twenty eight participants believed abuse to be one of the main problems facing OVC, see Figure 8.1. NCP 2 talks of factory workers offering children money for sex and because they are desperate they say yes, children “even as young as primary school” age, which is why it is so crucial to educate these children from a young age and try to create a situation where they are not so desperate for money that they are put at undue risk.
Abuse is not the only problem faced by OVC, many people take advantage because they are children on their own and often food and appliances are stolen from the children. This is where the idea of institutions as safe places for OVC to live becomes apparent.
One recommendation that came up during the research was that of “a big house” (NCP9), “something like an orphanage” (NCP8) or “a special place for the kids” (NCP7). 2/28 participants stated that a good way to improve the NCPs was to have accommodation there as well (Figure 8.2). NCP 9 states that once they leave the NCP they no longer know where the children are, or what they are doing but that a communal house for them all would mean they could keep an eye on them. Swaziland has never had a need for many residential care homes in the past and “UNICEF considers institutionalization of children a last resort” (UNICEF 2005). The number of residential institutions for children has doubled in recent years due to the increased number of uncared for OVC, but UNICEF (2007) worries as most of these homes have been set up without “any legal framework, policy guidelines, registration requirements or national standards” so work needs to be done on correcting this if institutions are going to be an option for the future. The cost aspect of institutions also needs to be addressed, where will the money come from? The traditional practice of OVC being cared for by the extended family meant that the government did not need to provide financial assistance, although with an initiative such as an orphanage, the government may be approached for funding.
NCP 10 proposes setting up a house for the children who are sick, because as mentioned earlier, it takes a dedicated caregiver to ensure the ARVs are taken correctly and often for OVC “there is nobody at home who is going to say now it is time for your tablets or now it is time for your medicine” (NCP 10). Small houses could be set up, along the same lines as NCPs where caregivers can keep an eye on the children and be there for the children “because as it is, the kids have nowhere to find help” (NCP 7) once the NCPs are closed. This way children would be kept in their local communities and not lose their Swazi identity, this proposal is similar to the work of the Lutsango Mothers.
Keeping the children within their local communities has been stressed as vital by UNICEF (2007) as it is important “to give these children the opportunity to preserve their identity and sense of culture and heritage” this is also important for Swazi tradition as often institutions or NGOs can impart their ways of life onto the children in their care and if children regularly grow up like this then there is a risk of them losing their Swazi identity. UNICEF (2007) criticised one institution because they believed children were “allowed to experience only one culture, the culture of the care facility.” This same institution was also criticised for violating the children’s identities, due to “changing all the children's surnames to one surname” the reasoning for this may be so that the children all felt like part of a family. While in Swaziland it became apparent to the researcher that it is not only the surnames of the children that are changed, it is also their first names, the children are all given Christian names, this has no adequate reasoning behind it as the children are African and should maintain their African names, how will these children ever feel like true Swazis when they have grown up in an institution with it’s own culture that mainly stays separated from the outside world. This centre has been set up to care for children who “have fallen through the net” (NGO 12) and the work that is conducted here to provide a good quality of life to these children is exceptional, even if some of the ethics are controversial.
If all the OVC in Swaziland grew up in houses or orphanages just for OVC, it would be hard for them to then try and live normal lives in the future outside the institution. This research argues that institutions should be a last resort; if it is possible and safe for the children, they should remain in communities where they can maintain their culture and identities and learn from others how to lead normal lives. For those children in institutions, it is crucial to ensure that the children are educated into how to live a normal life and not just told to leave at eighteen with no experience of normal Swazi life.
UNICEF (2005) discuss a proposal from an organisation called ‘Dream for Africa’ who planned “to build a complex that could house 10,000 orphans” this so called “Orphan City” has stirred much controversy but the plans were turned down “citing that the approach of isolating orphans was contrary to Swazi tradition” (UNICEF 2005).
To propose a solution for the future is hard as the best plan would be for OVC to remain in their communities, as research has shown this is beneficial to them. With the help of communities, the setting up of small scale institutions could be possible, where many children would live together and look out for each other as well as having regular attendance by caregivers. This would ensure that the OVC were not getting into trouble themselves as reported by NCP 2 that “it is difficult because there is nobody to control them” and also ensure that they were safe from people trying to take advantage of them.
Although this chapter was originally not planned, the information provided clearly addresses Objective Three and outlines the importance of emotional support and guidance as well as proposing some ways that it may be possible to achieve this, for example through residential children’s homes. It was investigated as to whether this is really the right way forward for a country that has a strong sense of community, as this could be jeopardised when children are taken away from their communities and brought up in potentially non Swazi environments, often run by western NGOs.
Chapter Nine
Conclusion
The Aim and Objectives of this dissertation were structured around the main areas of importance to OVC in Swaziland. The research addressed the political economy impacts of AIDS in Swaziland, which has the world’s highest HIV/AIDS prevalence. The impacts of this on OVC in Swaziland were then investigated.
Education was investigated through Objective Two and it became apparent that work is underway to improve the Swazi education system; the government are aiming to achieve free primary education (FPE) for all by 2015, as stated in the MDGs. The government are experiencing problems but it is crucial that FPE is achieved to allow OVC a positive future. The problem was also recognised that it is important to not stop once FPE is achieved as many children will struggle with other school related fees such as uniform, or paying the fees to attend secondary school. Improving the education system will provide Swaziland with a generation of educated people who can work towards developing Swaziland and fighting the HIV/AIDS pandemic.
Many NCPs are providing informal education to children, who cannot afford to attend school, but this has been criticised and it is hoped that once FPE is achieved that the role of the NCP can change. The main aim of NCPs is to provide at least one hot meal a day to the OVC, it is crucial that this happens, although this research has highlighted that in many cases it does not. This suggests the need for NCPs to be monitored and structured. This research proposes that NCPs should be used as preschool centres for preschool aged children and could also be used to compliment the formal education system by offering extra curriculum activities and HIV/AIDS awareness programmes, which will also solve the need for increased awareness of the pandemic, which will help with developing more educated and supported young people. If NCPs are used to their full advantage they could become a centre that addresses all the needs of OVCs. Extending the use of NCPs to become small institutes where OVC lived and are cared for by caregivers all the time was also investigated as this minimises the risks to OVC that are present when they are left to live alone, this allows OVC to remain in their communities but gives them added support as they have guidance and support close to them.
Awareness is definitely an area that needs addressing, although this research highlighted that often it is not the awareness that needs improving but the lack of change in people’s behaviour. A multi – pronged approach is called for where all organisations and the government work together in order to pull together their talents, resources and finances to create a campaign that really works and gets through to the Swazi people. This research calls for a hard hitting approach such as an advert which addresses the true extent and risk of the pandemic which can be distributed in a number of mediums, such as leaflets, television, radio, billboards, newspapers and any other way that people will have access to.
This study set out to determine the political economy of OVC in Swaziland and it is clear that it would be naive to conclude that the 120,000 OVC have a bright future, but this study has shown that with work and co-operation between governments and the many NGOs operating in this very small country, the situation can be improved. Swaziland will then be left with a generation of children who have lived through these tough times and can ensure that the current situation is never repeated. For this to be achieved, it will take work and commitment to helping these OVC, not only to receive an education, but by giving them adequate food, shelter and clothing and also giving them the support, love and guidance that children need. Children are often described as being responsible for the future, but it is society’s job to ensure that these children are educated and guided to ensure they do not carry on the pandemic, creating another generation of OVC.
There are many organisations working towards a brighter future but it is so important that they work together, as this research has revealed, the many initiatives that are currently being undertaken could be hugely successful if the leading organisations worked together and the ways that they could complement each other were recognised, for example the use of NCPs for food, awareness raising and monitoring of children, could compliment the formal school system as well as the awareness raising campaigns. For a change to be possible in Swaziland the need for all sectors of society working together is really stressed by this research.
Chapter Ten
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Chapter Eleven
Appendices
Appendix One: Questions for NCPs –
1) How long has this NCP been open?
2) How long have you worked here?
3) How many volunteers/ paid staff do you have?
4) How is the work here funded?
5) How many children come here?
6) How has the number of children coming here changed over time?
7) Is there any help to encourage orphans into education in Swaziland? What plans have you heard of?
8) Is attendance good? If not, why do you think children do not attend?
9) What is a child’s normal day like here?
10) Do you have lesson plans?
11) What kinds of lessons or activities do you teach here? (?life skills/ academic lessons)
12) Do you think children and young adults are well educated on the dangers of HIV/AIDS in Swaziland?
13) Do you teach children here about the dangers of HIV/AIDS?
14) What do you think needs to be done to control the spread of HIV/AIDS?
15) Do you provide food to the children? If so where does this come from?
16) Do you think that Neighbourhood Care Points are a good idea?
17) Do you think NCPs achieve what they are designed to achieve?
18) How do you think the idea of NCPs could be improved to further benefit orphans?
19) What do you believe to be the main problems facing orphans in Swaziland?
20) What help is offered to child headed families?
21) What do you think the future holds for orphans in Swaziland?
22) Have you heard of the National Plan of Action for Orphans and Vulnerable Children? Do you think it has been successful?
23) What impact does the number of orphans in Swaziland have on the country?
Appendix Two: Questions for NGOs –
1) How long has this NGO been operating? In Swaziland?
2) How long have you worked here?
3) How many volunteers/ paid staff do you have?
4) How is the work here funded?
5) What work have you undertaken into helping AIDS orphans and vulnerable children?
6) Do you think children and young adults are well educated on the dangers of HIV/AIDS in Swaziland?
7) What do you believe to be the main problems facing orphans in Swaziland?
8) What do you think needs to be done to control the spread of HIV/AIDS
9) Is there any help to encourage orphans into education in Swaziland? What plans have you heard of?
10) What help is offered to child headed families?
11) What do you think the future holds for orphans in Swaziland?
12) Have you heard of the National Plan of Action for Orphans and Vulnerable Children? Do you think it has been successful?
13) Do you think that Neighbourhood Care Points are a good idea?
14) Do you think NCPs achieve what they are designed to achieve?
15) How do you think the idea of NCPs could be improved to further benefit orphans?
16) What impact does the number of orphans in Swaziland have on the country?
Appendix Three: Questions for Clinics –
1) How long has this clinic been open?
2) How long have you worked here?
3) How many volunteers/ paid staff do you have?
4) How is the work here funded?
5) Do you offer any help with funding treatment for orphans or vulnerable children whose families cannot afford treatment?
6) Do you think children and young adults are well educated on the dangers of HIV/AIDS in Swaziland?
7) What do you think needs to be done to control the spread of HIV/AIDS
8) What do you believe to be the main problems facing orphans in Swaziland?
9) Is there any help to encourage orphans into education in Swaziland? What plans have you heard of?
10) What help is offered to child headed families?
11) What do you think the future holds for orphans in Swaziland?
12) Have you heard of the National Plan of Action for Orphans and Vulnerable Children? Do you think it has been successful?
13) Do you think that Neighbourhood Care Points are a good idea?
14) Do you think NCPs achieve what they are designed to achieve?
15) How do you think the idea of NCPs could be improved to further benefit orphans?
16) What impact does the number of orphans in Swaziland have on the country?
Appendix Four: Questions for MOEd –
1. What is your opinion on grades one and two being free next year?
2. What do you think children gain from formal education that they don’t get from learning at home/ at NCPs etc?
3. How could NCPs be improved?
4. Do you think that one day NCPs won’t exist in Swaziland or do you think they will stay around for a long time?
5. What do you think the most important thing about formal education is, is it that they can get jobs when they leave or what do you think the children come out being able to do that they can’t get elsewhere?
6. Do you plan to extend free education to all grades?
7. Do you think uniform poses a problem? Is there any help to fund the uniforms?
8. What percentage of Swazi children do you think will attend school now that it is free?
9. Do you think that children and young adults in Swaziland are well educated into the dangers of HIV/AIDS?
10. What do you believe to be the main problems facing orphans in Swaziland?
11. What help is offered to child headed families?
12. What impact does the number of orphans in Swaziland have on the country?
