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Lecture 11 Study Notes

Health Studies
Course Code
Jason Ramsay
Study Guide

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Lecture #11: AIDS Orphans
Monday, March 21st/2011
Sub-Saharan Africa
12.3 Million children under the age 15 have lost one or both parents to AIDS.
Life expectancy in this area has been reduced to 39 years old.
Parents may give HIV to their children through lateral transmission (during
delivery, through blood, etc.)
In Zimbabwe, the AIDS epidemic has been affected by the 70% unemployment rate,
100% or higher annual inflation, no agricultural system anymore (takeover and
mismanagement of settler owned farms.
50% increase in mortality for children under 5
The Virus
When Growing up is Hard
Growing up in sub-saharan Africa is already a difficult proposition
There is widespread political strife
Lack of adequate medical/prenatal resources
Lack of adequate medical resources
Lack of nutrition, malaria, disease.
Lack of educational resources.
Poor and Infected
If you are in sub-saharan Africa and infected, your chance of getting drugs is pretty
Some govts, notably South Africa were VERY slow to recognize that HIV even
needed to be treated.
SA refused to accept that ART was important.
Other countries denied or under-reported the HIV crisis.

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There are still some HIV/AIDS Deniers that persist in spreading misinformation
about the cause of AIDS (e.g., the virus was never isolated, etc.)
Debates amongst faith based vs. government funded vs. NGO based players about
how prevention efforts should be directed (e.g., promoting abstinence vs. condom
Politics of HIV/AIDS in Africa
Some countries dont record death from AIDS, due to the stigma.
Other countries (e.g., Uganda) have been very successful in prevention efforts, but
these efforts can be subject to changes in political climate (e.g., ABC).
Great difficulty in changing attitudes and beliefs surrounding sexual practice, and
folk theory of disease.
In many countries, political strife and civil war compromise efforts to deal with the
The Developmental Crisis
We can see from our readings that developmental health is crucial to the present and
future economic well being of a country.
So even if the pandemic resolves, what shape are the children going to be in?
There is very little research that provides any kind of baseline estimate of
psychosocial functioning of HIV orphans.
Without a baseline, how can we determine what programs/interventions are
necessary to provide for the future development of children?
On being an AIDS orphan
AIDS orphans have had to endure:
oCaring for a sick parent
oCaring for a sick younger sibling (or older)
oWatching them die
oLiving in a child centered household
oOr being raised by a distant relative

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oThey are incredibly vulnerable to exploitation
oDo not receive the necessities of life
oMay be engaging in risky sexual behaviors as a result of not having a
functional parent/family. household
Who looks after orphans?
Traditionally cared for by the extended family, but this system is weakening
Poor fostering system
Or, the oldest child ends up as head of a child run household
Worst case scenario, children end up as street children
Orphans have serious barriers to normal development:
oLack of nutrition
oLack of proper housing
oLack of medical care
oRisk for abuse and economic exploitation
Research on Psychological Effects
Barriers to implementing research:
oThere are very few culturally specific psychological instruments.
oResearch conducted on other populations may not be equivalent.
oHard to find/document children living in townships
oVery low literacy level
oThere are barriers of training: staff are unable to respond to the crisis
oLack of resources: poor places cannot afford to feed kids, let alone test them.
oThere may be cultural barriers at work that prevent people from taking part
in the research
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