Qualitative research report on orphans and vulnerable children in Palapye, Botswana pot

Figure 1: Number of registered orphans, Botswana, 1999–2003 Source: Ministry of Local Government 2003, Department of Social Services 1999–2003 The number of registered orphans has been i

Qualitative research report on orphans and vulnerable children in Palapye, Botswana

© 2007 Human Sciences Research Council

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2.1 Aims of the qualitative research 5CHAPTER฀3:฀METHODOLOGY฀฀฀6

3.1 Research design 63.2 Research participants and sampling procedures 63.3 Data collection instruments 8

3.4 Ethical considerations 83.5 Data analysis 9

CHAPTER฀4:฀฀LIVING฀CONDITIONS฀฀

AND฀SERVICES฀฀฀104.1 Description of site 10

4.2 The situation of OVC 124.3 Household situation 144.4 Institutional care of children 174.5 Child abuse 18

4.6 Community members’ and leaders’ perceptions of OVC 194.7 Support structures for OVC in community 20

4.8 Context of HIV/AIDS 25CHAPTER฀5:฀฀CONCLUSION฀AND฀

RECOMMENDATIONS฀฀฀265.1 Recommendations on care of OVC 27

5.2 Recommendations on support of households and communities caring for OVC 27

5.3 Recommendations on service providers for OVC 28Appendix 1 Interview schedule for OVC 29

Appendix 2 Interview schedule for immediate caregivers of OVC 31

Appendix 3 Interview schedule for members of NGOs, CBOs and FBOs 34Appendix 4 Interview schedule for members of state services or government 36Appendix 5 Interview schedule for background for BSS component 38

This study was supported by the WK Kellogg Foundation and undertaken by Masiela Trust Fund OVC Research-Botswana under the umbrella of the Human Sciences Research Council in South Africa Masiela Trust Fund OVC Research-Botswana is indebted to the field assistants, respondents and community leaders who participated in this study We are also grateful to our research team which has worked tirelessly in the preparation of instruments and collection of data

We also thank all those who helped at various stages in the writing of this report, especially Dr Dudu Jankie who analysed some of the data

AIDS acquired immune deficiency syndrome

ARV anti-retroviral therapy

BSS behavioural risks and sero-status

CBO community-based organisation

CHBC community home-based care

FBO faith-based organisation

HIV human immuno-deficiency virus

HSRC Human Sciences Research Council

MTF Masiela Trust Fund

MTP medium-term plan

NGO non-governmental organisation

OVC orphans and vulnerable children

PLWA people living with HIV and AIDS

PMTCT prevention of mother to child transmission of HIV

STPA short-term plan of action

TCM total community mobilisation

VCT voluntary counselling and testing

Basic human rights These are rights held to be common to all people, such as education, health, protection from abuse and neglect, food, shelter, non-discrimination, preservation of identity, etc

Street children These are children who have run away from home and live in the streets Many are believed to be orphans while the rest have run away from home due to lack of parental love and care

An orphan The most accepted definition of an orphan is a child who has lost both parents through death In Botswana an orphan is a child below 18 years who has lost both adoptive or biological parents, or the one single parent if unmarried (Skinner et al 2004)

A vulnerable child A child who has no or very restricted access to basic needs The child may have both parents but his/her rights might be denied (Skinner et al 2004)

In 2002 the Human Sciences Research Council (HSRC) received funding from the WK

Kellogg Foundation to develop and implement a five-year intervention project on the

care of orphans and vulnerable children (OVC), as well as households and communities

coping with the care of affected children in Botswana, South Africa and Zimbabwe The

project comprises two components: firstly funding and technical assistance directed at

interventions to assist OVC; and secondly research to develop a better understanding

of the situation of OVC and towards the development of best practice approaches

for interventions The HSRC is collaborating with research institutions in Zimbabwe

and Botswana, and with non-governmental organisations (NGOs) that would act as

implementing partners for the interventions In Botswana, the Masiela Trust Fund (MTF)

was chosen to work with the University of Botswana Research Team as an implementing

partner MTF’s mission is to mobilise resources to address the needs of orphans in order

to minimise the phenomenon of street children, juvenile delinquency, and to help divert

a culture of destitution, as well as forge a threat-free environment in the interest of a

better tomorrow MTF works with community-based organisations (CBOs) and faith-based

organisations (FBOs), and funds their projects in the intervention sites to ensure delivery

of necessary services to those who need them In Botswana, Palapye was chosen as an

intervention site for this project, in addition to the already existing sites where MTF has

interventions

This study used qualitative techniques to enable in-depth understanding of the situation of

OVC in Palapye Different approaches were used in data collection, including structured

and semi-structured interviews and focus group discussions These helped the researchers

understand issues related to behaviour, attitudes, opinions, beliefs, feelings, knowledge

and values about OVC A total of 32 key informant interviews and eight focus group

discussions were conducted Purposive sampling was used to make sure that all significant

sectors of the communities were systematically covered Interviews were held with

OVC, immediate carers of OVC, NGO/CBO/FBO representatives, community leaders and

government officials

Palapye is a semi-urban locality and Setswana is the predominant language used in the

area It also has advanced infrastructure The community has access to different shops

(food, furniture, and clothing), public phones, public transport, electricity, water, tarred

roads and others It is a typical village where some families still reside in one-roomed

traditional houses constructed of mud with a thatched roof Most of the households do

not have running water and proper sewerage Palapye has some urban dwellings, where

families reside in modern multi-roomed houses that have running water, proper sewage

and electricity The Department of Water Affairs has provided community standpipes in

the village for use by villagers who do not have running water in their homes

There are an increasing number of OVC in Palapye, and the situation is compounded

by HIV/AIDS resulting in the death of able-bodied parents This leaves the children in

the care of old and poor grandparents Poverty levels seem quite high, as many reported

shortages of basic needs including housing Poverty alleviation initiatives are crucial for

this community

Though the government has programmes to cater for orphaned children and the destitute,

there are challenges in registering those who qualify for these services, which results

in programmes not being accessible Another complicating factor is the reluctance of

families to register such children with appropriate authorities The community needs to be

educated on available programmes and their benefits

Further, due to shortages of transport, finance and manpower in delivery of services, accessing services remains a challenge On the other hand, NGO/CBO/FBO efforts to address the issues are frustrated by the great lack of funds This calls for a stronger partnership in caring for OVC.

In some poorer households even the support from social welfare services of providing food rations does not benefit OVC, as it is said that some caregivers steal these supplies and use them for their own gain This calls for education on caring for children and home management

Stigma continues to be a major challenge regardless of how long HIV/AIDS has been

in existence and how much education has been done A general lack of knowledge

on HIV/AIDS is apparent in the myths surrounding transmission, prevention and cure Communities need more education on issues of HIV/AIDS, especially to try and decrease the extent to which people are subject to stigma

ChApTER฀ 1

Introduction

The AIDS epidemic has left behind an estimated 15 million orphans worldwide Around

80 per cent of these AIDS orphans live in sub-Saharan Africa (Fredriksson-Bass &

Kanabus 2004) Tragically, the number of orphans in sub-Saharan Africa will continue to

rise in the years ahead, due to the high proportion of adults in the region already living

with HIV/AIDS, and the continuing difficulties in expanding access to life-prolonging

anti-retroviral treatment (UNICEF 2003) In sub-Saharan Africa, even more catastrophically

than elsewhere, the HIV/AIDS epidemic has deepened poverty and exacerbated myriad

deprivations The responsibility of caring for orphaned children is a major factor in

pushing many extended families beyond their ability to cope (UNICEF 2003) Many

countries are experiencing large increases in the number of families headed by women

and grandparents, and these households are often progressively unable to provide

adequately for the children in their care

Children orphaned by HIV/AIDS are disadvantaged in numerous and often devastating

ways For instance, in addition to the trauma of witnessing the sickness and death of

one or both parents, they are likely to be poorer and less healthy than non-orphans

(UNICEF 2003) They are more likely to suffer damage to their cognitive and emotional

development, to have less access to education, and to be subjected to the worst forms of

child labour (UNICEF 2003) Young people who have lost one or both parent are among

the most exposed in the society This is particularly true in sub-Saharan Africa where few

social support systems exist outside of families and where basic social services are largely

inadequate (Fredriksson-Bass & Kanabus 2004)

Furthermore, orphans may grow up without basic material resources and may lack

the love and support that emotionally-invested caregivers usually provide They may

be discriminated against because of the sero-status of their parents, or be forced to

discontinue their education because of lack of money or the need to take care of their

siblings (Skinner et al 2004)

There is general consensus in the literature that help for orphans should be targeted at

supporting families and communities and improving their capacity to cope, rather than

setting up institutions for the children, as orphanages are not a sustainable long-term

solution (UNAIDS 2002) In addition, institutional care is known to have deleterious

effects on children Children sent away from their villages may lose their rights to their

parents’ land and other property, as well as their sense of belonging to a family and a

community

Skinner et al (2004) define an orphan as a child who has lost one or both parents

through death, desertion or if the parents are unable or unwilling to provide care They

further define a child as someone who is aged 18 and below The Botswana Short Term

Plan of Action (STPA) (Ministry of Local Government Lands and Housing 1999: 9) on the

care of orphans defines an orphan as a ‘child below 18 years who has lost one [single

parent] or two [married couples] biological or adoptive parents’ The plan of action

goes on to categorise another group of orphans as social orphans and defines them as

‘abandoned or dumped children whose parents cannot be traced’ For the purposes of

The number of orphans in Botswana has increased tremendously in recent years due

to high and increasing prevalence of HIV and AIDS In 1999, the number of registered orphans was 21 109 and this number doubled to 42 000 by 2003 (Ministry of Local Government 2004) This trend is shown in Figure 1

Figure 1: Number of registered orphans, Botswana, 1999–2003

Source: Ministry of Local Government (2003), Department of Social Services 1999–2003

The number of registered orphans has been increasing, and findings from the rapid assessment on the situation of orphans in Botswana (Ministry of Health 1998) indicated that many orphans do not have access to basic necessities such as food, clothing, shelter and toiletries The assessment also established that their basic fundamental human rights were violated by society and caregivers, including relatives in some cases – for example, their food rations being sold and being used as cheap labour by the business community What further aggravates the problem is that many caregivers are aged grandparents, who live in abject poverty, and in many cases are supported through the destitute programme

or old age pension (Ministry of Local Government Lands and Housing 1999)

The advent of HIV and AIDS has not only increased the problem of orphans but also compounded the phenomenon of vulnerable children The long-term sickness and eventual death of a parent or both parents to HIV and AIDS exposes OVC to all kinds

051015202530354045

2002), the main underlying reason why children go onto the streets is poverty

In view of the rapid increase of registered orphans due to HIV/AIDS, the government of

Botswana, through the Ministry of Local Government which has a sectoral responsibility

for the protection, care and mitigation of the impact of HIV/AIDS on children, developed

a short term plan of action (STPA) on the care of orphans for 1999–2001 This programme

seeks to support and protect affected and infected children and their families Some of

the key activities/projects are discussed below

1.2.1 National orphan care programme

The government of Botswana initiated a national orphan care programme in 1999

to coordinate all efforts addressing the orphan problem through the Social Welfare

Department under the Ministry of Local Government Since the start of the programme in

1999 all districts have taken responsibility to assess, register and support orphans

The Botswana orphan care programme is guided by the STPA (Ministry of Local

Government Lands and Housing 1999), which has the following stated objectives:

• Facilitating an efficient and effective system of provision of material and emotional

support services and protection of their basic rights;

• Facilitating the identification, assessment and registration of orphans regardless of

the cause of death of parents;

• Identifying the various stakeholders and defining their roles and responsibilities in

responding to the orphan crisis;

• Identifying mechanisms for supporting community based responses to the orphan

problem; and

• Developing a framework for guiding long-term development programmes for orphans

The orphan care plan of action has implemented the following regarding provision of

basic needs:

• Food baskets: Given that many of the orphans are without adequate food, clothing,

decent shelter and toiletries, provision of these basic needs was perceived as the most urgent and immediate focus of the orphan care programme In collaboration with the Ministry of Health, a ‘food basket’ was established for orphans and other children in need of nutritional care This basket contains all the necessary food items, including, for example, maize-meal, rice, meat, vegetables and toiletries

These are issued on a monthly basis nationwide (Ministry of Local Government Lands and Housing 1999)

• Access to education: To ensure that orphans remain in school and get appropriate

education, orphans are provided with suitable school uniforms, shoes and other miscellaneous school costs

• Security: To ensure sustained or continued protection of orphans from abuse and

neglect, characteristics of the socio-political environment in which children and OVC

in particular find themselves, the orphan care programme is mandated with the responsibility for the well-being and security of orphans For example, one of the programme activities is provision of legal interventions that are in place to protect the rights of children and orphans The Children’s Act includes provisions targeting abuse and neglect of children

• Alternative care: Given the complexity of the orphan problem, the government

has identified the need to establish alternative care for orphans, guided by the

‘Regulations governing alternative arrangements for children in need for care’ (STPA

on Care of Orphans in Botswana)

• Provision of psycho-social support: This is provided by social workers in government

and non-governmental organisations (NGOs) such as MTF and other private institutions.The response of the government of Botswana is in line with the Millennium Development Goals that were adopted by 189 United Nations member states in 2000 in order to combat poverty, hunger, disease, discrimination against women, degradation of land, and illiteracy (UN 2000)

1.2.2 Institutional partnerships/collaboration

NGOs and community-based organisations (CBOs) have responded positively in providing various childcare and protection activities Their countrywide initiatives focus on orphan feeding, clothing, counselling, home visits, day care and home-based care for the

terminally ill

To complement government efforts and strengthen community initiatives, Masiela

Trust Fund (MTF) was established through a notarial deed of trust on 9 February 2001,

in accordance with the laws of the Republic of Botswana MTF is charged with the responsibility of raising funds for the care of orphans, and support to CBOs and FBOs that are involved in care for OVC as part of increasing the volume and quality of care However, NGOs and CBOs have certain limitations in their quest to provide care to OVC For instance, due to manpower, skills and financial constraints, their contributions have been limited and concentrated more in urban and semi-urban areas thus limiting the desired national response to addressing orphan needs The government orphan care programme is limited to the care of only orphans registered with the Social Welfare Division, leaving out the unknown numbers of unregistered orphans

Background to the project

In 2002 the HSRC received funding from the WK Kellogg Foundation to develop and

implement a five-year intervention project on the care of OVC, as well as households

and communities coping with the care of affected children in Botswana, South Africa

and Zimbabwe The project comprises two components; firstly, funding and technical

assistance directed at interventions to assist OVC; and secondly, research to develop

a better understanding of the situation of OVC and towards the development of best

practice approaches for interventions In Botswana, the MTF was chosen to work with the

University of Botswana Research Team as an implementing partner MTF’s mission is to

mobilise resources to address the plight of orphans in order to minimise the phenomenon

of street children and juvenile delinquency, and help to divert a culture of destitution, as

well as forge a threat-free environment in the interests of a better tomorrow MTF works

with CBOs and FBOs, and funds their projects in the intervention sites to ensure delivery

of necessary services to those who need them

The ultimate goals of the project are to develop, implement and evaluate best practice

approaches for existing and new OVC intervention programmes that will:

• Improve the social conditions, health, development, and quality of life of vulnerable

children and orphans;

• Support families and households coping with an increased burden of care for

affected and vulnerable children;

• Strengthen community-based support systems as an indirect means of assisting

vulnerable children; and

• Build capacity in community-based systems for sustaining care and support to

vulnerable children and households over the long term

There were other activities undertaken as part of this project Situation analyses were

conducted to identify the existing services in the study areas, as well as to establish

their strengths and weaknesses and gather suggestions on how to improve or strengthen

services This was followed by the baseline studies including census surveys and

qualitative research This was to aid in the planning of interventions that were to be

developed, as already stated These baseline studies are to be repeated at the end of the

project in an effort to assess the effects of interventions

The purpose of this qualitative study was to obtain a detailed description of the situation

of OVC at selected sites The information obtained is to be used to develop appropriate

intervention programmes for OVC The specific objectives of the study were to:

• Develop an understanding of the magnitude and nature of the OVC problem in the

study sites;

• Identify and describe key and potential support systems for the OVC;

• Assess the social conditions, health, development and quality of life of OVC; Identify

family and household support systems for coping with the burden of care for OVC

at family and community level

to the process of constructing research knowledge as researchers ‘observe, interview, record, describe, interpret and appraise settings as they are’ (Eisner 1991: 145) Within this context, qualitative researchers interact with participants, such as orphans, vulnerable children and their carers, as they attempt to understand and make sense of the social world/natural setting from the perspectives of the targeted participants.

Considering that the importance of qualitative research lies partially in exploring

the participants’ multiple realities and experiences of the social phenomenon under investigation, the researchers used structured and semi-structured interviews, focus

group discussions, and document analysis to gain insights into the issues related to the behaviour of, attitudes, opinions, beliefs, knowledge and values regarding OVC These sources of research data not only provided descriptive data essential in qualitative

research studies, but also made it possible to triangulate data for purposes of data analysis and reporting the findings of the study Thus, the qualitative nature of this study is also partially evident in the triangulation of the research data The importance of this lies in the fact that triangulation increases the credibility of research results since it ‘increases the likelihood that the phenomenon of interest is being understood from various points of view and ways of knowing’ (Maykut & Morehouse 1994: 146)

3.2 Research participants and sampling procedures

Participants who were purposefully chosen for this study included individuals from significant sectors of the community who were familiar with and knowledgeable about the situation/social conditions of OVC More significantly, participants included OVC, thus giving these children the opportunity to share their knowledge and insights regarding their lived experiences and realities Yet, it is important to note that the experiences and realities of these children may not be viewed as representative of the social conditions

of all OVC in selected sites Other participants consisted of carers of OVC, community members, members of NGOs, government officials, and community leaders

3.2.1 The OVC

Ten OVC were interviewed, including five males and five females Of the five female OVC interviewed for this study, two were aged between six and 12 years, whilst the other three were aged between 13 and 18 Likewise, of the five male OVC, two were aged between six and 12 years, whereas the other three were 13- to 18-year-old teenagers Because of the sensitivity of information required from them, OVC were interviewed individually

3.2.2 Immediate carers of OVC

The purpose of interviewing caregivers was to find out their experiences and the

challenges of caring for OVC and how to address these In all, one male and seven

female caregivers were interviewed Five of the seven female carers were grandmothers,

while the other two were aunts Of significance too is that one of the grandmothers was

blind, a phenomenon that makes it more challenging to perform the role of a caregiver

The only male carer interviewed was a grandfather who was responsible for orphaned

children The carers, who in fact reported that they were taking care of up to four

children, started taking care of the orphaned children after their mothers passed away

Of note in this regard is that there was no mention of fathers as possible caregivers for

these children following the passing away of their mothers, thereby suggesting that these

children were from single-parent families

3.2.3 CBOs, FBOs, and NGOs

This category consisted of organisations working with OVC The nature, structure and size

of these organisations differed Some were mainly made up of volunteers while others

offered paid employment NGOs also offered different services such as care, support,

counseling, and so on Only NGOs working directly with OVC were selected At least

one person from each of the following organisations was interviewed: Itsoseng Banana,

House of Hope, Total Community Mobilization, Home-based Care Community, as well as

the Full Gospel Church, making a total of five participants These were people likely to

be conversant with and/or knowledgeable about the plight of OVC and the services that

their organisation offered The main reason for interviewing this group was to find out

about services they offered for OVC, what they thought were major needs of OVC, and

challenges faced in assisting them

3.2.4 Government officials

This category comprised of people who were working for government departments

involved in orphan care The three individuals interviewed in this regard were a

social worker, a police officer and a district medical officer The main reason for

interviewing government officials was to identify their views on OVC problems and

their understanding/awareness of government’s involvement in improving the condition

of orphans Topics covered included the policies set out to deal with OVC, and the

government departments tasked to deliver these services, obstacles to their delivery and

methods to address obstacles

3.2.5 Community leaders

The three community leaders who participated in this study comprised of the chief

(Kgosi), councillor and village development committee chairperson Interviews with these

individuals explored their attitude to OVC, as well as perspectives regarding HIV/AIDS

and risk behavior

3.2.6 Focus group discussions

Focus group discussions provided the opportunity for collecting descriptive data from

community members who participated in this study Eight focus group discussions were

conducted The main purpose of these was to gather information relating to participants’

knowledge and beliefs about HIV/AIDS and risk behaviour, as well as OVC issues

Participants were grouped according to age and gender Categories were ages 6–12, 13–

18, 19–24 and 25 years and above For each age group, separate male and female groups

Permission was sought from the participants to tape interviews The audio-taped

interviews were later transcribed for purposes of analysing, coding and reporting the research findings Moreover, the participants were informed that the research data would only be used for purposes of this study The length of interviews varied depending on who was interviewed For instance, the OVCs were interviewed for 30 to 60 minutes, whereas the duration of the interviews with carers was 45 to 60 minutes, while members

of NGOs, state officials and community leaders were interviewed for 60 to 90 minutes

3.3.1 Interviews

The primary data collection strategies used for generating qualitative data for this study were structured and semi-structured interviews, focus group discussions and document analysis An interview guide was developed by the researchers for use in both the key informant interviews and focus group discussions The schedule focused on background information of the informant, attitudes of the community towards OVC, care and support structures, challenges for the community in providing care and support to OVC, as well

as policy and legislation for the protection of OVC Secondary questions asked dealt with knowledge, beliefs and behaviour regarding HIV as well as the extent of HIV/AIDS in the community and how people could protect themselves (see Appendices 1–5)

Time was spent with the community including leaders in Palapye to negotiate entry This was done in consultation with other CBOs working with OVC in the study site Kgotla (public) meetings were held to reach the community at large Such preparation helped the community and leaders to understand the programme and to accept its ownership Ethical considerations are an important aspect of qualitative research projects At

participants Within the context of this study, the importance of this lies in that children/

minors were among the key participants Hence, informed consent for their participation

had to be sought from those who were legally responsible for their care and from the

children as individuals Verbal consent was used in this study, as consensus to accept it

was reached by the participating countries The consent forms, which were written in

both English and Setswana (both official languages, with the latter being the dominant

local language at site), were first read to those who were asked to participate

Considering the sensitive nature of the themes or issues that this study explored, such

as HIV/AIDS, and thus the sensitive nature of knowledge and insights sought from the

participants, it was important to assure the latter that their participation would not expose

them to any risks, such as unfair treatment, pain and injuries Moreover, the researchers

informed the participants that their participation was voluntary, and confidentiality would

be observed by using pseudonyms to protect them Consequently, the knowledge or

information they shared would be kept anonymous Within this context, before the

interviews and focus group discussions started, facilitators provided participants with full

information regarding their participation in the discussions

Access to organisations was sought from their respective managers, or in the case of

government officials, from senior personnel in the department As gatekeepers to the

organisations, these individuals were instrumental in giving permission for the researchers

to interview their staff members, as well as in identifying the documents that were

requested for purposes of the study Informed consent forms were also read to potential

participants in these organisations and their consent sought before proceeding with the

interviews

Data from structured and semi-structured interviews, focus group discussions and relevant

documents were read and re-read and coded in order to identify emerging themes and

their relationships to the main objectives of the study This thematic content analysis

method was used to identify the major themes and discourses that emerged from the

transcriptions, to acknowledge and represent the multiple voices and perspectives of

individuals who participated in the study

Living conditions and services

Palapye is situated in the Serowe/Palapye district in Central Eastern Botswana, about

275 km north of the capital city Gaborone It is one of the largest villages in Botswana with a population of 26 293, of whom 12 087 (46 per cent) are males and 14 206 (54 per cent) are females (CSO 2001) Palapye is built around a coal-driven power station called Morupule Colliery, which supplies the coal for the power station Most of the people living in Palapye are employed by either the power station or the colliery The other groups of people are mainly employed by the government in the ministries of health, education and local government However, most families still depend on livestock rearing and ploughing for survival

Palapye is a semi-urban locality and residents use Setswana as the predominant language

It also has advanced infrastructure The community has access to different shops (food, furniture, and clothing), public phones, public transport, electricity, water, tarred roads and others It is a typical village where some families still reside in one-roomed traditional houses that are made up of mud and a thatched roof Most of the households do not have running water and proper sewerage Palapye has an urban area where some

families reside in modern multi-roomed houses that have running water, proper sewerage and electricity The Department of Water Affairs has provided community standpipes in the village for use by villagers who do not have running water in their homes

The locality of Palapye still embraces the traditional style of an extended family culture of caring, although there are signs that the extended family has begun to disintegrate The extended family has always provided a safety net but it is now undergoing a tremendous social and economic change that has a direct impact on families’ ability to provide care for OVC The socio-economic developments taking place in the country have had both negative and positive impacts One of the negative impacts at societal level has been the break-up of the extended family as more and more family members move into towns

to seek employment As a result of these movements, and the rise in the cost of living, families are no longer able to be as intact as they used to be This has resulted in the tendency to have more nuclear families

Palapye has both the traditional and modern type of leadership comprising of a chief, two deputy-chiefs, a district commissioner and other state officials such as the police, political councillors, members of parliament and others

There is one primary health care facility and four clinics These are government-supported facilities that provide for the health care needs of the community, including those of OVC The Botswana 2003 second-generation HIV/AIDS surveillance study did not single out numbers for Palapye as a community but includes its numbers with those from the rest of the Serowe/Palapye district HIV prevalence for the district was 43.3 per cent in

2003 The healthcare system provides an array of services to benefit people living with HIV/AIDS, and these include Prevention of Mother-to-Child Transmission of HIV/AIDS (PMTCT), Sexually Transmitted Infections clinics, tuberculosis treatment and access to

Gaborone

Palapye

of Palapye, whereas Mahalapye Hospital is located about 60 km south of Palapye People

living in Palapye also have access to a free voluntary counselling and testing (VCT) centre

provided through a local VCT provider called Tebelopele, which uses rapid tests and

has been supported through a collaboration between Botswana and the United States of

America government called BOTUSA

There are schools in Palapye which are operated by both the private and public sectors

There are six day-care centres Out of these only one is provided by an NGO called

House of Hope Other day-care centres are provided through the private sector and

charge monthly rates of between P300–P450 ($60–$90) per child per month There are

eight primary schools and three secondary schools, all supported by government through

the Ministry of Education

Through the Ministry of Local Government, Social Welfare Division, orphaned children

in Palapye benefit from the government orphan care programme The purpose of the

programme is to identify and register orphans, as well as provide monthly rations in the

form of food and toiletries Clothing is provided on a yearly basis By December 2004,

the programme had registered 1 743 orphans The number of children registered in the

destitute programme was not available

Figure 2: Map of Botswana

4.2 The situation of OVC

Discussions from interviews indicated that vulnerable children are a growing problem

in the community Of major concern in this community is the escalating number of orphaned children Though there was a concern about vulnerable children, the lack

of a clear understanding of which children are vulnerable complicated the discussions Thus discussions centred on orphans, though it was generally agreed that both orphans and vulnerable children should be registered with the relevant offices so that they could enjoy the benefits offered by the government programmes Orphans are registered into the national orphan care programme, while vulnerable children who are not orphans are registered into the destitute persons programme

The extent of the OVC problem was not known due to the failure of carers to register such children with relevant authorities Some of the participants who were interviewed identified limited knowledge of procedures involved in the registration of OVC, attitudes

of members and carers towards registering OVC, and lack of social workers as factors that contributed to the magnitude of the problem

Registration of OVC with social workers was seen as essential for providing basic care for them This support included getting clothing, school uniforms, and food supplies Likewise, registering OVC with social workers for instance made it possible for them to have access to social services such as counselling and healthcare

The importance of registering OVC so that they may benefit from services of this nature could not be over-emphasised This however was crippled by reluctance of families in registering such children, as one government officer said about registering orphans: ‘Some parents do not want to show that they have orphans.’

According to participants, poverty was the reason for this lack of enthusiasm in registering children Poor people often felt stigmatised and this made them shameful Registering their children would mean they were asking for assistance and thus exposing their poverty Poverty was often viewed negatively as a phenomenon that was humiliating, and consequently, most individuals felt ashamed of being labeled as poor

Poor families found it challenging to provide the basic needs of OVC, such as food, clothing, education and decent housing What made this challenging most times was that,

in addition to taking care of orphans, these families often had other dependants in their care Within this context, some participants expressed the view that what contributed to negative attitudes towards registering orphans was the shame and embarrassment felt by some family members especially towards poverty In the words of the district medical officer when asked about families who fail to register the children:

Some of them are shy to do that because they feel that if I [they] go to the social workers, they will say, why are you failing to look after your child, or they will be thinking that I am [they are] too poor to fend for this child So people choose to suppress their suffering

The following excerpts from the focus group interview data reinforce this view:

You see Batswana are full of shame A lot of people have orphans but they do

down upon They pretend they are not needy so that people think they have the ability to care for themselves They do not accept their situation People are scared to register their children, as they fear what others will say about them

People will say you are not able to care for your children

Of significance too was that, whereas some individuals or families did not register

OVC because of the stigma attached to poverty, some working carers felt embarrassed to

register OVC because they believed that doing so implies that: ‘When I get the

food rations while I am employed, people will say I am poor and that is why I get the

free rations.’

At another level, some wealthy individuals or families did not register these children

because they felt that they did not need any form of assistance from the government to

help with the welfare of the OVC in their care Some focus group discussion participants

felt that an attitude of this nature should not be encouraged because all OVC have a right

to enjoy the benefits of the programmes aimed at promoting their welfare, regardless

of the social status of their carers After all, the carers are not the intended primary

beneficiaries of these programmes

It is also important to note that one of the female carers interviewed indicated that some

employed carers often felt that the food supplies provided for orphaned children were

meagre and hence not worth registering these children for: ‘It discourages you to think of

registering when you think of the meagre supplies you will get and so you choose to rely

on your own means.’

The fact that some individuals felt that they were able to maintain the orphans from their

own salaries may have discouraged them from registering these children

One of the benefits of registering children was that they were provided with basic needs

such as food and clothing, including school uniforms Those of school-going age were

therefore motivated to stay in school Failure to register children denied them the benefits

of the government programme, as a social worker interviewed pointed out:

OVC who go to school are in much better circumstances in that at school they are provided with the school feeding programme, and not only that, they have much more access to social workers’ services For example, they are provided with uniforms, shoes, clothing They are also taken care of through the school feeding program They are very well covered with services and they are much better [off] than those that are left at home or in the other places where the crèches are not well-organised or places with no schools Most of [those]

orphans are taken out of the villages to the lands and into the cattle post and dumped there They then do not have access to schools

Furthermore, regarding orphans, the district medical officer captured it when he said:

We still have the majority of orphans not in school although they are school age, because they are not accessible to the [welfare] officers that would put them in schools That’s why I would like to appeal to parents to say when they have such orphans, to straight away get in touch with the social workers so that [the social workers] can assist the children and see whether they can help them with school placement and [whether they] will automatically be qualifying for food at the school under the school feeding programme We still have a lot

of children who are not going to school because they are not registered with

the social worker, and because the relatives have taken them out of the villages where there are schools, to the cattle posts and to the lands

The district medical officer believed that this situation could be changed through

dissemination of information on the purposes and benefits of registering orphans, as well

as through educating family members and carers in particular, regarding positive care of these children, which involved registering orphans in schools at their appropriate grade levels As the district medical officer further explained, this was beneficial to the children:One of the things that was discovered in our district is that the children tend to enrol at school very late because they are taken away to these areas [lands and cattle posts] and therefore we feel that if the parents are educated, things are explained to them, either through the social workers, through the teachers, and

so on; by launching special campaign through the various meetings, the village health committees, village development committee and schools

The importance of educating orphans was also reinforced by other participants, such

as carers and the police officer interviewed, who viewed schools as social institutions where registered orphans could get valuable knowledge on HIV/AIDS, such as how the epidemic was transmitted and the stigmas related to it

Educating family members and carers regarding the registration and positive care of orphans also implies sensitising these individuals to the need to register all orphans with relevant authorities, regardless of whether or not their carers could afford to cater for them financially Yet, it is important to acknowledge the view expressed in one of the focus group discussions: that registering OVC could only yield its intended results if carers were committed to their welfare, which among other things should be demonstrated by keeping regular contact with relevant authorities Registering orphans and then failing

to be in contact regularly with relevant government authorities such as social workers and the staff of NGOs like House of Hope regarding their welfare, often prompted these individuals to visit specific families to check on the welfare of the orphans in their care Such visits more than often revealed that the orphans were neglected A focus group discussion participant who identified herself as a staff member of House of Hope explained: ‘Sometimes you find that a child is not in school Actions of this nature limit possibilities for orphans to improve their lives and thus have a better future.’

Interviewers were asked to make observations about their general impressions of the households where they conducted the interviews A majority of these households were reported as lacking most necessities such as running water, flush toilets or electric stoves The general impression was that the households displayed poor environments for the raising of children The house structure was also of concern, as housing is an important factor in caring adequately for OVC Of significance in this regard was that carers or guardians do not only care for orphans but other children as well as family members Lack of adequate housing was one of the main issues that emerged from this study Most

of the participants interviewed expressed the opinion that providing housing for OVC was essential in that it would improve their lives Within this context, various factors were identified that made housing an issue of concern in caring for OVC Firstly, some of the OVC lived in incomplete housing structures, which meant that they were not adequately

responding to the question on the status of their family housing, one of the OVC stated

that:

If you want to care for us you should build us houses At times our aunt brings

a lot of stuff from Gaborone and puts them in the house We then do not have enough space We are not able to sleep well in the house

While she acknowledged that the household items could benefit them, her concern was

that there would be less space available for sleeping comfortably Another OVC explained

that the house they inhabited was infested with rats and that the rats at times bit them

Thirdly, the OVC were taken care of by carers who were not able to effectively maintain

their houses Thus, although some of the OVC and their carers lived in dilapidated

traditional huts/houses which needed constant maintenance, the carers were not able to

do the necessary renovations Lack of maintenance was often due to the fact that some

carers, especially grandmothers, were too old to renovate the homesteads As one member

of the Home-based Care Programme explained:

Traditional Setswana houses in particular need constant care and maintenance and this might be a challenge where there are adults who are not able to even mix the mud for housing (mixture for building traditional houses) and therefore are not able to look after the yard or housing

It is important to note that failure to renovate houses also emanated from the fact that

most of the carers interviewed for this study were not employed and hence lack the funds

needed to carry out this exercise

4.3.1 Food and clothing

The registered children are provided with basic provisions such as food and clothing

Each child on the programme is entitled to a food basket containing basic food items,

toiletry and meat These items are valued at P250.00 ($50) and are offered on a monthly

basis The supplies are obtained through local supermarkets In addition to food and

toiletries, there is some money which is set aside per child per year for clothing and

blankets An assessment is done yearly to determine if the child needs a replacement of

clothing and blankets The carers of these children receive the food rations on behalf of

the children and this has challenges as some steal these from the children

It was reported by immediate carers and also in the focus group discussions that an

undisclosed number of OVC, especially orphans in poor households, did not have

adequate clothing This was especially so in the case of those who lived with old

grandparents who had no means to provide for themselves Some relatives who had taken

in these children did not buy them clothes when they bought for their own children Thus

some orphans did not have adequate clothing, as shown in the following quotation from

an interview with an orphan: ‘We need clothes We got clothing in 2002 but in 2003 we

did not get anything…Our clothes are now worn out and not fitting properly.’

The guardians revealed that orphans were normally given uniforms but that when the

uniform got worn out and torn or no longer fitted properly, it took them a long time to

get a replacement The reasons for this delay were not given The majority of the carers

complained that orphans were not supplied with general clothing As a result some

orphans were seen in tattered clothes or still wearing school uniform even after school

4.3.2 Food theft

Though all the guardians who were interviewed expressed satisfaction at the food rations received from the Department of Social Welfare and Community Development, there were challenges The respondents frequently reported that food from Social Services did not always reach the recipient children but was given to the children of the caregivers, aunts and uncles Frequently, carers accommodated or moved in with orphans so that they could use orphans’ belongings and food supplies for personal gain Sometimes orphans found themselves with no housing, as some of the relatives who decided to take care of them took over houses they had inherited from their parents Likewise, as the councillor interviewed for this study explained: ‘Government offers support for orphans in the form

of food rations, blankets, and school uniforms for those who are of school age; but some carers tend to use these to benefit their own children and not the orphans.’ This view was further reinforced by a participant in one of the focus group discussions who stated:

‘Orphans are not well cared for When they are supplied with food, people take it from them for their own use instead of giving them.’

Consequently, orphans were starved, with some becoming malnourished in the process For some orphans the situation was worsened by the fact that their carers or guardians were unemployed For instance, one of the orphans explained that he resided with his alcoholic aunt and uncles, all of whom were not working The following quote shows the dissatisfaction of these children with the food supplies:

I am an orphan I am not happy where I stay I receive food rations from social welfare services but my guardian does not give me food She only gives her children and tells me I am old enough to buy my own food

It was frequently reported in the group discussions that some guardians collected orphan food rations from social services and sold them to buy other necessities Guardians did not care whether the beneficiary had anything to eat or not All the orphans interviewed revealed that they felt they would be better off being adopted than living the life they were leading They generally felt the need for care centres to be established for OVC, especially the street children Of significance too is that some female carers often use orphan food supplies to cater for their boyfriends or male partners In the words of one

of the focus group discussion participants: ‘I sometimes take some of the food supplies, such as eggs, to reserve them for my boyfriend I leave the mealie-meal and cabbage for them [children].’

In similar vein, focus group discussion participants explained that orphans were deprived

of their food rations by older siblings who were not residing with them and their

carers The following quote illustrates this phenomenon: ‘The older siblings who reside elsewhere, only come on the day the food supplies arrive and they come to get a share

of everything and then go.’

In all, the fact that some carers denied orphans the opportunity to reap the benefits of the programmes designed for them confirms that food rations from the Social Services Department in particular did not always reach the intended recipients This in turn could have a negative impact on the orphans As one of the orphans explained, for instance, his uncle often sold all the food rations or supplies provided to the family, and due to lack

of food at home, he turned to the streets where he now stays and tries his level best to