CHAPTER ONE
INTRODUCTION
1.1BACKGROUDN TO THE STUDY
In 2007, an estimated 145 million children 0 to 17 years old were orphaned, having lost one or both parents (UNICEF 2008). Many millions of other children can be described as vulnerable, due to the effects of illness and poverty. There are many reasons for this situation, including conflict, disease, and accidents.
However, in recent times, a new and significant cause of the increase in children in orphanages home and vulnerable children has been the impact of the HIV pandemic. Worldwide, 15 million children have been orphaned due to AIDS, with 11.6 million orphans due to AIDS in sub-Saharan Africa alone (UNICEF 2008b). AIDS is also unique in its impact on double orphans, or children who have lost both parents. If one parent is living with HIV, there is a high likelihood that the other parent is as well and that a child will lose both parents in a short period of time. Children who are orphaned are more likely to suffer from detrimental health and nutritional outcomes; orphaned children are more likely to be stunted compared to non-orphans. Paternal orphans are also more likely to have suffered from recurring sickness in the past month compared to non-orphans. Additionally, caregivers of double and maternal orphans are less likely to report that the child has been sick in the last 12 months although maternal orphans are more than twice as likely to report being treated worse than other members of the household, compared to non-orphans (UNICEF 2006).
Estimating the number of children in orphanage homes and vulnerable children depends in large part on how orphans and vulnerable children are defined and on different methods used to project future levels of factors that cause children to be orphaned and made vulnerable, including the course of the HIV and AIDS pandemic.
Orphans tend to be defined as children aged under 18 who have lost their mother, father or both parents (UNAIDS et al. 2004).
Vulnerable children can be defined as children whose safety, well-being or development is at significant risk. Amongst others, such children can include children orphaned due to AIDS, children infected with HIV, children caring for terminally sick parents with AIDS, fostered children, children in poor households which have taken in orphans, disabled children, street children, children exposed to excessively hazardous labour, children involved in the sex industry, children affected by conflict, migrant children and children out of school. The extent to which such children can be said to be vulnerable will vary from place to place and community to community.
Children move in and out of various groups of vulnerability as their life circumstances change. It can be observed that while orphanhood often imposes a heavy burden on children, not all children orphaned are needy or poor. Similarly, there are many children who are not orphans but who are needy or vulnerable. Other factors, such as quality of parental care, the presence of conflict and families’ needs for children to work, can also act strongly to affect children’s vulnerability. Many such factors are not readily quantified or recognized, as a result, common understandings or definitions of vulnerability are difficult to achieve. While anecdotal evidence of the experience of orphans and vulnerable children exists, the extent of the ‘invisible’ causes of vulnerability remains unknown.
Rapid advances in biological and behavioural research show early childhood as a time of tremendous brain growth. It is during a child’s first few years that the neural connections that shape physical, social, cognitive, and emotional competence develop most rapidly and show the greatest ability to adapt and change. Connections and abilities formed in early childhood form the foundation of subsequent development. As a result, providing the right conditions for healthy early development is likely to be much more effective than treating problems later in life (centre on the Developing child 2007).
Just as strong foundations provide the basis for positive and healthy adaptations, weak foundations create physiological disruptions that can undermine subsequent learning, behaviour, and lifelong physical and mental health. This biological evidence explains how, in the absence of nurturing and supportive relationships—the type of environment in which many orphans and vulnerable Children live— adversity can create “toxic stress” that undermines all aspects of a child’s subsequent development, creating significant, physically based, and long-term obstacles to positive outcomes for these children. Centre on the Developing child (2010); Shonkoff (2010).
Vulnerability is a complex concept to define, as is illustrated in local/community definitions of vulnerability, which often include disabled or destitute children; in policy and support provision definitions, which list categories of children; and in working definitions, which are used in various.
A major concern is that the orphan estimates do not reflect children who are vulnerable but still living with parents, or children vulnerable due to other causes or in addition to AIDS. Countries seeking to quantify the current and future burden of orphan and vulnerable children (OVC) may need to supplement their data on orphans with information from a situation analysis that covers all vulnerable children.
There is a body of evidence that challenges the assumption that orphans are the most vulnerable children. Using non-enrolment and non-attendance rates in schools as proxies for vulnerability, studies by Ainsworth and Filmer (2002) and Huber and Gould (2003) found that in many countries poor children (rather than orphans) were most likely not to be enrolled in or to be out of school. Though generalizations across countries (28 countries in four regions in the Ainsworth and Filmer study) can be challenged, the link between poverty and vulnerability seems well established, suggesting that policies to raise enrolment among the poor will also have a positive impact on disadvantaged OVC. These findings seem to suggest that poverty at the community level is a main factor driving the conditions in which vulnerable children find themselves, and that if poverty is addressed, the quality of many children’s lives would be improved.
The future of any society depends on its ability to foster the health and well-being of the next generation” (2007), ensuring a strong start for orphans and vulnerable children is especially” important in societies facing high levels of HIV infection, where illness and death erode the ability of the adult generation to nurture children.
A child’s “environment of relationships” refers to the day-to-day interactions between the child and the people in the child’s world. This includes family members or caretakers in the home or institutional setting, as well as the people who interact more broadly with children, such as individuals and groups within a community, in school, and in health facilities (Shonkoff 2010). A large body of research documents that loving, supportive care and secure attachments are critically important for positive child development. The consistent presence of stable, caring adults is one of the most, if not the most, important protective factor in mitigating toxic stress of the kind that many orphans and vulnerable children(OVC) face (center on the Developing child 2010; Shonkoff 2010).
Intellectual development of children growing up in orphanages is thought to be at risk. Because of care in large groups and poor environments, brain development may become delayed during the formative period after birth (Chugani et al., 2001), and the lack of challenging stimuli and stable attachments may impair the intellectual development of institutionalized children (Gunnar, Bruce, & Grotevant, 2000; Johnson, 2000; Miller, 2005; Van IJzendoorn & Juffer, 2006).
More than 30 years ago, Dennis (1973) addressed the question of how large the cognitive delay of children in orphanages was compared to children adopted into families. He studied children who were abandoned immediately after birth and were reared in children’s homes in Lebanon.