Situational analysis of the socioeconomic conditions of orphans and vulnerable children in seven districts in Botswana Free download from www.hsrcpress.ac.za Edited by GN Tsheko Free download from www.hsrcpress.ac.za Research report prepared by the Human Sciences Research Council (HSRC) and the Nelson Mandela Children’s Fund (NMCF) for the strategy of the W.K Kellogg Foundation (WKKF) for the care of orphans and vulnerable children (OVC) in Botswana, South Africa and Zimbabwe in commemoration of the WKKF’s 75th Anniversary Published by HSRC Press Private Bag X9182, Cape Town, 8000, South Africa www.hsrcpress.ac.za First published 2007 ISBN 978-0-7969-2195-6 © 2007 Human Sciences Research Council Copyedited by David Le Page Typeset by Janco Yspeert Cover design by Oryx Media Cover photo: © Tessa Frootko Gordon/iAfrika Photos Print management by Compress Distributed in Africa by Blue Weaver Tel: +27 (0) 21 701 4477; Fax: +27 (0) 21 701 7302 www.oneworldbooks.com Distributed in Europe and the United Kingdom by Eurospan Distribution Services (EDS) Tel: +44 (0) 20 7240 0856; Fax: +44 (0) 20 7379 0609 www.eurospangroup.com/bookstore Distributed in North America by Independent Publishers Group (IPG) Call toll-free: (800) 888 4741; Fax: +1 (312) 337 5985 www.ipgbook.com Free download from www.hsrcpress.ac.za The researchers (Dr GN Tsheko, Prof SD Tlou, Ms M Segwabe, Dr LW Odirile) and Ms A Kabanye-Munene) who co-authored some parts of the document, would like to thank all those who made it possible for this work to be completed This study was supported by the Kellogg Foundation and undertaken by Masiela Trust Fund, OVC Research-Botswana under the umbrella of the Human Sciences Research Council’s (HSRC) Social Aspects of HIV/AIDS & Health research programme in South Africa The Masiela Trust Fund and the HSRC are indebted to the field assistants, respondents, and community leaders in Palapye, Letlhakane, Kanye, Molepolole, Mahalapye, Serowe and Maun who participated in this study We are also grateful to our research team, the members of which have worked tirelessly in the preparation of instruments, collection of data and report writing We cannot stop thanking the staff at Masiela Trust Fund for the support they provided during the study period Free download from www.hsrcpress.ac.za Lastly, we thank Dr GN Tsheko for editing the final report iv antiretroviral AIDS Acquired Immune Deficiency Syndrome BOCAIP Botswana Christian Aids Intervention Programme BOTUSA Botswana USA Project CBO community-based organisation DSS Department of Social Services FBO faith-based organisation HBC home-based care HIV Human Immunodeficiency Virus HSRC Human Sciences Research Council IEC information, education and communication MRC Medical Research Council NGO Free download from www.hsrcpress.ac.za ARV non-governmental organisation OVC orphans and vulnerable children PMTCT prevention of mother-to-child transmission (of HIV) STPA Short Term Plan of Action TCM total community mobilisation VCT voluntary counselling and testing VDC village development committee WKKF WK Kellogg Foundation v The overall aim of this project is to implement research-driven, evidence-based, intervention programmes to assist children, families and communities affected by HIV/AIDS in Botswana The overall philosophy is to empower communities to help themselves, and to ensure sustainability of the project after donor funding ceases Free download from www.hsrcpress.ac.za The situation analysis was carried out in seven research sites in Botswana These are Palapye, Letlhakeng, Kanye, Mahalapye, Molepolole, Serowe and Maun The data collection methods used for the qualitative research included key informant interviews and focus group discussions Information was collected from orphans and vulnerable children (OVC), their caregivers, community members, community-based organisations (CBOs), government officials and community leaders; as well as members of non-governmental organisations (NGOs) and faith-based organisations (FBOs) The objectives of the study are to improve the living conditions of orphans and vulnerable children; to support households and families to cope with the increasing burden of care for affected and vulnerable children; to strengthen community-based support systems under which vulnerable children exist; and to build community-based systems for sustaining care and support to vulnerable children and their families The seven sites are located at different distances from the capital city Gaborone but are reachable by (tarred) road Maun is the furthest away (around 1000 kilometres from Gaborone) and can be reached by both road and air, as this is the one village that has an airport The major challenges facing orphans and vulnerable children are poverty related and include female-headed households, and inability of families to provide even the most basic necessities such as food, clothing and shelter The poverty of these children places them at greater risk of experiencing other social problems such as property grabbing, ill-treatment, abuse and congested households The findings are that there is free, non-compulsory education as well as free medical services, orphan care and destitute programmes provided by the government at all sites The spirit of volunteerism is present within all communities, though it varies from one site to another The absence of a policy that advocates for OVC makes it difficult for NGO, CBO, FBO and government officials to protect orphans and vulnerable children from property grabbing Most service providers, including both government and non-governmental organisations mentioned issues such as transport, financial and staff shortage as their major challenges in delivery of services Our findings reveal that HIV/AIDS stigma continues to be a major challenge, despite the maturity of the epidemic, and the extent of education to sensitise the community to the need for support and acceptance of those infected A general lack of knowledge about HIV/AIDS was found, as evidenced by 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 stigmatised vi Introduction Free download from www.hsrcpress.ac.za Skinner et al (2004) define an orphan as a child who has lost 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 years and below, though in some cases 21 is the cut-off age used Skinner et al (2004) also define a vulnerable child as someone who has no or restricted access to basic needs and whose rights are denied even if they have both parents The Botswana Short Term Plan of Action (STPA) on the care of orphans defines an orphan as a ‘child below 18 years who has lost one or two biological parents’ The STPA goes on to categorise another group of orphans as social orphans and defines them as ‘abandoned or dumped children whose parents cannot be traced’ (Ministry of Local Government, Lands and Housing, Social Wellfare Division 1999) For purposes of this report, both definitions cited above will be used A vulnerable child is a child who is either orphaned or is living in crisis situations due to multiple causes Such situations may result in prostitution or to living on the street These are children who belong to high-risk groups and lack access to basic social facilities Risk is identified in terms of malnutrition, morbidity, death and loss of education (World Bank and UNICEF 2002) Findings from the Rapid Assessment on the situation of orphans in Botswana as cited by the Ministry of Health (1998) indicate that many orphans not have basic necessities such as food, clothing, shelter and toiletries The assessment also established that their human rights are violated, not only by society, but also by caregivers in some cases The other problem that orphans face is that many caregivers are elderly grandparents who live in poverty and are in some cases supported through the destitute programme or the oldage pension scheme Though the problem of orphans is not new in Botswana, the advent of HIV/AIDS has contributed significantly to the escalating orphan problems in the country In 1999, the number of registered orphans was 21 209 and the number doubled to 42 000 in 2003 Available data in the country shows that HIV/AIDS prevalence in all the districts is similar, which means that all districts are affected This suggests that the problems of orphans and their needs should also be similar across all the districts However, according to the Botswana 2003 Second-Generation HIV Surveillance Report (National AIDS Coordinating Agency 2003), HIV prevalence rates by districts show Kweneng West (includes Letlhakeng) has an HIV prevalence of 27.0%, Kweneng East 32.1% (includes Molepolole), Serowe/Palapye 43.3% (includes Serowe and Palapye), Mahalapye 37.4% Southern 25.7% (includes Kanye) and Ngamiland 38.4% (includes Maun) Given the magnitude of the problem, the government has declared the orphan problem a national crisis needing immediate and long-term sustainable interventions by the various stakeholders Free download from www.hsrcpress.ac.za Background to the OVC project Free download from www.hsrcpress.ac.za One of the biggest challenges facing southern Africa today is HIV/AIDS The governments of southern African countries have called on every African to join the fight against this disease The Human Sciences Research Council (HSRC), together with its partners within the Southern African Development Community (SADC) region, were commissioned by the WK Kellogg Foundation (WKKF) to develop and implement a five-year intervention project on orphans and vulnerable children (OVC) The project looks at the families and households coping with an increased burden of care for affected children in Botswana, South Africa and Zimbabwe All three research institutions have identified non-governmental organisations (NGOs), which are referred to as grant makers, with whom to work The grant maker identifies local NGOs to implement recommended interventions In South Africa, the Nelson Mandela Children’s Fund (NMCF) was chosen to work with the HSRC and the Medical Research Council (MRC) of South Africa In Zimbabwe, Family AIDS Caring Trust (FACT) was chosen to work together with Blair Biomedical Institute and Biomedical Research and Training Institute The University of Botswana (researchers) and Botswana Harvard Institute chose to work with the Masiela Trust Fund The grant maker selects community-based organisations (CBOs) and faith-based organisations (FBOs) to implement the appropriate intervention programmes at all the sites that are identified Outline of specific state plans to support OVC There are two major government programmes that cater for the needs of OVC in Botswana, namely the orphan care programme and the destitute programme These programmes are coordinated through the Social Welfare Department under the Ministry of Local Government Since the start of these programmes, all the districts through the Social Welfare Department have taken responsibility for assessing, registering and supporting orphans and destitute persons, depending on their need All seven sites of Kanye, Kweneng West, Mahalapye, Maun, Molepolole, Palapye and Serowe have systems of registering new orphans and destitute persons, as well as keeping this register up-to-date The Botswana orphan care programme is guided by a Plan of Action, which has the following objectives: • responding to immediate needs of orphans i.e food, clothing, education, shelter, protection and care; • 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 In relation to the immediate needs of orphans, the orphan care plan of action concentrates on the following areas: • Provision of basic needs (food, clothing, toiletries and shelter): Many of the orphans are without adequate food, clothing, decent shelter and toiletries Therefore, provision of these basic needs remains the most urgent task for the orphan care programme In collaboration with the Ministry of Health, a ‘food basket’ was • • Free download from www.hsrcpress.ac.za • established for orphans and other children in need of nutritional care The food basket contains all the necessary food items, for example maize-meal, rice, meat and vegetables, as well as toiletries and other items This is issued once a month Ensuring access to education: Orphans are provided with appropriate school uniform, shoes and other miscellaneous school items to ensure that orphans remain in school and get appropriate education Protecting orphans from abuse and neglect: The sociopolitical environment of orphans poses serious challenges to their livelihoods, well-being and security Their basic rights are often violated, so the orphan care programme sees to it that legal interventions that are in place to protect the rights of children also apply to orphans Providing alternative care for orphans and children in need: Given the complexity of the orphan problem, the government identified the need to establish alternative care for orphans and drafted the ‘Regulations governing alternative arrangements for children in need of care’ These guidelines have identified foster care, guardianship, children’s homes, schools of industry, and approved child welfare shelters as possible alternative care systems for orphans These guidelines have not yet been approved for implementation, putting a limitation on the overall progress of the programme The orphan care programme only caters for children classified as orphans in line with the provisions of the short term plan of action on care of orphans in Botswana of 1999 Those children referred to as ‘in need’ or ‘vulnerable’ are treated as destitute persons and are taken care of under the destitute policy The government of Botswana initiated the destitute programme in 1980 after the realisation that the extended family was disintegrating Before Botswana’s political independence, the extended family system served as a major safety-net, meeting all kinds of needs, be they material, social or emotional Independence brought urbanisation, migration and rapid economic development These changes attracted the educated and the young to the urban areas in search of employment, leaving the elderly alone in rural areas In some cases, this led to a gradual loss of support for poorer members of the extended family system As a result, the 1980 National Policy on Destitute Persons was formulated to systematically tackle poverty (Ministry of Local Government 2002) The revised 2002 destitute policy provides a definition and guidelines for what should be considered before classifying a person as a destitute Children who are under 18 years of age can be considered under the destitute policy These are children who: • are ‘in need of care and may not be catered for under the orphan care programme’; • ‘have parent(s) who are terminally ill and incapable of caring for the child; and • ‘have been abandoned and [left] in need of care and are not catered for under the orphan care programme’ The • • • • • destitute care programme focuses on the following areas: assessment of identified individuals or families; provision of food component for adult destitute persons; provision of cash component; provision of funeral expenses; and shelter for eligible destitute persons The destitute policy caters for specific needs of children, such as food for children under 18 years of age Thus a food basket, as prescribed under the orphan care programme, is provided to all needy and vulnerable children even those families who not have children It is felt that people rely too much on the government, and tend to focus on their own needs while ignoring the needs of the community Mothers Union Centre The Mothers Union Centre aims at providing psychosocial support to OVC through counselling and provision of material needs The centre gets information on OVC through partners and other NGOs in the community and government departments The organisation is trying to help OVC adapt to modern society, and expose them to the environment, hence dealing with the problem of stigma and discrimination Mothers Union Centre have a day care centre that provides three meals a day, and clothing, for OVC The organisation has passion and capability for their work Free download from www.hsrcpress.ac.za Like most NGOs in the area, the centre has limited funds This hampers its work; staff cannot help everyone who needs assistance Retaining the services of volunteers is a challenge There are insufficient funds to pay staff salaries and allowances to the volunteers The centre also lacks communication facilities Botswana Railways Social Welfare Office The Botswana railways offers pre- and post-test counselling, provides training on HIV/ AIDS issues such as ARV treatment, PMTCT, safer sex, and visits people living with HIV/ AIDS throughout the rail system The Botswana railways have identified some gaps at Mothers Union Centre and are willing to help the centre with funding They are also concerned about OVC, but not have funds to initiate a project Conclusion As indicated throughout the report, the number of OVC in Mahalapye has been increasing over the years Developing comprehensive services for OVC is a huge task, and one that must run in tandem with addressing other social challenges These include reducing unemployment and poverty, and the high rate of HIV/AIDS There is a feeling among the NGOs in the area that more could be done to assist OVC in the community There is a need for better coordination among individuals, NGOs and those community members who are involved with OVC care and support Almost all the OVC and caregivers interviewed are unaware of the policies and legislation intended to support and protect them If the situation is not dealt with, the problem will continue to increase The NGOs in the district are a playing major role in addressing the issue of OVC and people living with HIV/AIDS Most of the NGOs not have adequate resources to handle the needs The home-based care volunteers are receiving inadequate allowances, hampering their ability to perform their duties well Most of the NGOs need resources to provide for the OVC, and capacity building to be able to effectively administer the programmes There are various socioeconomic restrictions placed on countless families There is a need for improving coordination among stakeholders working with children, particularly between government departments and NGOs There are lot of organisations offering similar services, but they not work together 56 Amongst all people interviewed, there was a heightened sense of caring and desire to all that was possible to assist children affected by HIV/AIDS, including OVC Recommendations • • • Free download from www.hsrcpress.ac.za • • • • • • The government should continue supporting OVC until they are employed, and should not stop at 18 years Provision of adequate food, shelter, clothing and education are urgently needed by orphaned and vulnerable children Many caregivers for OVC cannot afford to provide adequate food and clothing for these children, as they have their own children to take care of, and are often unemployed For families who are taking care of OVC, food and accommodation is still a burning issue All community members should be sensitised about the importance of caring for those in need (even those not related to them) OVC in the communities are often stigmatised and discriminated against as a result of loosing a parent to AIDS or being themselves affected by AIDS There is a need for parents and guardians to be trained in HIV/AIDS, sexuality and bereavement issues in order to provide counselling and support to OVC Of the OVC interviewed, almost all were not aware of policies that protect them The community needs to be educated and made aware of the children’s rights and the importance of these rights NGOs need community participation in order to deliver services efficiently Transportation, especially when there is a need to travel long distances, is a serious obstacle, as many NGOs are not equipped with vehicles to travel Lack of skilled staff members: staff need to be better trained if they are provide efficient services to the community There is a dire shortage of staff in many of the organisations involved with OVC as a result of insufficient funding Hence a good source of funds is paramount if these organisations are to continue with their services Finally there is also a need for commitment from all stakeholders to monitor and evaluate the programmes that are implemented 57 Free download from www.hsrcpress.ac.za Molepolole GN Tsheko and A Kabanye-Munene Description of the site Free download from www.hsrcpress.ac.za Molepolole is situated in the Kweneng East district of Botswana It is one of the largest villages in Botswana, with a population of 54 561, of whom 24 150 are male, and 30 411 female (Central Statistics Office 2001) This means females comprise 56% of the population Molepolole is located about 50 kilometres to the west of the capital city Gaborone Molepolole is the administrative centre for the district Setswana is the predominant language in this village With 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 with no proper sewerage 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 not have running water in their homes Traditional extended family structures in the district are experiencing the same pressures as elsewhere in Botswana Molepolole‘s community leadership is typical of the country The Botswana 2003 second-generation HIV/AIDS surveillance does not single out numbers for Molepolole as a community but includes its numbers with those from the rest of the Kweneng East district Prevalence for the district was 32.1% in 2003 The healthcare system provides an array of services to benefit people living with HIV/ AIDS, and these include PMTCT, Sexually Transmitted Infections treatment, tuberculosis treatment and access to antiretroviral treatment for both children and adults, through a primary hospital located in this village, the Scottish Livingston Memorial Primary Hospital There is also access to a free voluntary HIV counselling and testing centre provided by Tebelopele The government orphan care programme had registered 425 orphans by December 2004 General conditions From interviews with caregivers and the OVC, it is apparent that the village has a serious problem with orphans and vulnerable children There are more orphans than other vulnerable children These children are left with mainly grandmothers who are old and therefore not able to provide proper care for them Most of the caregivers are poor and are supported through either the destitute programme or old age pension scheme, where 59 everyone who is aged 65 or over draws a monthly salary of P110 (US$20) irrespective of socioeconomic status This is meant to assist in providing basic needs such as food and personal hygiene items Some elderly caregivers use these benefits to take care of their own needs, as well as the needs of the children with whom they live Free download from www.hsrcpress.ac.za Orphans and vulnerable children who are registered with the government orphan care programme and destitute programme respectively, become entitled to government support, which includes food, blankets, uniform and clothes It seems easier to register orphans into the orphan care programme than to register vulnerable children into the destitute programme In one vulnerable household, the caregiver had nine children (four of her own and five grandchildren) to care for and only two of the children were registered to get supplies Supplies from these programmes are said to be insufficient, as they are often stretched beyond the number of children they are meant for, especially in the case of food Clothing was reported by both caregivers and OVC as being insufficient Delays from government support, which in most cases is the result of shortages of staff, is compounded by poverty in homes, and this exacerbates the poor OVC living conditions Housing is reported as a concern in caring for both orphans and vulnerable children Most of the households have traditional housing with no running water, electricity and proper sewerage Both caregivers and OVC lamented the inadequacy of housing: one 10year-old girl described how there were seven of them living in one room The general feeling among OVC is that orphanages should be built to ease the housing situation Regarding love and support in the home, there were divided opinions, as some OVC claim ill treatment and neglect by caregivers The complaint of lack of care was echoed by a 14-year-old boy who was left by the death of his mother as the caregiver of his 10 year-old brother, as their grandmother lives away at the cattle post, and only visits occasionally However, there are OVC who claim to be living just as well with their extended families as they did whilst their mothers were alive Actually of the interviewed OVC, two of them claimed they did not even know their caregivers were not their real mothers The Molepolole community is said to be very supportive and not discriminating, though some of the school-going OVC claim to be discriminated against by their classmates Discrimination in the form of name calling, insults and refusing to share food with other children was also displayed by some adults in the community The business community is also said not to be supportive of the OVC, as they not contribute in any recognisable way There is eagerness on the part of most OVC to perform well at school as a means to a better future The lack of knowledge on laws and policies that affect OVC was evident among most of the participants Challenges in caring for OVC The major obstacle to caring properly for OVC is the lack of proper housing Although there is modern housing, many still live in traditional huts which have no running water and have limited space One caregiver had seven children under her care, in addition to her own children She was afraid that, given the limited house space, her own children would later on chase out the orphans under her care Most of the caregivers are elderly and have health challenges of their own, and therefore are not able to provide proper care for the children in their care Carrying out household chores for a sickly, elderly woman is a big challenge In some cases the caregivers have many orphans to care for and in such cases, resources become even more limited 60 Although government support is available, there are often some delays in delivery of supplies, especially clothing Some caregivers have experienced situations where their orphans either did not receive winter clothing or received it very late, forcing these older women to spend their own meagre money to take care of the needs of these children Knowledge of HIV/AIDS in the community There is still a general lack of knowledge about HIV/AIDS Free download from www.hsrcpress.ac.za There is a general agreement by the respondents that a lot of people are infected in the community Beliefs and misconceptions are typical for the country For example, some people believe that one can get infected by sharing a face cloth with an infected person Lack of knowledge is also demonstrated by some caregivers who fail to use protective gloves when taking care of the sick, who are likely to expose the carers to their bodily fluids Even though respondents displayed limited knowledge, they also acknowledged that there are a lot of sources of information for HIV/AIDS The challenge is that people are not taking advantage of the available sources of information to learn more about HIV/ AIDS, and they continue engaging in risky behaviours An 11-year-old OVC boy claims that the information on HIV/AIDS is limited in schools Government departments and their services Ministry of Education The Ministry of Education is obliged to provide the usual programmes and facilities in the district Ministry of Local Government Molepolole has both the orphan care programme, which takes care of all registered orphans, as well as the destitute persons programme which can cater for children both below and above 18 years old who are vulnerable, with the same provisions and facing the same challenges as described above Ministry of Health Molepolole has a primary hospital, the Scottish Livingstone Hospital and eight clinics The nearest referral hospital is in Gaborone and is about 50 kilometres east of Molepolole The referral hospital in Gaborone catering for the needs of people in the southern part of the country (including Molepolole) Residents of Molepolole access the antiretroviral therapy programme from their primary hospital (Scottish Livingstone), or Princess Marina Hospital in Gaborone if they choose to so Availability of public transport between Molepolole and Gaborone is excellent, as there are buses leaving either area at least every hour Travel is also made easier by the fact there is a tarred road from Gaborone to Molepolole According to the Masa antiretroviral programme, by the end of March 2004, there were 26 603 patients with CD cell counts less than 200 and/or AIDS defining illnesses in Botswana Out of these, 14 400 were already on therapy through the government program, with 155 in Molepolole (no specific information for children is provided) (Ministry of Health 2004) 61 NGO, FBO and CBO services Apostolic Faith Mission The role of this church in caring for OVC has not been visible However, the church has at times made donations to such children in the form of clothes and money The donations are not given to individuals but rather to Bana ba Keletso, which is well known in Molepolole as a responsible centre for orphans and vulnerable children The church acknowledges that the OVC problem has escalated and that this has left the community without hope The church therefore has to play a much more visible role in bringing the community together through faith-based structures United Evangelist Church of Christ in Africa This particular church’s role in caring for OVC is to make home visits and donate clothing The church admits that they have not done enough in caring for OVC and would like to turn their attention to this Free download from www.hsrcpress.ac.za Keletso Counselling Centre The centre is supported by BOCAIP and as such is Christian driven, with children doing Bible study, story telling and singing gospel music to boost their spiritual growth This is an orphan care centre for children aged 2–18 years There is also a youth centre within Keletso that caters for youth over the age of 18 This centre assists OVC by providing psychosocial and other support For example, they assist those OVC who are on ARV treatment with adherence support and monitoring The centre provides funding for travel for those in need, as well as feeding and second-hand clothing Pre-school basic education is provided for the 2–6-year-olds For those older than six, there is an afterschool programme where they are assisted with homework House of Men The House of Men is a drama club made up of men who volunteer their time to disseminate information on HIV/AIDS, mainly in the form of pamphlets, to the community The group also has a vegetable garden where they grow vegetables to feed the sick in the village The group was started by young men who were worried about the level of promiscuity that they deemed existed in the village, and decided to something about it They outreach through drama in the village and school Specifically for OVC, they disseminate information and drama to reduce stigma that is associated with being an OVC The group admits that HIV/AIDS has a role to play in the escalating OVC problem and is mostly affecting youth The stigma toward OVC comes in the form of name calling and stigmatisation of the food basket that OVC receive from government Anne Stine School This is a stimulation centre for all children aged 4–18 years who have mental and physical disabilities The centre has a coordinator who is assisted by a professional special education teacher The centre provides pre-school education, and also does referrals to other specialised centres, such as those with physiotherapy and audiologist services At this centre, basic skills taught include toilet training and learning how to eat They home visits to sensitise parents and distribute donated clothes Staff at this centre work closely with social workers who facilitate foster care for the vulnerable children The centre has 29 children coming to the centre, and works with another 95 who are homevisited 62 Challenges facing NGOs/CBOs/FBOs All organisations in this category indicated that lack of funding was their greatest challenge They all wished they could more but lack of resources hampered their service provision In addition to lack of funding, the following were also cited as challenges to service provision: • The number of OVC in the village is increasing and the organisations are not expanding as fast; • Transport: most organisations not own any form of transport Molepolole is one of the largest villages in Botswana and therefore moving from one end to the other is quite a distance; • Networking between NGOs, CBOs, FBOs and government and council is poor, which leads to some duplication, and referrals are difficult to For example, one CBO reported that they did not know what service was provided by the well-known OVC centre, Bana ba Keletso; and • Knowledge of laws and policies pertaining to OVC is low Free download from www.hsrcpress.ac.za Conclusion As in other areas described in this report, the number of OVC in Molepolole has been increasing over recent years The increase has come with challenges, as the generally poor elderly caregivers find themselves burdened and unable to care for these children Housing and food shortages are reported, despite government efforts to provide such basic needs Shortage of staff is a major challenge inhibiting government in fully providing services to all who could be benefiting from such programmes NGOs in the district are playing a major role in addressing the issue of OVC and people living with HIV/AIDS However, they not have enough capacity to meet the challenges Most of the NGOs need resources to provide for the OVC, and capacity building to effectively administer the programmes Additionally, OVC and caregivers interviewed are unaware of policies or legislation that protect them There is still a general lack of knowledge about HIV/AIDS Those who claim to know something about HIV/AIDS also exhibit some misconceptions around transmission, prevention and cure But though respondents displayed limited knowledge, they acknowledged that there are a lot of sources of information on HIV/AIDS Recommendations • • • • The government should continue supporting OVC until they are employed, and should not stop services at 18 years Food, shelter, clothing and education are the most urgent needs of orphaned and vulnerable children Many of the caregivers for OVC cannot afford to provide adequate food and clothing for these children, as they have their own children to take care of For families who are taking care of OVC, food and accommodation is still a burning issue Caregivers have to provide these children with food and clothing, which is seen as another obstacle; many of the caregivers cannot afford this since they are not employed All community members should be sensitised about the importance of caring for those in need (even those not related to them) OVC in the communities are often stigmatised and discriminated against, as a result of losing a parent to AIDS or being themselves infected with HIV/AIDS There is a need for parents and guardians to be trained in HIV/AIDS, sexuality and bereavement issues in order to provide counselling and support to OVC 63 • • • Free download from www.hsrcpress.ac.za • 64 The community needs to be educated and made aware of children’s rights and the importance of these rights NGOs need community participation in order to deliver services efficiently Transportation, especially when there is a need to travel long distances, becomes another obstacle as many NGOs are not equipped with vehicles to travel There is a dire shortage of staff in many of the organisations involved with OVC, as a result of insufficient funding Greater funding is essential if these organisations are to continue with their services Finally there is also a need for commitment from all stakeholders to monitor and evaluate the programmes that are implemented Overall conclusions and recommendations Free download from www.hsrcpress.ac.za Conclusions The Ministry of Health commissioned a study on the rapid assessment of the situation of orphans in Botswana in 1998 (Ministry of Health 1998) The major findings from that study showed that orphans needed food, clothing, toiletries and shelter Grandparents were seen as the main caregivers, yet were not able to provide proper care because they are aging and are no longer as strong as they used to be It was also established that orphans are usually given second priority in provision of parental guidance Recommendations to address these challenges were made and some interventions of significance, such as the orphan care programme, were put in place to address these challenges The orphan care programme, which was started in 1999, involves having a systematic way of registering orphans and providing basic needs such as food, clothing and toiletries Despite the existence of the orphan care and the destitute programmes, some families with orphans and vulnerable children still report shortages of food, clothing and shelter This clearly points to the state of poverty that most families experience Some of the challenges to executing the provisions of these programmes, as stated by the social welfare officers, include shortages of transport which makes it difficult to travel to all the villages to identify, register and issue handouts The bad state of roads in some of the areas makes the situation even worse The Social Welfare Division in Palapye, for example, cited having only have one vehicle to cover the entire Palapye area and its surroundings This therefore, makes it difficult to deliver services and assessments Shortages of transport also made it difficult for them to follow up cases at homes even when it is necessary There is a need to evaluate and revise the programme appropriately to ensure that it better supports OVC, so that these children can start to enjoy life more and can apply themselves more fully to their growing responsibilities The support system is provided through the public and private sector, for example free education (schools), free health (health facilities), day care centres, the church and other non-governmental organisations A lot of families with OVC are overwhelmed and need to be assisted by organisations Despite the willingness to provide support especially by the non-governmental organisations, there are challenges that include shortages of staff and transport so as to be able to reach out to the OVC and provide services Some study sites, such as Kweneng West, not have many NGOs, CBOs and FBOs There is a need for more such organisations in these settlements/villages, as these organisations usually fill the gaps left by government One of the observations made is that the churches in the Kweneng West area not seem to play an active role in the care of orphans and vulnerable children, as compared to the other sites The spirit of volunteerism in this area is left to three CBOs The situation in the other sites was different, as there are some churches involved in the care and support of OVC There is a need for the church to get involved, as the church can 65 Free download from www.hsrcpress.ac.za play a significant role in addressing the emotional and spiritual needs of OVC It is important to note that this study addresses the situation of orphans and vulnerable children These are children who are mainly aged between 0–18 years and have lost either one parent or both, or are living in crisis situations due to multiple causes As a result of the loss, children become stressed In the Tswana culture, there is usually nothing in place to provide psychosocial support to these children, as it is believed that some of them are too young and will forget It is important for society to start thinking about ways of meeting the emotional and psychosocial needs of OVC during times of loss Social workers and other service providers working in the field of orphan care realise the need to provide this support, but are challenged by staff and financial capabilities in their respective work environments Officials working with orphans and vulnerable children are still struggling with issues of OVC safety, property grabbing and violations of human rights, despite the recommendation that was made by the Rapid Assessment on the situation of orphans in Botswana (1998) The Rapid Assessment recommended that existing legal statutes be reviewed to ensure consistency with the needs of orphans, as well as ensuring protection of their basic human rights, including those related to property inheritance, social security and identity It made it clear that it is very difficult to take decisive action in the interests of OVC, in the absence of strong policies or legislation that empower social welfare officer to act to protect an OVC Due to cultural issues, social welfare officers are still struggling to confront caregivers who might be abusing orphan property It becomes difficult for these officers to approach any family where this abuse takes place, because culture dictates that family members automatically take over property and responsibilities when a parent dies Some families not always use the property left behind wisely, but claim their actions are in the interests of the orphans There is a need to have ways of protecting orphan property and encouraging parents to make wills while still alive, so that their property can be protected legally after they have died Through government support, basic healthcare is accessible in all the seven sites This is evidenced by the presence of clinics, schools, health posts and mobile stops However in Kweneng West, the scattered nature of the settlements and villages makes it difficult to have permanent structures that provide healthcare, hence the plan to have mobile stops to ensure that healthcare is taken to where the people are As much as this system works, it also presents the problem that people not always get assistance when they need it At times, people have to wait before help gets to them, or have to walk long distances to get the necessary help The fact that some respondents in the study sites reported low levels of knowledge on HIV/AIDS matters is of great concern There is a need to ensure that information reaches all people It is possible that some areas in these sites are not reached at all with HIV information, hence the low levels of knowledge that emerged in the findings Efforts to ensure that all people are reached with HIV/AIDS information are needed Where there are programmes in place to educate people, it is necessary to motivate people to use them People need to understand the epidemiology of HIV/AIDS and how they can prevent themselves getting infected, or how they can care for themselves once infected The findings revealed that a number of OVC were being mistreated by close relatives who were looking after them OVC need psychosocial support in order to cope with the loss of parents, and with all forms of abuse and exploitation 66 Guardians of OVC were experiencing difficulties in looking after their own families and some of them accused the OVC in their care of causing a deterioration of living standards in their households Free download from www.hsrcpress.ac.za The death of parents followed by the neglect of their children, were common reasons for guardians to take in OVC This is not surprising, given that HIV/AIDS is claiming the lives of many people The fact that some vulnerable children had been taken in by their relatives and community members, because of either neglect or failure to provide them with the basic needs, is important to note A positive development is that a large number of families are taking care of children and that community members are giving moral, and to a lesser extent, material support to OVC As the HIV/AIDS epidemic takes its toll on the population, some families and extended families are under threat of being wiped out, and this is forcing OVC to move from one household to another, as relatives die one after the other Women are bearing the full brunt of the epidemic through caring for OVC and people living with HIV/AIDS Caregivers are at great risk of infection themselves, as they either lacked protective clothing or found it culturally insensitive to use protective clothing when nursing close relatives living with HIV/AIDS Caregivers need training in counselling, especially on how to impart life skills to OVC and how to identify cases of child abuse Caregivers, as well as children, wanted legal education on the laws that protect them from abuse Participants suggested that to counter stigma and discrimination, people had to be encouraged to go for HIV testing and to disclose their status, especially to sexual partners and caregivers, and that coping skills be taught to those infected and affected Recommendations Evaluation of national programme on the care of orphans The national programme on the care of orphans has been in existence for more than five years now Since its introduction, a systematic way of identifying and registering orphans, as well as giving out monthly rations, has been established This was in response to other studies conducted before this situational analysis Despite having this programme in place, problems that families have identified before, such as shortage of food, clothing, toiletries and lack of proper and safe housing, still exist There is a need to evaluate the programme and establish what factors might be contributing to the same recurring problems, despite the interventions in place Educating the community about the national orphan care programme Many community members not know how the national orphan care programme works There are families who would not register orphans for fear of being stigmatised, since they understand the programme to cater for families that have been affected by HIV/AIDS, and so not wish to be associated with it In some instances family members would not register their children, as they can afford to cater for them, but miss the important point that registration is also needed for statistical purposes Some families are indignant when after assessments it becomes clear that they not need assistance; such families feel that the social welfare department is denying their orphans the right to access what rightfully belongs to them As previously noted, many guardians are also reluctant to be seen to be receiving assistance, as it marks them as poor There is a need 67 to address these gaps and provide more education, so that there is better understanding in communities, which will hopefully improve working relationships with the social welfare officers Shortage of financial, skilled staff and transport resources There are challenges for the government support systems, which include shortage of finances, staff and transport These same concerns were observed for the nongovernmental organisations, where there is a shortage of skilled staff (volunteers), transport and finances NGO volunteers need training in skills such as counseling, gardening and proposal writing Volunteers also need to be constantly encouraged to provide their free services, and some system of non-monetary rewards is recommended Monetary rewards might encourage in-fighting and lead to break-up of the groups Free download from www.hsrcpress.ac.za Limited availability of NGOs The seven research sites were under-serviced by non-governmental, community based and faith based organisations These organisations are needed to fill the gaps that exist after government interventions There is a need, for example for non-governmental day care centres This is a critical need, as the findings showed that most children are cared for by elderly grandparents who are also physically challenged, and so unable to provide fully for a growing child The existence of day care centres that either provide services freely or cheaply will assist in ensuring that OVC are well cared for during the day in a place where they enjoy some nutritious well-prepared food, attention and a chance to mingle with other children Legislation to protect OVC The Social Welfare Department feels the existing Children’s Act is inadequate, as it does not help the social welfare officers to protect OVC in cases of abuse and property grabbing There is a need to develop legislation that will protect the OVC from abuse and property grabbing, and protect officers who act on behalf of OVC Addressing the knowledge gap on HIV/AIDS Community organisations are staffed by committed volunteers, who are however mainly illiterate and not aware of the different policies in place to address HIV/AIDS and orphan issues Coupled with these issues is the lack of electricity in schools in some areas, leading to students failing to benefit from such educational TV programmes as Talk Balk This programme can assist many students with HIV/AIDS information to supplement what they learn in class There is a need for interventions that not only concentrate on the care of orphans, but which also address ignorance of HIV/AIDS Addressing ignorance will also help reduce stigma, which in some cases acts as a hindrance to the success of available programmes There is a need to consult with community members regarding the types of programmes to implement Provision of psychosocial support to OVC and their caregivers It is important to take care of the emotional and psychosocial needs of OVC These are children who are experiencing stress, either because they have lost one or both parents, or because they live in conditions which are not conducive to child development The need to integrate psychosocial support in the orphan care programme is clear This will 68 help orphans cope with emotional and psychosocial issues affecting them on a daily basis, and contribute towards the positive development of their characters Caregivers also need psychosocial support, confronted as many are with the often overwhelming challenges of raising many children at the same time with limited resources Provision of shelter Free download from www.hsrcpress.ac.za Shelter is a basic need yet there are many families with inadequate shelter Some families live in houses that are old, made of mud and with thatched roofing that could collapse at any time There is a need to work closely with the Department of Social Welfare to establish a system of identifying households that need help with shelter, and providing improved shelter to them 69 Central Statistics Office (2001) 2001 Population and Housing Census: Population of towns, villages and associated localities Gaborone: Government of Botswana Ministry of Health (1998) The rapid assessment on the situation of orphans in Botswana 1999-2001 Gaborone: AIDS/STD Unit Ministry of Health (2004) Masa Newsletter, March Gaberone: Government of Botswana Ministry of Local Government, Lands and Housing, Social Welfare Division (1999) Short Term Plan of Action on Care of Orphans in Botswana Gaborone: Government of Botswana Ministry of Local Government (2002) Revised National Policy on Destitute Persons Gaborone: Government of Botswana National AIDS Coordinating Agency (2003) Botswana 2003 Second Generation HIV/AIDS Surveillance: A Technical Report Gaborone: NACA Free download from www.hsrcpress.ac.za National AIDS Coordinating Agency (2004) NACA Report to National AIDS Council, November Gaborone: NACA 70 Procek E (2003) Situation analysis on orphans and vulnerable children: Institution and Community responses to orphans and vulnerable children in Botswana Gaborone: Ministry of Local Government Skinner D, Tsheko N, Mtero-Munyatsi S, Chibatamoto P, Segwabe M, et al (2004) Defining Orphaned and Vulnerable Children Cape Town: Human Sciences Research Council World Bank (2007) Data and Statistics: Country Groups by Income Accessed July 2007, http://go.worldbank.org/D7SN0B8YU0 World Bank and UNICEF (2002) Ensuring Education Access for Orphans and Vulnerable Children Mombassa: World Bank ... alcoholic beverages In cases where caregivers move in with orphans bringing in their families, they end up taking the supplies of orphans to feed and clothe their own children Some orphans in Palapye... of members One of the activities of these groups involves maintaining gardens so as to provide OVC with vegetables The gardens are mainly based in clinics, since the clinic is the group’s main... move in with orphans, bringing in their families, they end up taking the supplies of orphans to feed and clothe their own children Some of the caregivers sell the provisions in exchange for alcoholic