Tài liệu Multiple Vulnerabilities qualitave data for the stydy of orpharns and vulnerable children

Multiple vulnerabilities

Qualitative data for the study of

orphans and vulnerable children

in South Africa

Alicia Davids, Nkululeku Nkomo, Sakhumzi Mfecane,

Donald Skinner & Kopano Ratele

Edited by Donald Skinner & Alicia Davids

Free download from www.hsrcpress.ac.za

Compiled by the Social Aspects of HIV/AIDS and Health Research Programme,

Human Sciences Research Council

Published by HSRC Press

Private Bag X9182, Cape Town, 8000, South Africa

www.hsrcpress.ac.za

© 2006 Human Sciences Research Council

First published 2006

All rights reserved. No part of this book may be reprinted or reproduced or utilised in

any form or by any electronic, mechanical, or other means, including photocopying

and recording, or in any information storage or retrieval system, without permission

in writing from the publishers.

ISBN 0-7969-2139-3

Production management by comPress

Distributed in Africa by Blue Weaver

PO Box 30370, Tokai, Cape Town, 7966, South Africa

Tel: +27 (0) 21 701 4477

Fax: +27 (0) 21 701 7302

email: [email protected]

www.oneworldbooks.com

Distributed in Europe and the United Kingdom by Eurospan Distribution Services (EDS)

3 Henrietta Street, Covent Garden, London, WC2E 8LU, United Kingdom

Tel: +44 (0) 20 7240 0856

Fax: +44 (0) 20 7379 0609

email: [email protected]

www.eurospanonline.com

Distributed in North America by Independent Publishers Group (IPG)

Order Department, 814 North Franklin Street, Chicago, IL 60610, USA

Call toll-free: (800) 888 4741

All other enquiries: +1 (312) 337 0747

Fax: +1 (312) 337 5985

email: [email protected]

www.ipgbook.com

Free download from www.hsrcpress.ac.za

CONTENTS

List of tables and figures v

List of authors vi

Acknowledgements vii

Acronyms and abbreviations viii

Executive summary ix

Chapter 1 Introduction — Donald Skinner and

Alicia Davids 1

Defining orphanhood and vulnerability 1

The situation of OVC in South Africa 2

Chapter 2 Background and aims of the

project — Donald Skinner and

Alicia Davids 5

Aims of the research 5

Chapter 3 Methodology — Donald Skinner and

Alicia Davids 7

Semi-structured interviews 7

Research instrument 7

Sampling method 7

Sample Kopanong 8

Sample Kanana 8

Observations 9

Analysis 9

Chapter 4 Qualitative Report Of Ovc Living

Conditions And Services In The

Kopanong Municipality, Free State

Province — Sakhumzi Mfecane, Donald Skinner

and Alicia Davids 11

Geographical context 12

Economic situation 14

Poverty and unemployment 14

Situation of youth 15

Situation of HIV/AIDS 17

Context of people living with HIV/AIDS 21

Context of OVC 24

Support systems for OVC 30

Challenges facing government departments 35

NGO, CBO and FBO support structures 37

Challenges facing NGOS/CBOS 39

Discussion 40

Free download from www.hsrcpress.ac.za

Chapter 5 Qualitative Report Regarding

The Situation Of Orphans And

Vulnerable Children (Ovc) In Kanana

And Umuzimuhle Townships, North

West Province — Kopano Ratele, Donald

Skinner and Nkululeku Nkomo 43

Distinctive and common elements between the two townships 43

Umuzimuhle 43

Kanana 44

Major problems in the target areas: unemployment, poverty and

shortages of food 45

HIV/AIDS: impact on the community 49

The situation of OVC 54

Situation of households caring for OVC 61

Support structures for ovc in the community 73

Conclusion 78

Chapter 6 Overall Conclusions And

Recommendations — Donald Skinner and

Alicia Davids 81

Care of OVC 82

Support for families and households that care for OVC 83

Support for communities that care for OVC 84

HIV prevention and intervention 84

Recommendations for state services 85

Recommendations for NGOs that support OVC 86

Appendices 89

References 105

Free download from www.hsrcpress.ac.za

v

Tables

Table 1 Ethnic composition in 2001 compared with the average for the district

in 1996 11

Table 2 Education levels for persons 20 years and older, 2001 12

Figures

Figure 1 Map of the Kopanong Municipality 13

v

LIST OF TABLES AND FIGURES

Free download from www.hsrcpress.ac.za

vi

Alicia Davids,

Health Promotion and Behavioural Intervention Research Unit, Medical Research Council

Nkululeku Nkomo,

Social Aspects of HIV/AIDS and Public Health, Human Sciences Research Council

Sakhumzi Mfecane,

WISER, University of the Witwatersrand

Donald Skinner,

Social Aspects of HIV/AIDS and Public Health, Human Sciences Research Council

Kopano Ratele,

Dept of Psychology, University of the Western Cape

AUTHORS

Free download from www.hsrcpress.ac.za

vii

This report reflects a collaborative endeavour involving many people. Although the list

below is not an exhaustive one, we wish to thank the following people and organisations

for their participation and unstinting support in this study:

• The WW Kellogg Foundation for their financial support and making this study possible

• The Nelson Mandela Children’s Fund, our partner for this project in South Africa.

• Our colleagues from the HSRC who assisted in providing information, doing

fieldwork, reading and editing and giving comments, including Alicia Davids,

Nkululeku Nkomo, Adlai Davids, Leickness Simbayi and Anna Strebel.

• Representatives from Kopanong, who provided assistance when needed. Particular

thanks is given to Jackie Lingalo, Mr Lethuteng and Thomas Tladi, District Manager

Department of Social Development; Mr Serf Van Schalkwyk, District Manager

Department of Agriculture; Mrs Rebecca Sempe, District Co-ordinator of the health

department; Mr Lerato Khetshane, District Manager Municipality; Mr Motshepehi;

Jacob Mphakwanyana, Teacher and HIV Educator; Vuyokazi Buwa, Social Worker

and Community Liason (OVC and HIV focused) Department of Social Development;

Ms Magazine Peterson, Councillor Springfontein; Mr Thabo Hlasa, ANC Chaiperson

Trompsburg; Mr Mancane Rigala, fieldwork guide Springfontein (now working for

municipality); Ms Mariana Sibunyane, Councillor Jagersfontein; Mrs Anna Morapelo,

Councillor Bethulie; Mr Michael Moitse Councillor Fouresmith; Mr Sello Ntaysane,

Mayor of Kopanong and Ms Nonceba Tafane, Philani Victim Support Centre.

• In Matjhabeng: Mr Mpho Ralipeli from the Matjhabeng AIDS Consortium; Ms Palesa

Mphatsoe (Social Development); Mr Clifford Clark from Mathjaben Christian Leaders

Forum; Mr Ernest Molefi (Morning Star); Mr M Khantsi from the Department of

Health; Ms Lebohang Mokoena Department of Home Affairs; Ms Nuku Radebe from

Meloding Day Care Centre advisory board; Ms Monica Mokalake (Day Care Centre

advisory board). The three women from Thabong and Bronville who gave us a tour

of Thabong and other areas surrounding the township, Elizabeth Noe, Gladys Khasu

and Rosina Thajana, and last, but not least, Rev Paul Okpon.

• In Kanana: Ms Nella Modjanaga and Mr Gideon Engelbrecht from the Department

of Health. They, particularly Mr Engelbrecht, facilitated interviews with people from

NGOs and nursing sisters at Grace Mokgomu Clinic. Matladi Lesupi and Nomonde

Lehloo, from KOSH Care and Support Group and Hospice respectively, both of

whom facilitated interviews with carers and OVC. Sibongile Dlamini and Ncebo

Molefe, who took us for a tour of Kanana and Umuzimuhle. Officials from the

Departments of Health, Education and Social Development, as well as from the

City Council of Klerksdorp (i.e the office of the speaker) who granted interviews.

Representatives from NGOs who granted interviews.

Finally, we would like to thank all the people who participated and provided information,

including those OVC and their carers without whose generosity this study would not have

been possible. Their participation is testimony that if we all put our energies together

we can obtain the information necessary to tackle the epidemic that confronts us all and

provide the much-needed care for orphaned and vulnerable children.

ACKNOWLEDGEMENTS

vii

Free download from www.hsrcpress.ac.za

viii

ACRONYMS AND ABBREVIATIONS

AIDS acquired immunodeficiency syndrome

ARV antiretroviral drugs

CBO Community based organisation

DoA Department of Agriculture

DoE Department of Education

DoH Department of Health

DSD Department of Social Development

FBO Faith based organisation

GDP gross domestic product

GMC Grace Mokgomu Clinic

HIV human immunodeficiency virus

IDP integrated development plan

KOSH District of Klerksdorp, Orkney, Stilfontein and Hartebeesfontein

NGO non-governmental organisation

OVC orphans and vulnerable children

PLWHA people living with HIV/AIDS

PMTCT prevention of mother-to-child transmission

STI sexually transmitted infection

RDP reconstruction and development programme

UNICEF United Nations International Children’s Fund

Free download from www.hsrcpress.ac.za

ix

EXECUTIVE SUMMARY

In 2002 the Human Sciences Research Council (HSRC) received funds from the Kellogg

Foundation to undertake research and interventions for orphaned and vulnerable children

(OVC) in three countries in southern Africa, these being South Africa, Botswana and

Zimbabwe. The project aims to contribute towards improvement of the conditions of OVC

in these countries. In South Africa, the HSRC partnered as the researchers with the Nelson

Mandela Children’s Fund (NMCF) as the facilitators of the interventions. The NMCF directs

the funding and provides support to local non-governmental organisations (NGOs) and

community-based organisations (CBOs) in identified sites to implement interventions. Work

is being done in two provinces identified as having a great need for such interventions.

Qualitative studies were conducted in Kopanong, a local municipality in the Xhariep

district, Free State, and Kanana, a local municipality in the southern Klerksdorp district,

North West Province. This research was conducted to develop an understanding of the

core dynamics affecting OVC in these communities. This information would facilitate

developing and implementing interventions to provide assistance to OVC, their carers

and their communities and act as part of the baseline information for evaluating these

interventions. Thirty in-depth interviews were conducted in Kopanong and 36 in Kanana.

Information was collected from government departments, NGOs/CBOs, OVC and their

carers, community leaders and community members. These explored in detail the

situation of OVC, status of people living with HIV/AIDS (PLWHA) and that of carers of

OVC. Finally, this phase intended to document services offered to OVC by government

and NGOs, identify strengths and weaknesses of these services and to identify possible

ways of improving them. A brief summary based on the results of the interviews follows.

Kopanong district, in the southern Free State province, covers a large area geographically,

but is very sparsely populated. It comprises some small towns, but consists mostly of

farms. The community is extremely poor, with high levels of unemployment. While some

of the towns are built close to the major highway leading to Bloemfontein, many of the

roads between the towns are untarred. The poor roads and long distances between towns

make community development and the provision of services more complicated.

Kanana, in the North West province, is a large, densely populated township close to

Orkney that constitutes part of a series of towns servicing the gold mines. The towns

comprise many migrant workers from across the country, their families and many others

who have come to seek work or income. There are a large number of informal houses in

the district, which contain their own health threats. The industry in the area is threatened

as the gold price comes under increasing pressure.

HIV/AIDS is a significant concern in the communities. The respondents all felt that the

poverty in the area was the most serious contributor, with the high levels of substance

abuse and the silence around and fear of HIV/AIDS also being serious. In Kopanong

particularly, there were very few HIV/AIDS interventions because even the large national

campaigns such as LoveLife did not have a presence there. A particular problem noted

was alcohol abuse among both youth and adults, which was regarded as resulting from

inactivity and pessimism about the future, as career prospects within the area are limited.

Alcohol abuse was felt to have multiple negative consequences, for example, engaging in

unsafe sex and wasting already limited financial resources.

A number of factors were felt to be contributing to children feeling vulnerable. Both

communities were reported already to have large numbers of children who had been

orphaned by HIV/AIDS, as well as by other causes. The number of fathers who were

Free download from www.hsrcpress.ac.za

x

absent made this worse. Concern was already being raised that there are insufficient

caretakers to look after the children who are in need of assistance. At the time of the

research, it appeared that virtually all of the children were living with a caretaker, with

few child headed households.

A number of the other contextual variables were given as contributing to the vulnerability

of children living in these areas. Prevalence of HIV/AIDS was already seen as high in

the communities, with respondents feeling that the figures were rising steeply. A further,

and ultimately greater, concern related to the financial capacity of existing households

to provide care. Poverty was felt to be the major factor that would lead to children not

being cared for in the future. Other factors included the impact of the desperate levels of

poverty, which respondents felt was forcing boys into crime and girls into survival sex as

a means of coping. Other concerns centred around substance abuse, both by carers and

the children themselves, and very high levels of child abuse. The latter included physical

and sexual abuse for the purposes of financial gain. This is a particular concern as the

damage done to children has long-term implications.

It appeared from the interviews that most caretakers who took in additional children were

doing this to provide care and were genuinely concerned about these children. Varying levels

of ubuntu (sense of community caring for one another) were found in both communities.

However concerns were raised about carers taking in children for the purposes to take

advantage of their grants. A number were accused of taking the grants for themselves and

providing minimal care and assistance to the children that they had taken on. Substance

abuse was felt to result in the adults not being available to provide care and direction, and it

absorbed most or all of the financial resources of the household. Concern about carers also

centred around the potential for their neglect of the children generally while child abuse too

was seen as a serious problem, including sexual, physical and financial abuse. This has

serious long-term implications and is difficult to prevent or address.

Unemployment results in inactivity and subsequent involvement in destructive lifestyles,

which further contribute to the vulnerability amongst community members. This has major

implications for the OVC who live in these communities. Carers who have limited or no

financial support and who are unemployed, care for the majority of OVC. Households

then lack resources to provide for children and are in turn resistant to taking on more

children. Often they lack access to basic necessities for a child, for example, school

uniforms, regular and healthy food, and have insufficient time to offer adequate individual

care. Concerns were also raised regarding social conditions that lead to some parents

neglecting their children and who rather entertain themselves in local shebeens than look

after their children, which further exacerbates OVC vulnerability.

The interviews showed municipalities characterised by poverty, high rates of

unemployment, limited resources, poor roads and infrastructure, and for many, problems

of access to services. Direct access to individual services varied. Most children had access

to health services, with virtually all living within accessible distance of a clinic. Difficulties

in talking about HIV made services for treatment and prevention in this area difficult to

reach. For example services are difficult to deliver as service providers are expected to

travel long distances on poor roads. The municipality of Kopanong is dispersed, which

exacerbates the slowness of service delivery.

Multiple vulnerabilities

Free download from www.hsrcpress.ac.za

xi

Government departments and NGOs/CBOs are doing their best to address local

problems but are often limited, particularly the NGOs/CBOs, by lack of funds and other

infrastructural constraints. Both communities have battled to sustain NGOs, a more

serious problem in Kopanong given the small towns and distances between them.

However, despite these problems, there is hope and commitment to improving the lives

of OVC and services offered to them. The HSRC and NMCF will work closely with the

communities and their representatives to try and address limitations expressed in the

delivery of services for OVC.

Executive Summary

Free download from www.hsrcpress.ac.za