Table of Contents
Tembisa Child Welfare established in 1986 in maintenance form, in fabricated buildings and railway containers accommodating local children who were either lost or abandoned. The organisation’s major aim is to look after abandoned, abused, and lost, HIV/AIDS infected and affected orphans, neglected and battered kids .These children will later on be placed with foster homes or they will be adopted if they are lucky. Those that don’t make to either being adopted or placed in a foster home will be looked after by the two children’s home that the society has been able to build from donations and sponsorships from various entities. These homes’ accommodate a total of 103 as it is.
Tembisa like many other townships in South Africa is the result of the apartheid regime. Loosely translated Tembisa means hope, it became an escape place to black people who lived in neighbouring suburbs such as Midrand and Edenvale to name a few. Majority of the population still live in poverty, many live in shacks while a few live in small houses provided by the government in the form of Reconstruction and Development Programme commonly known as RDP houses.
The Society assists in providing a variety of services that the government can’t immediately attend to in the township, especially for children who lost their parent to HIV/AIDS and their surviving guardians, HIV remains a serious social ill in the community of Tembisa.
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The Community Problem
The population currently stands at about 463109 people as at the 2011 census. Tembisa, an Nguni name meaning Promise or Hope, is a large township situated to the north of Kempton Park on the East Rand, in the Ekurhuleni Municipality in Gauteng, South Africa. As mentioned earlier in the introduction section it is the direct result of black oppression. In the year 1957 black South Africans were removed from Alexandra and other areas including the likes of Edenvale, Kempton Park, Midrand and Germiston and placed in an area that they called their beacon of hope, their new home with other people they identified with.
It is said to be one of the largest townships in the Southern hemisphere and like any other township Tembisa also has its fair share of political and social problems and other social ills including HIV/ Aids. The population of orphaned children in Tembisa remains steep Tembisa Child and Family Welfare Society recording a number of more than 3000 families every year. The HIV/AIDS pandemic leaves large numbers of orphans to be looked after by burdened elderly women to assume a huge task of catering for the children’s societal provisions, while neglecting their own engagement and participation in the society at large (Tanga, Khumalo, & Gutura, 2017).
Tembisa Hospital is the main hospital in the area, it has a facility specifically for children infected with HIV and AIDS, these are not the only people the hospital caters for, it also provides a service to squatter camps such as Diepsloot and Kaalfontein which fall under different municipalities. Because these are children and like all other children they like to experiment and be seen as normal, they eat most of the things that they are told not to eat at the hospital.
They consume these things behind the caregivers’ backs. Such defaults only come forth when the children’s viral loads spiral after hospital check‐up, an activity which many are reluctant to participate in. The trips to the hospitals only end up with restrictions on how they should live and it also puts them on the spot light. The caregivers mentioned that they sometimes are unable to afford nutritious food to give the children and the health of the children suffers predominantly because of lack of nutritious food to eat which is required by those children who were living with the virus.
Another factor that impacts the children is poor school performance, the loss of a parent or parents affects young children in numerous ways. The effects differ from countries, societies and even depends on culture. In Tembisa these children are cared for by mainly their grandparents and older siblings who are unable to cope or to afford extra food and clothing, or they may be cared for reluctantly by relatives who already have too many demands. In such circumstances, young children have less chances to be sent to school or even where children are not withdrawn from school, education often begins to compete with the many other duties that affected children have to assume (Richter, 2012). The Tembisa Child and Welfare has partnered with schools in the community to take them in, this in an effort to turn around the bleak future that some of these kids’ faces.
HIV and AIDS epidemic has a major impact on all levels of society. The impact is particularly devastating not only for the individual who is infected, but also for the family and the wider community. In Ekurhuleni, the municipality that Tembisa falls in, the HIV prevalence of 28.9% among adults aged between 18 and 29 was reported (Sesane, 2014). HIV and AIDS adds to cost of living, it becomes a wild and vicious cycle of misfortune, dampers the livelihoods and lifestyle that people have been accustomed by threatening their food security, deepens poverty, and increases the vulnerability of women and children, and leads to the adoption of coping mechanisms such as the selling of household assets, which can result in irreversible destitution the main reason why many of the children are now based at Society, young girls having to resort to prostitution and the boys end up engaging in criminal activities which could cut their active participation in the short by ending up in jail.
The virus is attracted and flourishes in situations of poverty, inequality and leads to conflict between family members. Poor people, particularly women, youths, children and carers for older persons are the most vulnerable, be it physiologically, economically or socially.
According to UNAIDS 2018, in their article South African HIV Epidemic Profile the number of infections have dropped among South African children, from 25,000 in 2010 to 13,000 in 2017. This decrease is due to the successful implementation of the prevention of mother-to-child transmission programmes. This puts South Africa on track for eliminating mother to child transmission the lives we keep losing to the virus are still way too much for comfort.
The children are also affected by HIV through the loss of family members. In South Africa more than 2 million children have been orphaned by HIV and AIDS. Orphans are particularly vulnerable to HIV because of economic and social insecurities and that is how many find their way in the Society.
Prioritized Groups To Benefit And Those Implimenting The Intervention
The Tembisa Child and Welfare Society was developed not only to provide food, clothes, and education to the children but they also have social workers and counsellors that provide free counselling to the children. Children and youth that are infected by HIV will have common physical and psychological characteristics. This intervention program will help the social workers to identify these characteristics to better enable them to provide adequate and appropriate help. Attending school will also provide normality to these children. They will get to engage and participate in activities with their peers.
Another advantage is that this program will be beneficial to the children on multiple levels. Not only will they be getting education and being part of their peer group but they will also be able to get equipped with skills to better take care of themselves and have an understanding that HIV does not automatically spell the end of their lives.
According to (Dooley & Mutie, 2004) affected children display a common set of problematic behaviours.
Physical Characteristics
- Babies infected with HIV will have growth concerns, they are more likely to be under weight and as they grow they seldom have problems with eating and that in most times results in poor nutrition.
- The children are prone ill-health which is a consequence of their compromised immune system.
- Due to the endless illnesses, the children often miss school, have concentration issues and have little if any strength to play with other children.
Psychological (Emotional) Characteristics
- Feelings of sadness and despondency which if left untreated lead to unexpected episodes of aggression.
- The children worry about their future and wonder if they will living until old age, they fear death
- Withdrawal from others, fearing that people will talk about their health status and isolate themselves from the world.
Like the At Risk Tree Metaphor says, all growing trees needs pruning. The project will act as a Gardener with the intention to being to improve the fruit of the tree. The children in this analogy are the fruits.
The caregivers of the Society on the other hand will learn many countless ways to help children deal with these problems as when they arise. They will be equipped with the understanding that these children, like all other children have basic needs that should be met on a continuous basis and they are namely: the needs for food, shelter, clothing, safety, and also for love, belonging, and accomplishment of goals and more so importantly to be loved and have a sense of belonging and normality.
The basic understanding of children’s needs along with knowledge of HIV/AIDS will help them to cater to the children who are infected by HIV while allowing them to grow and develop as normal as possible.
This program will also help the children in the Society. Children, like adults and all other need information about HIV/AIDS. As much as they are children they need to make informed and sound decisions. They also need information about service providers available to them, the likes of hospitals and clinics, the impact of the medication they take on a daily and more importantly that HIV is like any other disease its manageable and they will be able to lead well full lives if they take care of themselves. This information will be readily available from the project, the social workers and counsellors during their sessions. They will have a better understanding of what is HIV/AIDS and what is not HIV/AIDS. The biggest factor is to always consider and clearly articulate the advantages of knowing their HIV status that they must not shy away from having regular tests and checking their viral load, well this is only relevant to those living with the virus.
The focus around knowing the advantages of knowing their HIV status will be beneficial for them and others but we will always be cognisant not to shy away from the disadvantages that come with knowing as well. Be open about the disadvantages of knowing their status if they are HIV positive, such as feeling angry and resentful, being depressed, and experiencing a loss of hope. It’s during these sessions that we can tackle and equip them with methods of coping during such times. The objective is to ultimately help those infected and affected to cope with the realities of the pandemic. To give assurance that the virus does not automatically spell end of life and hope.
Obtaining Clients’ Input
While basic counselling skills are the similar for all ages, counselling children and youth requires however requires a more sensitive approach. There are many reasons for this and such reasons include that children and youth may find it more difficult to understand their fears and emotions. These are people that have not fully grasped their concept of self and a whole other abstract constructs that come with the phenomena e.g. self-efficacy and self-esteem, and at their level and age, they are not yet able to differentiate between the concepts and their varied implications thereof. Furthermore, children feel embarrassed when talking about HIV/AIDS because it is usually linked to sex, a subject that is culturally sensitive and one that children are not supposed to be talked to about.
The information will be collected in Tembisa, it will only have data from only HIV/AIDS orphans and their caregivers and social workers. The purpose will be to get views from both the orphans themselves and the people who care for these orphans on a daily basis. For those that still have parent or guardians, their consent will have to be obtained. This research project will only be limited to HIV and AIDS orphans being serviced by Tembisa Child and Family Welfare Society and the people residing in the surrounding areas. The questions asked will be targeted the caregivers of the orphans, the children themselves and the social workers who were servicing them. The nature of this does not require any sampling therefore. These questions will be drafted taking into account the culture of the people in Tembisa, what they are comfortable to converse about and tailor them accordingly.
The Aim Of The Intervention Program
No single method or approach can comprehensively stop the HIV epidemic on its own. Varied methods have been used in reducing the risk of infection and protection of contracting HIV. However, despite the availability of this broad spectrum of effective HIV preventative tools and methods and a massive scale-up of HIV treatment in recent years, new infections among adults globally have not decreased to a comfortable level, this is according to the 2016 United Nations Political Declaration on Ending AIDS.
As mentioned earlier, the number of infected youth in Tembisa currently stands around 30% which is fairly high. The high percentage could be attributed to lack of education and the stigma around the disease. The main objective of this project is to break the stigma around the disease and that will be done by giving young people the knowledge to stay healthy. The central point of this project is the Comprehensive Sexuality Education also referred to as CSE. This kind of sexual teaching plays a central role in preparing adolescents and young people for a safe, productive and fulfilling life, and it is an important component of an HIV prevention package for young people. It provides opportunities to learn and acquire complete, accurate, evidence-informed and age-appropriate knowledge on sex and reproductive health topics. This kind of education has shown to contribute to delayed debut of sexual intercourse, decreased frequency and participation of sexual intercourse, decreased number of sexual partners, reduced risk taking, and increased use of condoms and increased use of contraception among young people.
Is This Project Appropriate For The Community?
Majority of the population In Tembisa is the youth and since it has been established that children and the youth are most vulnerable to HIV, this project will help educate them while keeping the number infections low.
There are a lot factors that make the youth a target for HIV. The transition from adolescence to early adulthood happens during the growth spurt period. It’s during this period that adolescents and young people seek personal autonomy, self-mastery and responsibility for their individual health. This transition from childhood to adulthood is also a time for adventure, this is the time for exploring and navigating peer relationships, gender norms, sexuality and economic responsibility.
At the heart of CSE is health and well-being. The quality of CSE will be based on education that covers a wide range of topics that are relevant to the wellbeing of a human being, topics such as human rights, sexuality, gender and equality, intimate relationships and healthy sexual life and expression. CSE is vital so that the youth can shield themselves from unwanted pregnancies, HIV and sexually transmitted infections.
CSE has demonstrated its impact in terms of improving knowledge and self-esteem, changing attitudes, gender and social norms, and building self-efficacy. It has a positive impact on safer sexual behaviours while not denying the youth sexual activity. Yet despite the clear and valid evidence, many children and young people are not receiving access to good quality CSE. The subject life orientation is not playing a vital role in sex and HIV education. The teachers still feel that sex is still a subject not appropriate for children and depriving them the information that they are desperately yearning for.
To be effective, CSE content must respond accordingly to the specific context and needs of the youth and elimination of all type of discrimination, being it sexual orientation, break the stigma around HIV and AIDS, child marriages and harmful traditional practices and beliefs that still promote the old school of thought and the promotion oppression against women. Parents and the community must be fully engaged the implementation and it is critical, as is the adequate training and capacity of the teachers who deliver it. It is important to recognise that the education alone cannot improve young people’s sexual and reproductive health and must be complemented by youth friendly, non-judgemental, confidential health services
