Health Care, Education, Hygiene and Social Support for Orphans and Vulnerable Children of Piave, Kenya A Sustainable, community-based joint initiative between the Society for Women and AIDS in Kenya, Sanofi-Aventis and ROTH – Reach Out To Humanity
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ccording to the World Health Organization, 47.5 million children in sub-Saharan Africa
have experienced the loss of one or both parents. More than a quarter of these children have been orphaned as a direct result of HIV and AIDS. It is well established that orphaned and vulnerable children (OVC) have trouble accessing essential health care services, experience greater food insecurity and are less likely to complete their secondary education. OVC are also at a greater risk of contracting HIV. One interesting response to the growing number of orphaned and vulnerable children has been the coalescing of concerned community members to form support groups and to attempt to address some of the physical, emotional, and educational needs of children. The Society for Women and AIDS in Kenya (SWAK) is one such example. Comprised entirely of women over the age of 50, the Piave Chapter of SWAK has been working to improve the lives of 424 OVC in their community by providing essential health care, education and indispensable social support for some of Kenya’s most vulnerable children.
Reach Out to Humanity (ROTH) is a non-profit, secular organization that is founded on the principle that every human being has the right to proper health care, clean water, education, nutrition, and shelter regardless of race, gender, or religion. ROTH aims to uphold these ideals through various ongoing initiatives in disadvantaged areas throughout the world. From May until July 2010, SWAK partnered with Sanofi-Aventis and ROTH to deliver one of its most successful projects to date. The objectives of this project were: To increase SWAK’s community based team by educating new volunteers; screen 150 children to know their HIV status; educate 200 children on disease prevention, sexual and reproductive health and hygiene; distribute 200 mosquito nets to vulnerable populations and distribute 300 sanitary napkins to girls.
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Objective 1 Increase SWAK’s community based response team by educating an additional 100 community based volunteers on how to care for OVCs. The training of the additional community based volunteers took place during May and June. During this time 120 caregivers went through rigorous training in partnership with staff from the Ministry of Public Health. Topics covered during training included defining what makes a child vulnerable; the impact of HIV and AIDS on children including psychological stress, loss of inheritance and malnutrition; the current status and statistics on OVC in Kenya; water and sanitation, TB, malaria and other disease prevention; child abuse and children’s rights. Caregivers were also trained on how to fight stigmatisation and were trained as psychosocial support people in order to provide important physical and emotional support to the 424 children in the programme. Caregivers were also asked to identify stakeholders involved in the OVC programme in the community and were introduced to local groups of People Living with HIV and AIDS (PLWHAs).
Lessons Learned and Recommendations for Future Projects:
selected to be trained as community caregivers were very eager and excited to participate in the • Those programme. expressed a need to work with discordant couples since this has emerged as an important • Participants issue within the community. also expressed a desire to follow a bereavement training course in order to better be able to • Caregivers respond to cases of recent death in a family. of the biggest challenges we faced during the training was mainly due to many of the caregivers • One never having received a formal education. Many of the health related topics took longer to explain as a result. We strongly recommend that these caregivers undergo continuous education in order for them to fully grasp the topics covered.
training in psycho-social support and bereavement counselling would be beneficial to the • Ongoing caregivers.
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Objective 2 Bring a total of 150 children for VCT (Voluntary Counselling and Testing) to know their HIV status. Knowing the status of the 424 OVC under SWAK’s care is vital in order to ensure that HIV positive children are receiving adequate nutrition and are adhering to antiretroviral treatment. Thanks to the efforts of this project, the status of an additional 176 OVC in the programme is now known. A total of 382 children have now been tested for HIV and know their status. Out of these 382 children 27 (7%) of them are HIV positive and need AIDS care service. Counseling for those children who tested positive for HIV began immediately. SWAK will continue to deliver important care to these children. This includes making sure these children are enrolled in ARV programmes and that they regularly attend visits to the local dispensary. They will also work closely with them as they learn to live positively with HIV. Making sure these children receive adequate nutritional intake will be a continuous priority for the caregivers.
Lessons Learned and Recommendations for Future Projects:
stigma associated with HIV is still a very prevalent obstacle in getting primary guardians to consent • The to their child being tested for HIV. of the older children tested also act as primary caregivers to their younger siblings (i.e. child • Some headed households). These children need additional support since they are both primary caregivers and people living with HIV.
to the cost of traveling to the voluntary counseling and testing site many of the guardians who • Due came to get their children tested requested a travel subsidy.
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Objective 3 Educate 200 children on TB, malaria and disease prevention, sexual and reproductive health and hygiene through guidance and counselling sessions 204 OVC attended weekend sessions focusing on communicable and non-communicable disease prevention. The training took place over four days at Ngano Primary School. The children were split into four different streams according to their age group and level of understanding of the topics covered. A total of eight facilitators were recruited for the training. Most of these facilitators came from the Ministry of Health or the Children Social Welfare Department. Topics covered included coping with life as an OVC, fighting stigma and discrimination; water and sanitation and personal hygiene practices; HIV and AIDS including the stages of disease progression, modes of transmission and signs and symptoms; drug and substance abuse; sexual and reproductive health; TB modes of transmission and infection, signs and symptoms, prevention and control; malaria modes of transmission, signs and symptoms, prevention and control.
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Lessons Learned and Recommendations for Future Projects:
more simplified and demonstrative approach is necessary for some of the younger children. • AOlder showed great enthusiasm to learn and many of them had a number of questions when • it camechildren to the topics of sexual and reproductive health. children were getting their information from unreliable sources emphasising a need to concentrate • Many on dispelling many of the myths surrounding the topics covered. reported being sexually active as young as 10-14 years of age. Future projects need to provide • Children additional resources on sexual and reproductive health.
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Objective 4 Distribute 200 mosquito nets and 300 sanitary napkins to girls By tightly adhering to the proposed budget, SWAK and project managers were able to secure an excess of funds following the completion of the previous three aspects of the project. As a result, we were able to purchase an extra 150 mosquito nets to be delivered to vulnerable and immunologically naive populations. Project managers visited local primary schools in partnership with a Public Health Officer in order to teach children about malaria transmission and the importance of sleeping under a net. Demonstrations were given in class about how to use a mosquito net and children engaged in educational puzzles provided by sanofi-aventis’ Impact Malaria programme. Along with health staff, project managers travelled to various homes in the village to properly hang nets and to show families how to stow nets during the day. Sexual and reproductive health sessions were held exclusively with some of the female OVC. During this time sanitary napkins were distributed and girls were encouraged to come back to SWAK offices regularly in order to receive additional supplies.
Lessons Learned and Recommendations for Future Projects:
were not enough mosquito nets to distribute one to every student in the 1-5 year age group in • There primary schools. children knowing the causes of malaria transmission, many of their families could not afford to • Despite have a net in the home. In cases were nets were present in the home, there was often not enough for everyone.
road conditions and the neglect of many households to cover open containers acted as frequent • Poor mosquito breeding sites in this community. Future efforts need to emphasise the importance of covering stagnant water.
was a frequent reason why girls reported missing school. • Menstruation to sanitary napkins, many of the girls reported not having under garments which they could • Inuse.addition Future projects should include the provision of both under garments and sanitary napkins.