Rachel Bray

Predicting the social consequences of orphanhood in South Africa

This paper examines and questions the predictions found in the academic and policy literature of social breakdown in southern Africa in the wake of anticipated high rates of orphanhood caused by the AIDS epidemic. Analysis of the logic underlying these predictions reveals four causal relationships necessary to fulfil such dramatic and apocalyptic predictions: 1. High AIDS mortality rates will produce high numbers of orphans. 2. These orphans will become children who do not live in appropriate social environments to equip them for adult citizenship. 3. Poor socialisation will mean that children orphaned by AIDS will not live within societys moral codes (becoming, for example, street children or juvenile delinquents). 4. Large numbers of such ‘asocial’ or ‘antisocial’ children will precipitate a breakdown in the social fabric. Evidence for each of these steps in the argument is scrutinised using available data from southern Africa and other regions that have moved further through the epidemics cycle. The paper finds strong evidence for the first step, although variable definitions of ‘orphan’ make it difficult to draw accurate comparisons over time and space. Evidence for the second step is found to be mixed in terms of outcomes of AIDS orphanhood for child well-being. Moreover the argument takes little account of the social and economic environments onto which AIDS is mapped, including the economic fragility of households and pervading socio-cultural patterns of child-rearing. Data to substantiate the third step are anecdotal at best and no research is able to demonstrate a link between the long term effects of AIDS orphanhood and rising rates of juvenile delinquency. Arguments made towards the fourth step are shown to be based heavily on notions of the ‘correct’ social and physical environments for children and on unsubstantiated fears of alternatives to these. There is no evidence from countries where numbers of AIDS orphans are already high to suggest that their presence is precipitating social breakdown. The paper argues—somewhat provocatively—that such apocalyptic predictions are unfounded and ill-considered. By misrepresenting the problems faced by children and their families, attention is distracted from the multiple layers of social, economic and psychological disadvantage that affect individual children, families and communities. Consequently, insufficient consideration is given to the multi-faceted supports necessary to assist children to cope with extremely difficult circumstances brought about over the long term by the HIV/AIDS epidemic.

CHILD CARE AND POVERTY IN SOUTH AFRICA

This article draws on ethnographic research with children and their caregivers to explore the interaction between poverty and the nature and quality of child care in a resource-poor urban community in South Africa. The authors attend to issues such as mobility and “family fragmentation,” the role of the extended family and other networks, and childrens contributions to their own and others’ care, all matters that provoke particular concern in the context of HIV/AIDS. The research challenges some of the more conventional interpretations on these matters by pointing to the continuities children experience in what can appear a disrupted care setting as well as the positive aspects of childrens involvement in care. It also supports the case for a closer look at mens participation in various child-care roles in a climate where they are often dismissed as absent or unemployed and therefore non-contributory. Future research and policy on child care would benefit from the conceptual approach adopted across this work, which employs a relational lens and encompasses the dynamic contexts in which care is experienced and performed.

Women coping with AIDS in Africa: contributions of a contextually grounded research methodology

Abstract The primary objective of this report is to describe a contextually grounded approach to the investigation of coping and psychological functioning in AIDS-sick mothers. Five AIDS-sick women on antiretroviral therapy who had at least one child under 6 years of age living in their households were interviewed. Among the issues that emerged was the complexity of the womens psychological functioning, the fact that they made strategic decisions about disclosure aimed at protecting important social support networks, and that their well-being was dynamically influenced by factors in the home and community. The study provides evidence for the value of a contextual approach when investigating the psychological functioning of HIV positive mothers living in poor high-HIV prevalence communities in developing countries.

Disclosure of physical, emotional and sexual child abuse, help-seeking and access to abuse response services in two South African Provinces

Abstract Physical, emotional and sexual child abuse are major problems in South Africa. This study investigates whether children know about post-abuse services, if they disclose and seek services, and what the outcomes of help-seeking behaviour are. It examines factors associated with request and receipt of services. Confidential self-report questionnaires were completed by adolescents aged 10–17 (n = 3515) in South Africa. Prevalence of frequent (>weekly) physical abuse was 7.4%, frequent emotional abuse 12.4%, and lifetime contact sexual abuse 9.0%. 98.6% could name one suitable confidante or formal service for abuse disclosure, but only 20.0% of abuse victims disclosed. Of those, 72% received help. Most common confidantes were caregivers and teachers. Of all abuse victims, 85.6% did not receive help due to non-disclosure or inactivity of services, and 14.4% received help: 4.9% from formal health or social services and 7.1% through community vigilante action. Emotional abuse, sexual abuse and female gender were associated with higher odds of help-seeking. While children in South Africa showed high knowledge of available services, access to and receipt of formal services among abused children was low. Notably fewer children received help from formal services than through community vigilante action. Urgent action is needed to improve service access for child abuse victims.

How does AIDS illness affect women's residential decisions? Findings from an ethnographic study in a Cape Town township

This paper explores the nature and consequences of residential decision-making for women on treatment for AIDS illness in a poor urban settlement in South Africa. Drawing on ethnographic data collected over a two-year period, it points to the subtle shifts in ‘householding’ practices and kinship relationships prompted by womens individual experiences and understanding of their HIV status, illness and treatment. Womens decisions to move or to arrange that other family members move can be explained by pre-existing threats to individual wellbeing or family residential security. But an HIV diagnosis can intensify a mothers thoughts and actions in relation to residential and emotional security, in particular on behalf of her children. In a context where extended periods of childcare by rural relatives is common, mothers with AIDS illness may gather all their children in their home to offer direct care, achieve intimacy and facilitate disclosure. They are likely to avoid making frequent contact with, and demands on, their elderly parents. Siblings are favoured as co-residents and confidants in disclosure, but their long-term support is contingent on reciprocity. Partners, where present, are valued for economic, social and emotional security. Women attempt to balance their childrens nurturing, in the short and long term, with care of the self. Their efforts do not always succeed and can incur high costs to their wellbeing and relationships with their children.