• Overview of Possible Interventions
• The strategic framework of the lead agencies
• Preventive initiatives
• Care for orphans
• Psycho-social support for orphans

Psycho-Social Support for Orphans

Children who have watched their parents die may show some symptoms of post-traumatic stress. These include withdrawal, a sense of guilt, depression, aggression, and eating, sleeping and learning disturbances. Some children do better than others in withstanding these shocks. Children who have a stable, affectionate relationship with an alternative caregiver seem to do better than those who don’t. Often caretakers and teachers fail to detect the symptoms of psychological distress, either ignoring or punishing the child in response to the behavior changes they see. In addition, children whose parents have died of AIDS may confront secondary stress factors such as rejection by friends, neighbors, and teachers because of the stigma of AIDS. According to Save the Children, “the long-term threat to child development lies in the accumulation and interaction of distressing experiences and chronic secondary stress factors.”

Save the Children argues that the best way to promote the psychosocial well-being of traumatized children are sympathetic caregivers, preferably from a member of the extended family; safety and security; familiar routines and tasks – regular school-attendance, for one – and interaction with other children in play and sports. Those children whose symptoms persist may benefit from a home visit from a community worker with whom they can discuss their troubles. Support groups for children is another approach that can be used. Individualized western trauma therapy in a residential treatment center would be inappropriate, possibly causing further harm, and a poor use of limited resources. As a general rule, activities that help to integrate the traumatized child into his extended family and the community are preferable to those that segregate him/her.

While teachers would seem to be ideally positioned to provide psychosocial counseling to OVC, a joint UNICEF-World Bank training module points out that there are a number of challenges to getting teachers more involved in this type of activity. If counseling is to be incorporated as an integral part of a teacher’s duty, there will be a need to review their workload. Some school teachers may have to devote most of their time to counseling related to psychosocial trauma and how to stay in school, but there is usually no additional budget for paying assistants who can then provide regular teaching. Nor is there additional income for teachers who take up counseling and this makes it difficult to recruit interest. For these reasons, the document recommends to explore possibilities of other community figures who could perform this role, such as community leaders and semi-professional teachers trained in life skills and communication.” (See Bundy et al. Education and HIV/AIDS: Ensuring Education Access for Orphans and Vulnerable Children – A Training Module. UNICEF-World Bank. Mombassa. November, 2002 )

The Regional Psychosocial Support Initiative (REPSSI) program in Zimbabwe (See the REPSSI Psycho Social Support Portal) identifies the following factors as key to successful psychosocial support interventions: community ownership, engaging children and young people in planning and implementation, tailoring activities to local cultural practices and beliefs and to different age groups, since children at different ages respond to trauma and loss differently.

How can a MAP best promote the psycho-social well-being of children?

By making grant support available to local organizations (CBOs, NGOs, and FBOs) to:

For prevention

For assistance

At the national level, a MAP can: