Changing patterns of orphan care due to the HIV epidemic in western Kenya

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Abstract

The HIV/AIDS epidemic has given rise to major demographic changes including an alarming number of orphans in sub-Saharan Africa. The study describes a rural community in western Kenya in which one out of three children below 18 years of age had lost at least one biological parent—and one out of nine had lost both. The main problems these children faced were lack of school fees, food and access to medical care. The high number of orphans has overwhelmed the traditional mechanisms for orphan care, which were based on patrilineal kinship ties. Thus, 28% of the orphans were looked after by culturally “inappropriate” categories such as matrilineal kin or strangers. Furthermore, many of the caretakers were themselves not capable due to ill health or old age. Factors such as poverty, negative attitudes, and traditional funeral customs made the orphans’ situation even worse. The authors conclude that though community-based interventions are urgently needed as the most appropriate way to address the issue, the complex, local reality in which cultural factors, kinship ties, and poverty are interwoven needs to be taken into consideration if sustainable solutions are to be found.

Introduction

The HIV epidemic has spread rapidly during the past decade and African sub-Saharan countries have been most severely affected. According to the National AIDS/STDs Control Programme, 200,000 more Kenyans were expected to die of AIDS in the year 1999 and this number is expected to increase to 300,000 annually by 2005 (NASCOP, 1998). The Kenya National Human Development Report (Republic of Kenya/UNDP, 1999) stated that AIDS prevalence has been high and continues to grow in western Kenya, especially in areas immediately north and south of Lake Victoria and along the road corridor to Nairobi.

According to projections, by the end of the year 2000, a total of 13 million children will have lost their mothers or both parents globally due to AIDS and 10.4 million of them are under the age of 15 (UNICEF/UNAIDS, 1999). Many of them stay with ailing caretakers, mostly surviving mothers, and the already meagre resources available in the community cannot adequately cater for children's needs (Barnett & Blaikie, 1992; Poonawala & Cantor, 1991). Hunter and Williamson (2000) estimate that there will be approximately 1.5 million orphaned children in Kenya by the year 2005.

The drastic increase in the number of disadvantaged children outstretches the traditional caring mechanisms towards orphans. The extended family system is no longer adequately prepared to meet the orphans’ needs, especially in terms of education, health, clothing and nutrition (Republic of Kenya, 1994; Forsythe & Rau, 1996; Nyambedha, 2000). In some places, Kenyan families are headed by children as young as 10–12 years old (Saoke & Mutemi, 1996). In other instances, children are living completely outside of any family structure, either in orphanages or on the streets (Forsythe & Rau, 1996). Thus, there is a need for the affected nations to develop relevant responses that emphasize community-based initiatives. This is already happening in some African countries severely hit by the epidemic such as Botswana, Malawi, Zambia, Zimbabwe and Uganda where the respective governments have developed plans that are already showing progress (UNICEF/UNAIDS, 1999).

This paper describes the rapidly changing situation for orphans and the new patterns of care in an East African community. The aim is partly to document the dramatic and unprecedented demographic change and partly to provide evidence for planning and implementation of relevant, community-based interventions.

The study took place among the Luo in western Kenya. Now, as before, many of them live in extended families in homesteads where up to three generations often cohabit: the elderly couple, their sons and their wives and children (grandchildren). The kinship system is patrilineal, which means that descent is traced through the male line (Seymour-Smith, 1986, p. 218). The women marry outside their clan (exogamy) and move to the husband's clan (virilocality).

Among the Luo levirate marriages play a significant role. According to Seymour–Smith, levirate marriage requires, upon the death of a married man, his widow to marry one of his classificatory “brothers” within the extended family network. This rule is often interpreted as an expression of patrilineality since it is predicated upon the notion that the woman once married becomes irreversibly attached to her husband's patrikin especially if bride wealth was paid to the woman's kin (Seymour-Smith, 1986, p. 166). Traditionally, when a husband died, the levir was chosen by the lineage with little or no consultation of the widow. The widow was supposed to accept the man, but she could also decline to remarry if she found, for instance, that the proposed levir was not of the social status equivalent to that of the deceased husband, in which case the lineage should find an alternative. However, it was the responsibility of the community to ensure that children were supported from within the lineage and therefore there was a need to retain their mothers. In circumstances where the paternal relatives did not support them adequately, children sought help from maternal relatives. It was not usual for orphaned children to support themselves in their deceased parent's households when there were other adults present (Kayongo-Male & Onyango, 1984). The institutions of duol and siwindhe where food was served to all males and females, respectively, at a central place helped a great deal in ensuring that no one within the village, including the orphans, went hungry. This centrality was also functional when it came to identifying desperate cases in the village for communal action (Whisson, 1964; Mboya, 1965). Such children were easily noticeable under this system of duol and siwindhe and it could be an embarrassment if children from a certain lineage went looking for assistance on the outside (Potash, 1986).

The levirs were not held responsible in case the widow and her children suffered. It was the brothers of the deceased who were blamed if the orphaned children were not well cared for. The levir was somebody who was married and was expected to concentrate on his own family, although he occasionally visited the deceased's wife and her children (Potash, 1986, p. 61). Leviratic rules among the Luo complicate the concept of who is an orphan or not. Culturally, children born to the levir were considered to belong to the deceased's lineage alongside his own biological children. The levirs would only give assistance out of their own kindness. This is so because the deceased man was the one who paid bride wealth. The levir was considered to be causing birth on behalf of the deceased. Consequently, such children were also considered orphans since the levir did not have control over them.

Section snippets

Study area and population

This study was carried out in the Nyang’oma Sub-location of Bondo District (formerly part of Siaya District), Nyanza Province in western Kenya between November 1998 and January 2001. The district lies along the shores of Lake Victoria and covers a total area of 1069 km2 with a population of 79,833 (1999) (Republic of Kenya, 2001). The majority of the inhabitants are people with a Luo ethnic background.

Generally, the area is characterized by overall poverty and a lack of major development

The orphans

In the second survey, 243 children out of 724 (33.6%) had lost at least one of their biological parents. Of these, 29 (11.9%) were below 5 years of age, 73 (30.0%) were between 5 and 9 years-old, 137 (56.4%) were between 10 and 17 years-old and four cases (1.7%) were missing information. The 243 orphans were cared for in a total of 108 households or an average of 2.25 orphans per household.

About half (49.2%) of the orphans had lost their father while 19.6% of the orphans studied had lost their

Discussion

The present study has shown that one out of three children under 18 years of age had lost at least one biological parent and that one out of nine had lost both. Furthermore, the prevalence of both single and double orphans was found to have increased exponentially. Their dire situation is documented by the numerous quotes above—the main problems faced were lack of food, poor access to medical care, and lack of school fees (Nyambedha, 2000; Nyambedha et al., 2001). These recent, dramatic,

Conclusions

Civil societies in many sub-Saharan countries are threatened by the HIV/AIDS epidemic that leaves a high and exponentially growing number of orphans with unmet needs in the areas of education, food, and medical care. The present study among the Luo in rural western Kenya has shown that the traditional, mainly kinship-based structures, which previously catered for orphans, are being overwhelmed by the present situation where one out of three children has lost at least one biological parent and

Acknowledgments

The authors are greatly indebted to the Institute of African Studies, University of Nairobi, for assistance during the early planning process. Many thanks go to the Danish Bilharziasis Laboratory (DBL) for the financial support (grant number KEN.6.2.8) without which the fieldwork would not have been possible. Special thanks also go to the Kenyan-Danish Health Research Project (KEDAHR) for practical support, to the people of Nyang’oma for their hospitality and to Prof. Susan Rifkin for her

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