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The triple whammy: Children affected by HIV, poverty and disability in the Zambezi Valley, Zimbabwe
Chenjerai Sisimayi and Thenjiwe Masuku, Save the Children
February 2009

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Executive Summary

1. The Triple Whammy: Child Carers affected by HIV, Poverty and Disability is a 2 year project funded by the European Commission (EC). Save the Children UK (SCUK) through this project is committed to implement the full spectrum of interventions necessary to address the plight of Child Carers (CC) in households affected by HIV&AIDS, Disability and Poverty. The European Commission has provided a grant to implement The Triple Whammy in three of the poorest and least developed districts in Zimbabwe: Binga, Kariba Rural (Nyaminyami) and Hwange. This report presents information on the experiences, needs and resilience of children caring for parents and relatives living with HIV & AIDS and disability ('child carers') and also affected by poverty. The survey sought to identify some of the key issues and challenges which need to be addressed if services and interventions for children and families affected by HIV, disability and poverty are to become more responsive to their needs. Therefore, information on knowledge of HIV&AIDS, awareness about HIV and AIDS services, children's vulnerability and their coping strategies is presented.

2. A total of 586 individuals participated in this baseline study. Of these, 347 were child carers and 71% of them were orphans (23% were double orphans, 17% maternal and 31% paternal orphans), 25 were care recipients, 17 were key informants, and 197 were Community HBC facilitators, Community Child Protection Committee members and Peer Educators. 35 child carers and 25 care recipients answered structured interview questions. Specific questionnaires and FGD guides were designed for the children and adult groups. The study population was derived from the three districts in selected villages.

3. Overall, HIV&AIDS knowledge levels together with uptake of AIDS services are low. These coupled with poverty and some cultural-traditional factors rampant within the districts emerged as the most important and specific drivers of the AIDS epidemic in the Zambezi Valley. Five (5) types of Child Carers were identified and these fall into the three major categories of the Typical, Complex (combination of the typical) and the Salient characteristics and structure of the Child Carers household.

4. The general characteristics and structure of child carers' households are important in determining child carers' caring roles and domestic tasks carried out by the children involved. They also provide an indication on the burden of care the children are shouldering. In turn these have a bearing on their vulnerabilities in terms of risk to HIV infection, livelihoods and food security, access to education and abuse.

5. Child carers in the complex category, those living with a disabled and elderly relative and those in child headed households were the ones who undertake the actual caring roles in addition to carrying out the usual domestic tasks. Their burden of care is greatly elevated, the caring they undertake includes dressing the wounds, bathing and feeding the patients. Children living with a chronically ill family member were mainly carrying out domestic tasks involving undertaking household chores with the actual caring tasks of dressing the wounds, changing soiled linen, bathing and feeding patients being mostly done by adult persons within the household or neighbors and other support systems like home-based care facilitators. While the levels of care provided by the children varied according to the specific situations they find themselves in, in all cases, children provided a communal opinion that they actually face challenges in undertaking some of the household chores as well as the caring. A rather salient but distinct challenge these children are also facing is to do with their social and psychological wellbeing.

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