Hesperian Health Guides
Mobilizing your community for children’s needs
Young, HIV-affected children face many serious problems — death, loss, illness, family separation, poverty, and property loss. These problems have overwhelmed too many families and left too many children not very well cared for or lacking any care at all.
When problems are so widespread and serious, it may feel like one person cannot do much. While there are always small, neighborly things one person can do, often a group of people working together can do more. And people who talk about a problem together can usually come to a deeper understanding and develop a plan of action.
- 1 Working together as a group
- 2 Pay attention to families that need extra help
- 3 Help families get health care
- 4 Help families have enough food
- 5 Help families make ends meet
- 6 Help families take care of children
Working together as a group
When you see something is needed, you can organize a way to help.
Start by involving 2 or 3 parents with children who have HIV, or concerned men and women in your church. Get whoever is interested to start working on a specific, short-term goal, such as delivering a weekly food basket to families, offering rides to a clinic, or providing a few hours of childcare each week.
By taking on and succeeding at a small project, you can show people that you are serious, that it is worth trying to improve things, and how by joining together people can make a difference. That will lead more people to take the next step or contribute to your next activity.
Whenever you work on problems in a community, different people will have different ideas about what is most important. It takes time and patience to involve everyone and to make them feel that their participation is valued.
Anyone concerned about the well-being of children has something to contribute. It can be very useful to ask elders or leaders to join you as well as people who understand the problems facing children and caregivers.
Do not forget to ask children about their opinions and needs. Children often have creative ideas that can make programs more successful. Since children usually have fewer responsibilities than adults, they can bring a lot of energy to an activity
Make sure everyone has a chance to speak at group meetings. Ask people to listen carefully to what others say. At first, women may feel more comfortable discussing problems with other women only. Then, they can share their ideas with a group of both men and women.
Pay attention to families that need extra help
Families headed by grandparents or led by older children often need extra help.
|Grandmothers often need care themselves, and may lack money for orphaned children’s food and other needs.||Older children who care for their younger sisters and brothers are often not ready emotionally or financially to head a family.|
Support for basic needs such as food, clothing, medicine, school fees, and childcare can help these families survive. Also providing emotional support, friendship, and solidarity can help them succeed.
Help families get health care
The health system can be difficult to understand and may seem out of reach to many of the families who most need services. Caregivers who have learned how to access services can help others enroll in programs, understand HIV tests and treatment, get to a clinic regularly, and learn how to live with HIV. Training outreach workers for community HIV clinics can also help.
Mothers as mentors
Many women find out they have HIV when they become pregnant and seek prenatal care. The news can be terrifying and women can feel that they and their babies will die. Busy health workers may not have enough time to reassure and explain to these women how they can stay healthy and protect their babies from HIV. Although medicines now make it easy to prevent HIV from spreading to babies during pregnancy, many women leave the clinic after testing, too afraid to share their secret with anyone. They may never come back to get the medicine and support they need to keep themselves and their babies healthy.
A group in South Africa, mothers2mothers, trains HIV-positive mothers to support pregnant women with information, guidance, and encouragement in their own space in the clinic. They choose women who are understanding, wise, and easy to talk to. During a 2-week training, the mothers learn about HIV and preventing infection, how to help a woman disclose her HIV to her family, nutrition, medications for HIV, and other concerns. They learn how to counsel — to talk with other women in a helpful way. These mentor mothers build upon their own experiences of being HIV positive as new mothers to support women during pregnancy, delivery, and beginning to breastfeed. They help new mothers find other needed care during the first 18 months after the birth.
Mentor mothers are paid and respected as part of the health care team. They are role models in the clinic and also in the community. They serve for 2 years and then recruit new women to replace them from among the mothers they mentor. The experience and wages they earn as mentors have given some the boost in confidence and resources they need to start their own businesses and continue to support their families.
Help families have enough food
Adults and children with HIV need enough food to stay healthy and help their medicines work. Children with HIV really do need more food than children without HIV! Yet many families struggle for even a little to eat.
Organize a way to provide food to families who do not have enough. You might ask families to set aside a share of food each week and bring it to their place of worship or a community organization, so it can be redistributed to those in need. Or you can help a childcare center, school, or religious facility to serve a nutritious meal to children each day.
Try to help all children who need it, not only those with HIV.
- A system where only some children get help can cause resentment.
- When all children in the community eat better, they will be better able to resist other diseases as well as HIV.
- When families have enough to eat, both children and adults are less likely to do risky things for money or food, such as stealing, joining gangs, or having unsafe sex. This helps prevent HIV infection from spreading.
Giving food to hungry families helps them right away. But for people to have enough nutritious food all year round, giving food is not enough. People need places to grow food for themselves and ways to store it that protect against pests and spoiling. People also need money to buy food they cannot grow, especially in towns and cities.
Other ways communities can support better nutrition for children and families:
- Encourage women to breastfeed for up to 2 years. (See Chapter 9.)
- Help a family that is weak from illness till their soil and plant their crops.
- Organize a group of families to buy foods such as rice, beans, or wheat at a lower, bulk price. Then divide the food among the group.
- Help people start gardens in their yards or on rooftops, and reclaim land for farming in a settlement or urban neighborhood.
- Start a seed bank. People can borrow seeds and return more new seeds after the harvest.
- Make high energy, Ready-to-Use foods, like “PlumpyNut,” so malnourished children can benefit from them (see a recipe).
- Teach your community about the dangers of “junk food” — cakes, sweets, chips, sodas, and other sweet or salty processed foods. They make children feel full but provide no nutrition. Buying them means there is less money to spend on healthy foods.
Junior Farmer Field and Life Schools
In Mozambique, thousands of children have lost parents to AIDS. Many of these children live in farming communities, but now have few adults to teach them how to farm. In schools for “junior farmers,” children 12 to 18 years old learn to prepare the soil, plant seeds, care for crops, harvest, and save seeds for the next crop. They also learn to care for goats, chickens, and other animals, and how to improve the soil.
For more ways to eat better when you have less money or land, also see Good nutrition for children.
Help families make ends meet
One of the biggest problems in communities affected by HIV is that so many adults have died from lack of treatment. When this happens, families lose their wage earners and farmers. These families are left without enough food or income to meet their most important needs. To help, many community projects focus on ways people can earn money.
- Give a pregnant goat to a family in need. The family can drink the goat milk and baby goats can be raised to be eaten or sold. Some families give their first baby goat to another family to share the gift. You can also give chickens, ducks, rabbits, or other animals.
- Help people grow food crops they can eat and sell, especially vegetables that produce well in a short time.
- Teach crafts such as sewing, beadwork, basketweaving, and pottery.
- Teach repair skills. TASO Uganda has an apprenticeship program for older children who have lost a parent. The children learn mechanics, hairdressing, catering, tailoring, or other skills. When they finish, they are given a set of tools to use in their new professions.
- Hire people with HIV to work in your business or agency. This fights poverty and stigma at the same time.
There are also less direct ways to help people gain more income. If you organize childcare, caregivers will have more time to work or sell things. If you make it easier for families to get water or fuel, that will free up time as well. Paying children to stay in school has been successful in Brazil.
Help families take care of children
When there are not enough adults to take care of young children at home, group childcare can be a big help. While children are cared for, family members can farm, go to school, earn money, and get other things done, which helps them have more time for and patience with their children at home.
Childcare can be large or small, in its own building, in someone’s house, or outside under a tree. A group of families can take turns watching all their children. Larger nursery schools can care for many children, though they need more staff to provide good, safe care. Even more caregivers are needed for children under age 2.
It is important in any childcare that caregivers understand the needs of babies and young children, including those with HIV, and know how to give them learning opportunities and help them feel loved. Experienced teachers and childcare staff often know a lot about the abilities and needs of children of different ages. They can help understand and manage problems that arise with children, and may be able to help refer to services. Childcare programs can also provide a healthy daily meal or snacks for children.
Whether children are being cared for at home or in childcare, both caregivers and children will benefit from having a common area where they can meet and play. Work with others to make a community playground, with benches and tables where caregivers can sit, talk, and watch the children, and things for children to climb, balance, or swing on. Include things that children with disabilities can use. For more about building playgrounds for all children, see Disabled Village Children, Chapter 46.
A friend to talk to when you really need it
Childline Zimbabwe has drop-in counseling centers for children and a telephone-based crisis line — the Helpline — which is available 24 hours a day, every day of the year. Trained volunteer counselors provide multi-lingual counseling in English, Shona, and Ndebele.
Children can reach the Helpline simply by calling a short-code number — 116, a toll-free call. This number works from all phones operating in Zimbabwe (both landlines and cell phones). All calls to the Helpline are strictly confidential, and are usually disguised with another number on the telephone bill.
Childline provides counseling for a wide range of issues and challenges affecting children, including abuse, bullying and harrassment at school, homelessness and neglect, HIV, relationship problems with friends or caregivers, depression or thoughts of suicide, financial problems, and legal concerns.
They are part of a global network of 181 member organizations in 139 countries that supports the creation and strengthening of national toll-free child helplines worldwide.