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WHO study reveals harsh realities for older persons caring for orphans and people living with AIDS

A new WHO report, "Impact of AIDS on older people in Africa”, reveals the harsh realities faced by older persons caring for their HIV-infected adult children and/or their orphaned grandchildren. The report, based on a case study done in Zimbabwe, highlights the additional stigma faced by older people who care for orphans and people living with AIDS.

The report contends that older people are largely left on their own in the important role they are providing in the care and support of their adult children who are terminally ill and, following their deaths, the orphans. They do this in poverty, without recognition, and often in poor health. Their contribution is critical within the broad context of improving access to HIV/AIDS care and support, but is generally ignored by society.

The report recommends that older people's caretaker role should be recognized and supported. It stresses that unless these carers are in good health they cannot continue providing the care that is required. The report calls for a change in the attitude of health workers and other service providers, as well as a change in the policies of health and other agencies to ensure that older people have access to proper social, economic and emotional support.

“Looking after orphans is like starting life all over again, because I have to work on the farm, clean the house, feed the children, buy school uniforms," says a 65-year old man in Makoni Manicaland, who has become the main care-giver of three school-aged children. "I thought I would no longer do these things again. I am not sure if I have the energy to cope”.

The study took place in 2001 in six of the ten provinces of Zimbabwe. It used a mix of qualitative and quantitative research methods to interview 685 older people consisting of 40% urban and 60% rural households, all of them providing HIV/AIDS-related care; two thirds of all these care-givers are women.

A 62-year old woman from Bulawayo, guardian of three grandchildren who are all attending school, summarizes the worry of most grandparents when she says “I am so afraid of what the future has in store for these orphans. If I were to die and leave them, who would look after them?”

"The contribution of older people as care-givers for their children dying from AIDS and of their orphaned grandchildren - Africa's future human capital - is as vast as it is unsung, unrewarded and unsupported,” says Dr Alex Kalache, of the WHO Ageing and Life Course team. “However obviously important, such contribution is, by and large, ignored by societies."

The main findings of the report are:

  • Loss of economic support through loss of remittances from their sick/dead adult relatives
  • Lack of access to basic needs such as food, clothing and medical care
  • Limited access to care services due to transport difficulties and high cost of services
  • Financial hardships leading to inability to pay for medical or school fees
  • Stigma and negative attitudes of health workers towards older persons, as well as towards people living with HIV/AIDS
  • Physical and emotional stress resulting from increasing levels of violence and abuse - often as a result of accusations of witchcraft

The study further identified that older people in most Zimbabwe societies are a vulnerable group as a result of a lifetime of hardship, malnutrition, poverty and, because of their age, a high risk of suffering from chronic diseases. The AIDS pandemic is now posing an additional burden on them, further increasing their vulnerability. Thus, their health is seriously compromised. It concludes that basic investments in health care and support for these care-givers in the long run would improve their capacity to continue supporting their families and communities.

"Healthy older persons are resources to their families, their communities and to the economy of their countries." - (WHO, the Brasilia Declaration on Healthy Ageing, 1996.)

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For more information contact:

Mr Robert Agyarko
Telephone: (+41 22) 791 34 33
Fax: (+41 22) 791 48 39
E-mail: agyarkor@who.int