Lyn @ 1st OVC in Africa Conference, Sandton Convention Centre 31 Oct- 3 Nov 2010.
I attended this inaugural conference from Sunday 31 October tol Wednesday. 3 November. My daily eports are posted below. Please remember that I am limited by my typing speed and the fact that I am not able to attend al the session at a time! I also realise that we 'hear' different things, depending on our paradigm and perspective. So I apologise to the speakers if I did not manage to reflect their thoughts accurately! Some of the presentations are available on the conference website.
Day 4 Wednesday 3 November
Ms Moipone Buda-Ramatlo said she was ‘given’ the topic: Food Insecurity – food vouchers or food parcels. Where are we in this debate?
The speaker questioned the value of this debate and the danger of fragmenting the OVC issue, with the risk of diluting service delivery. She reminded us thatOVC issues are not homogenous, but complex. The desired outcomes of any program are well-resourced children in stable environments. It is critical to note that there is no linear way in which to achieve this.
The key focus should be asset based; strengthening the family, ensuring sustainability, ensuring family income security; be reliable and sustainable, should allow for family self determination.
She warned agains the use of grants, which can disrupt community patterns, and problem solving approaches: Problems occur when children become the government’s children, rather than the community’s children.
Ms Anita Sampson spoke on the PEPfAR support on Orphans & vulnerable children programme in South Africa. She again emphasised the importance of strengthening the family and community and prolonging the life of parents. The PEPfAR program is moving from an emergency response to sustainability with strong focus on country ownership and leadership. Funding will increasingly be channelled to and through government.
Ms Mary Crewe’s presentation had the challenging title “It is Wrong.” I whish I could give a more comprehensive report of this challenging session! She highlighted some suggestions for strengthening the response to young people. Ms Crew presented case studies highlighting some of the emotional challenges of young people who face multiple challenges, even when they have the financial and social support required. She speaks of emotional hollowness or emptiness and wonders how much more severe the emotional effects would be on children in more challenging environments.
She warned that a lot of what we say about orphans make us feel good, but does not make any real difference.
We cannot deal with the complex issues of orphanhood using the constructs of our present thinking. We need a new definition of family, community and identity.
Final Plenary and Rapporteur Session
The rapporteur reports will be on the conference website soon. I will identify the highlights from each track.
Track 1: Treatment, Care and Support – Shanaaz Kaperia Randeria
Our main focus should be on the eed to capacitate and build family and community.
Track 2 – Roundtable Report: Sherri Le Mottee
Track 3 – Disaster and Risk Management - Noki and Scott
Closing Plenary Address – Dr Siobhan Crowley
Day 3, Tuesday 2 November.
In this session, chaired by Dr Tammy Myers, we first listened to the sobering presentation of Prof Brian Eley on the challenges of “Reducing Child Mortality (MDG4)”.
Ms Lynette Mudekunye spoke about “Children Crossing Borders”. Ms Mudekunye mentioned the different types of children crossing borders: The relatively ‘normal’ situation of children crossing with parents or caregivers, children crossing on their own or with group of other children; ‘oscillatory migrants’ that move back and forth between countries and children being trafficked. Sometimes we consider all these children as ‘victims’. But we should remember that children often make a informed choice based on their circumstances and expectations. It is strange to think that a child could be desperate enough to make a conscious choice to leave behind all that is familiar and travel, in many cases for hundreds of kilometers, to another country where they dream of a better future. “These children have purpose, have agency, have hope and have dreams.”
It is clear that the issue of children crossing borders is complex. Ms Mudekunye shared many touching stories of the realities of these children.
Mr Zane Dangor (?) conveyed a message from the new Minister of Social Development, Ms Dlamini as well as previous minister Ms Molewa.
He emphasised that the protection of children is a key responsibility of the department of social development. This is closely embedded in the rights of the child according to the constitution.
We have good policies to improve maternal and child health – all the good work was countered by the failure to properly address the HIV epidemic.
Session 2 today focussed on Carers and Caregivers
Kerry Steele reported on “Who are the Carers? Using surveys to identify adults caring for vulnerable children”. She again emphasised that the primary burden of care for OVCs lies in the community.
Their study was based on a question in the SA Behaviour and Communication Survey in 2009: “In the past year have you personally cared for a child whose parents died of AIDS?”
If the results are generalised – 2.8 mil people cared for an orphaned child in past year.
The results were compared with burden of disease and regions, and indicated an unequal distribution of care givers in proportion to children requiring care.
This method of assessing the situation around carers can be very effective, as can mass media. However, methods of communication with the minority should be kept in mind.
Bev Killian highlighted “Community Caregiver Perspectives on their work and challenges”. Once again she mentioned that the extended family bears the brunt of the epidemic in terms of child care.
In KZN alone there are 10 000 community care givers working with children affected by HIV and AIDS - 2.3 mil in Africa
David Roth reported on a Self Report Measure of Wellbeing (OWT) for orphans and vulnerable children undertaken in Kenia by Catholic Relief Service.
This presentation outlined an OVC Wellbeing Tool developed by Catholic Relief Services to assess self-reported child wellbeing by measuring 10 domains (food/nutrition, education shelter, economic opportunities, protection, mental health, family, health, spirituality, and community cohesion).
They use different tools for appropriate age groups.
In this evaluation spiritual, educational and family wellbeing scored highest, economic domain lowest.
This can be a useful tool to use in communities in order to evaluate services and interventions required
More info about the tool available on CRS website at http://crsprogramquality.org/pubs/hivaids/OWTguide.pdf
Caroline Kuo reported on the unmet physical and mental health needs of adults caring for orphaned children in a HIV endemic community in SA.
It is clear that caring for orphans can have sever adverse effects on the health of carers.
All carers of orphaned children had less than optimal health and need interventions.
Dr Cluver and Dr Casale continued to address the Relationship between Carer and Child Mental Health in a HIV-endemic community in South Africa. This study was linked to the previous presentation
Orphaned children have poor mental health, as carers of orphaned children can have, and people living with HIV can have. This interplay and linked vulnerability can have serious implications for the mental health of a community
There are close links between depression, anxiety and PTSD in carers and the children they care for. This increases dramatically in AIDS affected families.
After lunch I had to make a difficult decision between attending a session which included presentations on food security, nutrition and disclosure or more about the challenges of carers, social and para-social workers and the best interest of the child and young adult.
The first speaker in the session I attended was Rita Muyambo who spoke about Measuring the Psychosocial wellbeing of community care givers. She emphasised the critical role of NGOs in service delivery at grass root levels
In order to measure and evaluate the Thogomelo project, measuring social wellbeing was necessary.
A variety of tools were evaluated – none deemed appropriate
Developed new appropriate scale; was developed and tested (some info available at http://www.aidstar-one.com/task_orders/thogomelo_project and http://www.ovcsupport.net/s/library.php?ld=1096)
Pre and post training evaluation will be compared.
The process and further development of this tool could be very useful.
Daphyne Williams spoke about the tool developed by CRS and highlighted by David Roth earlier in the session “Creating Age Appropriate self-Report tools for children: Using a pictorial scale to rate wellbeing”. This tool highlights the perception of the child of his family health in 10 different domains. It was decided to use a 5 point rather than a 3point scale in order to identify more nuances and assess change more accurately.
In the evaluation of the younger group (6-8yers) the tool was used in a picture format as well in verbal form. It became clear that what adults, even in a specific culture, read into a picture might not be the same as children see. Culture appropriate might not be child appropriate, and especially not young child appropriate!
Conclusion: It is important to pilot any tool or intervention!
Basani Malambe spoke about “Developing resilience in life through psychosocial support: A community based approach for OVCs and guardians in South Africa. Psychosocial support is only sustainable and manageable if handled as cross-cutting issue. It is however essential as it lays the foundation for the wellbeing of the children in their care.
The Red Cross model is family centred and uses many tools already mention – Memory work, journey of life, hero’s book etc. Remember that psychosocial support is an ongoing process and not a one-time intervention. Although the impact evaluation of the programme will only be done in 2011, there are many positive results reported.
Josianne Roma-Reardon highlighted the OneVoice South Africa Schools Programme: HIV and AIDS prevention with and for young people. OneVoice South Africa (http://www.onevoice.org.za) is a vibrant and unique non-governmental organisation (previously known as Dance4Life), which uses innovative and creative ways of actively involving young people in HIV and AIDS prevention. The programme is appealing to young people because it provides them with a platform to discuss and address HIV and AIDS, sexual reproductive health, gender and human rights issues.
The school programme includes a series of nine workshops which focus on Gr. 8 learners and provide a manual and notebook dealing with Life Skills, Sexual and Reproductive health and management of projects.
Russel Linde presented on the topic “The Children’s Act Requires a Legal Resource Unit.
His personal experience in trying to access legal services around the children’s act motivated his approach for this presentation.
Like any legislation, the Children’s Act has no use if it can not be enforced. He highlighted the serious underfunding in the social and legal domain in order to implement the act.
Conclusion:The potential benefits of such a unit far outweigh the cost and should be seriously considered.
He quoted Samantha Waterhouse: “We do not measure success by the number of laws alone, but rather when all South African children have equal access to the protection and services contained within the legislation”
For the Best Interest of the Child and Young Adult
Dr Sissel Olssen reported on her study to Identify Critical and Key factors determining appropriate school support systems.
The recommendations of the study were included in a joint partnership that will focus on the support and wellbeing of teachers.
Mokgadi Malahlela spoke on “Improving the Lives of Orphans and Vulnerable Children through Social Access.”
She highlighted the work of Kheth'Impilo, an organisation whose mission is to support the South African Department of Health in achieving the goals outlined in the National Strategic Plan for the scale up of quality services for the management of HIV/ AIDS in the Primary Health Care sector.
Grant Access Strategy – the organisation is involved in most provinces to facilitate access to identity documents and social grants
More about the organisation at http://www.khethimpilo.org/
Evelyne Kamote reported on the Tanzanian approach in “Beyond Handouts! Integrating quality in OVC Services”.
Ms Kamote mentioned many points in the Tanzanian program for ensuring quality in the care of children. An important point for me was that in the focus on MVC – most vulnerable children. They consider the fact that orphans might not necessarily be the most vulnerable, but that a community might have other children, who are not orphans, who could be highly vulnerable for a variety of reasons.
It is important to build consensus on what constitutes quality!
Adele Clark CRS spoke on “Developing Solidarity Among Children Using Therapeutic tools for multiple purposes. She highlighted that 163 mill children have lost one or both parents due to many different causes and that orphans are not the only children who are vulnerable.
A Toolkit was developed – “Psychosocial care and counselling for HIV- Infected Children and adolescents”. It includes games eg ‘Just like me’ with variety of details and levels and is available online.
Another full and informative day!
Monday, 1 November 2010
Plenary Session 2, chaired by Prof Leickeness Simbayi. Prof Simbayi referred to the cabinet re-shuffle announced yesterday, and mentioned that as Min Molefe is no longer minister of Social Development, her presence at the conference is unsure.
Prof Lorraine Sherr – Bringing up Orphans – Why We Need Support of Families. She highlighted the dilemmas of defining ‘orphan’ and made a plea that we should be clear about what we are speaking about when we talk of orphans.
SSA - 7.5% Paternal Orphan; 5.2% maternal; double orphans 12.1%;
Sub Saharan Africa - 5-10 times higher than other regions.
Family approaches to the challenges of orphanhood and HIV is much more successful than individual models.
88% of orphans are cared for by extended families
Considerations in Orphan care
Prof Sebastian van As: Trauma and Children – A World Perspective
True disasters for children
Highligted work of http://www.childsafe.org.za/
Child safety starts with all of us
“A better society will and must be measured by the happiness and health of our children”
Dr Zosa de Sas Kropiwnicki: Child Trafficking and Exploitation of Children across Borders
She started of by warning against the sensationalist and inaccurate data often used in this field. The definition of child trafficking is movement of a child with the intention of abuse. In the case of children, permission is deemed to be irrelevant.
If children move ‘on their own’ it is not trafficking, but that does not mean that children that are not trafficked but still abused need less care
The perceived success of SA leads to increased risks and vulnerabilities to trafficking of children from neighbouring countries.
Many criteria for a effective response were mentioned, including that a response should be rights based, protective and interlocking, regional, systemic, intersectorial, comprehensive, participative, appreciative, asset based, family strengthening, capacity strengthening, evidence based
In the first session 1 there were 2 options – ‘Access/Community Based Coordinated Care’ and ‘Lessons of Management Systems Support’
I attended the session on ‘Access/Community Based Coordinated Care’ chaired by Mrs Lynette Mudekunye
Nancy Kemo spoke on “Improving Access to Health Care for OVCs through Community/Health Facility Linkage”.
A help desk managed by specialised care workers increased the access of children to treatment and improved communication and relationships between community health workers and institute based care workers.
Due to stigma care givers in the community is still reluctant to disclose the HIV status of the children in their care.
David Green explained methods of Developing Caring Communities through narrative practices
By allowing the community the opportunity to share their stories and experiences sustainable approaches can be developed to enhance the wellbeing of children. The stories and approaches can be documented and used by other communities.
Joan Marston spoke of the Sunflower Effect, and how one programme expanded access to palliative care for children in Free State province.
Palliative care is the care of body, mind, spirit of the child with a life limiting disease and includes care of the family.
A multi-sector approach, partnership and networking is crucial, but can provide a rich resource for the effective expansion of palliative care for life limited children to improve their quality of life.
Jacqueline Khumalo highlighted the magic of networks in supporting organisations that work with orphans and vulnerable children.
The CINDI (Children in Distress) Network does capacity building and provides networking opportunities for the organisations in the area responding to children.
An analysis was given based on a study of 176 member organisations of CINDI
- Capacity Building
- Resource mobilization
Sumaya Mall highlighted the Vulnerability to HIV/AIDS of deaf and hard of hearing adolescents: and the Perceptions of educators in Schools in South Africa.
Literature shows increased risk of abuse as well as low self esteem amongst disabled people, including people who are deaf and hard of hearing. This can be acerbated by the fact that there are limited or culturally inappropriate educational resources for people with hearing disability.
A study on selected schools for the deaf explored condom policies, perceptions of sexual risk behaviour in deaf learners etc
After lunch I attended a session on Institutional Partnerships chaired by Dr Sissel Olsen
The first speaker was John Capati, who spoke of the use of Social Work Partnerships to Build Sustainable Capacity to address the needs of orphans and vulnerable children. He introduced the work of the Twinning Centre which created 30 North-South and 9 South – South twinning agreements.
Twinning is flexible, collaborative and gets results.
He highlighted the work done to strengthen the work of social work auxillaries, or para social workers. This untapped resource links to the community and further capacity building helps to augment the severe shortage of trained social workers in the community.
It was initially important to create a share understanding of the role of this group. Curriculum development is crucial, although there are universal principles, it is also crucial to make it specific to the context and environment. Structured follow up is essential for the success of the process.
Various country representatives reported on the success the programme had in their country
- Leah Natujwa Omari from Tanzania
- Justice Chukwudi Ulunta - Nigeria
Marietta Slabbert spoke about a Motivation strategy for rural advancement. She highlighted the work of the Ndlovu Care Group that works through Autonomous Treatment Centre (ATC) and Community Health Awareness Mobilization & Prevention (CHAMP)
Once again the importance of working from an asset based perspective was emphasised.
Ndlovu adapted the Hertzberg Theory of motivation to behaviour change communication
Story from a project: Maria, you get a food parcel and school uniforms, why do you still not go to school? I don’t sleep at night, our door does not lock, and I am afraid people come in at night and rape me and my siblings.
I very interesting session by Susan Wilkenson Maposa focussed on “Understanding Organisational Resilience: How organisations supporting child well being survived Zimbabwe’s socio economic collapse.”
The Firelight Foundation was interested that all grantee partners of the foundation in Zimbabwe survived the socio-economic collapse, even though these organisations are often seen as ‘low resourced organisations’.
The results showed:
Community based organisations identified 5 resources or strengths they depended to help them survive in challenging conditions
This is supported by literature where the following 5 behaviours can be identified which are used to construct resiliency in organisations
The presentation was one of the highlights of my day. We have all seen so many organisations overcome challenges, where it seems humanly impossible, and do remarkable work. It was good to be reminded that the strengths that help organisations overcome hardship is often internal and local, and does not necessarily depend on tangible factors or external resources.
Nataly Woolett spoke about “Child Witnesses of Domestic Violence: the Overlooked Victims”. She spoke about Trauma Focussed Cognitive Behaviour Therapy in a art and play based group in a domestic violence shelter.
USA research shows that a third of US children are exposed to violence in the home. SSA probably higher!
Natalie highlighted the high incidence of Post Traumatic Stress Syndrome or Complex Psychological Trauma in children in South Africa.
Creative art therapies have much strength in dealing with trauma. A process was explained where therapy of this kind was used with children, with very good results.
Many resources are available eg the book “A Terrible Thing Happened: A Story for Children Who Have Witnessed Violence or Trauma”. More info at http://www.apa.org/pubs/magination/4416428.aspx
Opening Session, Sunday 31 October
The opening session started with a song “When will the Children Play Again”, starkly sketching the reality and asking ‘how many children must raise more children before we take a stand?’. Suddenly this does not seem ‘just a conference’ but the reality of children who are unable to play or laugh, because they are raising more children. Tina Schouw - South African Singer Songwriter touched the participants’ hearts.
The opening session was billed as follows.
Dr Ashsaf Grimwood CEO Kheth ‘Impilo Conference Chair
Hon Minister Bomo Edna Molewa Welcome Address –
Dancing with the Darkness on my Back
Dr Annette Gerritsen, EPI Result: Estimating the Need for Orphaned and Vulnerable Children Services in the city Tswane Metropolitan Municipality 2010
Dr Nono Silemela; CEO SANAC: SANAC’s National Plan of Action for OVC’s
However, as Dr Ashsaf Grimwood CEO Kheth ‘Impilo welcomed participants as the conference chair, he also announced that Min of Social Dev Edna Molewa is unable to attend this evening and Dr Silemela would be unable to attend due to ill health. It is quite a disappointment that these two ‘star’ speakers are not here.
Dr Grimwood highlighted what had been achieved around development and MDGs, but also the challenges that remain for children and the opportunities to address these.
Dr Johanna Kistner and the children Sophiatown Children on the Move Project presented “Dancing with the Darkness on my Back. Children’s Sories of Hope and Courage.” Firstly we were reminded that these children do not think of themselves as OVC’s – they reminded us:
We listened to the children’s stories; stories of death, of loss, of xenophobia, of displacement of overcrowding, of living with multi –cultural life, of displacement, but mostly of “Dancing the darkness away” the incredible resilience of children in the midst of multiple challenges.
Dr Annette Gerritsen’s presentation covered “Estimating the Need for Orphaned and Vulnerable Children Services in the city Tswane Metropolitan Municipality, 2010”.
A survey was done on service providers in Tswane between 2005 and 2010:
Conclusion – The overall picture of service provision in Tswane is more positive than 2009. The unique information obtained by the survey will assist the metropolitan municipality in their planning in future
The Ndlovu choir entertained participants before we were invited to attend the opening cocktail function.
The function was hosted by SABCOHA and highlighted the “Camp I Am” programme, an exciting public/private/NGO initiative for 15 000 children during the extended 2010 school holiday. Hopefully this successful programme wil be extended in future.