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This affects my crop yields as I am not harvesting like before.

AIDS and the New Orphans: Coping With Death

Although the majority of female participants seemed to be aware of the negative impacts of reducing cultivable land through selling or renting, they did not have alternative choices to address their circumstances. The reduction of cultivable land subsequently had food and livelihood implications, and would usually lead to hunger and food insecurity. They will not last long. It is just not enough for children and me. The study elucidated that some families, especially those headed by females, opted to work elsewhere than in farming in order to generate more soft income for family needs. However, because the alternative jobs including casual work and seasonal petty businesses were low paying, these families continued to struggle to make the ends meet.

Even though I get paid less, it helps us [the family head and her children] survive. Due to a high dependency ratio involving a large family size, comprising children and the elderly, there was a reduction in the number of people in the working age group who provide the prime labour pool for families. In addition to low human resources for labour, families experienced high socio-economic and cultural burdens due to raising AIDS-orphaned children, which took the necessary energy and time needed to generate income.

The poor labour force has implications and negative effects on the ways families implement their coping strategies. As a way of mitigating these effects, children were enlisted to participate in income-generating activities, including in raising poultry in the house. Two participants exemplified these assertions in the following statements. So I often ask two of my children to help me out.

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My son sells vegetables and my daughter takes care of the poultry at home. Readjusting including minimising the time to work on farms, hiring labour from neighbours, using child labour, moving farming work closer to the family dwelling and cultivating short- term and drought resistant crops, such as cassava and sweet potatoes which can be ploughed multiple times in a year, were some of strategies adopted by adoptive families to address low human resource and its consequences.

Now my children and I grow vegetables just next to our house. It is a bit easier for me to do and the kids can also take care of them. It seems good because I can adjust the time needed for working and for taking care of my children [orphans].


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Because of serious AIDS-related consequences in adoptive families, especially those headed by females, children were de-enrolled from school to provide needed workforce to produce for living and for necessary school expenses. In contrast to male-headed adoptive families, all female-headed adoptive families reported to have- temporarily or sometimes permanently-withdrawn children from school due to financial constraints and to cover for labour shortages.

Withdrawing children from school was also an important strategy to reduce the school requirements and to allow savings from these to cover other essentials. I withdrew my older boy from school to help me out with taking care of the younger children in the family while I am working. He also helps me with taking care of poultry; sometimes he sells vegetables and gets some money. If I will send all of them to school, then I will not have enough money to feed them. So I have decided to send two children who are in their final year and I will send the others after getting enough money.

Because this is harvesting period, my children and I expect to get casual work on farms to harvest crops. From this work, I will be able to raise some money to send my grandchildren to school. That is why some farms owners do not want to spend their money on hiring labourers like us. Of particular interest is the finding that AIDS-orphaned female children in adoptive families engaged in high-risk work to earn the hard needed money for their adoptive families.

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In the female-headed adoptive families, engaging in sexual activity was often viewed as an opportunity to make quick money. Some female participants acknowledged the fact that their female AIDS-orphaned girls engaged in sex for money so that they could buy their own stuff and other family needs.


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  • It is difficult for me to blame them because I do not have money to give them to buy clothes, body lotion and other things. They used to go to the weekly market which is held once a week on Saturday and came back on Sunday with money, sugar, salt and other items, which they did not show me. The market attracts business people from the town and nearby villages. It is difficult for me to know with whom they got involved.

    One day I asked one child who was responsible for her pregnancy, and she told me that she did not know and threatened to poison herself and follow her parents if I kept on asking. I am expecting that in the next four months, one of the three children will give birth. Similar to many settings in developing countries, the communities in Mbeya Rural District are male dominated.

    Compared to female-headed adoptive families, the decision to sell family assets is easier in male-headed adoptive families. Here everything [assets] in the family belongs to men [the husbands] … After he [her husband] passed away, his relatives always want to know about all these: the land, livestock, and so on. Inequalities in assets and land ownership were additional factors contributing to the challenges faced by adoptive families, particularly those headed by females. The majority of the female participants stated they had no power and control regarding their cultivable land and some of the family assets.

    On the contrary, the male heads of adoptive families owned large pieces of land and had control over what they could use the land for. I cannot rent out the land either unless it is done under the control of his relatives because people have to deal with the land owners. By examining the experiences of care provision to AIDS-orphaned children, the current study provides information that can be used to improve our understanding about coping strategies employed by adoptive families to address the impact of AIDS and AIDS-orphaned children on their households.

    Consistent with previous literature [ 39 — 41 ], the current study suggests that to mediate these impacts, families adapt various coping strategies including the selling of family assets and implementing small-scale projects such as poultry farming. Findings from previous studies [ 41 — 44 ] have indicated that the sale of family assets including land, bicycles and radios, leads to unsustainable achievements, as most families end up becoming asset poor, which often exacerbates the impact of AIDS on these families.

    Renting out land as a strategy for coping with the impact of AIDS as reported in this study has also been described in previous studies [ 45 — 47 ]. However, in the socio-cultural context of African communities, in which men dominate and are recognised as owners of family assets, female-headed adoptive families often tend to be disadvantaged. The reduction of land used for cultivation and reallocation of labour have been reported [ 43 , 48 , 49 ] as additional mitigating and coping strategies used by adoptive families to address time constraints and low human resource for labour issues.

    Similar practices were observed in the current study. These strategies were used to minimise the time spent working on farms in order to create time needed to provide essential care to AIDS-orphaned children, who at times needed intensive caring, especially when they were unwell. Our research findings are also consistent with evidence suggesting that addressing the impact of AIDS on adoptive families leads to further consequences including a decrease in crop yields and a decline in the range of crops grown for food and revenue [ 42 , 44 , 50 ].

    The reduction in education opportunities for AIDS-orphaned children and the emergence of child labour - while problematic - were seen as necessary strategies for coping with the impact of AIDS. For example, older children were de-enrolled from school so that they could care for the others, usually younger children or work on the farm to supplement income to meet adoptive families extended needs.

    AIDS and the New Orphans: Coping with Death

    Similar findings have also been noted elsewhere [ 51 — 56 ], suggesting unequal distribution of disadvantages mainly skewed to poor families, especially those located in poor rural settings. The detrimental effects resulting from withdrawing children from school and the use of AIDS-orphaned child labour have been documented in several studies and have led to further problems such as poor child development [ 57 — 60 ]. Similar to findings reported elsewhere [ 42 , 61 , 62 ], the current study confirms that children, especially girls, engage in transactional sex in order to generate the money needed for basic essentials in their new adoptive families.

    These factors lead to a vicious cycle of disadvantages in affected families, communities and nations. The current study provides information regarding strategies employed to address and mitigate the impact of AIDS on adoptive families in Mbeya Rural District, Tanzania.

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    Our findings demonstrated an unequal distribution of power for decision-making between female-headed and male-headed households, which influenced the ways families coped and mitigated the impact of AIDS with female-headed households being unequally disadvantaged. While the findings of the current study provide significant insights regarding socioeconomic and cultural strategies adopted by adoptive families to cope with the impact of AIDS-Orphaned children, the study has a few strengths and limitations. The use of a qualitative approach in this study provided an in-depth and highly contextualized information and insights into pertinent issues including those affecting AIDS-adoptive families and AIDS-orphaned children.

    It also involved adoptive families that varied in leadership including female-headed and male-headed families, providing further in-depth understanding of socio-cultural and gender dynamics and the impact of these in coping with the AIDS related issues in the study setting. Recognition of these issues highlights the need for targeted interventions to address the underlying social determinants of health in these populations and to further prevent the imposition of social, cultural and economic disadvantages on adoptive families.

    The study limitations include the inability to offer generalisation of these issues to the whole of Tanzania outright. However, we believe that lessons learned from these findings can be transposed to similar settings in Tanzania and beyond. Further studies are recommended to elucidate issues that the current study could not provide. Accessed 28 Apr Washington, D. Accessed Apr The Stephen Lewis Foundation.

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