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AIDS And The Older Caregiver - 2002-12-13


In sub-Saharan Africa, when someone infected with the AIDS virus falls seriously ill, odds are that man or woman will not be cared for in a hospital or clinic. Instead, the love and care will often come from an older person. The World Health Organization has released a new study that “reveals the harsh realities for older persons caring for orphans and people living with AIDS.”

Throughout sub-Saharan Africa, older people have watched their grown children die from HIV/AIDS. Millions of them. The huge toll the pandemic has taken on those in the prime of their lives has upset the cycle of life and death, where children are supposed to bury their parents, not the other way around.

Yet those in their sixties, seventies, eighties and even nineties have found themselves burying their children, and raising their grandchildren, the AIDS orphans.

A new WHO report says, “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.”

Robert deGraft Agyarko is the principle researcher and author of the report, which is based on research in Zimbabwe. He says older people face many obstacles as caregivers.

He says, "One of the main consequences is the loss of remittances, which is loss of income from their sick or dead children. Loss of income because they are providing fulltime caregiving and do not have time to engage in economic activities, the older people I mean. And also an inability to pay for medical bills or for school fees. In most of the households we visited you find that the household savings and resources have been depleted.”

He says they face stigma and discrimination for caring for people with AIDS – and for simply being older. Some even have been physically or verbally abused after being called witches.

He says, "If you lose three, four or five of your children from AIDS in five years, then people begin to ask what it is that is killing (them)? And then the older person, who naturally has red eyes and has lost a few of their teeth, becomes the person everyone looks to and says, well, she might be the one or he might be the one who’s killing the children."

The profile of the average older caregiver is that of a woman, sixty years old or more, who’s looking after three or four orphans. The caregiver is generally poor and unable to pay all the fees to keep the children in school. Malnourishment is also a problem.

But not every caregiver fits the average.

He says, "The highest amount of orphans that we came across was twenty-one. We had one household where the older person was taking care of twenty-one orphans. And these ranged from nineteen to infants."

And not every caregiver is a woman. The WHO researcher tells about one sixty five year old man in Zimbabwe’s Manicaland.

He says, "This is what he says: Looking after orphans is like starting life all over again because I have to work on the farm, clean the house, feed the children and buy school uniforms. I thought I would no longer do these things again. I’m not sure if I have the energy to cope."

Mr. Agyarko says in their old age, when they expect to be taken care of, they must reinvent themselves and become parents again.

The WHO report calls for more resources, such as medical supplies and training, to help the older caregivers. It also recommends economic support, including the waiving of school fees for AIDS orphans, school lunch programs and foster care grants. The report makes similar recommendations for older people who are caring for those with serious or terminal illnesses other than HIV/AIDS. The World Health organization plans follow-up studies of older persons and AIDS in Ghana, South Africa and Tanzania.

Mr. Agyarko says a healthy older person is a resource to their family and community. He says neglecting them means neglecting Africa’s future. He says in this time of AIDS, Africans help one another through what’s called ubuntu – the collective spirit of the community.

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