Malawi Medical Journal; 22(4): 101-103 December 2010<\/p>\n
Anthony P. Sefasi<\/strong><\/p>\n Catholic University of Malawi<\/p>\n Abstract <\/strong><\/p>\n HIV may affect the elderly in a number of ways. They may become Aims <\/strong><\/p>\n We wanted to understand the socio-economic impacts of HIV\/ hope that our findings will increase awareness and lead to more<\/p>\n being done to alleviate the problems faced by older people as a Results <\/strong><\/p>\n The results reveal that older people have no alternative but to Conclusion <\/strong><\/p>\n Elderly people need more resources and assistance to enable them<\/p>\n to fulfil their vital role in caring for HIV-AIDS orphans. They<\/p>\n are also in critical need of more information about HIV-AIDS, Introduction. <\/strong><\/p>\n According to the World Health Organisation and the United resulted in more than 25 million deaths since the first clinical<\/p>\n evidence was reported in 19811. family life. Studies in Eastern and Southern Africa indicate about 970,000 people are living with HIV, with new infections<\/p>\n estimated at 90,000 per annum. These figures pose an<\/p>\n enormous challenge in terms of care for people who will in need of support3. taken on new roles by providing care and financial support<\/p>\n to orphaned children, playing child-rearing roles within their According to a study in Zambia(1996) 57% of primary care The World Health Organisation (2002) reported that 30% In terms of older people themselves being infected with Since there have been few studies of this kind in Malawi, we Objectives <\/strong><\/p>\n The main objective of the study was to establish the impact Methods. <\/strong> We used both qualitative and quantitative approaches. Questions and discussions during data collection centred on This study was conducted in Chiradzulu district in the Impact of HIV on the eldery <\/strong><\/p>\n estimated it using major historic events \u2013 eg \u2018At what stage in<\/p>\n your life did Dr. Kamuzu Banda first return to Malawi?\u2019)<\/p>\n The Group Village Headman and a child protection worker<\/p>\n identified households where an older person was taking<\/p>\n care of a terminally Ill HIV\/AIDS patient or taking care Another sample was identified for focus group discussion,<\/p>\n with 12 participants being drawn from different villages in Results<\/strong><\/p>\n Roles played by older people in caring for a sick 40% of the respondents had been guardians of a sick child financial and other support to the sick relative. 22% were<\/p>\n recorded to have been providing palliative care and spiritual Challenges faced by older people taking care of 59% of the sample reported that they had difficulty sourcing<\/p>\n money for orphan grandchildren\u2019s school uniform, for food Challenges faced during illness and death of a family 43% of the respondents reported spending all the money (who had been working and supporting them, financially and<\/p>\n otherwise, before their illness made this impossible). 55% of the enrolled elderly people were affected through get better.\u201d An old Lady of 77 years from Masikini Village our financial resources and now I do not have anybody to ask for help<\/p>\n and support.\u201d<\/p>\n Factors that put older people at risk of getting 56% of the respondents felt that lack of knowledge on HIV\/ Discussion <\/strong><\/p>\n Old people face a lot of challenges because of the HIV\/ orphaned grandchildren, without sufficient resources, and are consistent with studies worldwide from areas hardest hit<\/p>\n by HIV\/AIDS pandemic. In a country like Malawi where there are no social pensions Conclusion <\/strong><\/p>\n The impact of HIV\/AIDS on older people in Malawi is Diverse stakeholders should take an active role in alleviating in this area for us to begin influencing policy change with<\/p>\n Government.<\/p>\n Acknowledgements.<\/p>\n I would like to acknowledge support received from the MMJ 22(4) 2010 www.mmj.medcol.mw<\/p>\n Impact of HIV on the eldery<\/p>\n References<\/p>\n 1. World Health Organisation Community home-based care: Family This map is an approximation of actual country borders. Probability of dying under five (per 1 000 live births) 120<\/p>\n Probability of dying between 15 and 60 years m\/f (per 1 000 population) MMJ 22(4) 2010 mmj.medcol.mw<\/p>\n <\/em><\/p>\n","protected":false},"excerpt":{"rendered":" Malawi Medical Journal; 22(4): 101-103 December 2010 Anthony P. Sefasi Catholic University of Malawi Abstract HIV may affect the elderly […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[216,203,76,81],"tags":[275],"class_list":["post-786","post","type-post","status-publish","format-standard","hentry","category-malawi-culture","category-malawi-education","category-health-well-being","category-national-news","tag-hiv-and-aids"],"_links":{"self":[{"href":"https:\/\/new.faceofmalawi.com\/index.php\/wp-json\/wp\/v2\/posts\/786","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/new.faceofmalawi.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/new.faceofmalawi.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/new.faceofmalawi.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/new.faceofmalawi.com\/index.php\/wp-json\/wp\/v2\/comments?post=786"}],"version-history":[{"count":0,"href":"https:\/\/new.faceofmalawi.com\/index.php\/wp-json\/wp\/v2\/posts\/786\/revisions"}],"wp:attachment":[{"href":"https:\/\/new.faceofmalawi.com\/index.php\/wp-json\/wp\/v2\/media?parent=786"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/new.faceofmalawi.com\/index.php\/wp-json\/wp\/v2\/categories?post=786"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/new.faceofmalawi.com\/index.php\/wp-json\/wp\/v2\/tags?post=786"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\ninfected themselves; their children may suffer prolonged illness
\nand incapacity, and need the elderly to look after them; the same
\nchildren may then die from the illness, leaving the elderly without
\nthe support of the next generation; this bereavement also leaves
\nthe older people to meet funeral costs and then to take care of
\norphans left behind. HIV has impacts on old people in ways that
\nare social , economic, psychological and physical in nature.<\/p>\n
\nAIDS on lives of older people following the death of their
\nproductive children, and to examine how the elderly struggle to
\ntake care of HIV\/AIDS orphans. While it is generally appreciated
\nthat older people undergo such hardships, little research has been
\ndone in Malawi to unravel the magnitude of these problems. We<\/p>\n
\nresult of HIV\/AIDS.<\/p>\n
\nprovide care and support to their ill children, and following the
\ndeath of their children to become parents again in taking care of
\nthe orphaned grandchildren. This is a particularly big challenge in
\na country like Malawi, dependent on hand-hoeing for subsistence
\nagriculture, where food production requires people who are
\nphysically strong. 79% of older people taking care of HIV\/AIDS
\npatients or orphans were found to have limited or no information
\nabout HIV\/AIDS. 31% were dependent on relatives for support,
\nwhile 69% sustained themselves through piece work, small business
\nor farming.<\/p>\n
\nas many are sexually active with multiple partners, and preventive
\ninformation is currently not reaching this important section of the
\ncommunity.<\/p>\n
\nNations AIDS Programme. 34.4 million people were living
\nwith HIV\/AIDS as of the end of 2008 and AIDS had<\/p>\n
\nThe high incidence of HIV\/AIDS in the sub-Saharan
\nAfrican region is leading to a devastation of individual and<\/p>\n
\nthat women and children are AIDS\u2019 greatest victims2.
\nIn Malawi according to a Ministry of Health 2007 report,<\/p>\n
\nsoon develop AIDS, some of whom will die leaving orphans<\/p>\n
\nThroughout sub-Saharan Africa, older people \u2013 particularly
\nolder women \u2013 are a key resource for combating AIDS and
\nalleviating its impact3. At household level, they are the persons
\nwho provide daily care for both AIDS patients and children
\nleft orphaned by the pandemic. These older people have<\/p>\n
\nextended families and continuing their more traditional roles
\nas advisors to their adult children and grandchildren. They
\nlargely absorb the enormous additional burdens placed on
\nfamilies and society by the AIDS pandemic.<\/p>\n
\ngivers were grandparents. Of these, 37% were between
\n60 and 85 years of age. This \u2018skip-generation parenting\u2019
\naccounted for 45% of the cases in another study of 1996 in
\nZimbabwe. According to Kadzandira (2007) in countries that
\nhave a high prevalence of HIV and AIDS such as Malawi,
\nolder people are increasingly playing the principal role of
\ncaring for younger adults sick with HIV and AIDS and for
\norphaned grandchildren4.<\/p>\n
\nof all households in sub-Saharan Africa were headed by an
\nolder person. In Namibia, South Africa and Zimbabwe,
\n60% of orphans live with their grandparents. Up to 56% of
\ncarers for orphans and vulnerable children in Namibia are
\nmore than 60 years old5.<\/p>\n
\nHIV, UNAIDS (2005) reported that 2.8 million adults
\naged 50 years and older were living with HIV worldwide,
\nrepresenting 7% of all cases.<\/p>\n
\ninvestigated whether older people in Malawi \u2013 who account
\nfor 6% of the general population \u2013 are undergoing similar
\nchallenges in this era of HIV and AIDS.<\/p>\n
\nof HIV\/AIDS on older people in Malawi using Chiradzulu
\ndistrict in southern Malawi as a case study.<\/p>\n
\nDesign <\/strong><\/p>\n
\nUsing in-depth interviews and focus group discussions, we
\ncollected data from 116 older people who were found to be
\ntaking care of HIV and AIDS orphans. We conducted the
\nstudy between January and April 2010.<\/p>\n
\npersonal information, numbers of children, possible causes
\nof death of the orphaned children\u2019s parents, the burden of
\ncare being undertaken, and mechanisms used to cope with
\nthis.
\n
\nStudy population and Site <\/strong><\/p>\n
\nSouthern part of Malawi, a district with a high HIV\/AIDS
\nprevalence. The age criterion for inclusion in the study was
\n60 years. (For individuals who did not know their age, we<\/p>\n
\nof HIV\/AIDS orphaned grandchildren. Once we knew the
\nnumber of older people for possible inclusion per village
\nwe employed a simple random sampling technique to come
\nup with our sample. Once an individual had consented to
\nparticipate, s\/he was interviewed using a questionnaire.<\/p>\n
\nthe district.<\/p>\n
\nrelative from within the household<\/p>\n
\nor grandchild; while 38% reported having been providing<\/p>\n
\ncounselling to the patient prior to their death.<\/p>\n
\norphans.<\/p>\n
\nand for meeting hospital bills in case of illness. 22% of the
\nsample indicated that taking care of orphaned grandchildren
\nhalted their own development because they were forced to
\nbe at home looking after the sick grandchild or taking the
\nchild to hospital. They particularly stressed that they had
\nto spend their reserved resources to make the lives of their
\ngrandchildren better, while impoverishing themselves in the
\nprocess. 19% of the respondents indicated that while they
\nwere able to support their orphaned grandchildren now,
\nthey were worried about what will happen to these children
\nfollowing their death; as to who will support the children,
\nwho will look after them when they are sick, and who will
\nremind them to take their anti-retroviral treatment without
\nfail every day.<\/p>\n
\nmember.<\/p>\n
\nthey had on medication (which included both western and
\ntraditional) and on buying food. 44% of the respondents
\nindicated having sold property to get money for meeting
\nexpenses both for medication and for the funeral ceremony.
\n12.5% indicated losing direct support from the deceased<\/p>\n
\n
\nEconomic impact of HIV and AIDS on the Aged <\/strong><\/p>\n
\ndeath and sickness of their children who gave them support
\nand care. One grandmother commented; \u201cAll the money had
\nbeen used to care for my children. They all died and now I have the responsibility
\nto look after the grandchildren.\u201d There was regret that
\nan economically productive person had been lost by the
\nhousehold. Generally, the longer the illness dragged on, the
\nmore resources were depleted. For example one old lady
\nrecounted her ordeal as follows; \u201cI cared for my daughter who
\nsuffered for three years at home. All the resources which she had were
\nexhausted, and I started using my own resources thinking that she will<\/p>\n
\nlamented, \u201cThe illness and eventual death of my son exhausted all<\/p>\n
\ninfected with HIV.<\/p>\n
\nAIDS speeds up the infection rate among their age group,
\nas most of the times preventive messages target the youth
\nand not older people. One old lady explained that following
\nthe death of a young person, \u201cwe are asked to wash the dead
\nbody; most of the times we do not know the cause of death, hence we
\nwash the body without gloves. This puts our lives at risk.\u201d 12.5%
\nbelieved that taking care of a sick relative with HIV\/AIDS
\nwithout protection at home put them at risk of the infection.
\nRespondents reported that having multiple sexual partners is
\ncommon among older people.<\/p>\n
\nAIDS pandemic. HIV\/AIDS is wiping out productive children,
\nand grandparents must assume responsibility for the<\/p>\n
\noften without sufficient strength, to do so. These findings<\/p>\n
\nHIV\/AIDS messages have not been reaching older people5.
\nThere is a great misconception that when people grow old
\nthey become sexually inactive. Our study established that in
\nfact older people do commonly have multiple sexual partners,
\nwhich is why we need to include them in our preventive
\nmessages on HIV\/AIDS.<\/p>\n
\nfor older people, the HIV\/AIDS impact is particularly
\nintense. Some older people, as established by this study,
\nhave no alternative but to be beggars in an effort to make
\nends meet.<\/p>\n
\ndiverse and deep. Social support networks are disrupted, and
\nolder people are left impoverished. Meanwhile they are also
\nat risk of becoming infected themselves because preventive
\ninformation on HIV\/AIDS is not reaching them.
\n
\nRecommendation <\/strong><\/p>\n
\nthe burdens being carried by older people in Malawi as a
\nconsequence of HIV\/AIDS. Access to subsidized fertilizer
\nand other amenities should not be age-based, as this leaves
\nout older people who are taking care of orphans. Messages
\nabout the disease and its prevention strategies should not
\nbe limited to people in the reproductive age groups only,
\nas is the case currently10. There is need for more research<\/p>\n
\nfollowing people; Marango Singini, Eluby Fukiza and
\nImmaculate Sefasi without them this work would not have
\nbeen possible. I would like to thank chiefs from the villages
\nwhere participants were drawn, child protection workers and
\nthe participants themselves for their time and commitment
\nto this exercise. <\/strong><\/p>\n
\ncare giving. Caring for family members with HIV\/AIDS and other
\nchronic illnesses: Impact on older women and girls. Geneva (WHO\/
\nNMH\/CCL\/01.01) 2000.
\n2. World Health Organisation. Impact of AIDS on older people in
\nAfrica: Zimbabwe case study. Geneva, WHO. (http:\/\/whqlibdoc.who.
\nint\/hq\/2002\/WHO_NMH_NPH_ALC_02.12.pdf)
\n3. Chimwanza, A. and Watkins, S. Giving care to people with AIDS
\nsymptoms in sub-saharan Africa. AIDS Care.2004; 16 (7): 795-807.
\n4. Kadzandira J. Rural Aging and Livelihood challenges. Centre for
\nSocial Research. University of Malawi. Zomba.2007
\n5. Zablotsky, G. \u201cOverlooked, ignored and forgotten: Older women
\nat risk of HIV infection and AIDS.\u201d Research on aging 20: 460-775.
\nhttp:\/\/www.avert.org\/older-people.htm. 1998
\nWHO HEALTH STATISTICS ON Malawi<\/p>\n
\nStatistics
\nTotal population 13,571,000
\nGross national income per capita (PPP international $) 690
\nLife expectancy at birth m\/f (years) 49\/51
\nHealthy life expectancy at birth m\/f (years, 2003) 35\/35<\/p>\n
\n554\/514
\nTotal expenditure on health per capita (Intl $, 2006) 70
\nTotal expenditure on health as % of GDP (2006) 12.3
\nFigures are for 2006 unless indicated. Source: World Health Statistics 2008<\/p>\n