February 28, 2004
Phone: (504) 865-5714
There are countries in sub-Saharan Africa where more than 40 percent of the population has HIV or AIDS. These nations are looking at a future where large numbers of children will have lost both parents.
But in Rwanda, that future has already arrived. While HIV and AIDS are significant problems in Rwanda, the epidemic there hasn't reached the levels it has elsewhere. But 10 years ago, after decades of ethnic tension and violence on both sides, the Rwandan government called on the Hutu majority to kill every member of the Tutsi minority.
In a three-month period, 800,000 people--about seven percent of the population--were killed in the streets. Today, there are many households in Rwanda that are headed by children or young adults who look after their younger siblings.
Their parents might be dead due to AIDS, other diseases, or because of the genocide. Or they might be in prison. The non-profit organization World Vision helps provide for the basic needs of child-headed households in the Gikongoro region of Rwanda. But just taking care of bare necessities and dealing with immediate crises is an overwhelming task.
Members of child-headed households are struggling. They often feel that their community is hostile to them and report being stigmatized for being orphans. The aid that they receive from World Vision, modest as it may be, sometimes makes them a target of resentment. They report being exploited, harassed and abused by neighbors and feel that nobody cares.
"They're really the most vulnerable members of the community," said Lisanne Brown, assistant professor of international health and development.
She and Leslie Snider, also an assistant professor of international health and development, are co-principal investigators of a project to develop and evaluate a mentorship program that could help reconnect child-headed households to the community. World Vision and the Rwanda School of Public Health are Tulane's partners on the program. If it works, it could serve as a model for other places in Africa with growing numbers of AIDS orphans. Yet Rwanda is a special case.
"It's more complicated than I can understand," said Neil Boris, an assistant professor of community health science who is helping to develop the program. He visited Rwanda for the first time last November. "The genocide impacted every single person. Everyone saw it, everyone was a part of it. How can a country that survived that remember it, yet forget it enough to go on?"
The hostility and indifference that the orphans face is a sign of how stressed and distressed the community as a whole is. Yet Rwandans express the desire to put the past behind them and build a caring community. The mentorship program could be a way to help do that. The idea is to find caring adults in the community, train them to provide support and interaction for children and adolescents, and match them with a family that they will visit at least once a week.
World Vision works with more than 800 child-headed households in the area. About half would receive a mentor right away, while the other half would first serve as a control before being matched with a mentor. The mentors will be unpaid volunteers, though they will receive gifts and incentives. The program will be evaluated to see if it makes a tangible difference in the children's lives.
"We know from the Big Brothers/Big Sisters programs in this country that mentoring programs for young people can be quite powerful in their impact," Boris said. "Sometimes they impact things that you're not directly aiming at."
Young people who are struggling to look after their siblings expressed hope that mentors could provide them with companionship, guidance, comfort and protection. "If a visitor comes it would be useful. He can advise you and tell you what to do in order to lead a normal life like others," one person commented in an interview with researchers.
Another expressed hope that, "If someone visits us our neighbors will start to respect us." Everyone involved agrees it's important to listen to the community and build support for the program, rather than push it on them. "It's going to be a challenge," Brown said. There are many sensitive issues to negotiate.
For example, they are wary of matching Tutsi mentors with Hutu children, but the government now mandates that they can't ask questions about ethnicity. But if the program is successful, it could not only help orphaned children but also be a step toward healing the community as a whole. "We've got to try," said Boris.
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