Author: Victoria Wilmarth

“Everyone Deserves Compassion:” Sir Elton John Inspires at AIDS 2012

Written by Victoria Wilmarth on . Posted in Blog: News, Events and Opinion. Leave a Comment

Nearly 25,000 activists, medical professionals, policy makers, researchers, politicians, dignitaries, students, leaders, and HIV-positive individuals from around the world are gathered in Washington D.C. for AIDS 2012. The theme of the XIX International AIDS Conference, organized by the International AIDS Society, is “turning the tide together.”

In the first several days of the conference, a diverse and influential group of global leaders have spoken to the conference and the world. This distinguished group includes: President Bill Clinton, U.S. Secretary of State Hilary Clinton, South African Deputy President Kgalema Motlanthe, HRH Mette-Marit, Crown Princess of Norway, World Bank President Jim Yong Kim, UNAIDS Executive Director Michel Sidibé, Philanthropist Bill Gates, and many others.

However, amongst these “prominent voices” music legend and dedicated AIDS activist Sir Elton John stands out. In his keynote address to the conference, Sir Elton argues that a “sentiment” can “beat a virus.”

[box] “…No matter who you are or who you love, no matter where you live or how you live, no matter what you have or haven’t done, everyone deserves compassion. Everyone deserves dignity. Everyone, everyone, everyone deserves love.

Why am I telling you this? Because the AIDS disease is caused by a virus, but the AIDS epidemic is not. The AIDS epidemic is fueled by stigma, by hate, by misinformation, by ignorance, by indifference…

…Cynical people will say: how could a sentiment possibly beat a virus? If you show compassion, no one will be forced into the shadows. If you show compassion, no one will be afraid to seek treatment…”[/box]

This powerful call for compassion resonates with AIDS activists and with those committed to supporting orphans and vulnerable children. Millions of children around the globe have been orphaned or made vulnerable by AIDS. Like Sir Elton John, we need to encourage compassion in order to support OVC and to combat the debilitating stigma and suffering that HIV/AIDS leaves in its wake.

Thank you Sir Elton John for an inspiring and though provoking start to the AIDS 2012 Conference.

——            ——-              ———              ———-

This is an excerpt from Sir Elton John’s keynote address to the AIDS 2012 conference, which was delivered on July 23, 2012 in Washington D.C.

“…No matter who you are or who you love, no matter where you live or how you live, no matter what you have or haven’t done, everyone deserves compassion. Everyone deserves dignity. Everyone, everyone, everyone deserves love.

Why am I telling you this? Because the AIDS disease is caused by a virus, but the AIDS epidemic is not. The AIDS epidemic is fueled by stigma, by hate, by misinformation, by ignorance, by indifference. There is so much talk now about the end of AIDS and rightly so. We can end AIDS thanks to you out there. You have made it possible because of your research and your advocacy, we have life saving treatment and we have prevention.

Cynical people will say: how could a sentiment possibly beat a virus? If you show compassion, no one will be forced into the shadows. If you show compassion, no one will be afraid to seek treatment. Do you want to stop the epidemic in South Africa? Then show compassion by telling those living with HIV to be proud of knowing their status. That’s what the South African government is beginning to do, and it’s working. We need to put our arms around people who are HIV-positive. Celebrate the actions of individual change, celebrate people who are willing to get tested – that’s the compassion that will help get everyone tested and on treatment.

Do you want to end the epidemic in America? The show compassion to those who can’t afford treatment and are waiting lists to receive it. Show compassion for HIV positive people in Washington DC, most of whom are poor and black and forgotten even though they live in the capital of the richest and most powerful nation on earth. America has shown so much love for people living with HIV in the developing world. If this country wanted to end new infections at home, it could do so in a heartbeat…

…I know I sound idealistic, but if you don’t have a vision and don’t have a plan, then you are nowhere. My vision is for people to be much more tolerant of each other in every way possible. To be much more compassionate. And then we all embrace this idea of getting rid of AIDS, of getting rid of the cost not only of human lives, but also the incredible cost of billions of dollars a year and put it to good use.

We can beat this disease, but we have to do it together. We are doing it together…let’s have an AIDS free world soon.”

 

GUEST POST: The Moral Molecule, Hugging, and Children’s Wellbeing

Written by Victoria Wilmarth on . Posted in Blog: News, Events and Opinion. Leave a Comment

At first glance, The Moral Molecule: The Source of Love and Prosperity, seems like something of a scientific thriller. The book jacket goes as far as to describe the “Moral Molecule” and the associated research as “a revolution in the science of good and evil.” However, upon closer examination, neuroeconomist Paul J. Zak’s new book has important implications for child-welfare.

In his early work, Zak tied countries’ prosperity and growth to how “trusting” societies are. He has since found that the release of the reward chemical in the brain, oxytocin, gives rise to people, including children, having greater caring, bonding, empathy – as well as trust and moral behavior.  Zak has also found an array of behaviors that cause a release of oxytocin – including hugs.  In my view he charts an explanation for why children who have deprived childhoods behave the way they do: their oxytocin receptors may have been damaged by the absence of hugs and other vital human contact and affection.  Although further research is needed, Zak’s work provides a possible neuroscience-based explanation for attachment disorders that psychologists and child development experts have long observed in children who have missed human touch, especially in their early years.

In my experience as an alumnus of an orphanage and research on orphanages generally, I have seen that many modern-day children’s homes actively discourage hugging (or forbade hugging altogether). Others teach “appropriate hugging,” which limits physical contact by administering hugs from the side.  These policies were created to protect children from inappropriate behavior and contact, including sexual abuse. However, based on Zak’s long-running work in the burgeoning field of “neuroeconomics,” there is a (potentially) strong argument to be made on how policies restricting hugging and other physical contact in daycare centers, schools, children’s homes, and even sports teams can limit the release of oxytocin, which could in turn limit the potential improved behavior associated with oxytocin. It is imperative that we design policies that both protect children and also recognize the important benefits of hugging and other affectionate contact.  As it is, widely publicized cases of pedophilia, which will likely drive interest in additional restrictive hugging policies, can cause harm for children far removed from pedophiles’ direct victims.

Moving forward, Paul J. Zak’s work has a wide range of implications for child welfare that ought to be considered in upcoming research and future policies.

This blog post was written by Richard McKenzie, the Walter B. Gerken Professor Emeritus of Enterprise and Society at The Paul Merage School of Business at the University of California, Irvine. Dr. McKenzie is also a member of the OVC Wellbeing Advisory Board and an alumnus of Barium Springs Home for Children where he grew up in the 1950s.

Please respond to this article in our discussion forum.

PEPFAR’s support for orphans and vulnerable children: some beneficial effects, but too little data, and progress spread too thin

Written by Victoria Wilmarth on . Posted in OVC and HIV/AIDS. 2 Comments

Title: PEPFAR’s support for orphans and vulnerable children: some beneficial effects, but too little data, and progress spread too thin

Authors: Malcolm Bryant, Jennifer Beard, Lora Sabin, Mohamad I. Brooks, Nancy Scott, Bruce A. Larson,

Godfrey Biemba, Candace Miller, and Jonathon Simon

Date: July 2012

Abstract: Sixteen million children in developing and middle-income countries have been orphaned by HIV/AIDS, and at least another million children per year are rendered vulnerable by parental HIV/AIDS-related illness. Since 2003 the US government has provided approximately $1.6 billion to give four million of these children care and support through the President’s Emergency Plan for AIDS Relief (PEPFAR). We conducted five studies to evaluate the effectiveness of PEPFAR’s interventions for such children in East Africa and southern Africa. We found evidence of beneficial changes in school enrollment rates and on the psychosocial well-being of children. However, we could not demonstrate empirically the impact of most of the PEPFAR initiatives that we examined, primarily because of a lack of baseline data and clear outcome and impact indicators. We also found that many programs were spread so thin across a vulnerable population that little in the way of services actually reached beneficiaries, which raises questions about whether PEPFAR funds are sufficient, or if the program is attempting to do much with too few resources. We offer several recommendations, including better measuring the effect of programs for orphans and vulnerable children by collecting baseline data and conducting well-designed, rigorous outcome and impact evaluations.

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U.S. Global AIDS Effort to Help Orphans and Vulnerable Children

Written by Victoria Wilmarth on . Posted in Blog: News, Events and Opinion. Leave a Comment

One June 26th members of the OVC researchers, policy makers, advocates, and journalists gathered in Washington DC for U.S. Global AIDS Effort to Help Orphans and Vulnerable Children, a briefing hosted by the Kaiser Family Foundation.  This event included a range of panelists from non-profit and US government organizations who discussed the role of both the U.S. government and faith-based groups in supporting African orphans and vulnerable children.

John Donnelly, a panelist at this briefing and global health journalist with GlobalPost, noted that faith based group are one of the largest source of remittances and donations to OVC worldwide. Donnelly explores the role of faith-based groups in the African OVC crisis in his forthcoming book: A Twist of Faith:  An American Christian’s Quest to Help Orphans in Africa.

Panelists at this event included:

  • Nicole Behnam, Senior Technical Advisor for Orphans and Vulnerable Children, Office of the U.S. Global AIDS Coordinator
  • John Donnelly, Global Health Journalist, GlobalPost
  • Charles Lyons, President and CEO, Elizabeth Glaser Pediatric AIDS Foundation
  • Pauline Muchina, Senior Partnership Adviser, UNAIDS
  • David Nixon, Jr., President, The NOAH Project
  • Jen Kates (Moderator), Vice President and Director, Global Health & HIV Policy, Kaiser Family Foundation

To learn more about this event, please visit: globalhealth.kff.org/Multimedia/2012/June/26/gh062612video.aspxgg

Assessment of emotional status of orphans and vulnerable children in Zambia

Written by Victoria Wilmarth on . Posted in Psychological Effects of Orphanhood. Leave a Comment

Title: Assessment of emotional status of orphans and vulnerable children in Zambia

Authors: Sharon M. Kirkpatrick PhD, RN, FAAN,

Wilaiporn Rojjanasrirat PhD, RNC

Beverly J. South MSN, RN-BC, CNE

Jeri A. Sindt MSN, RN

Lee A. Williams MA, MLIS, AHIP

Date: May 3, 2012

Abstract:

Purpose: To describe the emotional status of orphans and vulnerable children (OVC) in two communities in Zambia.

Methods: The Health Ed Connect Adaptation Questionnaire (HECAQ) was used to interview 306 OVC and 158 primary caregivers in Zambia in 2010.

Findings: Child participants and caregivers reported evidence of emotional distress behaviors in the majority of OVC.

Conclusions: More research to evaluate the efficacy of intervention programs for loss and grief, normal and abnormal reactions to grief, and positive coping skills is needed to assist both children and their caretakers. In the population studied, caregivers and OVC could benefit from additional support for promoting emotional health and managing emotional distress in vulnerable children.

Clinical Relevance: Healthcare professionals play a key role in promoting the emotional health of OVC through identification of deviant behaviors and the development of interventions to alleviate emotional and psychological distress.

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Childhood adversity, mental ill-health and aggressive behavior in an African orphanage: Changes in response to trauma-focused therapy and the implementation of a new instructional system

Written by Victoria Wilmarth on . Posted in Psychological Effects of Orphanhood. Leave a Comment

Title: Childhood adversity, mental ill-health and aggressive behavior in an African orphanage: Changes in response to trauma-focused therapy and the implementation of a new instructional system

Authors: Katharin Hermenau, Tobias Hecker, Martina Ruf, Elisabeth Schauer, Thomas Elbert, Maggie Schauer

Date: September 25, 2011

Abstract:

Background

The number of orphans in Sub-Saharan Africa is constantly rising. While it is known that family or community care is preferable over institutional care of African orphans, little is known about the quality of care in orphanages and possibilities of improvement.

Study 1

Methods

Exposure to traumatic stress, experiences of violence in the home, school and orphanage, as well as mental ill-health and aggression of 38 children (mean age of M = 8.64 years) living in an orphanage in rural Tanzania were assessed at two time points. The severity of post-traumatic stress disorder symptoms (PTSD), depressive symptoms, and internalizing and externalizing problems were used as indicators of mental ill-health.

Results

Violence experienced in the orphanage correlated more strongly with all indicators of mental ill-health than violence in the former home, school or neighborhood at time point 1. Additionally, violence experienced in the orphanage had a positive relationship with the aggressive behavior of the children at time point 2.

Study 2

Methods

With the help of the pre-post assessment of Study 1, the implementation of a new instructional system and psychotherapeutic treatment (KIDNET) for trauma-related illness were evaluated.

Results

In response to both, a change in the instructional system and psychotherapeutic treatment of PTSD, a massive decline in experienced violence and in the severity of PTSD-symptoms was found, whereas depressive symptoms and internalizing and externalizing problems exhibited little change.

Conclusions

These studies show that violence, especially in the orphanage, can severely contribute to mental ill-health in orphans and that mental health can be improved by implementing a new instructional system and psychotherapeutic treatment in an orphanage. Moreover, the results indicate that the experience of violence in an orphanage also plays a crucial role in aggressive behavior of the orphans.

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Are orphans at increased risk of malnutrition in Malawi?

Written by Victoria Wilmarth on . Posted in Longterm Consequences of Orphanhood. Leave a Comment

Title: Are orphans at increased risk of malnutrition in Malawi?

Authors: R Panpanich, B Brabin, A Gonani, S Graham

Date: 1999

Abstract: The objective of this study was to compare the nutritional status and health problems of village orphans, non-orphans and orphanage children, and to identify factors associated with undernutrition. A cross-sectional study was conducted in three orphanages and two villages near Blantyre, Malawi. Seventy-six orphanage children, 137 village orphans and 80 village non-orphans were recruited. Anthropometric measurement was done and guardians were interviewed. In the group of children aged < 5 years, the prevalence of undernutrition in orphanage children was 54.8% compared with 33.3% and 30% of village orphans and non-orphans, respectively. Sixty-four per cent of young orphanage children were stunted compared with 50% of village orphans and 46.4% of non-orphans. The mean (SD) Z-score of height/age was significantly lower in the orphanage group, -2.75 (1.29) compared with -2.20 (1.51) and -1.61 (1.57) in the village orphan and non-orphan groups (p < 0.05). Conversely, older orphanage children or = 5 years) were less stunted and wasted than orphans and non-orphans in villages. Illness of children in the last month was reported to be higher in the non-orphan group, especially diarrhoeal disease, which occurred in 30% compared with 10.8% of village orphans and 6.6% of orphanage children. More than three children in a family being cared for by guardians was significantly associated with undernutrition. Orphanage girls were more likely to be malnourished than orphanage boys. Children who had been admitted to an orphanage for more than a year were less malnourished. In village orphans, there was no association between undernutrition and duration of stay in extended families. Age and education of guardians were not associated with the nutritional status of children. We conclude that young orphanage children are more likely to be undernourished and more stunted than village children. Older orphanage children seem to have better nutrition than village orphans. There was no significant difference in nutritional status between village orphans and non-orphans.

 

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Sexual risk behavior among South African adolescents: is orphan status a factor?

Written by Victoria Wilmarth on . Posted in OVC and HIV/AIDS. Leave a Comment

 

Title: Sexual risk behavior among South African adolescents: is orphan status a factor?

Authors: Tonya R Thurman, Lisanne Brown, Linda Richter, Pranitha Maharaj, Robert Magnani

Date: 2006

Abstract: There is concern that orphans may be at particular risk of HIV infection due to earlier age of sexual onset and higher likelihood of sexual exploitation or abuse; however, there is limited empirical evidence examining this phenomenon. Utilizing data from 1,694 Black South African youth aged 14-18, of whom 31% are classified as orphaned, this analysis explores the relationship between orphan status and sexual risk. The analysis found both male and female orphans significantly more likely to have engaged in sex as compared to non-orphans (49% vs. 39%). After adjusting for socio-demographic variables, orphans were nearly one and half times more likely than non-orphans to have had sex. Among sexually active youth, orphans reported younger age of sexual intercourse with 23% of orphans having had sex by age 13 or younger compared to 15% of non-orphans. Programmatic implications of these findings for the care and protection of orphans are discussed.

 

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Sexual risk among orphaned adolescents: is country-level HIV prevalence an important factor?

Written by Victoria Wilmarth on . Posted in OVC and HIV/AIDS. Leave a Comment

Title: Sexual risk among orphaned adolescents: is country-level HIV prevalence an important factor?

Author: Laura Robertson, Simon Gregson, Geoff P Garnett

Date:  2010

Abstract: Previous studies from sub-Saharan Africa have found that orphans experience increased sexual risk compared to non-orphans. We developed a theoretical framework for the investigation of determinants of HIV risk and used it to generate specific hypotheses regarding the effect of country-level HIV prevalence on the sexual risk experience of orphans. We expected that countries with high HIV prevalence would experience a higher prevalence of orphanhood. We further hypothesised that orphans in countries with high HIV prevalence would experience increased sexual risk, compared to non-orphans, due to pressure on the extended family network, which is primarily responsible for the care of orphans in sub-Saharan Africa, resulting in poorer standards of care and guidance. We used hierarchical logistic regression models to investigate this hypothesis using cross-sectional, Demographic and Health Survey data from 10 sub-Saharan African countries. We found that countries with high HIV prevalence did indeed have higher prevalence of orphanhood. We also found that, amongst female adolescents, maternal and double orphans were significantly more likely to have started sex than non-orphans in countries with high HIV prevalence but were not at increased risk in low HIV prevalence countries. This effect of country-level HIV prevalence on the sexual risk of orphans was not explained by household level factors such as wealth, overcrowding or age of the household head. The same pattern of risk was not observed for male adolescents male orphans were not more likely to have started sex than non-orphans. This suggests that orphaned adolescent women are an important target group for HIV prevention and that efforts should be made to integrate prevention messages into existing support programmes for orphans and vulnerable children.

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A longitudinal study of adolescents with perinatally or transfusion acquired HIV infection: sexual knowledge, risk reduction self-efficacy and sexual behavior

Written by Victoria Wilmarth on . Posted in OVC and HIV/AIDS. Leave a Comment

Title: A longitudinal study of adolescents with perinatally or transfusion acquired HIV infection: sexual knowledge, risk reduction self-efficacy and sexual behavior

Authors:  Lori S Wiener, Haven B Battles, Lauren V Wood

Date: 2007

Abstract: As HIV-positive children are surviving to adolescence and beyond, understanding their HIV knowledge and sexual behavior is critical. Forty HIV+ adolescents/young adults were interviewed twice, approximately 21 months apart (mean age 16.6 and 18.3 years, respectively). Data on demographics, safer sex knowledge, sexual risk behaviors, risk reduction self-efficacy, and Tanner stage were collected. Twenty-eight percent of HIV+ youth at Time 1 and 41% at Time 2 reported being sexually active. HIV transmission/safer sex knowledge was low, increased with age, and both self-efficacy for and actual condom use was relatively high. Secondary prevention messages should be incorporated into routine medical settings.

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