Nyambedha Erick Otieno, Wandibba Simiyu, Aagaard-Hansen Jens
Institute of African Studies, University of Nairobi, Kenya.
Soc Sci Med. 2003 Jul;57(2):301-11. doi: 10.1016/s0277-9536(02)00359-3.
The HIV/AIDS epidemic has given rise to major demographic changes including an alarming number of orphans in sub-Saharan Africa. The study describes a rural community in western Kenya in which one out of three children below 18 years of age had lost at least one biological parent-and one out of nine had lost both. The main problems these children faced were lack of school fees, food and access to medical care. The high number of orphans has overwhelmed the traditional mechanisms for orphan care, which were based on patrilineal kinship ties. Thus, 28% of the orphans were looked after by culturally "inappropriate" categories such as matrilineal kin or strangers. Furthermore, many of the caretakers were themselves not capable due to ill health or old age. Factors such as poverty, negative attitudes, and traditional funeral customs made the orphans' situation even worse. The authors conclude that though community-based interventions are urgently needed as the most appropriate way to address the issue, the complex, local reality in which cultural factors, kinship ties, and poverty are interwoven needs to be taken into consideration if sustainable solutions are to be found.
艾滋病毒/艾滋病的流行已导致重大人口结构变化，包括撒哈拉以南非洲地区数量惊人的孤儿。该研究描述了肯尼亚西部的一个农村社区，在这个社区中，每三名18岁以下儿童中就有一人至少失去了一位亲生父母，每九人中有一人失去了双亲。这些儿童面临的主要问题是缺乏学费、食物和医疗服务。孤儿数量众多，超出了基于父系亲属关系的传统孤儿照料机制的承受能力。因此，28%的孤儿由母系亲属或陌生人等文化上“不合适”的群体照料。此外，许多照料者自身因健康不佳或年事已高而无法胜任。贫困、消极态度和传统丧葬习俗等因素使孤儿的处境更加艰难。作者得出结论，尽管作为解决这一问题的最恰当方式，迫切需要开展基于社区的干预措施，但如果要找到可持续的解决方案，就需要考虑文化因素、亲属关系和贫困相互交织的复杂的当地实际情况。
