Drew R S, Makufa C, Foster G
Family AIDS Caring Trust, Mutare, Zimbabwe.
AIDS Care. 1998 Apr;10 Suppl 1:S9-15. doi: 10.1080/09540129850124325.
As a result of the severe HIV/AIDS epidemic in sub-Saharan countries such as Zimbabwe, where between 25-30% of the adult population are estimated to be infected, there are a growing number of orphans requiring care and support. Traditionally, orphans have been absorbed within the extended family but this is becoming more difficult because of the large number of young adults dying. The burden of care and support is falling on the very young and the very old. A number of strategies have been introduced to provide this care and support. Institutions, though popular, are very expensive to run, have limited capacity and only really cater for physical needs. Interventions which simply react to those who present to them may not reach the most needy and may encourage dependency. Community-based orphan care has been identified as the best and most cost-effective way of caring for orphans. An example of a community-based orphan visiting programme is presented. In the last six months of 1996, the FOCUS programme's 88 volunteers made a total of 9,634 visits to 3,192 orphans in 798 families at an average cost of US+1.55 per visit. The key elements of such programmes have been identified. They need to be implemented by a community-based organization (CBO) within a defined community. Volunteers should be selected from within the community. They need to be trained and supported as they enumerate orphans, identify the most needy and carry out regular visits. The volunteers should keep records of all their activities. These records can then be used as a basis for monitoring the programme. In order to cope with the increasing number of orphans in resource-poor settings like Zimbabwe, it is essential that such programmes be replicated and scaled up. This not only an economic necessity but is also a way of providing appropriate and effective services to those who need them.
在撒哈拉以南的国家，如津巴布韦，艾滋病疫情严峻，估计25%至30%的成年人口受到感染，因此需要照顾和支持的孤儿数量日益增多。传统上，孤儿由大家庭收养，但由于大量年轻人死亡，这种做法变得越来越困难。照顾和支持的重担落在了年幼者和年老者身上。已经采取了一些战略来提供这种照顾和支持。机构虽然受欢迎，但运营成本很高，能力有限，而且只真正满足身体需求。仅仅对前来求助者做出反应的干预措施可能无法惠及最需要帮助的人，还可能助长依赖心理。基于社区的孤儿照料已被视为照顾孤儿的最佳且最具成本效益的方式。本文介绍了一个基于社区的孤儿探访计划的实例。1996年最后六个月，“聚焦”计划的88名志愿者总共对798个家庭中的3192名孤儿进行了9634次探访，平均每次探访成本为1.55美元。此类计划的关键要素已被确定。它们需要由特定社区内的一个社区组织（CBO）来实施。志愿者应从社区内部挑选。在他们清点孤儿人数、确定最需要帮助的人并进行定期探访时，需要对他们进行培训和支持。志愿者应记录所有活动。这些记录随后可作为监测该计划的依据。为了应对像津巴布韦这样资源匮乏地区日益增多的孤儿数量，必须推广和扩大此类计划。这不仅是经济上的必要之举，也是为有需要的人提供适当和有效服务的一种方式。
