Qualitative research report on orphans and vulnerable children in Palapye, Botswana pot

Qualitative research report on orphans and
vulnerable children in Palapye, Botswana
Edited by GN Tsheko
W
Free download from www.hsrcpress.ac.za
Published by HSRC Press
Private Bag X9182, Cape Town, 8000, South Africa
www.hsrcpress.ac.za
First published 2007
ISBN 978-0-7969-2187-1
© 2007 Human Sciences Research Council
Copyedited by Vaun Cornell
Typeset by Janco Yspeert
Cover design by Oryx Media
Cover photo: ©Eric Miller/iAfrika Photos
Print management by Compress
Distributed in Africa by Blue Weaver
Tel: +27 (0) 21 701 4477; Fax: +27 (0) 21 701 7302
www.oneworldbooks.com
Distributed in Europe and the United Kingdom by Eurospan Distribution Services (EDS)
Tel: +44 (0) 20 7240 0856; Fax: +44 (0) 20 7379 0609
www.eurospangroup.com/bookstore
Distributed in North America by Independent Publishers Group (IPG)
Call toll-free: (800) 888 4741; Fax: +1 (312) 337 5985
www.ipgbook.com
Free download from www.hsrcpress.ac.za

Acknowledgements iv
Acronyms and abbreviations v
Definition of terms vi
Executive summary vii

CHAPTER฀1:฀INTRODUCTION฀฀฀1
1.1 Defining orphans and vulnerable children 1
1.2 Background to situation of OVC in Botswana 2
CHAPTER฀2:฀BACKGROUND฀TO฀THE฀PROJECT฀฀฀5
2.1 Aims of the qualitative research 5
CHAPTER฀3:฀METHODOLOGY฀฀฀6
3.1 Research design 6
3.2 Research participants and sampling procedures 6
3.3 Data collection instruments 8
3.4 Ethical considerations 8
3.5 Data analysis 9
CHAPTER฀4:฀฀LIVING฀CONDITIONS฀฀
AND฀SERVICES฀฀฀10
4.1 Description of site 10
4.2 The situation of OVC 12
4.3 Household situation 14
4.4 Institutional care of children 17
4.5 Child abuse 18
4.6 Community members’ and leaders’ perceptions of OVC 19
4.7 Support structures for OVC in community 20
4.8 Context of HIV/AIDS 25
CHAPTER฀5:฀฀CONCLUSION฀AND฀
RECOMMENDATIONS฀฀฀26
5.1 Recommendations on care of OVC 27
5.2 Recommendations on support of households and communities
caring for OVC 27
5.3 Recommendations on service providers for OVC 28
Appendix 1 Interview schedule for OVC 29
Appendix 2 Interview schedule for immediate caregivers of OVC 31
Appendix 3 Interview schedule for members of NGOs, CBOs and FBOs 34

Appendix 4 Interview schedule for members of state services or government 36
Appendix 5 Interview schedule for background for BSS component 38
References 40
Free download from www.hsrcpress.ac.za

iv
This study was supported by the WK Kellogg Foundation and undertaken by Masiela
Trust Fund OVC Research-Botswana under the umbrella of the Human Sciences Research
Council in South Africa. Masiela Trust Fund OVC Research-Botswana is indebted to the
field assistants, respondents and community leaders who participated in this study. We
are also grateful to our research team which has worked tirelessly in the preparation of
instruments and collection of data.
We also thank all those who helped at various stages in the writing of this report,
especially Dr Dudu Jankie who analysed some of the data.
Thank you.
Masiela Trust Fund Research Project Director

Free download from www.hsrcpress.ac.za
v

AIDS acquired immune deficiency syndrome
ARV anti-retroviral therapy
BSS behavioural risks and sero-status
CBO community-based organisation
CHBC community home-based care
FBO faith-based organisation
HIV human immuno-deficiency virus
HSRC Human Sciences Research Council
MTF Masiela Trust Fund
MTP medium-term plan

NGO non-governmental organisation
OVC orphans and vulnerable children
PLWA people living with HIV and AIDS
PMTCT prevention of mother to child transmission of HIV
STPA short-term plan of action
TCM total community mobilisation
VCT voluntary counselling and testing
Free download from www.hsrcpress.ac.za

vi

Basic human rights These are rights held to be common to all people, such as
education, health, protection from abuse and neglect, food, shelter, non-discrimination,
preservation of identity, etc.
Street children These are children who have run away from home and live in the
streets. Many are believed to be orphans while the rest have run away from home due to
lack of parental love and care.
An orphan The most accepted definition of an orphan is a child who has lost both
parents through death. In Botswana an orphan is a child below 18 years who has lost
both adoptive or biological parents, or the one single parent if unmarried (Skinner et al.
2004).
A vulnerable child A child who has no or very restricted access to basic needs. The
child may have both parents but his/her rights might be denied (Skinner et al. 2004).
Free download from www.hsrcpress.ac.za
vii

In 2002 the Human Sciences Research Council (HSRC) received funding from the WK
Kellogg Foundation to develop and implement a five-year intervention project on the
care of orphans and vulnerable children (OVC), as well as households and communities
coping with the care of affected children in Botswana, South Africa and Zimbabwe. The

project comprises two components: firstly funding and technical assistance directed at
interventions to assist OVC; and secondly research to develop a better understanding
of the situation of OVC and towards the development of best practice approaches
for interventions. The HSRC is collaborating with research institutions in Zimbabwe
and Botswana, and with non-governmental organisations (NGOs) that would act as
implementing partners for the interventions. In Botswana, the Masiela Trust Fund (MTF)
was chosen to work with the University of Botswana Research Team as an implementing
partner. MTF’s mission is to mobilise resources to address the needs of orphans in order
to minimise the phenomenon of street children, juvenile delinquency, and to help divert
a culture of destitution, as well as forge a threat-free environment in the interest of a
better tomorrow. MTF works with community-based organisations (CBOs) and faith-based
organisations (FBOs), and funds their projects in the intervention sites to ensure delivery
of necessary services to those who need them. In Botswana, Palapye was chosen as an
intervention site for this project, in addition to the already existing sites where MTF has
interventions.
This study used qualitative techniques to enable in-depth understanding of the situation of
OVC in Palapye. Different approaches were used in data collection, including structured
and semi-structured interviews and focus group discussions. These helped the researchers
understand issues related to behaviour, attitudes, opinions, beliefs, feelings, knowledge
and values about OVC. A total of 32 key informant interviews and eight focus group
discussions were conducted. Purposive sampling was used to make sure that all significant
sectors of the communities were systematically covered. Interviews were held with
OVC, immediate carers of OVC, NGO/CBO/FBO representatives, community leaders and
government officials.

Palapye is a semi-urban locality and Setswana is the predominant language used in the
area. It also has advanced infrastructure. The community has access to different shops
(food, furniture, and clothing), public phones, public transport, electricity, water, tarred
roads and others. It is a typical village where some families still reside in one-roomed
traditional houses constructed of mud with a thatched roof. Most of the households do

not have running water and proper sewerage. Palapye has some urban dwellings, where
families reside in modern multi-roomed houses that have running water, proper sewage
and electricity. The Department of Water Affairs has provided community standpipes in
the village for use by villagers who do not have running water in their homes.
There are an increasing number of OVC in Palapye, and the situation is compounded
by HIV/AIDS resulting in the death of able-bodied parents. This leaves the children in
the care of old and poor grandparents. Poverty levels seem quite high, as many reported
shortages of basic needs including housing. Poverty alleviation initiatives are crucial for
this community.
Though the government has programmes to cater for orphaned children and the destitute,
there are challenges in registering those who qualify for these services, which results
in programmes not being accessible. Another complicating factor is the reluctance of
families to register such children with appropriate authorities. The community needs to be
educated on available programmes and their benefits.
Free download from www.hsrcpress.ac.za
viii
Further, due to shortages of transport, finance and manpower in delivery of services,
accessing services remains a challenge. On the other hand, NGO/CBO/FBO efforts to
address the issues are frustrated by the great lack of funds. This calls for a stronger
partnership in caring for OVC.
In some poorer households even the support from social welfare services of providing
food rations does not benefit OVC, as it is said that some caregivers steal these supplies
and use them for their own gain. This calls for education on caring for children and
home management.
Stigma continues to be a major challenge regardless of how long HIV/AIDS has been
in existence and how much education has been done. A general lack of knowledge
on HIV/AIDS is apparent in the myths surrounding transmission, prevention and cure.
Communities need more education on issues of HIV/AIDS, especially to try and decrease
the extent to which people are subject to stigma.
Free download from www.hsrcpress.ac.za

11

Introduction
The AIDS epidemic has left behind an estimated 15 million orphans worldwide. Around
80 per cent of these AIDS orphans live in sub-Saharan Africa (Fredriksson-Bass &
Kanabus 2004). Tragically, the number of orphans in sub-Saharan Africa will continue to
rise in the years ahead, due to the high proportion of adults in the region already living
with HIV/AIDS, and the continuing difficulties in expanding access to life-prolonging
anti-retroviral treatment (UNICEF 2003). In sub-Saharan Africa, even more catastrophically
than elsewhere, the HIV/AIDS epidemic has deepened poverty and exacerbated myriad
deprivations. The responsibility of caring for orphaned children is a major factor in
pushing many extended families beyond their ability to cope (UNICEF 2003). Many
countries are experiencing large increases in the number of families headed by women
and grandparents, and these households are often progressively unable to provide
adequately for the children in their care.
Children orphaned by HIV/AIDS are disadvantaged in numerous and often devastating
ways. For instance, in addition to the trauma of witnessing the sickness and death of
one or both parents, they are likely to be poorer and less healthy than non-orphans
(UNICEF 2003). They are more likely to suffer damage to their cognitive and emotional
development, to have less access to education, and to be subjected to the worst forms of
child labour (UNICEF 2003). Young people who have lost one or both parent are among
the most exposed in the society. This is particularly true in sub-Saharan Africa where few
social support systems exist outside of families and where basic social services are largely
inadequate (Fredriksson-Bass & Kanabus 2004).
Furthermore, orphans may grow up without basic material resources and may lack
the love and support that emotionally-invested caregivers usually provide. They may
be discriminated against because of the sero-status of their parents, or be forced to
discontinue their education because of lack of money or the need to take care of their
siblings (Skinner et al. 2004).
There is general consensus in the literature that help for orphans should be targeted at

supporting families and communities and improving their capacity to cope, rather than
setting up institutions for the children, as orphanages are not a sustainable long-term
solution (UNAIDS 2002). In addition, institutional care is known to have deleterious
effects on children. Children sent away from their villages may lose their rights to their
parents’ land and other property, as well as their sense of belonging to a family and a
community.
1.1 Defining orphans and vulnerable children
Skinner et al. (2004) define an orphan as a child who has lost one or both parents
through death, desertion or if the parents are unable or unwilling to provide care. They
further define a child as someone who is aged 18 and below. The Botswana Short Term
Plan of Action (STPA) (Ministry of Local Government Lands and Housing 1999: 9) on the
care of orphans defines an orphan as a ‘child below 18 years who has lost one [single
parent] or two [married couples] biological or adoptive parents’. The plan of action
goes on to categorise another group of orphans as social orphans and defines them as
‘abandoned or dumped children whose parents cannot be traced’. For the purposes of

Free download from www.hsrcpress.ac.za

2
this report, both definitions cited above will be used. Defining a vulnerable child can be
complex but focuses around three core areas (Skinner et al. 2004):
• Material problems, including insufficient access to money, food, clothing, shelter,
health care and education;
• Emotional problems, including lack of caring, love, support, space to grieve and
containment of emotions; and
• Social problems, including lack of a supportive peer group, of role models to follow,
stigma or of guidance in difficult situations, and risks in the immediate environment.
1.2 Background to situation of OVC in Botswana
The number of orphans in Botswana has increased tremendously in recent years due
to high and increasing prevalence of HIV and AIDS. In 1999, the number of registered

orphans was 21 109 and this number doubled to 42 000 by 2003 (Ministry of Local
Government 2004). This trend is shown in Figure 1.
Figure 1: Number of registered orphans, Botswana, 1999–2003
Source: Ministry of Local Government (2003), Department of Social Services 1999–2003
The number of registered orphans has been increasing, and findings from the rapid
assessment on the situation of orphans in Botswana (Ministry of Health 1998) indicated
that many orphans do not have access to basic necessities such as food, clothing, shelter
and toiletries. The assessment also established that their basic fundamental human rights
were violated by society and caregivers, including relatives in some cases – for example,
their food rations being sold and being used as cheap labour by the business community.
What further aggravates the problem is that many caregivers are aged grandparents, who
live in abject poverty, and in many cases are supported through the destitute programme
or old age pension (Ministry of Local Government Lands and Housing 1999).
The advent of HIV and AIDS has not only increased the problem of orphans but also
compounded the phenomenon of vulnerable children. The long-term sickness and
eventual death of a parent or both parents to HIV and AIDS exposes OVC to all kinds
of abuse. For instance, it was frequently mentioned that many vulnerable children end
up leaving their homes to join the ranks of street children while some remain in poverty
in their homes. According to a Situation Analysis of Street Children in Botswana (Dynah
0
5
10
15
20
25
30
35
40
45
1999 2000 2001 2002 2003

21 109
24 341
30 855
37 850
42 000
Thousands
Free download from www.hsrcpress.ac.za
3
2002), the main underlying reason why children go onto the streets is poverty.
In view of the rapid increase of registered orphans due to HIV/AIDS, the government of
Botswana, through the Ministry of Local Government which has a sectoral responsibility
for the protection, care and mitigation of the impact of HIV/AIDS on children, developed
a short term plan of action (STPA) on the care of orphans for 1999–2001. This programme
seeks to support and protect affected and infected children and their families. Some of
the key activities/projects are discussed below.
1.2.1 National orphan care programme
The government of Botswana initiated a national orphan care programme in 1999
to coordinate all efforts addressing the orphan problem through the Social Welfare
Department under the Ministry of Local Government. Since the start of the programme in
1999 all districts have taken responsibility to assess, register and support orphans.
The Botswana orphan care programme is guided by the STPA (Ministry of Local
Government Lands and Housing 1999), which has the following stated objectives:
• Facilitating an efficient and effective system of provision of material and emotional
support services and protection of their basic rights;
• Facilitating the identification, assessment and registration of orphans regardless of
the cause of death of parents;
• Identifying the various stakeholders and defining their roles and responsibilities in
responding to the orphan crisis;
• Identifying mechanisms for supporting community based responses to the orphan
problem; and

• Developing a framework for guiding long-term development programmes for orphans.
The orphan care plan of action has implemented the following regarding provision of
basic needs:
• Food baskets: Given that many of the orphans are without adequate food, clothing,
decent shelter and toiletries, provision of these basic needs was perceived as the
most urgent and immediate focus of the orphan care programme. In collaboration
with the Ministry of Health, a ‘food basket’ was established for orphans and other
children in need of nutritional care. This basket contains all the necessary food
items, including, for example, maize-meal, rice, meat, vegetables and toiletries.
These are issued on a monthly basis nationwide (Ministry of Local Government
Lands and Housing 1999).
• Access to education: To ensure that orphans remain in school and get appropriate
education, orphans are provided with suitable school uniforms, shoes and other
miscellaneous school costs.
• Security: To ensure sustained or continued protection of orphans from abuse and
neglect, characteristics of the socio-political environment in which children and OVC
in particular find themselves, the orphan care programme is mandated with the
responsibility for the well-being and security of orphans. For example, one of the
programme activities is provision of legal interventions that are in place to protect
the rights of children and orphans. The Children’s Act includes provisions targeting
abuse and neglect of children.
• Alternative care: Given the complexity of the orphan problem, the government
has identified the need to establish alternative care for orphans, guided by the
‘Regulations governing alternative arrangements for children in need for care’ (STPA
on Care of Orphans in Botswana).
• Provision of psycho-social support: This is provided by social workers in government

Free download from www.hsrcpress.ac.za

4

and non-governmental organisations (NGOs) such as MTF and other private institutions.
The response of the government of Botswana is in line with the Millennium Development
Goals that were adopted by 189 United Nations member states in 2000 in order to combat
poverty, hunger, disease, discrimination against women, degradation of land, and illiteracy
(UN 2000).
1.2.2 Institutional partnerships/collaboration
NGOs and community-based organisations (CBOs) have responded positively in providing
various childcare and protection activities. Their countrywide initiatives focus on orphan
feeding, clothing, counselling, home visits, day care and home-based care for the
terminally ill.
To complement government efforts and strengthen community initiatives, Masiela
Trust Fund (MTF) was established through a notarial deed of trust on 9 February 2001,
in accordance with the laws of the Republic of Botswana. MTF is charged with the
responsibility of raising funds for the care of orphans, and support to CBOs and FBOs
that are involved in care for OVC as part of increasing the volume and quality of care.
However, NGOs and CBOs have certain limitations in their quest to provide care to
OVC. For instance, due to manpower, skills and financial constraints, their contributions
have been limited and concentrated more in urban and semi-urban areas thus limiting
the desired national response to addressing orphan needs. The government orphan care
programme is limited to the care of only orphans registered with the Social Welfare
Division, leaving out the unknown numbers of unregistered orphans.
Free download from www.hsrcpress.ac.za
5
Background to the project
In 2002 the HSRC received funding from the WK Kellogg Foundation to develop and
implement a five-year intervention project on the care of OVC, as well as households
and communities coping with the care of affected children in Botswana, South Africa
and Zimbabwe. The project comprises two components; firstly, funding and technical
assistance directed at interventions to assist OVC; and secondly, research to develop
a better understanding of the situation of OVC and towards the development of best

practice approaches for interventions. In Botswana, the MTF was chosen to work with the
University of Botswana Research Team as an implementing partner. MTF’s mission is to
mobilise resources to address the plight of orphans in order to minimise the phenomenon
of street children and juvenile delinquency, and help to divert a culture of destitution, as
well as forge a threat-free environment in the interests of a better tomorrow. MTF works
with CBOs and FBOs, and funds their projects in the intervention sites to ensure delivery
of necessary services to those who need them.
The ultimate goals of the project are to develop, implement and evaluate best practice
approaches for existing and new OVC intervention programmes that will:
• Improve the
social conditions, health, development, and quality of life of vulnerable
children and orphans;
• Support families and households coping with an increased burden of care for
affected and vulnerable children;
• Strengthen community-based support systems as an indirect means of assisting
vulnerable children; and
• Build capacity in community-based systems for sustaining care and support to
vulnerable children and households over the long term.
There were other activities undertaken as part of this project. Situation analyses were
conducted to identify the existing services in the study areas, as well as to establish
their strengths and weaknesses and gather suggestions on how to improve or strengthen
services. This was followed by the baseline studies including census surveys and
qualitative research. This was to aid in the planning of interventions that were to be
developed, as already stated. These baseline studies are to be repeated at the end of the
project in an effort to assess the effects of interventions.
2.1 Aims of the qualitative research
The purpose of this qualitative study was to obtain a detailed description of the situation
of OVC at selected sites. The information obtained is to be used to develop appropriate
intervention programmes for OVC. The specific objectives of the study were to:
• Develop an understanding of the magnitude and nature of the OVC problem in the

study sites;
• Identify and describe key and potential support systems for the OVC;
• Assess the social conditions, health, development and quality of life of OVC; Identify
family and household support systems for coping with the burden of care for OVC
at family and community level.

Free download from www.hsrcpress.ac.za
6
Methodology
The research design, sample, data collection instruments, data collection procedures and
data analysis for this study are described in this chapter.
3.1 Research design
To examine, understand, and interpret the magnitude and nature of the problems of
OVC, potential support systems and care for OVC, as well as social conditions of these
children, this study draws on the qualitative research approach. This approach contributes
to the process of constructing research knowledge as researchers ‘observe, interview,
record, describe, interpret and appraise settings as they are’ (Eisner 1991: 145). Within
this context, qualitative researchers interact with participants, such as orphans, vulnerable
children and their carers, as they attempt to understand and make sense of the social
world/natural setting from the perspectives of the targeted participants.
Considering that the importance of qualitative research lies partially in exploring
the participants’ multiple realities and experiences of the social phenomenon under
investigation, the researchers used structured and semi-structured interviews, focus
group discussions, and document analysis to gain insights into the issues related to the
behaviour of, attitudes, opinions, beliefs, knowledge and values regarding OVC. These
sources of research data not only provided descriptive data essential in qualitative
research studies, but also made it possible to triangulate data for purposes of data analysis
and reporting the findings of the study. Thus, the qualitative nature of this study is also
partially evident in the triangulation of the research data. The importance of this lies in
the fact that triangulation increases the credibility of research results since it ‘increases the

likelihood that the phenomenon of interest is being understood from various points of
view and ways of knowing’ (Maykut & Morehouse 1994: 146).
3.2 Research participants and sampling procedures
Participants who were purposefully chosen for this study included individuals from
significant sectors of the community who were familiar with and knowledgeable about
the situation/social conditions of OVC. More significantly, participants included OVC, thus
giving these children the opportunity to share their knowledge and insights regarding
their lived experiences and realities. Yet, it is important to note that the experiences and
realities of these children may not be viewed as representative of the social conditions
of all OVC in selected sites. Other participants consisted of carers of OVC, community
members, members of NGOs, government officials, and community leaders.
3.2.1 The OVC
Ten OVC were interviewed, including five males and five females. Of the five female
OVC interviewed for this study, two were aged between six and 12 years, whilst the other
three were aged between 13 and 18. Likewise, of the five male OVC, two were aged
between six and 12 years, whereas the other three were 13- to 18-year-old teenagers.
Because of the sensitivity of information required from them, OVC were interviewed
individually.

Free download from www.hsrcpress.ac.za
7
3.2.2 Immediate carers of OVC
The purpose of interviewing caregivers was to find out their experiences and the
challenges of caring for OVC and how to address these. In all, one male and seven
female caregivers were interviewed. Five of the seven female carers were grandmothers,
while the other two were aunts. Of significance too is that one of the grandmothers was
blind, a phenomenon that makes it more challenging to perform the role of a caregiver.
The only male carer interviewed was a grandfather who was responsible for orphaned
children. The carers, who in fact reported that they were taking care of up to four
children, started taking care of the orphaned children after their mothers passed away.

Of note in this regard is that there was no mention of fathers as possible caregivers for
these children following the passing away of their mothers, thereby suggesting that these
children were from single-parent families.
3.2.3 CBOs, FBOs, and NGOs
This category consisted of organisations working with OVC. The nature, structure and size
of these organisations differed. Some were mainly made up of volunteers while others
offered paid employment. NGOs also offered different services such as care, support,
counseling, and so on. Only NGOs working directly with OVC were selected. At least
one person from each of the following organisations was interviewed: Itsoseng Banana,
House of Hope, Total Community Mobilization, Home-based Care Community, as well as
the Full Gospel Church, making a total of five participants. These were people likely to
be conversant with and/or knowledgeable about the plight of OVC and the services that
their organisation offered. The main reason for interviewing this group was to find out
about services they offered for OVC, what they thought were major needs of OVC, and
challenges faced in assisting them.
3.2.4 Gover
nment officials
This category comprised of people who were working for government departments
involved in orphan care. The three individuals interviewed in this regard were a
social worker, a police officer and a district medical officer. The main reason for
interviewing government officials was to identify their views on OVC problems and
their understanding/awareness of government’s involvement in improving the condition
of orphans. Topics covered included the policies set out to deal with OVC, and the
government departments tasked to deliver these services, obstacles to their delivery and
methods to address obstacles.
3.2.5 Community leaders
The thr
ee community leaders who participated in this study comprised of the chief
(Kgosi), councillor and village development committee chairperson. Interviews with these
individuals explored their attitude to OVC, as well as perspectives regarding HIV/AIDS

and risk behavior.
3.2.6 Focus g
roup discussions
Focus group discussions provided the opportunity for collecting descriptive data from
community members who participated in this study. Eight focus group discussions were
conducted. The main purpose of these was to gather information relating to participants’
knowledge and beliefs about HIV/AIDS and risk behaviour, as well as OVC issues.
Participants were grouped according to age and gender. Categories were ages 6–12, 13–
18, 19–24 and 25 years and above. For each age group, separate male and female groups

Free download from www.hsrcpress.ac.za

8
were formed. There were 5–12 participants in each category. Places like sports clubs,
local NGOs and schools were used for recruitment of participants.
Each group discussed specific questions that were provided by the researchers. The focus
group discussion made it possible for the researchers to obtain detailed, descriptive data
from multiple perspectives, a phenomenon that might have been challenging in individual
interviews. The discussions were conducted in Setswana. There were two facilitators for
each of the focus group discussions. One was the primary interviewer, while the other
co-facilitated and provided support by taking notes, checking that the tape-recorder was
functioning well and that all participants were actually participating.
Permission was sought from the participants to tape interviews. The audio-taped
interviews were later transcribed for purposes of analysing, coding and reporting the
research findings. Moreover, the participants were informed that the research data would
only be used for purposes of this study. The length of interviews varied depending on
who was interviewed. For instance, the OVCs were interviewed for 30 to 60 minutes,
whereas the duration of the interviews with carers was 45 to 60 minutes, while members
of NGOs, state officials and community leaders were interviewed for 60 to 90 minutes.
3.3 Data collection instruments

3.3.1 Interviews
The primary data collection strategies used for generating qualitative data for this study
were structured and semi-structured interviews, focus group discussions and document
analysis. An interview guide was developed by the researchers for use in both the key
informant interviews and focus group discussions. The schedule focused on background
information of the informant, attitudes of the community towards OVC, care and support
structures, challenges for the community in providing care and support to OVC, as well
as policy and legislation for the protection of OVC. Secondary questions asked dealt with
knowledge, beliefs and behaviour regarding HIV as well as the extent of HIV/AIDS in the
community and how people
could protect themselves (see Appendices 1–5).
3.3.2 Secondary documents
Review of official documents and published works was done to further explore the
context and situation of OVC in Botswana. These included the Medium Term Plans I and
II, Short Term Plan of Action on Care of Orphans in Botswana, and documents from the
Central Statistics Office which reflected the numbers of orphans. Documents from other
organisations such as NGOs and CBOs which addressed services provided to OVC were
also analysed.
3.4 Ethical considerations
Time was spent with the community including leaders in Palapye to negotiate entry. This
was done in consultation with other CBOs working with OVC in the study site. Kgotla
(public) meetings were held to reach the community at large. Such preparation helped
the community and leaders to understand the programme and to accept its ownership.
Ethical considerations are an important aspect of qualitative research projects. At
one level, ethical considerations involve getting informed consent from the research
Free download from www.hsrcpress.ac.za

9
participants. Within the context of this study, the importance of this lies in that children/
minors were among the key participants. Hence, informed consent for their participation

had to be sought from those who were legally responsible for their care and from the
children as individuals. Verbal consent was used in this study, as consensus to accept it
was reached by the participating countries. The consent forms, which were written in
both English and Setswana (both official languages, with the latter being the dominant
local language at site), were first read to those who were asked to participate.
Considering the sensitive nature of the themes or issues that this study explored, such
as HIV/AIDS, and thus the sensitive nature of knowledge and insights sought from the
participants, it was important to assure the latter that their participation would not expose
them to any risks, such as unfair treatment, pain and injuries. Moreover, the researchers
informed the participants that their participation was voluntary, and confidentiality would
be observed by using pseudonyms to protect them. Consequently, the knowledge or
information they shared would be kept anonymous. Within this context, before the
interviews and focus group discussions started, facilitators provided participants with full
information regarding their participation in the discussions.
Access to organisations was sought from their respective managers, or in the case of
government officials, from senior personnel in the department. As gatekeepers to the
organisations, these individuals were instrumental in giving permission for the researchers
to interview their staff members, as well as in identifying the documents that were
requested for purposes of the study. Informed consent forms were also read to potential
participants in these organisations and their consent sought before proceeding with the
interviews.
3.5 Data analysis
Data from structured and semi-structured interviews, focus group discussions and relevant
documents were read and re-read and coded in order to identify emerging themes and
their relationships to the main objectives of the study. This thematic content analysis
method was used to identify the major themes and discourses that emerged from the
transcriptions, to acknowledge and represent the multiple voices and perspectives of
individuals who participated in the study.
Free download from www.hsrcpress.ac.za
10

Living conditions and services
4.1 Description of site
Palapye is situated in the Serowe/Palapye district in Central Eastern Botswana, about
275 km north of the capital city Gaborone. It is one of the largest villages in Botswana
with a population of 26 293, of whom 12 087 (46 per cent) are males and 14 206 (54 per
cent) are females (CSO 2001). Palapye is built around a coal-driven power station called
Morupule Colliery, which supplies the coal for the power station. Most of the people
living in Palapye are employed by either the power station or the colliery. The other
groups of people are mainly employed by the government in the ministries of health,
education and local government. However, most families still depend on livestock rearing
and ploughing for survival.
Palapye is a semi-urban locality and residents use Setswana as the predominant language.
It also has advanced infrastructure. The community has access to different shops (food,
furniture, and clothing), public phones, public transport, electricity, water, tarred roads
and others. It is a typical village where some families still reside in one-roomed traditional
houses that are made up of mud and a thatched roof. Most of the households do not
have running water and proper sewerage. Palapye has an urban area where some
families reside in modern multi-roomed houses that have running water, proper sewerage
and electricity. The Department of Water Affairs has provided community standpipes in
the village for use by villagers who do not have running water in their homes.
The locality of Palapye still embraces the traditional style of an extended family culture of
caring, although there are signs that the extended family has begun to disintegrate. The
extended family has always provided a safety net but it is now undergoing a tremendous
social and economic change that has a direct impact on families’ ability to provide care
for OVC. The socio-economic developments taking place in the country have had both
negative and positive impacts. One of the negative impacts at societal level has been the
break-up of the extended family as more and more family members move into towns
to seek employment. As a result of these movements, and the rise in the cost of living,
families are no longer able to be as intact as they used to be. This has resulted in the
tendency to have more nuclear families.

Palapye has both the traditional and modern type of leadership comprising of a chief,
two deputy-chiefs, a district commissioner and other state officials such as the police,
political councillors, members of parliament and others.
There is one primary health care facility and four clinics. These are government-supported
facilities that provide for the health care needs of the community, including those of
OVC. The Botswana 2003 second-generation HIV/AIDS surveillance study did not single
out numbers for Palapye as a community but includes its numbers with those from the
rest of the Serowe/Palapye district. HIV prevalence for the district was 43.3 per cent in
2003. The healthcare system provides an array of services to benefit people living with
HIV/AIDS, and these include Prevention of Mother-to-Child Transmission of HIV/AIDS
(PMTCT), Sexually Transmitted Infections clinics, tuberculosis treatment and access to
antiretroviral treatment for both children and adults through Serowe and Mahalapye
hospitals. The Sekgoma Memorial Hospital based in Serowe is located about 45 km west

Free download from www.hsrcpress.ac.za

11
Gaborone
Palapye
of Palapye, whereas Mahalapye Hospital is located about 60 km south of Palapye. People
living in Palapye also have access to a free voluntary counselling and testing (VCT) centre
provided through a local VCT provider called Tebelopele, which uses rapid tests and
has been supported through a collaboration between Botswana and the United States of
America government called BOTUSA.
There are schools in Palapye which are operated by both the private and public sectors.
There are six day-care centres. Out of these only one is provided by an NGO called
House of Hope. Other day-care centres are provided through the private sector and
charge monthly rates of between P300–P450 ($60–$90) per child per month. There are
eight primary schools and three secondary schools, all supported by government through
the Ministry of Education.

Through the Ministry of Local Government, Social Welfare Division, orphaned children
in Palapye benefit from the government orphan care programme. The purpose of the
programme is to identify and register orphans, as well as provide monthly rations in the
form of food and toiletries. Clothing is provided on a yearly basis. By December 2004,
the programme had registered 1 743 orphans. The number of children registered in the
destitute programme was not available.
Figure 2: Map of Botswana
Botswana
South Africa
Namibia
Zimbabwe
Free download from www.hsrcpress.ac.za

12
4.2 The situation of OVC
Discussions from interviews indicated that vulnerable children are a growing problem
in the community. Of major concern in this community is the escalating number of
orphaned children. Though there was a concern about vulnerable children, the lack
of a clear understanding of which children are vulnerable complicated the discussions.
Thus discussions centred on orphans, though it was generally agreed that both orphans
and vulnerable children should be registered with the relevant offices so that they could
enjoy the benefits offered by the government programmes. Orphans are registered into
the national orphan care programme, while vulnerable children who are not orphans are
registered into the destitute persons programme.
The extent of the OVC problem was not known due to the failure of carers to register
such children with relevant authorities. Some of the participants who were interviewed
identified limited knowledge of procedures involved in the registration of OVC, attitudes
of members and carers towards registering OVC, and lack of social workers as factors that
contributed to the magnitude of the problem.
Registration of OVC with social workers was seen as essential for providing basic care

for them. This support included getting clothing, school uniforms, and food supplies.
Likewise, registering OVC with social workers for instance made it possible for them to
have access to social services such as counselling and healthcare.
The importance of registering OVC so that they may benefit from services of this nature
could not be over-emphasised. This however was crippled by reluctance of families in
registering such children, as one government officer said about registering orphans: ‘Some
parents do not want to show that they have orphans.’
According to participants, poverty was the reason for this lack of enthusiasm in registering
children. Poor people often felt stigmatised and this made them shameful. Registering
their children would mean they were asking for assistance and thus exposing their
poverty. Poverty was often viewed negatively as a phenomenon that was humiliating, and
consequently, most individuals felt ashamed of being labeled as poor.
Poor families found it challenging to provide the basic needs of OVC, such as food,
clothing, education and decent housing. What made this challenging most times was that,
in addition to taking care of orphans, these families often had other dependants in their
care. Within this context, some participants expressed the view that what contributed to
negative attitudes towards registering orphans was the shame and embarrassment felt by
some family members especially towards poverty. In the words of the district medical
officer when asked about families who fail to register the children:
Some of them are shy to do that because they feel that if I [they] go to the
social workers, they will say, why are you failing to look after your child, or
they will be thinking that I am [they are] too poor to fend for this child. So
people choose to suppress their suffering.
The following excerpts from the focus group interview data reinforce this view:
You see Batswana are full of shame. A lot of people have orphans but they do
not register them. When a person gets the food package for destitutes you find
that it is like they are looked down upon. So others do not want to be looked
Free download from www.hsrcpress.ac.za

13

down upon. They pretend they are not needy so that people think they have
the ability to care for themselves. They do not accept their situation. People are
scared to register their children, as they fear what others will say about them.
People will say you are not able to care for your children.
Of significance too was that, whereas some individuals or families did not register
OVC because of the stigma attached to poverty, some working carers felt embarrassed to
register OVC because they believed that doing so implies that: ‘When I get the
food rations while I am employed, people will say I am poor and that is why I get the
free rations.’
At another level, some wealthy individuals or families did not register these children
because they felt that they did not need any form of assistance from the government to
help with the welfare of the OVC in their care. Some focus group discussion participants
felt that an attitude of this nature should not be encouraged because all OVC have a right
to enjoy the benefits of the programmes aimed at promoting their welfare, regardless
of the social status of their carers. After all, the carers are not the intended primary
beneficiaries of these programmes.
It is also important to note that one of the female carers interviewed indicated that some
employed carers often felt that the food supplies provided for orphaned children were
meagre and hence not worth registering these children for: ‘It discourages you to think of
registering when you think of the meagre supplies you will get and so you choose to rely
on your own means.’


The fact that some individuals felt that they were able to maintain the orphans from their
own salaries may have discouraged them from registering these children.
One of the benefits of registering children was that they were provided with basic needs
such as food and clothing, including school uniforms. Those of school-going age were
therefore motivated to stay in school. Failure to register children denied them the benefits
of the government programme, as a social worker interviewed pointed out:
OVC who go to school are in much better circumstances in that at school they

are provided with the school feeding programme, and not only that, they have
much more access to social workers’ services. For example, they are provided
with uniforms, shoes, clothing. They are also taken care of through the school
feeding program. They are very well covered with services and they are much
better [off] than those that are left at home or in the other places where the
crèches are not well-organised or places with no schools. Most of [those]
orphans are taken out of the villages to the lands and into the cattle post and
dumped there. They then do not have access to schools.
Furthermore, regarding orphans, the district medical officer captured it when he said:
We still have the majority of orphans not in school although they are school
age, because they are not accessible to the [welfare] officers that would put
them in schools. That’s why I would like to appeal to parents to say when they
have such orphans, to straight away get in touch with the social workers so
that [the social workers] can assist the children and see whether they can help
them with school placement and [whether they] will automatically be qualifying
for food at the school under the school feeding programme. We still have a lot
of children who are not going to school because they are not registered with
Free download from www.hsrcpress.ac.za

14
the social worker, and because the relatives have taken them out of the villages
where there are schools, to the cattle posts and to the lands.
The district medical officer believed that this situation could be changed through
dissemination of information on the purposes and benefits of registering orphans, as well
as through educating family members and carers in particular, regarding positive care of
these children, which involved registering orphans in schools at their appropriate grade
levels. As the district medical officer further explained, this was beneficial to the children:
One of the things that was discovered in our district is that the children tend to
enrol at school very late because they are taken away to these areas [lands and
cattle posts] and therefore we feel that if the parents are educated, things are

explained to them, either through the social workers, through the teachers, and
so on; by launching special campaign through the various meetings, the village
health committees, village development committee and schools.
The importance of educating orphans was also reinforced by other participants, such
as carers and the police officer interviewed, who viewed schools as social institutions
where registered orphans could get valuable knowledge on HIV/AIDS, such as how the
epidemic was transmitted and the stigmas related to it.
Educating family members and carers regarding the registration and positive care of
orphans also implies sensitising these individuals to the need to register all orphans with
relevant authorities, regardless of whether or not their carers could afford to cater for
them financially. Yet, it is important to acknowledge the view expressed in one of the
focus group discussions: that registering OVC could only yield its intended results if carers
were committed to their welfare, which among other things should be demonstrated by
keeping regular contact with relevant authorities. Registering orphans and then failing
to be in contact regularly with relevant government authorities such as social workers
and the staff of NGOs like House of Hope regarding their welfare, often prompted
these individuals to visit specific families to check on the welfare of the orphans in their
care. Such visits more than often revealed that the orphans were neglected. A focus
group discussion participant who identified herself as a staff member of House of Hope
explained: ‘Sometimes you find that a child is not in school. Actions of this nature limit
possibilities for orphans to improve their lives and thus have a better future.’
4.3 Household situation
Interviewers were asked to make observations about their general impressions of the
households where they conducted the interviews. A majority of these households were
reported as lacking most necessities such as running water, flush toilets or electric stoves.
The general impression was that the households displayed poor environments for the
raising of children. The house structure was also of concern, as housing is an important
factor in caring adequately for OVC. Of significance in this regard was that carers or
guardians do not only care for orphans but other children as well as family members.
Lack of adequate housing was one of the main issues that emerged from this study. Most

of the participants interviewed expressed the opinion that providing housing for OVC
was essential in that it would improve their lives. Within this context, various factors were
identified that made housing an issue of concern in caring for OVC. Firstly, some of the
OVC lived in incomplete housing structures, which meant that they were not adequately
protected from natural elements such as rain and winter cold. Secondly, OVC resided in
overcrowded houses, or conditions in these homes were not hygienic. For instance, in
Free download from www.hsrcpress.ac.za

15

responding to the question on the status of their family housing, one of the OVC stated
that:
If you want to care for us you should build us houses. At times our aunt brings
a lot of stuff from Gaborone and puts them in the house. We then do not have
enough space. We are not able to sleep well in the house.
While she acknowledged that the household items could benefit them, her concern was
that there would be less space available for sleeping comfortably. Another OVC explained
that the house they inhabited was infested with rats and that the rats at times bit them.
Thirdly, the OVC were taken care of by carers who were not able to effectively maintain
their houses. Thus, although some of the OVC and their carers lived in dilapidated
traditional huts/houses which needed constant maintenance, the carers were not able to
do the necessary renovations. Lack of maintenance was often due to the fact that some
carers, especially grandmothers, were too old to renovate the homesteads. As one member
of the Home-based Care Programme explained:
Traditional Setswana houses in particular need constant care and maintenance
and this might be a challenge where there are adults who are not able to even
mix the mud for housing (mixture for building traditional houses) and therefore
are not able to look after the yard or housing.
It is important to note that failure to renovate houses also emanated from the fact that
most of the carers interviewed for this study were not employed and hence lack the funds

needed to carry out this exercise.
4.3.1
Food and
clothing
The registered children are provided with basic provisions such as food and clothing.
Each child on the programme is entitled to a food basket containing basic food items,
toiletry and meat. These items are valued at P250.00 ($50) and are offered on a monthly
basis. The supplies are obtained through local supermarkets. In addition to food and
toiletries, there is some money which is set aside per child per year for clothing and
blankets. An assessment is done yearly to determine if the child needs a replacement of
clothing and blankets. The carers of these children receive the food rations on behalf of
the children and this has challenges as some steal these from the children.
It was reported by immediate carers and also in the focus group discussions that an
undisclosed number of OVC, especially orphans in poor households, did not have
adequate clothing. This was especially so in the case of those who lived with old
grandparents who had no means to provide for themselves. Some relatives who had taken
in these children did not buy them clothes when they bought for their own children. Thus
some orphans did not have adequate clothing, as shown in the following quotation from
an interview with an orphan: ‘We need clothes. We got clothing in 2002 but in 2003 we
did not get anything…Our clothes are now worn out and not fitting properly.’
The guardians revealed that orphans were normally given uniforms but that when the
uniform got worn out and torn or no longer fitted properly, it took them a long time to
get a replacement. The reasons for this delay were not given. The majority of the carers
complained that orphans were not supplied with general clothing. As a result some
orphans were seen in tattered clothes or still wearing school uniform even after school.
Free download from www.hsrcpress.ac.za

16
4.3.2 Food theft
Though all the guardians who were interviewed expressed satisfaction at the food rations

received from the Department of Social Welfare and Community Development, there were
challenges. The respondents frequently reported that food from Social Services did not
always reach the recipient children but was given to the children of the caregivers, aunts
and uncles. Frequently, carers accommodated or moved in with orphans so that they
could use orphans’ belongings and food supplies for personal gain. Sometimes orphans
found themselves with no housing, as some of the relatives who decided to take care of
them took over houses they had inherited from their parents. Likewise, as the councillor
interviewed for this study explained: ‘Government offers support for orphans in the form
of food rations, blankets, and school uniforms for those who are of school age; but some
carers tend to use these to benefit their own children and not the orphans.’ This view
was further reinforced by a participant in one of the focus group discussions who stated:
‘Orphans are not well cared for. When they are supplied with food, people take it from
them for their own use instead of giving them.’
Consequently, orphans were starved, with some becoming malnourished in the process.
For some orphans the situation was worsened by the fact that their carers or guardians
were unemployed. For instance, one of the orphans explained that he resided with his
alcoholic aunt and uncles, all of whom were not working. The following quote shows the
dissatisfaction of these children with the food supplies:
I am an orphan. I am not happy where I stay. I receive food rations from social
welfare services but my guardian does not give me food. She only gives her
children and tells me I am old enough to buy my own food.
It was frequently reported in the group discussions that some guardians collected orphan
food rations from social services and sold them to buy other necessities. Guardians did
not care whether the beneficiary had anything to eat or not. All the orphans interviewed
revealed that they felt they would be better off being adopted than living the life they
were leading. They generally felt the need for care centres to be established for OVC,
especially the street children. Of significance too is that some female carers often use
orphan food supplies to cater for their boyfriends or male partners. In the words of one
of the focus group discussion participants: ‘I sometimes take some of the food supplies,
such as eggs, to reserve them for my boyfriend. I leave the mealie-meal and cabbage for

them [children].’

In similar vein, focus group discussion participants explained that orphans were deprived
of their food rations by older siblings who were not residing with them and their
carers. The following quote illustrates this phenomenon: ‘The older siblings who reside
elsewhere, only come on the day the food supplies arrive and they come to get a share
of everything and then go.’

In all, the fact that some carers denied orphans the opportunity to reap the benefits of
the programmes designed for them confirms that food rations from the Social Services
Department in particular did not always reach the intended recipients. This in turn could
have a negative impact on the orphans. As one of the orphans explained, for instance, his
uncle often sold all the food rations or supplies provided to the family, and due to lack
of food at home, he turned to the streets where he now stays and tries his level best to
survive the hardships of ‘street life’.
Free download from www.hsrcpress.ac.za

17
4.4 Institutional care of children
The study revealed that there were mixed feelings or views regarding the creation of
orphan centres/orphanages as a means of alleviating the shortage of adequate housing
for orphans. Supporters or advocates of centres/orphanages contended that their creation
would open up possibilities for better care of orphans in well-structured and managed
environments. Within this context, orphan centres/orphanages are viewed as a means of
providing housing or shelter when parents die. As the councillor explained:
Orphanages should be built for these children, as some of these children are
left with no shelter when their parents die. The shelters would form a home for
these children. The children will be looked after better and they will be given
guidance to grow into responsible citizens.
This view was reinforced in the explanation of one of the focus group discussion

members that orphan centres/orphanages would provide OVC and ‘street children’ with
housing: ‘This would be where they can stay alone. A caregiver can be provided for them
and they can ensure that they receive care. This is because when they stay with other
people, they do not receive the care and support meant for them.’

Similarly, some participants contended that orphan centres/orphanages would benefit
orphans who did not have adequate housing in the sense that sometimes they associated
with peers who influenced them to become ‘street children’. This was clearly articulated
by one of the focus group members as follows: ‘Orphans should have orphanages built
for them. Sometimes they go out to sleep at friends’ places and sometimes such acts lead
them to being street children. The truth being that they do not have a place to sleep at.’
Community members, state officers and carers in particular considered that orphan
centres/orphanages would provide better care for orphans, as compared to the poor care
that some were subjected to in staying with family members and carers. To illustrate,
in explaining why orphan centres would benefit orphans, one of the state officers
explained that orphans whose carers were grandmothers were not likely to have better
care because: ‘Those who live with grandmothers sometimes do not have anything to eat.
There are times when they have nothing to eat all day having had only water to drink.’
Similarly, one of the carers (who was in fact blind), felt that orphan centres/orphanages
would benefit orphans because they would provide the adequate care that she was not
able to give her own grandchildren, such as cooking for them. Closely related to this
perspective was the view of one of the participants in the focus group discussions that, in
cases where orphan centres/orphanages were created, orphans who were well taken care
of by carers or family members be allowed to stay with them, provided their carers were
monitored closely to ensure that they were treating them accordingly.
It is also important to note that one participant in particular was of the view that:
‘Orphans should only be allowed to reside in orphan centres/orphanages until the age of
18. Thereafter, they should live with relatives.’
In all, to reinforce the view that orphan centres/orphanages could benefit OVC, some
participants cited community centres for OVC, especially House of Hope, to exemplify the

type of care OVC could receive in well-structured environments specifically designed for
them. Thus, they argued that institutionalised centres were offering better care as they were
better organised and had staff who considered the needs of the children a high priority.
Free download from www.hsrcpress.ac.za