New research AIDS: the frontline, by HelpAge International says older carers are the backbone of AIDS care. The research on supporting older carers of people living with AIDS and orphaned children in Mozambique, South Africa and Sudan, was revealed on World Aids Day.

Impact of HIV/AIDS on older people

Through its programme work in 11 countries in Africa, HelpAge International estimates that half of all older people in severely affected areas now care for adult children living with HIV/AIDS and/or orphaned children. The research looks at the impact HIV/AIDS has had over the last ten years on extremely poor communities in three countries, through the eyes of older people.

Older people are recognised as the backbone of AIDS care, caring for dying sons and daughters, and simultaneously for the grandchildren these parents leave behind. The research describes how older people and their organisations have coped so far and, as the number of those affected by AIDS continues to increase, draws out lessons for the future.

Cost of Care

AIDS causes older people who are already poor to fall into a state of destitution. Older carers face the challenge of finding enough resources to meet treatment and care costs, and the long-term costs of bringing up orphaned grandchildren. Among the expenses older people are expected to fund are the costs of care which include:

• Medical costs, including access to treatments such as antiretroviral therapy and, home-based care costs such as anti fungal soaps and oral rehydration salts
  
• Costs of food and of additional water consumption
  
• Burial costs
  
• Costs of school fees and uniforms for orphans and vulnerable children
  

Widow Niguinia cares for her son and his family

When 58 year-old Nguinia’s son Fungai became ill from the disease, he needed constant care. Nguinia, a widow bore the cost of caring for him, his wife and their children. “I had to find food and cook for all six of us” says Nguinia. “His wife couldn’t help as she was also sick. Fungai had constant diarrhoea and had to be helped to the pit latrine. Then he developed pains in his back and his legs became swollen.

“We went as far as Songo (40kms away) for medical treatment and consulted four traditional healers, but there was no improvement. The transport and treatment costs were expensive, so we sold many of our belongings. Throughout my life I have been a farmer, mostly growing millet and groundnuts. With all of this, there was no time to go to the fields so last year we didn’t harvest anything.”

Supporting older carers

Each of the 3 country reports focus on a different way of supporting older carers. In Mozambique credit funds were set up to provide loans to older people and other community members. These were used to set up small businesses such as goat trading. Half of the interest was put back into the credit fund and the other half was used to create a village social fund. Managed by older people’s committees, the funds are used to help meet the basic needs of older carers and pay for transport costs to help people living with HIV/AIDS (PLWHA) access treatment.

In South Africa, PLWHA may qualify for a disability grant and free Antiretoviral therapy (ARVs). Some older people caring for grandchildren are eligible for social grants and school fee exemptions. The social pension provides a regular cash payment and is a lifeline for older carers. But awareness of other entitlements is low; problems with identity papers are frequent and eligibility requirements deter people from applying. Older people's organisations have responded by providing paralegal support to help older people claim their entitlements.

In southern Sudan, prevalence of HIV/AIDS is relatively low but the risk of a rapid increase is high as soldiers de-mobolise after 22 years of civil war. As in many countries in Africa older people are excluded from HIV prevention campaigns and their role as carers of PLWHA and orphans is unrecognised. The response of older people’s organisations has been to run awareness activities targeted at older people and to promote recognition of the impact of HIV on older people.

Recommendations

The research recommends that older people be targeted with the following support:

• Targeted information on HIVAIDS and rights to entitlements
  
• Economic support to carers and their dependents including regular cash transfers for the most vulnerable
  
• Better support to access existing services, such as, help with transport costs, identity papers, legal paper work, accessing ARVs and school grants
  
• Data on carers must be collected, disaggregated by age and gender to assist with the targeting of resources.