REPUBLIC OF THE GAMBIA Situational Analysis of Orphans and Other Vulnerable Children in The Gambia Report 2004 Frances Foord, Cherno Jallow, Katie Paine and Alieu Sarr The Gambia Bureau of Statistics P.O. Box 3504 Serekunda Tel: (220) 437-7847 Fax: (220) 437-7848 E-mail: [email protected] Website: www. Acknowledgements The consultants wish to express their appreciation to the Government of The Gambia and UNICEF for the opportunity to carry out this situational analysis, and hope that the results will be useful in addressing the problems of OVC in The Gambia. In particular we thank the Department of Social Welfare, especially Fanta Sisay and Yayha Mohammed Bah, and UNICEF The Gambia, especially Salifu Jarsey and Sherriffo Sonko. We thank the other OVC taskforce members: CRS (Bertha Mboge) MRC (Kevin Peterson) WEC (Gisela Schneider, Kumba Ndure) SOS (Bakary Bojang) Santa Yallah (Rose Clair Charles) Red Cross (Halimatou Jawneh) CCF (Lisong Bah) NACP (Alhagie Kolley) NYC (Adama Beyai) GAFNA (Isatou Dibba) NAS (Nuha Ceesay, Saihou Ceesay) ISRA (Phoday Kebbeh) We thank all the other key informants, who included: ActionAid: Omar Badgi, Lamin Nyangado. CCF: Eustace Cassell. Department of State for Education: Planning Office - Siaka Camara; Girls Education Programme - Matty Boye; School Feeding Programme - Mrs Isatou Nyang and Lamin Touray. Department of Social Welfare, Basse: Seidu Sabally. GAFNA: Albert Cox. MRC: Sam McConkey, Vivat Thomas-Njie, Dr Togun. National Youth Council: Kebba Lang Sanneh. Sisters of Charity, Bakoteh. SOS: Dr Julieta Mendes. Standard Chartered Bank Child’s Centre: Mrs Gomez. URD DoSE: Omar Jatta and Samba Baldeh. We also thank the dynamic FGD co-ordinator, Jainaba Conteh; the efficient survey supervisors: Kumba Bah, Ousman Cham, Matarr Jallow, Baboucar Samba; and the hard-working survey interviewers: Ndey Binta Bojang, Ramatoulie Bojang, Fatou Camara, Baba Conteh, Fatou Faye, Amie Giggo, Omar Jabai, Fatou Jamba, Karamba Jammeh, Nyara Jammeh, Ousman Janneh, Fatou Jobarteh, Dobally Jobe, Edmond Martins Jobe, Sainabou Jobe, Alieu Kambi, Ousainou Mbye, Mamat Ngum, Agie Njie and Demba Saidykhan. In particular we extend our gratitude to the thousands of people who gave their time to be interviewed or to join a focus-group discussion. This report would not exist without their valuable contributions. We only hope that the findings will have some positive impact in terms of improving the life of vulnerable children in The Gambia. Executive Summary International concern about the consequence of the HIV/AIDS epidemic on children has been rising. Increasing numbers of children are becoming orphans and many others are being made vulnerable by illness and death relating to HIV. In sub-Saharan Africa there are also many other reasons for parents of young children to die. Losing a parent has a devastating impact on the life of a child, and has repercussions for their community and their country. There are also other groups of children that are disadvantaged who may be vulnerable, including disabled children, those living in a household headed by an elderly person or a child, those not living with their biological parents and those living in households where adults are sick or may die. The basic human rights of such vulnerable children may be threatened. In The Gambia it is not uncommon for children to lose one or both of their parents before adulthood. Fathers are often substantially older than their wives, and may die of natural causes before their children are grown up; there are many other causes of death for parents of young children. The prevalence of HIV is relatively low, but rising. An estimated 15000 people are living with HIV in The Gambia, and an estimated 5000 children are AIDS orphans. The Gambia set up a National Orphan and Vulnerable Children (OVC) Taskforce in 2002. This Taskforce commissioned this situational analysis to understand the current situation of orphaned children in The Gambia and to assess current models of care. This document reviews international literature about OVC, the Gambian literature on children, existing Gambian policies and laws on children and existing Gambian data on children to set the scene for the examination of the new data collected for the situational analysis. The issue of OVC is seen to threaten both individual child development and national development. In The Gambia high levels of vulnerability and poverty have been described in many studies. The Government of The Gambia has developed relevant policies for Social Welfare, Children, Education, Adoption, Youth, AIDS, Nutrition and Inheritance. Data from the National Censuses and from the Multiple Indicator Cluster Survey (MICS 2000) give useful background information. Census data of 1993 showed that 6.36% of all children below the age of 18 were orphans (had lost mother or father, or both); the MICS data showed that 8% of those aged 0-14 were orphans, while 73% of children were living with both parents. The MICS showed that orphans were significantly more likely to be malnourished that non-orphans. The situational analysis used 3 methods to collect further information on OVC in The Gambia: 1. A national representative survey which included interviews at household level using structured questionnaires 2. Focus group discussions (FGDs) with members of the communities, including orphans and non- orphan children; children in institutions and on the streets 3. Interviews with stakeholders and other key informants Survey A total of 63 Enumeration Areas (EAs) were sampled: 2.5% of the total population of The Gambia. All household members within the selected EAs were listed, and all orphans and disabled children were selected for interview, together with 10% of all other children as a ‘control’ group. For those aged under 12 years the caregiver was interviewed, and for those aged 12-17 years the children themselves were interviewed. All household heads from households from which a child was selected were also interviewed. The interviews covered the situation of the children within compound. Interviews were carried out in private and confidentiality was maintained. Highly experienced enumerators and supervisors were selected, and trained for 5 days. A total population of 29,046 was enumerated, 50.0% of whom were under the age of 18 years. In the western part of the country less than half of the population was under this age, whereas in the more rural areas over half was under 18. The total population under the age of 18 years was 14,509, and 9.1% of these children were listed as orphans. Both parents were dead for 0.6% of the young people, mother alive but father dead for 6.7% and father alive mother dead for 1.8%, showing clearly that many more children have lost their father than their mother. More orphans were found in URD (12.6% of all children were orphans) than in other parts of the country. Of those children enumerated 70.5% were living with both their parents in the same household; this was less common in the urban areas. Children living in households where both parents were absent (but not dead) are assumed to be in foster care, and overall this was the situation for 13.1% of those enumerated, most common in LRD, and least common in URD. The definition of vulnerability includes those who are disabled, and 1.1% of all children reported severe disability that limited their daily activities. Households were also asked whether an adult had been seriously ill for 3 months in the past year, or if there had been an adult death in the past year. This had not happened in the households of 79.7% of the children enumerated. A total of 2528 children or their caregivers (if the child was under 12) were interviewed. The pattern of ethnic distribution was similar between orphans and non-orphans and also reflected the distribution observed in the 1993 Census. Most were Gambians, 95.3%. Orphans seen in the survey were being raised by relatives and not by strangers. Many had only lost one parents so were living with the surviving parent; many were also being raised by a sibling of a parent (‘aunt’ or ‘uncle’) or a grandparent. Most children seen in the survey did not have a birth certificate, but no differences were seen between orphans and non-orphans. Orphans reported having received complete DPT3 and measles vaccinations more commonly than non-orphans. Questions on schooling established that 73.7% of orphans and 76% of control children were currently in school. Orphans were more likely than non-orphans to have previously attended school but discontinued. The main reasons for discontinuing for orphans were being unable to pay school fees, and that a parent died, whereas for non-orphans the most common reason was that they failed academically. For orphans those who had never attended school similar reasons were given. When asking about feeding it was found that most children reported having enough to eat. However orphans were significantly more likely to say that there were occasions when they had insufficient food (19.6%) compared to control children (14.1%). This suggests that a significant minority of orphans are ill-nourished. There were few significant differences between orphans and non-orphans when asked about sickness experienced recently and healthcare received. Questions on sexual relationships were only asked to children aged 12-17 years, and those questions on behaviour to those aged 15-17 years. No significant differences were seen between orphans and non- orphans. Most of the respondents had heard about AIDS, and knowledge of modes of transmission was high. All those interviewed were asked whether the child has some basic material things like soap, clothing and shoes. Orphans were significantly less likely to have access to soap to take a wash, and significantly more likely to do their own laundry.