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Challenges faced by an HIV infected child are multifaceted, complicated and intertwined that they require a multi disciplinary intervention.  Tribulations faced by these children are psycho –social in nature meaning that every social problem has a psychological impact to an individual.  At the end of 2011, 3.4 million children under the age of 15 worldwide were living with HIV, 28% of them needed pediatric ART and 91% were in Sub Saharan Africa, 24% of newly infections in 2011 were children[1].
 Hundreds of thousands of children are infected everyday but due to poverty they are failing to access antiretroviral drugs leading to decrease in life prospects and increased chronic illnesses. Although some can afford these drugs, they are not available in syrup which is recommended for children under 12 years of age and this result in caregivers breaking pills, but this can  lead to over and under dosage. For instance, the lives of children on Antiretroviral Therapy (ART) in Murambinda are at risk after revelations that some of the drugs supplied by MSF Belgium were crushed resulting in some of them taking either an over or under dose[2]. Failure to take a recommended dosage can worsen the health of a child leading to early deaths. Worldwide statistics in 2011, 230, 00 HIV infected children die before reaching the age of 15 due to variety of causes and among them is an inappropriate dose[3]. Government should ensure free access to antiretroviral drugs and efficient linkages to care and treatment of these children since every child has the right to life as stipulated by Article 6 of  the United Nations Convention on the Rights of Children (UNCRC) and article 5 of the African Charter on the Rights and Welfare of a Child (ACRWC). These children should access health care for free and carry out regular checkups so as to promote their physical well being as highlighted by Article 24 of the UNCRC which states that children should enjoy highest attainable standards of health and health facilities.
Discrimination is universally experienced by HIV infected children, at school and in society at large. Discrimination, labeling, stigma and alienation at school, show the way to poor performance , low self esteem as well as self fulfilling prophecy .Due to poor health, their absenteeism rate is very high leading to poor performance  at school so at the end they perceive themselves as unable and failures in life  to worsen the situation. They are not involved in decision making even in issues to do with their welfare meaning that their right to participate is being violated. Socially isolated people are more susceptible to illness and have a death rate two to three times higher than those who are not socially excluded[4].  According to undocumented research carried out in Murambinda by social work students at University of Zimbabwe in 2012 some of these children are given names related to HIV for example (matoroviro) meaning antiretroviral.  What is the root cause of these problems? Of course systems which surround the child since an individual is not an island (the society in which these children are living), so there is need to alter the society’s phenomenological field. Some individuals specifically in rural areas does not have adequate knowledge on how HIV spreads ,so there is need to apply   Freire’sconscientisation approach[5] , in which more light would be shade to communities on the fact that an uninfected and an HIV infected child have the same rights. The aim of this approach is to create equality within societies. Awareness campaigns needs also to be carried out so as to create a victim friendly environment.
 As a result of failure to access antiretroviral drugs, balanced and nutritious diet, discrimination and ill health these children are prone to mild to severe psychological disorders like anxiety, depression and increased stress. Children in this situation can be regarded as hard to reach because they cannot trust anyone and they feel worthless.  Communities and families should be a source of protection and support for these children providing psychological and emotional support and they should also embrace them for them to have a sense of belonging. These children should be mobilized into self help mutual groups so that they can share experiences since a problem shared is half solved. Professional counselors can help these children to face reality and doing away with negative schema they have about themselves.
Most of these children are living in abject poverty or below the poverty datum line since their parents are no longer able to look after them because of ill health .In most cases HIV infected children are orphans who contracted the disease from their parents before, during or after birth[6].In 2011, 17.3 million children lost one or both parents due to HIV[7] . Yes they can access antiretroviral drugs but these drugs need to be complimented with a nutritious and well balanced diet[8]. Good nutrition assists in improving the immune system which would have been compromised by the destruction of CD4 cells. There is need for community centered approach in which the communities take an upper hand in helping these children socially, economically and psychologically. Communities with the help of governmental    and     nongovernmental organizations should work collaboratively so as to do away with these problems.   However due to the prevalence of this disease communities are failing to provide psycho social support leading to the exacerbation of psycho -social problems.
 Some of the children contracted the disease through awful ways like sexual abuse by an HIV infected person, although the cases are slim. According to newspaper analysis of 2012 conducted by ZNCWC, out of 69 reported cases of child sexual abuse 2 contracted the hideous disease .Once an abused child is tested HIV positive it is very difficult for him / her to accept the situation. A situation like this affect a child the rest of his / her life and can lead to suicide .Pre and post counseling is carried out whenever an individual needs to be tested, whether voluntary or involuntary so as to help a child to face reality. There is need to apply crisis therapy when an individual is tested positive in which the change agent system acts as the child‘s pillar of strength .If a child has been abused by an immediate relative it is best to remove the child from that environment, because the presence of a perpetrator can deepen the intensity of psychological problems .This is in line with article 39 of the UNCRC which says measures to promote social and psychological recovery and social reintegration should be taken.
Zimbabwean children who are HIV positive are struggling to survive; so it’s a duty of every citizen to help these children stand psychologically, physically, socially, emotionally and economically since every child has the right to survival, protection and development as noted by article 5.2 of the African Charter on the Rights and Welfare of a Child.

 


[1] www.childinfor.org/hiv.aids.html
[2] Herald September 9 2012
[3] ibid
[4] ZAPSO and NECTOI December 2012
[5] Paulo Freire, 1972, Pedagogy of the oppressed
[6] ibid
[7] UNAIDS report on the Global AIDS epidemic 2012 retrieved from www.amfar.org/about hiv and aids/fact and stats/statistics worldwide
[8] ibid