A hidden disaster
By the spring of 2020, the pandemic had not yet hit Zambia, but Remmy Hamapande was concerned about the news of COVID-19 raging in different areas of the world. As national director of the non-profit organization Forgot votesoperating in various countries in southern Africa, Hamapande knew that a deadly pandemic would be a very severe blow to children in the region who had already lost their parents to AIDS and lived with their particularly vulnerable grandparents to the new disease.
“If COVID comes here and affects the elderly, there will be no one to take care of the orphans,” Hamapande remembers thinking. “These children will be orphaned twice”.
Hamapande called Hillis to share his concerns. During her decades-long career as a researcher at the Centers for Disease Control and Prevention in the United States, Hillis has studied orphans after health crises. In August 2020, Hillis assembled a team of researchers to assess how many children were in that situation, beginning with the United States and Brazil.
Preliminary data from the first two weeks alone “were shocking and heartbreaking,” Hillis says. Estimates showed that for every two deaths reported as a result of COVID-19 in these countries, at least one child had been orphaned. While the Delta variant peaked around the world, the number of orphans increased to one child for every COVID-19-related death, reaching two orphans for every victim in Africa at the end of October 2021.
Despite these numbers, the orphan crisis caused by COVID-19 has received little attention; it is a kind of pandemic hidden in the pandemic. Rachel Kidman, a social epidemiologist specializing in childhood problems at Stony Brook Universitystates that COVID-19 is perceived as a disease that primarily affects the elderly, so the effect on orphaned children who are left behind is neglected.
Yet as many as 38% of children worldwide have grown up in multi-generational households, according to Pew Research Center. In Zambia and large parts of sub-Saharan Africa, over 30% of children live in families consisting of grandparents and grandchildren without their parents.
Kidman further points out that COVID-19 not only kills grandparents: The uneven distribution of COVID-19 vaccines has created pockets of vulnerable individuals of all ages in some parts of the world whose exposure to danger increases in cases where access to health care is bad.
“There are a high number of people under 65 who have not passed COVID. These are people who still cared for their children,” says Kidman.
In Zambia, Hamapande has seen siblings who have had to separate and families who have welcomed the neighbors’ children and are now making a living. Assistance services are virtually non-existent, and Hamapande has discovered a number of manifestations as a result of the trauma, from nocturnal incontinence to waves of suicide.
“Imagine a child losing someone who has always cared for him and has nowhere to go,” Hamapande explains, adding that there is a desperate need for mental health services.
How to protect orphans
Previous crises have indicated to scientists which interventions work and which do not work to relieve trauma.
Thing Does not do? Putting children in orphanages, at least not in structures where abandoned children are crammed together like sardines. Authoritative studies of orphanages in Romania – which were notorious in the 1990s for their deplorable condition – showed that institutionalization had changed children’s brain structure markedly. Every year spent in the orphanage has resulted in cognitive and developmental delays compared to children placed in adoptive families.
Fortunately, these effects can be mitigated if the child is transferred to a loving family that cares for it. A 2012 study showed that children who went from orphanages to adoptive families were then able to reach a level of development similar to that of their peers.
Children need a family – of any kind – that provides them with a frame of reference, says Lucie Cluver, professor of social work at the University of Oxford and the University of Cape Town. The presence and care of a person who makes sure that the child can go to school, is well nourished and feels loved are “the decisive factors for the impact of the loss rather than the loss itself”.
But even orphans who receive adequate help and care need additional support. Cluver, who was part of the team Hillis formed to define the global estimates of orphans from COVID-19, says the three main elements that make a difference are financial support, the presence of someone to take over the place of the parents and the continued schooling.
It is important to ensure that families have adequate financial resources and adequate food. When parents do not have to do more jobs, they have more time to listen and support their children. When children have enough to eat and can go to school, they are less vulnerable to other risk factors. Providing financial support to needy families is a measure that has proven effective in reducing the risk of girls and boys ending up in prostitution.
Abuse is another risk. Parental stress can lead to outbreaks of violence in vulnerable families and provide for caregiver concrete practical tools are crucial in cases where suffering causes the child or caregiver to have violent outbursts. Studies have shown that dedicated parenting programs can significantly reduce the incidence of physical, sexual, and emotional violence in families.
Finally, it is important to ensure that orphans do not drop out of school. Going to school helps traumatized children regain a sense of normalcy. It has also been shown that not leaving school reduces poverty, delays children’s early sexual experiences and helps them integrate into society.
Is aid on the way?
By the end of September 2021, Calandra Cook had started her senior year on Georgia State University, when he suddenly had to retire to organize his mother’s funeral. When she had no other close relative to turn to, the 21-year-old suddenly found herself responsible for everything and overwhelmed by events.
Doctors had warned Calandra that her mother’s lungs were weakening, that her heart rate was too high and that her oxygen levels were too low. But the death of Yolanda Meshae Powell shocked Calandra and her three younger siblings, who were unable to talk to her mother or hug her until she left them. “I had to say goodbye to my mother through a window,” Calandra says.
Then there was the difficult task of finishing school. The university’s financial lending office informed Calandra that he had run out of student loans and would have to pay out of pocket – and could not go home to save.
“When my mother died, my safety net came with her,” Calandra says.
Earlier this year COVID collaborationa group of authoritative experts in public health, education and economics, has launched Hidden pain, an online platform that connects bereaved families with services such as funeral assistance, discounted internet services and mentor and support groups. In California, lawmakers are considering setting up a state-funded trust fund for COVID orphans, but not much has been done nationally yet.
In the rest of the world, too, support measures for orphans from a similar entity to those activated for the US Presidency’s Emergency Plan for AIDS Prevention have not yet been implemented (PEPPAR). It took 13 years to set it PEPPARsince researchers sounded the alarm about AIDS orphans, by which time the 903,000 orphans had grown to 15 million.
“I just hope we don’t have to wait 13 years,” Hillis says. “Otherwise, this tsunami will engulf us, with the continuous emergence of new varieties.”
For Calandra, the feeling that everyone else seems to have gotten over the pandemic – even the people who stood by her side when her mother died – is frustrating. “As time goes on, people are returning to their own lives,” he says. “And in the end, you find out that you can handle the grief yourself.”
She is still finishing her studies and was with the other students at the inauguration ceremony, which ironically took place on Mother’s Day. For her, it’s a bittersweet milestone: Yolanda was so excited about her daughter’s upcoming graduation that she called her three times a day to rejoice with her.
Calandra knows it will be hard to go on stage on graduation day, without her mother in the audience. “People tell me she wants to be there in the spirit, but it does not make me feel better,” says Calandra, who adds that it will help her follow her mother’s advice. “I know she would suggest what clothes she should wear. My mother taught me everything.”