A hidden disaster
By the spring of 2020, the pandemic had not yet hit Zambia, yet Remmy Hamapande was concerned when he saw how COVID-19 shook the rest of the world. As country director of the nonprofit organization Forgotten Voices, which operates in several countries in southern Africa, Hamapande knew the pandemic would be severe for children in the region who had previously lost their parents to AIDS and who were cared for by their grandparents. They belonged to the vulnerable group of COVID.
“If COVID hits here and kills all the grandparents, there will be no one left to take care of the bereaved children,” Hamapande thought. “Then those children will be orphaned for the second time.”
Hamapande contacted Hillis to sound the alarm. During his decades-long tenure at the U.S. Centers for Disease Control and Prevention, Hillis had researched children who lost their parents during various health crises. By August 2020, she had assembled a team of scientists to find out how many children were involved, starting with the United States and Brazil.
In just two weeks, they had collected preliminary data that was “shocking and heartbreaking,” Hillis said. It was estimated that for every two reported corona deaths in these countries, at least one child was left behind. As the delta variant caused peaks around the world, that number rose to one child left for every corona death. In Africa, from the end of October 2021, there were even two orphans for every death.
Despite the enormous number of deaths, the crisis for the bereaved children has received relatively little attention; it is a pandemic that remains hidden in a pandemic. According to Rachel Kidman, a social epidemiologist at Stony Brook University who specializes in childhood problems, COVID-19 is primarily considered a disease that affects older people, leaving little attention to its negative effects on children.
But according to the Pew Research Center, as many as 38 percent of children worldwide grow up in multi-generational households. In Zambia and many other countries in sub-Saharan Africa, more than 30 percent of the children live in a so-called ‘skipped-generation household’, which means that these children do not live with their parents, but with their grandparents.
In addition, Kidman points out that COVID-19 is not only lethal to grandfathers and grandmothers. Due to the global unequal distribution of vaccines against the disease, people of all ages are more likely to get the disease in some parts of the world. In addition, the disease is more often fatal to people for whom there are almost no health services available.
“There is now a significant group of people under the age of 65 who have died of COVID. People in that age group often have to take care of children,” Kidman said.
In Zambia, Hamapande experienced that children from a family had to be separated and that villagers who were already struggling to feed their own family members were accepting children from their neighbors. There is hardly any guidance, and Hamapande saw the signs of trauma, from wetting the bed to a tidal wave of suicide.
“Imagine if a child loses his caregiver and then virtually has no one to turn to,” he says. He also says that there is also a great need for psychological help.
How we can help children who have lost a parent
Past crises have taught scientists what can help and what certainly does not help relieve pain.
what for sure does not will happen? Putting children in orphanages – or at least in institutions where neglected children are crammed together like sardines. Leading research in Romanian orphanages, notorious for their poverty in the 1990s, found that institutionalization had a major impact on children’s brain structure. Each year in an orphanage led to additional cognitive and developmental delays compared to children in foster care.
The good news is that this effect diminishes when a child finds a good home. A 2012 study showed that children from orphanages placed in foster care were able to compensate for their developmental delay compared to their peers.
Children need a family (in whatever form) to provide structure to their lives, says Lucie Cluver, professor of social work at both the University of Oxford and the University of Cape Town. Whether a child is loved, has enough to eat and can go to school, ‘it determines the impact of a death, not the death itself’.
But even orphans who are well cared for need extra support. According to Cluver, which was part of Hillis’ team to estimate the number of orphans from COVID-19, financial support, parental support and the ability to stay in school are the three most important factors.
ensure that families have adequate money and food. When parents do not have to work multiple jobs at once, they can take the time to listen to and support their children. If children have enough to eat and go to school, they are less vulnerable to other risk factors. Financial support for families living in poverty has been shown to significantly reduce the likelihood that girls and young women will have to perform paid sex work.
Abuse is another risk. Parental stress can lead to violence in vulnerable families. It is important to equip caregivers with the necessary skills when a child or other caregiver exhibits problematic behavior during grief. Research has shown that special programs can significantly reduce physical, sexual, or emotional violence in families.
Finally, it is important that children who lose a parent can continue to go to school. This helps traumatized children to return to normal life a little. In addition, schooling has been shown to combat poverty, ensure that children later become sexually active, and that they can participate in society.
Is help on the way?
By the end of September 2021, Calandra Cook had just started her final year at Georgia State University when she had to drop out because she had to arrange her mother’s funeral. The 21-year-old, who had no close relatives to help her, had to decide everything on her own. She did, but was numb from the blow.
Doctors had warned Calandra that her mother’s lungs were weakening, her heart rate was too high and her oxygen level was too low. Still, the death of Yolanda Meshae Powell came as a complete shock to Calandra and her three siblings. They did not even have the opportunity to talk to their mother or give her a hug before she died. “I had to say goodbye to my mother through the glass,” Calandra says.
Then she faced the task of finishing her school. She was told by her education that she was no longer eligible for loans as a student and that she would have to pay for her studies herself. And that while she could not go home to save money.
‘When my mother died, so did my safety net,’ says Calandra.
Earlier this year, COVID Collaborative, a group of leading American experts in public health, education and economics, founded Hidden Pain. Through this online platform, families who have lost someone can find financing for things like funeral expenses, discounts on internet services and mourning groups. In the state of California, there are plans for a state-funded fund for COVID orphans. But something is happening nationally in the United States.
Also in the rest of the world, little is happening on the scale that applies to the US Government’s PEPFAR project (US President’s Emergency Plan for AIDS Relief). After researchers first sounded the alarm about the fate of AIDS orphans, it took another 13 years before PEPFAR was instituted. By this time, the number of orphans had increased from 903,000 to 15 million.
“I hope with all my heart that we do not have to wait thirteen more years,” Hillis said. ‘This tsunami engulfs us as one variant after another rises.’
Calandra finds it frustrating that the world has apparently already forgotten the pandemic, even the people who helped her right after her mother died. “Over time, everyone moves on,” she says. “Grief is something you do on your own.”
She still has a few subjects to complete, but she and her classmates will be finishing by May – this weekend Mother’s Day. It’s a bittersweet experience: Yolanda was so happy that her daughter got her degree that she called her three times a day.
Calandra knows she will have a hard time walking across the stage without her mother in the audience. “People say she wants to be there at some point, but that doesn’t really help you feel better,” Calandra says. She will stick to one of her mother’s favorite tips. “I can already hear her tell me I should not be a slut. I owe my mother everything.”
This article was originally published in English on nationalgeographic.com