Geography Reference
In-Depth Information
matter of national pride to believe that the
'Ugandan family' can cope with parent-less
children. To a degree, this has been a success story.
However, the experience is not generalisable—
perhaps even in one country. In Zimbabwe, there
is evidence that some orphans are left to fend for
themselves as 'orphan households'. This presents
different problems for social policy to the situation
in Uganda. Once again, the
particularity
of a sub-
group affected by or, as in this case, created by, the
epidemic, has to be tempered by its
specific
situation
as affected by culture (in this case), economic niche
or location. The case study of Ukraine, a very poor
country in Eastern Europe, provides more to think
about in relation to these questions (Box 39.5).
It is in relation to these problems of
particularisation and specification that further
work is required in all the social sciences—
geography, sociology, anthropology and
economics—if we are adequately to understand
the diverse impact of the global HIV epidemic.
Commercial sex workers
All women who take up commercial sex work are
not driven by poverty, some have been found to
use this as a way to accumulate business capital. The
distinction between the groups is important in the
development of education and prevention
programmes. There are differences between the
particular
population sub-group of 'all women
commercial sex workers in a society' and the
specific
characteristics of those who do this work to raise
capital (a minority) and those who are driven by
debt and poverty (a majority). The former group
will not respond to 'income-earning projects'
designed to raise them from poverty; the latter
group may. The former group may respond to
advice and training as to how to negotiate condom
use with clients; the latter are unable, in a
competitive market, to enter into such negotiations.
Orphans and orphaning
Not all orphans are the same. The number of
orphans created by the epidemic runs into many
tens of thousands (see Table 39.2). How are they
to be helped? In Uganda, there has been
considerable debate about institutional versus care
in the community and family. It has been in part a
GUIDE TO FURTHER READING
For those who want information about HIV/
AIDS and health and welfare matters, there are
few better points of departure than Alcorn, K. (ed.)
Box 39.5
Orphans and the elderly in the Ukraine
The break-up of the Soviet Union had acute social,
political and economic implications for the newly
independent Ukraine. The Soviet system was highly
centralised and controlled via four main mechanisms: the
party, the internal security apparatuses, the official trade
unions, and the administration. Entitlements to social,
economic and cultural goods were largely administered
within this structure.
Evidence and the modelling of the epidemic, which
started only in 1994, suggest that AIDS will not have a
significant demographic impact. However, there is a
likelihood of considerable increase in the number of
orphans, with an estimated 111,500 (low scenario) to
317,300 (high scenario) additional orphans by 2016. A
second group of concern is the elderly. The population
dynamics of Ukraine, which lost about a quarter to a
third of its population as a result of Stalin's agricultural
collectivisation in the 1920s and the Second World War
in the 1940s, and which has resulted in the oldest
population in Europe, are such that the elderly
comprise a sizeable proportion of the population and
numbers are increasing. While AIDS will not directly
affect them, it will affect their families—who are
increasingly viewed as a source of support. Thus while
the demographic consequences may not be great, they
will be compounded by the inability of the state to
provide the level of social services previously
available, and it certainly will not be able to meet the
increased demand from either the elderly or the
orphaned. The impact of the increased morbidity and
mortality is on reproductive labour, which, given the
demographic structure of Ukraine, is a shrinking group.
Thus the already adverse dependency ratio will be
made worse by HIV/AIDS and will affect policy
decisions to be made about the care of the young and
the old. In such circumstances, institutional care may
be the only option—but even so, who are to be the
carers? (Barnett and Whiteside 1997)
