Climate change is aggravating mental health amongst HIV-affected children and adolescents in Zimbabwe

Climate change is directly contributing to shorter rain seasons and less rainfall in Zimbabwe. Meanwhile, the country is still recovering from mass destruction and flooding caused by cyclone Idai in 2019, which impacted 270,000 people.  Inevitably, this has exacerbated the social and economic challenges already facing HIV-affected children. But surprisingly, it has created some new problems – and opportunities – as well. 

Climate change has pushed many more children into poverty.  Those families reliant on farming are generating smaller and poorer quality crops due to the lack of rain and shifting rainy seasons.  And, increasingly, are forced into survival strategies that put their children at risk.  Sharp rises in adolescent pregnancy are due in large part to girls and young women being forced or coerced by circumstance into child marriage or transactional sex.  More girls and young women are experiencing sexual violence as they walk further distances to fetch water. More children, especially girls, are missing out on school as families can no longer afford the fees, and because of the stigma associated with adolescent motherhood. And increasing numbers of children are being left without adequate care as their parents are forced to seek work in other parts of Africa and overseas.  All this, serves to increase the risk of HIV infection in a country where there are already 75,000 children living with HIV, 4,800 new child infections per year and many more HIV-exposed and orphaned due to HIV.

These are, unfortunately, not unexpected consequences of climate change. Rather they are extensions of nascent trends. However, there have also been some unforeseen impacts, including a notable rise in child drug addiction. The lack of adequate care caused by parents moving away to find work is leading to more children being at risk of drug use. Furthermore, children are turning to sex work to fund their addiction. The police report now regularly finding vulnerable children in possession of sex enhancement drugs alongside more regularly used narcotics. This is exposing children to HIV, other STIs as well as to violence.

Another unprecedented trend is the increasing number of children experiencing eco-anxiety, and post-traumatic stress from cyclone Idai.  Children are overwhelmed by the extreme weather and its visible impacts on lives and livelihoods.  This is especially harming those with pre-existing mental health conditions.  In particular, the depression and suicidal ideation that can accompany child HIV and adolescent pregnancy are exacerbated by the additional burden of climate-related anxiety and trauma.

Surprisingly, HIV-affected children are also being stigmatised and their parents blamed for climate change.  Children living with HIV, those with disabilities, adolescent mothers, marginalised children and other key populations are regarded by some as the cause of extreme weather events and low rainfall. A lack of awareness about climate science, especially amongst communities without proper access to education, is leaving people looking for answers amongst traditional beliefs. Those who are different, or who are considered to have brought shame on their families, are said to have ‘angered the gods’ and caused the extreme weather. This only serves to further ostracize children who were already   experiencing discrimination.

REPSSI is a small but mighty organisation enabling children to overcome these challenges.  They improve the mental health and resilience of HIV-affected children so that they have the tools to overcome adversity. This is achieved by a team of social workers, mental health experts and advocates working together with young peer educators in some of the poorest parts of the country. 

They support young mothers and fathers, children with disabilities, young sex workers, children and young people who identify as LGBTQ+ and other marginalised children to meet in peer groups and tackle together the challenges they face. They learn about HIV and support each other to get tested and stay on treatment; learn about positive parenting and how to care for HIV infected and exposed children; set up small businesses and improve their livelihood opportunities; champion their rights through dialogue with local leaders, and monitor local services to ensure they adequately serve marginalised children; and, most critically, they unlearn the self-stigma they feel about themselves and strengthen their own mental health.  All the while, REPSSI’s social workers and mental health experts are on hand to offer support and refer children for services.  And REPSSI’s advocates are building the capacity of faith and community leaders, health workers, frontline humanitarian workers, the police, and other service providers on how to better serve marginalised children and how to protect their mental health.  In addition, REPSSI supports the Department of Social Welfare to provide a free walk-in clinic for children experiencing drug addiction, where they can get mental health and medical support and be referred for further services.  And it is working with the Zimbabwean government to develop strong national policies and guidelines on psycho-social support.

REPSSI is also pioneering ways to minimise the impact of climate change on marginalised children. It has developed an eco-anxiety scorecard to enable families, teachers, frontline health workers and others who have contact with children, to recognise the warning signs of depression associated with climate change. It is also working directly with children to tackle poor mental health associated with climate change, including teaching them about indigenous knowledge systems for harvesting water and growing food on a small scale in order to relieve their anxiety, and supporting them to be climate activists in their own settings. And REPSSI is supporting the government to ensure its climate disaster risk reduction strategy adequately serves marginalised children, including those with disabilities.

There is no doubt that REPSSI’s work is having an impact. Suicidal ideation amongst Zimbabwean adolescent mothers has reduced from 35% to 9% in this last year, and almost 6000 engaged in community dialogues. REPSSI also raised awareness of disability inclusion with over 31,000 Zimbabweans, and it trained over 3000 frontline service providers on child mental health and psychosocial support.

However, there remains much more to be done. With further financial support REPSSI could strengthen its services for children facing drug addiction. And, it has identified an urgent need to support grandmothers in rural areas who are increasingly called upon to care for the children of adolescent parents. Many are socially isolated by the stigma associated with adolescent pregnancy and HIV that their young child brings. And they do not know about HIV and the need to keep the child on treatment. REPSSI Zimbabwe also wants to document what works so that others can learn from their experience. Finally, REPSSI wants to further support communities and other organisations serving vulnerable children in Zimbabwe on how to prepare for, prevent and respond to the increasing challenges brought on by climate change. 

Climate change may be wreaking havoc but HIV-affected children in Zimbabwe are not beaten by it. Far from it. With REPSSI’s support, they are overcoming the challenges it brings and finding new ways to adapt, thrive and tackle them.  Supporting child and adolescent mental health and wellbeing is paramount. It is a keystone for their capacity to progress in all areas of their lives.

This blog was written in collaboration with the REPSSI Zimbabwe team, which is part of the pan-African organisation REPSSI (www.repssi.org).  The largest home-grown international child mental health and psychosocial support organisation in Africa, REPSSI has been supporting children in 13 countries across Eastern and Southern Africa since it was established in 2001.   REPSSI is a proud member of the Coalition for Children Affected by AIDS.  And its former Director, the late great Noreen Huni, was previously co-chair of the Coalition’s Steering Committee.  We also honour Lynette Mudekunye and Brighton Gwezera who, until their recent retirement, represented REPSSI on the Coalition’s Steering Committee.  We welcome Kelvin Ngoma as REPSSI’s new representative and look ahead to many more years of REPSSI’s active role in the Coalition for Children Affected by AIDS.