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Exploring Child Abandonment in South Africa

This article discusses the increasing problem of child abandonment in South Africa and the decreasing rates of adoption. It explores the relevant laws and challenges faced in addressing this issue.

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Exploring Child Abandonment in South Africa

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  1. SAD, BAD & MADExploring Child Abandonment in South AfricaDee BlackieWits University1 October 2015

  2. Community Training & Engagement (2012) • Option counselling for crisis pregnancy, what to do if you find an abandoned child and the process of adoption:

  3. Back to school (2013)

  4. Introduction “It’s a big problem, if the child has no family, no nothing, it is better to give them to the government”, said Funani, in response to a question I had asked her about adoption. Funani is around sixty years old and lives in Alexandra Township, we were discussing the issue of unplanned pregnancy and what options are available to a woman in this situation; we had discussed abortion, parenting, and foster care, and had moved onto the option of adoption. I asked her to explain why the issue of no parents was such a problem, she went on to say, “if you know the parents of the child, you can go back and talk to them, if there is a problem”. I then asked, about a child that has been abandoned, and has no parents, what should happen to this child? She responded by saying, “the problem is you take it and help it, it’s not family, it’s nothing about you, what if that child is naughty, who can you go and talk to, to help you with it? It is a big problem”. She later came to me, full of concern, and said, “I don’t know where you are going to get that family for those children”.

  5. The problem? • Of the 18.5 million children in SA, 4.5 million live with neither parent. • Orphans have increased by more than 30% over the past decade. • 150 000 children live in 79 000 child headed households. • Over 13 000 live in residential facilities and 10 000 on the street. • In 2013 there were over 11 million children registered for child support grants and over half a million for foster care grants. Child Abandonment is Increasing in South Africa Adoption is Decreasing in South Africa Estimated that over 3500 babies abandoned in 2010 and most believe this is increasing (Child Welfare SA) Adoptions have decreased by more than 52% over the past decade and foster care has increased by 72%

  6. A Review of the Registry of Adoptable Children & Parents* * November 2013 • 297 parents wanting to adopt (14 black parents, 190 white parents, 43 Indian parents, the rest are unspecified) • Most are seeking a child of their own race • Girls are preferred where gender is specified • 50 applicants would consider a child with special needs (HIV/Aids, physical or mental disability etc.) • 410 children available for adoption (398 black children, 3 white children, 9 ‘mixed race’ children, the rest are unspecified) • Equal number of boys and girls • Over 60% were abandoned and less than 40% consented for adoption • 38 HIV Positive • 22 born premature • 53 with special needs challenges Only 29 possible parents for the registered children. Only 1699 adoptions took place in 2013 (2840 took place in 2004)

  7. Child Abandonment and the Law • The management of abandoned children is governed by the Children’s Act 38 or 2005, which was implemented in 2010. • Good piece of legislation, however, implementation a challenge: • Illegal immigrants are unable to legally place their children in the formal child protection system in SA, and face deportation should they try. • Relinquishing one's parental rights so that a child can be adopted, can only be done without a legal guardian’s consent from the age of 18 years, making this option inaccessible to teenage mothers (a child of any age can request an abortion in SA sending mixed messages about adoption). • Anonymous child abandonment has been criminalised, with mothers facing a range of charges such as concealment of birth and attempted murder. • Baby safes are considered illegal in terms of the Children's Act, however, these are being opened up more frequently given the increase in abandonment. • Child protection experts voiced concerns that the Act is being used as a tool to prevent adoption rather than to facilitate it by both the Courts and the Department of Social Development.

  8. Many abandoned children unreported • Police officers ask people reporting an abandoned child if they would like to keep the child. • Abandoned children being handed over to people in the community who have lost a child, or who have expressed a desire to take care of children who have been abandoned. • Individuals are required to sign an affidavit, attesting to the fact that they are taking care of the child, however, no further formal legal processes are undertaken. Ad-hoc allocation of guardians to abandoned children is contradictory to the rigorous screening and government intervention that takes place during a formal adoption “Anonymous abandonment leaves children without any real way of tracing family or heritage” – Minister Bathabile Dlamini (01/08/12)

  9. Child Abandonment Globally • Mass child abandonment has been reported around the world and across generations from as early as the 17th Century, usually associated with mass urbanization and the related social issues of broken extended family support systems, the vulnerability of young single women, and the devastating impact of poverty. • 17th & 18th Century Europe - first foundling homes and 'wheels‘ • 19th Century America - industrialization and migrant labour • 1980's China - implementing of the strict one child policy. • Studies conducted in the 1980s, 1990s and 2000s in Brazil, Jamaica and Peru where a combination of poverty, war, gender inequality and social suffering have led women to consider this 'survival strategy'. • In these examples we see how 'child circulation' through informal fostering and adoption becomes a means of managing abandoned children, similar to South Africa.

  10. Child Abandonment & Adoption in SA • Contemporary urban South Africa has all of the challenges identified as causes of child abandonment in global studies on the subject: • Restrictive legislation • Poverty • Mass urbanization • High levels of violence (rape is a major concern) • Extreme gender inequality • High levels of HIV/AIDS (Which has also been gendered as a disease) • Diminishing family support • Institutional & foster care systems are under pressure due to over-use. • Despite its proven success globally, government appear hesitant to openly support adoption as a means to alleviate the crisis. • A review of African ancestral beliefs indicates that the ‘Western’ practice of adoption, where unrelated children are incorporated into families in a form of ‘created kinship’ is problematic in SA.

  11. ‘Cultural Barriers’ are often cited as the reason for the decline in adoption “It would take years before there was a flexibility of mind about adoption among most South African’s. We would have to have a big indaba before it could be accepted. Ancestral spirits look after their relatives and no-one else. In our religion, in our culture, this thing is ring-fenced” – Jabulani Mphalala (Commissioner for Traditional Leadership Disputes and Crimes 24/02/14) “The ancestors will turn their backs on you, and you will have bad luck forever if you leave the ANC” – President Jacob Zuma (27/01/14)

  12. The process of Abandonment? I followed the people and the conflicts that I encountered around child abandonment to create a mobile ethnography

  13. My fieldwork and methodology • Participant observation and in-depth interviews/workshops with: • Teenagers and young adults experiencing unplanned pregnancy • Mothers who had been caught for abandoning their children • A range of community members in Soweto, Alexandra and Tembisa • Police men & women who have encountered child abandonment • Hospital nurses, social workers, doctors and pathologists • Accredited adoption social workers • Founders, managers, social workers and carers in baby homes and CYCCs • Babies and children in institutional care • Foster care mothers who also offer their services as a place of safety • Adoptive mothers and fathers • Adopted children both locally and internationally • Young adults who recently discovered they were abandoned and adopted • Child protection experts, consultants and lobbyists • Clinical psychologists and psychiatrists • Traditional Sangomas & Inyangas 37 interviews, 12 workshops, 134 participants, many hours of participant observation through my work in child protection.

  14. My fieldwork and methodology cont. • In support of my interviews and participant observation I also conducted a detailed discourse analysis of an archive of newspaper articles from the past 4 years – 2010 to 2013, rated to: • Unplanned pregnancy (111 articles) • Abortion (41 articles) • Child abandonment (151 articles) • Temporary safe care solutions e.g. foster care and CYCCs (137 articles) • Adoption (99 articles) • I analysed 539 articles in total to identify the messages, communication techniques and sources of information in each of these. • I used critical discourse theory to identify the dominant points of view on each of these topics, and how certain vocabulary and communication styles and images have been used to create a common way of talking and thinking about unplanned pregnancy, abortion, child abandonment, foster care and adoption.

  15. The Mindful Body – Conceptual Framework 1. The lived experience of the body self 2. The social/ symbolic body 3. The body politic Scheper-Hughes and Lock observe that “boundaries between the individual and the political bodies become blurred, and there is a strong concern with matters of ritual and sexual purity, often expressed in vigilance over social and bodily boundaries” (1987:24). This final perspective led to my observation that child abandonment is increasingly being medicalised in contemporary South Africa.

  16. The Medicalisation of Child Abandonment • Problem defined in medical terms, described using medical language, understood through a medical framework and treated using medical intervention (Conrad 2007). • Often focusses on normal life events e.g. childbirth and everyday emotions such as feeling sad or depressed. • It also often focuses on deviant, immoral and sinful social behaviour. • Social issues which should be dealt with at a community or country level, suddenly become the responsibility of the individual. • Problematic behaviour is reconstituted as sickness, taking the responsibility out of the ‘patient’s’ hands and placing it into those of the doctor or pharmacist. • Medicalisation, is more than just a tool of medical practitioners - the support of social organisations, the state and the individual’s concerned, often form a ‘collective action’ around the perceived issue being medicalised.

  17. Different views on social behaviour Exploration • AihwaOng - Spirit possession attacks on young, unmarried women, in multinational factories in Malaysia (1987). • Scheper-Hughes • Nervoso amongst Brazilian sugar cane cutters (1988) • Death without weeping (1992) • Arlene Mathieu’s homelessness in NYC (1993) • Junko Kitenaka’sDepression in 1980 Japan (2012) Bad faith community (Poverty & Inequality) Divert attention from state Medical definition (Resources) Medicalisation impoverishes cultural resources, diminishes capacity to reflect on the social and political roots of an affliction, ‘fragments bodies’, ‘shatters social obligations’ and ‘separates individuals from their culture and community’ (Ong 1987:40).

  18. What I explored The portrayal of teenage pregnancy, abortion, the abandoning mother and abandoned child by the media The management of the abandoning mother and the abandoned child by the police, medical practitioners and adoption social workers The understanding and treatment of the abandoning mother and the abandoned child by psychiatrists and psychologist vs traditional sangomas The experience of child abandonment from the perspective of the abandoning mother and the abandoned child

  19. Findings The portrayal of teenage pregnancy, abortion, the abandoning mother and abandoned child by the media The management of the abandoning mother and the abandoned child by the police, medical practitioners and adoption social workers The understanding and treatment of the abandoning mother and the abandoned child by psychiatrists and psychologist vs traditional sangomas The experience of child abandonment from the perspective of the abandoning mother and the abandoned child

  20. Sad, Bad, Mad Mothers • Young pregnant girls are increasingly individualised and demonised: • Language used includes: Shocking; skyrocketing; crisis, out of control; epidemic (medical term implying the widespread infectious disease). • The girls are getting younger and younger, and more ‘innocent’. • Parents and particularly mothers are chastised for abdicating their parental responsibilities.

  21. The reasons given for this ‘epidemic’? • Sugar daddies & intergenerational sex (highlight immorality of teen pregnancy) • 20% of teen pregnancies a result of rape • 60% of teen mothers claimed to have been coerced into having sex by men who were older than them (Mail & Guardian 03/02/2012) • Poverty • Rape • Drug & alcohol abuse • Proving one’s fertility • Grant dependency (disproved in research) • Peer pressure Noted in descending order of frequency of mentions in the media Usually listed in a rote fashion in the media with little to no representation from the young pregnant girls (less than 5% of articles)

  22. Immorality and Illness • Abortion remains a contentious issue, with girls who chose this option being labelled primarily as immoral versus that of making informed and responsible choices. • Illegal, backstreet, unsafe and botched abortions are reported on frequently, often resulting in the death of the young mother and her unborn child. • Abandoning mothers are portrayed as immoral criminals and murderers or suffering from severe mental disorders. • Child abandonment is increasingly being associated with postpartum depression and post-traumatic stress.

  23. Disposable & Disconnected Abandoned Children • No statistics are currently available from government, however, the reporting of child abandonment gives us some indication of the typical age of the children and places where they are found: • 65% were new-born babies, and more than 90% were younger than a year. • Of the more than 250 references to ‘sites of abandonment’, 70% would be deemed unsafe for the child (noted in descending order of frequency): • ‘toilets, drains, sewers and gutters’ (20%) • ‘rubbish sites, dustbins and landfills’ • ‘the park or open veld’ • ‘baby safes’ (considered safe) • ‘hospitals’ (considered safe) • The remainder included: on the street; in a township; on a door step; with a relative; with a stranger; in a river or dam; in a church or synagogue; buried; on or near train tracks; in a taxi rank; at a school; and at a crèche. • Only one article mentioned the abandonment of a child in the ‘suburbs’, however, a number of articles claimed that mothers chose to travel to informal township environments to abandon their children.

  24. Visual and verbal imagery of disposability • Headlines: ‘Born to be dumped’, ‘Sewer baby’ & ‘Weggooikinders’ • Photographs of police and rescue services removing baby’s bodies from rubbish dumps. • ‘Trashcankidz’ a range of commercial toys that are supposed to give a voice to the “millions of orphans, vulnerable and street children of the world”. • Vulnerable, sick, exposed to infection and HIV – often don’t survive. • “Large part of undetermined deaths in Gauteng for 0 to 4 yrs” • “Of every 200 abandoned babies found, only 60 are found alive.”

  25. The taboo of adoption • There is much coverage of the declining rates in adoption in South Africa, and the impact that long term institutional care has on abandoned children. • Although the implementation of the new Children’s Act is partially blamed, the most frequently cited challenge is that of the ‘cultural barriers’ associated with adoption. • Cross race adoption is stated as being a contentious issue by the media, with many adoptive parents sharing experiences of ‘judgement’ and ‘discrimination’ from social workers, the Department of Social Development, and society at large. • International adoption is also treated with a great deal of mistrust. Most of these concerns stem from a belief that the child will experience a “loss of cultural roots” and that their welfare will not be a priority in the receiving country (Pretoria News 09/12/2011).

  26. Adoption and Ubuntu • The notion of ‘Ubuntu’ appears conflicted in reference to adoption in the media. • It is cited repeatedly by both the National Adoption Coalition of South Africa (NACSA) and the Department of Social Development in newspaper articles, as a means to deal with the worsening crisis of orphaned abandoned and vulnerable children. • However, it is also stated as a reason for black adoptive parents rejecting adoption due to the child being of a different and unknown blood-line. Adoption is not an option as it is believed that the child is born spiritually linked to rituals peculiar to that ancestry, and a cross-pollination of rituals will anger the child’s ancestors and cause all sorts of misfortunes for the child, including sickness and disease (The Times 20/01/2012). “There were some who said adoption was taboo in black culture. Questions were asked about which tribe she came from. I was told the ancestors wouldn’t know her (Pretoria News 17/02/2012).

  27. Findings The portrayal of teenage pregnancy, abortion, the abandoning mother and abandoned child by the media The management of the abandoning mother and the abandoned child by the police, medical staff and adoption social workers The understanding and treatment of the abandoning mother and the abandoned child by psychiatrists and psychologist vs traditional sangomas The experience of child abandonment from the perspective of the abandoning mother and the abandoned child

  28. A clash of worlds and perspectives • Both have similar profiles of who abandons but differing perspectives on who or what is to blame: • Police officers, public hospital nurses and state social workers see abandoning mothers as immoral and irresponsible, and believe that they should be punished by the law and their ancestors - they also believed that they could be held accountable by their ancestors should they assist them. • Adoption social workers see abandoning mothers as victims of poverty and structural violence which has stripped them of their ability to love their child, and that the choice to abandon is often a ‘survival strategy’. Police Officers, Public hospital Nurses & Social Workers Adoption Social Workers Western model of childcare & protection Moral imperative to help children Pro-adoption Conservative Focus on morality of mothers Predominantly anti-adoption

  29. Perspectives on who abandons? • Women living in extreme poverty, and just surviving from one day to the next. • Illegal immigrants with no support structures. • Women with no family or support structures • Women who have moved from one relationship to another and their new boyfriend does not want to take care of the child from a previous relationship. • Women who have HIV/AIDS. • Women who have been raped by a family member (incest is often mentioned), someone in their community or a stranger (multiple perpetrator rape in SA is the highest in world). • Women who have been abandoned by their boyfriends. • Young teenagers who are still at school. • Prostitutes. • Alcoholics and drug addicts (usually living on the streets). • Women living in rural areas in extreme poverty who travel to the city to abandon.

  30. Unattached child • All of the social workers were very concerned about the impact of long term institutional care for these children, as they believed that it could lead to ‘attachment disorders’ such as behavioural and learning challenges later on in life (Howe 2005): • The child and their caregiver, develop a regulatory system together, through the continuous responding to a child’s signals e.g when a child is hungry and cries a caregiver would respond by feeding it. • Through this process, the child learns to recognise itself and others as persons, with thoughts and feelings, and this is the basis for empathy. Romanian Orphans Othandweni Granny Programme

  31. Findings The portrayal of teenage pregnancy, abortion, the abandoning mother and abandoned child by the media The management of the abandoning mother and the abandoned child by the police, medical staff and adoption social workers The understanding and treatment of the abandoning mother and the abandoned child by psychiatrists and psychologist vs traditional sangomas The experience of child abandonment from the perspective of the abandoning mother and the abandoned child

  32. Isolated, Individualised and Disconnected • Women who choose to abandon their children are often in desperate situations - many have been abandoned by the father of their child and their families on discovery of pregnancy. • Pregnancy brings a rapid shift in their social status in their family and their community - they move from someone who is loved and cherished, to someone who is isolated and shunned. • Many of the young women spoke of their frustration at being labelled as the sole perpetrators of their predicament by their community, their family and their boyfriends/partners. • Most of the women were completely unprepared for pregnancy, no one had told them about sex, conception, birth control or pregnancy. • Understanding of how conception takes place was often incorrect with many believing that ‘you have to have sex many times to make a baby’.

  33. Adoption as an option? • Adoption was viewed with great mistrust due to its permanence and its disconnecting of the child from their ancestors. • Most of the young women felt that foster care was a better alternative as this allowed a mother to retrieve her children later. • I was repeatedly told that a child must be introduced to its father’s ancestors if it is to live a full and happy life: • Thlabi(2013) notes that even if a girl has been raped, her family will try to get the guilty party to acknowledge paternity once the child has been born. • Especially in the case of a male child, only once their paternal lineage is determined and appropriated do they have an identity. • A woman who has not been introduced to her ancestors may still get married, but she could suffer many still born children, as it is very bad luck. • Formally relinquishing one’s rights is seen as a ‘conscious act’ of rejecting a child that has been given to you by your ancestors, who could then exact a similar punishment for that of abortion (infertility).

  34. Abandonment as an option • Most felt that a women who could not take care of her child would do better to abandon them into someone else’s care, as the mother could always apologise to the ancestors at a later stage, and claim that she was not herself at the time. • Unlike adoption, abandonment is not necessarily seen as permanent: “A women called me yesterday about two children that she abandoned nine years ago at our baby home. She just told me, ‘I am well now and would like to have my children’. I remember her from when she left her children with us. She was young, on drugs, living on the street and HIV positive. She told me that she has now found God and put her life back together, but she is not sleeping at night. The fact that she left her children is tormenting her and she is suffering. She literally arrived with the children and then disappeared, she never formally consented. When I told her that her children had been adopted and were now living overseas, she got very angry with me. She said ‘these are my children and I am suffering’, but it seemed to be more about her than about her children.” Adoption social worker

  35. Victims of fate • None could tell me why they had abandoned their children, but all appeared extremely disconnected from their child at the time of the abandonment, and believed themselves and their children to be at the mercy of fate. • None saw themselves as perpetrators of child abandonment, but rather as victims of their particular situation, making them feel disempowered, angry and depressed. “All I can say is that I don’t know. All I know is I just left him there. Even if he comes back, he will know what I did to him, cos even myself I can’t explain it. How do you tell a chid, you now my boy, I tried to kill you before. The psychologist said maybe I was being hormonal, and it was post natal depression. She didn’t give me any medicine for this, we just talked about it.” Abandoning mother

  36. To be abandoned • The physical act of abandonment is a traumatic and alienating experience for a child. • Most respondents believed that an abandoned child, who grows up in an African family who believes in ancestor, will live a difficult life. • Beyond their sense of loss and rejection, they will be unable to connect with their ancestors, as they have no knowledge of their father’s name and through this, their family’s ancestors. • Not knowing ones ancestors prevents you from fulfilling many of your traditional roles and rituals effectively: • These include paying damages for a child, paying lebola, celebrating big milestones such as matriculating, graduating or getting a new job. • Ancestors are also important for guidance and support, for understanding where illness may come from, and assisting a person in making important life decisions. 

  37. Kumbule’khaya The reason I am looking for my father is because I have some problems with my health. I was sickly growing up. I have a problem with my eye. I have problems with asthma as well… I just impregnated a woman back in Vereeniging. I do not know what to do since I know nothing about our family rituals. I also need to perform some family rituals for myself. Kumbule’khayaSeason 10 Episode 1

  38. Not telling • Global best practice indicates that parents should advise their children of their adoption as soon as possible, however, black adoptees are often not told that they were adopted by their parents, as they fear the stigma associated with adoption. Adoption is still taboo with us Africans. If you take someone else’s child, it’s not my blood-life. If it is first born, it cannot be given inheritance. A child will want a name and will cry for a name. A friend of mine discovered that her father was not hers at his death. She wanted to give input into his funeral arrangements but the family told her, ‘it is not up to you, he is not your father’. She was devastated, and she told me that she hated her mother for not telling her. (Adoptive mother) This young black couple are wanting to adopt. Neither of their families know that they are wanting to do this. The couple believe that they are taking a risk with their ancestors, but they are desperate for a child. They plan to pretend that the child is theirs, and not to visit their family whilst they are supposedly pregnant. They have agreed that when he has grown up, they will do some kind of ritual to help him, but in the meantime, no one needs to know. (Social worker)

  39. Findings The portrayal of teenage pregnancy, abortion, the abandoning mother and abandoned child by the media The management of the abandoning mother and the abandoned child by the police, medical staff and adoption social workers The understanding & treatment of the abandoning mother & abandoned child by psychiatrists and psychologist vs traditional sangomas The experience of child abandonment from the perspective of the abandoning mother and the abandoned child

  40. Abandonment and illness • Two models of illness: • Social workers, psychologists and psychiatrists interpret the abandoning mother’s suffering as depression and a mental breakdown caused by their anger, feelings of rejection and abandonment by their family or partner. • Community members, the police, public hospital nurses, state social workers, and sangomas, however, interpreted the suffering as being caused by their ancestors, who believed the abandoned/adopted children displaced. • Psychiatrists and psychologists advocate solving the problem through the treatment and medication of the individual patient. • Sangomasbelieve that the solution lies in healing the collective family. • Approximately 200 000 traditional healers practicing in South Africa in 1995, compared to only 25 000 ‘modern doctors’ (Truter 2007:56). • All research subjects had some knowledge of indigenous ancestral beliefs and most had engaged in rituals that concern themselves, or their families, and their ancestors.

  41. Sangomas and adoption • None of the sangomas I spoke to were openly against formal adoption, however, they all had concerns about the fact that the ancestors of the child and the adoptive parents were unrelated. • This was seen as something that needed to be managed proactively. Consulting with one’s ancestors was seen as critical, letting them guide you as a family was the only way to ensure their support of the process. • I was told that if the child was introduced to their new family’s ancestors from the start, they would be able to assist the child in connecting with his or her ancestors(ubigile – announcing a child to the ancestors). • In each instance, it appeared that consultation and honesty were the only way to resolve issues with one’s ancestors. • Conversely, suffering would only be meted out in instances of dishonesty and concealment.

  42. Ancestors are alive when you remember them. Some people think that it is just about slaughtering and feeding them blood, but it is not just about this. The ancestors are not happy with so much blood at the moment, they are looking into our fridges lately and seeing that we have dead meat in them, it is too much. Child abandonment is something about now, when you cut yourself off, and not only from your family, but from your soul. Blood and family is important. When we break the family, we break blood relatives, common lineage, heritage. When you look at what’s going on now, we have lost Ubuntu, it is just a brand, an idea, an abstract practice. You need to be realistic, I can’t say I can help the individual child. The African people need to understand what being African is about…. We can’t try to sort out the branches when the roots are a mess (SangomaAbusiwe).

  43. Conclusion • The critical role the media plan in defining the abandoning mother and abandoned child as a medical concern. • Mother first defined as a criminal and then as mentally unwell, citing postpartum depression and post-traumatic stress • Child is portrayed as physically and emotionally compromised with potentially long term consequences due to their difficult start in life • The media’s definition is reinforced by the social workers and psychiatrists supporting the mothers and children, citing trauma and attachment disorder as key areas of concern. • The police officers and nurses are more troubled with the immorality and criminality of the choice to abandon, however, they too believe in the possibility of long term suffering for the mother and child. • This view is also supported by the sangomas who emphasise the importance of making a child known to the ancestors, even if the child is not of their agnatic line.

  44. Conclusion • The final members of the ‘bad faith’ community, responsible for internalising the subjectivity of child abandonment as a medical category are the abandoning mothers and the abandoned children. • Both cited experiences of individualisation and appear to have internalised the medicalisation of child abandonment, the mothers referencing anger and depression and the children citing alienation, depression and even attempted suicide. • While the mother and the child can be healed, biomedical practitioners and sangomas see no easy cure. • The mothers, by succumbing to the medical diagnosis of their predicament, further individualise themselves by acknowledging their need for modern medicine, in the form of psychotherapy and medication, rather than the social support that they lost on falling pregnant, and which they so patently desire.

  45. 27 Newspaper Articles, 15 TV/Radio Interviews, 19 Online Articles

  46. Next Steps? • NACSA Conference 2014 – Adoption & Culture • Courage Child Protection Community Programme • Crisis Pregnancy Campaign – Choose to Care

  47. To download a print ready pdf version please visit www.couragechildprotection.com/toolkit.html

  48. SOUTH AFRICAN PILOT ZAMBIA PILOT NORTH WEST UNIVERSITY LESOTHO PILOT

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