A population study establishes that orphanages are important for Rwanda's orphans mainly because of lower stigma and marginalization they faced from the community. Children in orphanages are emotionally healthier, suffer less from mental distress and are less prone to high-risk behaviour than orphans living under other circumstances.

A doctoral dissertation completed for the University of Helsinki evaluates the psychosocial wellness of Rwandan orphans by focusing on their living circumstances and the quality of the care they receive. The results show that the children's living environmentquality of care had a profound impact. For example, orphans who had three meals a day and access to schooling expressed a higher level of emotional wellbeing and lower levels of distress.

The study was based on a survey conducted on more than 400 Rwandan orphans, and included children from four types of living circumstances: child-headed households, orphanages, children living on the street and those placed in foster families. Rwanda has had the worst orphan crisis in recent history due to the 1994 genocide and the AIDS epidemic. When doctoral student Tehetna Caserta began work on her dissertation research, Rwanda had nearly one million orphans, which is more than ten per cent of the population.

Interaction between orphans and their community is key

According to Caserta, the most important result was that the variation in psychosocial wellbeing due to living circumstances was significantly reduced when stigma, marginalisation and social support were considered.

"The interaction between the orphans and the surrounding community is a key factor for the emotional and mental health of the children. Understanding this complex reality could lead to completely new insights into how the psychosocial wellbeing of the orphans could be improved," says Caserta.

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The satisfaction the orphans felt regarding their living environment varied greatly. This indicates that the participating orphans seek protection, safety and love by expressed their dissatisfaction by transferring from one living environment to another, and that they never feel fully content or loved as they searched for protection, stability, safety and love.

Living environment strongly linked to stigma

The psychological vulnerability of the orphans, such as their experiences of stigma, was compared with their living environment, status and the cause of death of their parents. In addition, these factors were studied in terms of their impact on emotional wellbeing and mental distress. The results show that only the living environment is strongly connected to the children's experience of stigma. High levels of stigma were linked to low emotional wellbeing and high levels of mental distress.

"The results indicate that stigma and marginalisation account for more than 50% of the variation in the psychosocial wellbeing among Rwandan orphans," says Caserta.

The study also showed that AIDS orphans experienced higher levels of distress than children orphaned by genocide or due to another reason in terms ofeven after considering the effects of stigma, marginalisation and lack of social support.

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Social support connected to mental wellbeing

The dissertation examines the relative significance of social support for the orphans' ability to withstand the stress resulting from losing their parents and the effects on their emotional wellbeing and mental distress. Experiencing high levels of social support was linked to higher emotional wellbeing and lower levels of mental distress.

"Support from adults is the only form of support which significantly reduced the children's experiences of distress."

Help doesn't require money

The mental health of orphans is dependent not only on concrete factors, such as a lack of food, clothing or shelter. Neglect, stigma and abuse from their communities also caused great suffering for the children.

"The results may sound shocking, but they prove that society can alleviate the suffering of Rwanda's orphans without attending very much to their material provision spending any money. Any compassion, approval or signs of good will could help thousands of orphans heal from their trauma," says Caserta.

The researcher believes stigma, abuse and marginalisation of orphans should not be tolerated and be made illegal.

"Approval, inclusion, displays of affection and a little encouragement cost the community nothing, but can help these orphans survive their tragic circumstances."

See more at: http://urn.fi/URN:ISBN:978-951-51-2578-1