'Telling the truth is the best thing': teenage orphans' experiences of parental AIDS-related illness and bereavement in Zimbabwe.

Zimbabwe is one of the countries most affected by HIV/AIDS, and as elsewhere in southern Africa, the impact on children and young people living in affected households is significant. Loss is highly complex and dependent on developmental stage, resilience, quality of care, and social support networks, and often includes a progression of experiences from the onset of a parent's or caregiver's illness, through to the aftermath of death. For several reasons, AIDS-related bereavement is likely to be especially complicated and difficult to accommodate. Understandings of bereavement and grief among African children, and adults' responses to orphans' psychological difficulties, remain under-developed. This paper focuses on the narratives of older children in their teens, who have experienced parental AIDS-related illness and death in six sites in Zimbabwe. A key finding is that, while many orphaned teenagers desire direct communication with adults about parental illness and death, adults themselves--whether the sick parent, other relatives in the household or a caregiver following parental loss--are often ill-equipped to identify and manage children's distress positively. While most existing psychosocial interventions focus on bereaved children, this paper suggests that, in order to create an enabling environment for orphans, building the capacity of key adults in orphans' lives, particularly surviving relatives, caregivers, and teachers to address emotional issues relating to parental loss constructively is an essential, but neglected, area of programming.