Psychosocial disadvantage: preparation, grieving, remembrance and recovery for orphans in eastern Zimbabwe.

Few programmes for sub-Saharan Africa's 12.3 million children orphaned by AIDS have focused on their high risk for psychosocial problems. As groundwork for supporting orphans' healthy development, this study describes the preparation, grief, and memorial experiences and the physical and psychosocial well-being of 144 double orphans and 109 single orphans in rural eastern Zimbabwe. Most received no preparation or orphan-specific support for mourning and emotional recovery. On measures of physical and psychosocial well-being, orphans did more poorly than 87 non-orphaned classmates, perhaps reflecting the combined interaction of economic disadvantage and orphan status. Financial hardship was most severe among single orphans. Double orphans' responses suggested perceptions of isolation, lack of support and personal difference. Distress was greatest among younger orphans (<13 years). Given the importance of emotional health to child and societal development, scaled-up financial assistance should incorporate programmes to help children prepare for and recover from the loss of their parents.