Physiological needs

According to Maslow, physiological needs were crucial because they were a minimum requirement for human survival.

6.1.1 The need for Life Sustenance

Maslow considered food and water as essential for sustaining life. It was common for households keeping orphans to lack year-round access to food. This suggested that there was food insecurity which was a life threatening condition. Participants reported that often food supply from their gardens lasted about six months of the year. The rest of the year, they either bought food or engaged in food-for-work jobs. These alternative means of accessing food supply were erratic and inadequate to achieve food security.

Orphans and caregivers reported that food production was in many ways influenced by household food production factors, which included land ownership, land size, use of fertiliser or use of innovative farming technology.

We find food with struggles because sometimes we do not harvest enough food, sometimes we get few bags of maize (1 bag is 50 kilograms) sometimes we get three bags of maize (150kgs). The food is often not enough; right now, we are buying food. When we have money, we buy food. If we do not have money, we stay without food.

(Maternal orphan, aged 16, living with father)

It appeared that participants experienced two problems because of food shortage: reduction in food intake and decline in food quality. Participants reported that lack of food inevitably resulted in reduction of the number of meals per day; breakfast was often missed. For some this was attributed to lack of money for buying food, but others suggested that breakfast was not considered a high priority. Some orphans said that when there was no breakfast at home, they did not go to school.

We lack money to buy sugar for making tea or eating maize meal porridge. It is too expensive to spend K90 (£0.33) to buy whole grain maize meal for breakfast porridge- it is better to top up the money to K200 (£0.70) and buy enough maize flour for a meal because maize meal is more filling.

(Paternal caregiver, aged 62) It seems the frequency of meals differed with the type of household head. Varied responses were given by caregivers, regarding the number of meals eaten per day. It was common for most households to eat one or two meals in a day although some child-headed households reported that there were days when they had no meals. Food insecurity was not an issue for all households as some paternal caregivers reported having three meals in a day throughout the year.

The results suggest that it was a common experience that orphans struggled to find food and sufficient nutrition intake. Orphans and caregivers described the process of searching/sourcing food as ‘kupulutika’, which means a strenuous and hopeless activity. They also used the term ‘kukokera’to imply applying austerity strategies that compromise on food quantity and quality, to prolong food stock.

We have nothing to eat for breakfast and there is often too little maize flour for a meal at noon so we eat one meal in the evening. Sometimes, there is no food either in the evening, so we go without food for the whole day.

(Double orphan girl, aged 13) Oooh...to say the truth, my children do not eat as other people’s children because of ‘kukokera’ they eat mostly once per day. That’s it, I’m the one ‘Kholo’ (only surviving parent) who runs about, ‘kupupulika’.

(Maternal caregiver, aged 43) Apart from reduced food intake, poor quality of food was a recurrent theme in narratives by the orphans. In particular, orphans said their diet lacked the right balance of different foods and often lacked protein. Some orphans suggested that the decline in food quality was due to lack of money. Others suggested that it was due to the death of their parents. Ultimately, lack of money was the main issue.

Mostly we eat pumpkin leaves and wild vegetables. We rarely buy relish and sometimes we may not even eat small dried fish for a whole month.

(Double orphan in child headed household, aged 13) There is a difference between now and before my parents died. The food we have now is not nutritious because we have no money to buy nutritious food such as tomatoes and cooking oil.

(Double orphan caregiver boy, aged 16) Some orphans and caregivers articulated knowledge of the constitution of a nutritious and healthy diet. This suggested that it was food insecurity, rather than lack of nutritional knowledge, that was responsible for poor quality of food.

I do not have a healthy balanced diet, not 3 food groups. Foods that make you grow, food that protect you from diseases and food that give you energy. I miss tea or porridge for breakfast. I miss beans, meat and groundnuts for growth and health. We learn these at school.

(Paternal orphan girl, aged 14 living, with mother) Apart from lack of food, it seems orphans had different problems with access to clean water. Many orphans accessed water from wells or boreholes, but they had to walk

long distances to fetch water. Some of the water was not safe to use because they fetched water from unprotected wells or streams. A few orphans, who lived in semi- urban areas, reported that they had to buy water but money was not easy to find.

In other narratives, orphans reported having played in bilharzia-contaminated water, because they lacked information about health hazards of playing in unsafe water.

I suffered from bilharzia. I was bathing and playing in contaminated water with my friends. They told me afterwards, I did not know that bilharzia come from contaminated water.

(Double orphan boy, aged 14, living with grandmother)

6.1.2 The Need to Maintain Body Temperature

The responses by some orphans suggested that they experienced the need that was similar to Maslow’s level of need for protection from life threatening conditions because they lacked good shelter and clothes. There were a number of shelter problems reported by respondents. For some, their housing was dilapidated. For others, the housing design was described as a football2 _{pitch, suggesting lack of basic} shelter requirements. Many orphans and caregivers reported that housing problems were difficult to solve because there was no hope of getting assistance. According to Maslow, shelter and clothing are physiological needs necessary for maintaining normal body temperature (homeostasis).

It has been very difficult time...to keep the roof from leaking. We have termites here and during rainy season, flying ants come from the floor. The bathroom collapsed when dad died. Since we have no money to buy plastic sheet, we use the toilet as a bathroom. There is also a problem at the back of the house. The foundation was dug on a site of an old toilet, when rain comes, the bricks sink into the ground so I have to repair it. I do it myself because I have no one to ask for help.

(Double orphan caregiver girl, aged 15)

2 _{Football pitch was compared to a house that had no separated rooms for different use,}

It was common for orphans to report having limited access to appropriate clothing. Some only had one set of clothes with no change of clothes. Others were wearing clothes which were inappropriate sizes left by the deceased parent. Many orphans reported having no shoes. This led to sores and cracked feet during the hot season. Many orphans reported having no proper beddings. Orphans could not afford proper beds or mattresses; instead, they slept on mats and used pieces of cloth for a blanket. In some narratives, orphans said the mats were damaged by ants that came from poor quality housing floor (un-cemented floors). Therefore, with poor quality bedding, many orphans were exposed to harmful cold weather which threatened their health.

My daughter does not have problem with food but clothes because she compares herself with her friends. She also needs to sleep on a good place. When you do not have a blanket you begin to worry when it’s getting dark and the night gets long.

(Paternal caregiver with his children, aged 61). It was common for caregivers to report differences in finding clothes for boys and girl orphans. The caregivers explained that boys’ clothes were more expensive than girls’ clothes. Hence, caregivers took longer time to replace torn clothes of boys than for girls.

Clothes are a problem and my children cannot dress like other children. Sometimes they have one t-shirt and two shorts. Before long, you find that the clothes are torn. I buy for the one whose clothes are torn and others have to wait for their turn, it is a struggle you know!

(Paternal caregiver, aged 62)