Children and AIDS: A Need to Rethink Child Welfare Practice

Autor: Thomas O. Carlton, Jaclyn Miller
Rok vydání: 1988
Předmět:
Zdroj: Social Work. 33:553-555
ISSN: 1545-6846
0037-8046
DOI: 10.1093/sw/33.6.553
Popis: The Problem Recently, a baby boy was born in That threat produced action. A foster a teaching hospital located in a large homewasfoundforjoeywithintheweek. mid-Atlantic city. At birth, Joey (a He was discharged from the newborn pseudonym) tested positive for human nursery 6 months after his birth, immunodeficiency virus type 1 (HIV-1) Joey's story is true. It is not unusual, and was placed in the hospital's neonatal It raises an important question: What are intensive care unit (NICU). His parents we doing to our children who most need had no permanent address. Although our care and protection? they visited him occasionally at first, they refused to take him after his release from NICU. Shortly thereafter, his mother was imprisoned and his father disapAs of December 1987, 48,139 people peared. Responsibility for Joey was had been diagnosed in this country as assiimed by the city's child protective having acquired immune deficiency syn services (CPS) unit, but he remained in drome (AIDS). Of these, 703 were chil the hospital's newborn nursery, where dren. Sixty percent of the adults and 59.6 he had been moved from NICU. percent of the children had died (Centers As the weeks passed, the nursery staff for Disease Control, 1987). became attached to Joey and bought In December 1987, one of every 61 toys, a walker, and other items for him. babies born in New York carried an Nevertheless, they recognized that the tibodies to the AIDS virus ("Medicine," nursery was neither equipped nor staffed 1988). The situation abroad is no less to provide the kind of stimulation and alarming. Twenty-five to 30 percent of nurturing he needed. Contacts between infants born to AIDS-infected mothers the nursery's social worker and the CPS are expected to become infected. Of worker assigned to Joey failed to resolve these, 40 percent will have AIDS or his predicament. As the CPS worker exAIDS-related complex by the age of 10 plained, no foster home was available for months (Richmond Times Dispatch, him. A suggestion that Joey be trans1988). Worldwide, it is estimated that 30 ferred to a hospital for sick children, to 65 percent of infants born to HIV where his need for stimulation and nurpositive mothers will be infected at birth turance could better be met, also was (Piot et al., 1988). Lewert (1988) cited vetoed by the CPS worker on the basis Thomas (1984), who noted that a woman that Joey was "not sick" and, therefore, exposed to the HIV virus has a 50-percent the cost of his care in the hospital for sick chance of giving birth to an infected in children could not be reimbursed by fant. Although some infants convert to CPS. She failed to note that the cost of seronegative status sometime after birth, his "lodging" in the newborn nursery as their own immune systems develop, was not being reimbursed for the same most do not and they suffer repeated de reason and that the hospital was absorbbilitating illnesses. Their development is ing those costs as a result. erratic and they die—most of them before After all appeals failed to move the CPS they are 5 years old (Lewert, 1988). staff and all alternatives had been exThe development of AIDS among hausted, the director of the hospital's adults is stage like. Although 90 percent social work department threatened to file of those infected with HIV-1 experience child abuse and neglect charges against damaged immune systems within 3 to 5 the city's CPS and Joey's CPS worker, years of being infected, "AIDS may not show up for as long as a decade. This forces us to change our focus from certain high risk groups and AIDS to the grim reality that the full extent of the virus in fection will not be recognized until the end of the century" ("Medicine," 1988). Those who will be at highest risk in the near future will be the children who will be born in coming years. The highest percentage of these at-risk infants will come from the inner cities—born of black or Hispanic women who use intravenous drugs (Curran et al., 1988; Honey, 1988; Macks, 1988). Thus, increasing numbers of children already abused by contract ing AIDS in utero are likely to be neglected or abandoned by parents who are themselves living a marginal exis tence—many of whom may be ill already and will die shortly after the birth of their children.
Databáze: OpenAIRE
Externí odkaz: