Precious, a woman who looks well beyond her sixty-six years of age, sits in her yard in rural Zimbabwe watching over her three grandchildren, ages four, six and seven. “Gogo, gogo!” the youngest one beckons his grandmother, as he chases after his older siblings who are in search of guava fruits. Precious’ son, Michael, left for South Africa for work shortly after he married Mary, a girl from the same village. Michael contracted HIV in South Africa and transmitted it to Mary during one of his visits back home. While Michael was able to access antiretroviral drugs and continues to generate a small livelihood – a portion of which he sends from South Africa to Zimbabwe every few months – Mary died from AIDS shortly after the birth of her third child. Michael and Mary’s three children are now under the full-time care of Precious. 
Precious’ story is similar to those of many other grandmothers in Sub-Saharan Africa. The fact that Zimbabwe, Malawi, Kenya and other parts of the region are suffering from an Orphan Crisis is a topic of much debate internationally. The new systems of care that transnational economic structures are creating, and the pressing problem of HIV/ AIDS, continues to garner growing attention. For example, 2007 saw the first United Nations-led Global Summit on Grandparents and Kinship Caregivers. Sub-Saharan Africa currently has 17.9 million orphans, a large number of whom are being brought up by elderly grandparents.
A study conducted among the Luo ethnic group in Kenya demonstrates that older caregivers face severe strain while taking on parental roles in the lives of their grandchildren. For instance, grandmothers have noted going hungry on a regular basis to help feed the 1-9 orphans they care for. Many cannot sleep through the night as they have to nurse young infants. There is also the perpetually looming stress of being unable to provide financially for the children. This is especially hard when the children are HIV positive and require medical attention.
Another study in rural Uganda shows that caring for young children creates both physical and mental stressors, negatively impacting older caregivers’ health. The inability to participate in a livelihood livelihood generating activity causes grandparents to borrow from other households, which stigmatizes them in the societies they live in. In addition, children in the care of elderly are more likely to be victims of abuse as the elderly are often unable to protect them from these negative influences. All these factors culminate in weight loss, poor health and depression among the aging.
The preferred method of care for orphans in Sub-Saharan Africa is community-based as opposed to institutional. Keeping the child in a familial environment, and the village or tribe they come from, is key. While this method is certainly ideal, given the strain it places on the bulk of caregivers – grandmothers – there needs to be stronger social nets, such as feeding programs and free education, in place to help both caregivers and orphans live relatively successful lives. While certain NGOs provide stipends for food and education to such families, they do not have nearly enough capacity to address the issue of caregiver strain at the pace at which it is growing. It is important, thus, to consider the larger picture and understand how globalization and national policy can mitigate rather than exacerbate the issues that older caregivers face.
 This particular story is fictional. It is based on the lives of many women living in the rural Zimbabwe.
Sachi Shah is a recent graduate with a degree in International Development and Economics from Sarah Lawrence College, New York. She currently works as a grassroots campaign organizer, and is actively seeking opportunities in the international public health sector.