The unrelenting horror of the Aids epidemic is taking a heavy toll on caregivers in Mpumalanga.
Their daily experiences have left many traumatised.
“I was upset when I saw my patient coughing up blood clots. Bits of lung came out,” says one caregiver at Schoemansdal. “I too felt sick, but I had to be brave. I knew he was dying. This vomiting continued for three hours. He then lay back exhausted.”
The patient died the next day.
This is the daily reality of those who tend the dying, for most caregivers in Mpumalanga often lack the most basic resources and regularly face resistance from their communities.
“That village is becoming one big orphanage,” says Sally McKibbin of Thembalethu Home-based Care, as she points to Jeppe’s Reef, near the border with Swaziland.
In the first few months of 2002 the organisation dealt with about seven deaths a week; now at least 13 people die of Aids every week. The group makes its own coffins to give every victim a decent burial. And that is often all its members can do. With the rising death rate and only one caregiver for every 200 homes, they find it difficult to offer suitable help to the community.
Yet Thembalethu cannot count on support from the local government and depends on donations. Tragically, South African society continues to ignore the reality of the HIV/Aids pandemic, says McKibbin.
Sophia Jardim experiences the problem every day. She runs a home for abandoned children outside Barberton. In 1998 the Mail & Guardian reported that people spat at her in the supermarket for taking care of black children with HIV/Aids.
“They thought I was going to kill myself by taking an HIV-positive child into my house,” she says.
The community’s attitude has improved slowly since she started the home in 1995, but she recently experienced the distrust afresh when her farmhouse burnt down in the early morning. She rescued the sleeping children from the building.
“During the fire the neighbours did not even call the police and I was screaming for at least 12 minutes,” she says.
After the fire, local people brought around clothes and food. Jardim hopes the fire will improve the community’s attitude towards her home.
About 30km down the road in Barberton the “best barlady in town” says she does not know anyone with Aids, though people in the town do gossip. She would never go to the local clinic to be tested for HIV, she says, because she feels the results could not be kept confidential. “Everyone knows the people who work there,” she says.
Sister Anece Salay from Saint John’s, a community of Franciscan sisters close to town who run an orphanage for children with HIV/Aids, recognises the problem. “There are enough counsellors in Barberton, but the people are not committed to go there,” she says.
The sisters are constantly confronted with the ghastly effects of Aids on the dying.
Salay tells of a baby they had to tie down because her skin peeled off every time she scratched. Salay says the baby was “an open wound at the end”.
“I believe we have seen things doctors have never seen,” Salay says after years of experience with terminal Aids patients.
Saint John’s runs on a minimal budget, but Salay hopes attitudes are changing. People now drop by regularly with leftovers, clothing and toys for the orphans.