Joyce Sibiya (50) rests on one of the eight beds in the pristine ward at Ethembeni Care Centre near Richard’s Bay in KwaZulu-Natal. It is here that she is treated for her Aids-related infections. Her three children remain at home. Without Sibiya, these children would be orphans without resources.
Sibiya is one of the lucky ones — she is on anti-retroviral (ARV) treatment and receives 24-hour care from the sisters and doctors who work in the centre at Amangwe Village, the project of which Ethembeni is part.
In another part of KwaZulu-Natal, in the Valley of a Thousand Hills, six-year-old Mandla* has new hope. But for community-based organisation God’s Golden Acre, he would be just another orphan statistic living in a child-headed household.
In a few weeks’ time, God’s Golden Acre will renovate Mandla’s derelict shack and its leaking roof so that he and his companions have a decent home.
These are two people dealing with HIV/Aids and its consequences — with the help of community-based organisations, one of them funded by the private sector, the other by public donations. Both take a holistic approach.
UNAids estimates that by 2010 there will be 20-million orphans living in Africa. In Accelerating Action against Aids in Africa, its 2003 report, UNAids points out that the number of Aids orphans is rising in tandem with the number of uneducated, poorly socialised, malnourished and vulnerable young people in Africa. This, in turn, heightens social instability. The report says that any action against Aids must dovetail with poverty-reduction and development strategies.
The Mail & Guardian visited two community-based KwaZulu-Natal organisations taking a holistic approach to HIV/Aids and the issues that surround it.
God’s Golden Acre is partially a foster-care centre for children without parents or extended families to care for them. Ninety-seven children live there. They are sent to school and receive emotional support from house mothers and volunteers.
“The last thing we want to do is take children out of their communities,” Heather Reynolds, founder of God’s Golden Acre, told the M&G. She said that within the next 10 years there will be two million orphaned children in South Africa, placing a huge burden on the state.
Mandla is one of 4 500 children in the area receiving food parcels once a month from the organisation. But, said Reynolds, it is not just about providing food, but making sure orphans receive education, training, positive leadership, access to social grants and love.
God’s Golden Acre has an outreach programme in which the neediest families are identified and trained to raise chickens and grow fruit trees. Both can also provide extra income for the family.
“In six months’ time they have to give back six chickens, but by then they will have bred six more that they can use as a source of protein and possibly sell the eggs,” Ronette Heunis, project manager of the outreach programme, told the M&G.
God’s Golden Acre’s approach is to do more than simply support a child until he or she is 18: “We are starting a life-skills training centre where young people can be trained in beadwork, agriculture and chicken farming,” said Heunis.
Ethembeni Care Centre, about 100km away, is a private-sector initiative that also illustrates how ARV treatment is only one component of holistic care. Operating in Amangwe Village, Ethembeni also aims to empower families to earn a living and lift themselves out of poverty.
“Amangwe looks at the whole life cycle of the patient,” said Sally van Vuuren, manager of the village. She sees the role of the village as crucial in the ARV roll-out: it already has trained staff, outpatient and inpatient facilities to take the burden off the public health-care sector.
Amangwe will be expanding its hospital to include an extra 45 beds. It already has an outpatient’s clinic where members of the community can be treated. The village also monitors and trains 77 home-based care supporters who care for patients released from hospital. A key aspect of the ARV roll-out is the establishment of communication networks between hospitals, clinics and home-based care organisations.
“If a child is left unattended, the home-based care volunteer will refer the child to a social worker,” said Amos Mtshali, Ethembeni’s coordinator of home-based carers. He said the most common problem is lack of food. “The sick patients constantly ask the carers for food because there is no income in the home.”
* Not his real name