Zibango Hlabe sits watching his family building their new home. He is too weak to help. He has come back to his family in Nqabeni village, near Port Shepstone, after contracting HIV on the mines and growing too ill to work.
The impact of his death will psychologically, emotionally and financially affect the lives of his nine children, and brand them as “Aids orphans”.
The Hlabe children are unaware of the “apocalyptic predictions” that Aids orphans will grow up as a generation of criminals, delinquents and sex workers. They may not comprehend that their father’s death will add them to a rising number of orphans in South Africa — 2,2-million (12% of all children) last year and likely to be 3,1-million (18% of all children) by 2010, according to UNAids’s Global Report on the pandemic.
Their mother, Nothemba Hlabe, is a powerful woman whose painted red-mud face shows no signs of the virus. She has not been tested, but her husband says they have never used a condom during sex.
“When one parent is HIV-infected, the probability is high that the other parent is as well,” points out the Global Report. “Therefore, children often lose both parents in quick succession. An orphan’s caregivers may also succumb to Aids, with the result that children may suffer multiple bereavements.”
All the Hlabe children want is to finish building their two-bedroom house before their father dies.
It is hard to comprehend the children’s pain in watching the slow death of a parent while wondering what the future holds for them. It is evident that Zibango Hlabe — who still pulls on his miner’s boots every day — is revered by his children as the head of the household; they seek his advice in the best way to build the house.
“The family is the first, though not the only, place where the child learns the appropriate ways of interacting with value systems, like schools, issues and events from the global environment,” said Mambwe Kasese-Hara, senior lecturer in psychology at the University of the Witwatersrand.
“HIV/Aids is still stigmatised in our society … as a result [children] suffer social isolation, shame and a lack of emotional support as well as financial support.”
The children do have a slim chance of evading orphanhood, if Zibango receives anti-retroviral treatment from one of the 31 sites in KwaZulu-Natal. But the province is behind in reaching its target of 20 000 people by March 2005. Currently it has about 3 000 people on treatment, despite the fact that it has the highest HIV prevalence rate in the country, with the Department of Health’s 2003 antenatal survey putting it at 37,5%.
It is through the South Coast Hospice, a palliative care programme, that the Hlabe family has received emotional and financial support.
The hospice has identified the Hlabe children as “potential orphans”, which means they are shown how to make memory boxes, which they decorate to store mementoes, pictures and letters from their parents. “This makes the children feel like they are important and belong to a family,” said Aggressia Maluleka, who works with Virginia Nzama as one of the South Coast Hospice’s caregivers. They also counsel parents on who should look after the children after their death.
On the death of their parents the younger Hlabe children could be looked after by their elder brothers or a relative — often a grandmother. They could be divided among foster parents or, as a last resort, placed in an orphanage. But the death of parents does not mean the end of the family. “Many family forms exist in Africa. However, academic literature and media reports draw on ‘traditional’ demographic models, which fail to take into account the actual living arrangements of children,” said Jo Stein, principal scientific officer at the Aids and Society Research Unit at the University of Cape Town.
An option for the Hlabe children could be a child-headed household — like the one the Mkuhungo brothers have set up in their parents’ house in a township near Port Shepstone. Their parents did not die of Aids, but because they are visited by hospice staff they are stigmatised as if they had.
“We didn’t have any idea that God was going to call you that day.” This is part of the poem Johannes wrote to deal with the death of his mother two years ago of cancer, five years after his father’s death from a stroke. He had taken it out of the hiding place behind a sexy picture of Christina Aguilera. A nine-year-old sister lives with their aunt in Machison, two hours away, but feeding two teenage boys can be an expensive responsibility, and so the boys live on their own.
It is hard not to notice how neatly every pot, pan and plate is packed in the Mkuhungo house. The old, red carpet has been worn away where Jeffrey sweeps every morning before school. Their black school shoes stand sparkling from shoe polish and vigorous shining, and two threadbare but ironed white school shirts are hanging up on the door.
These boys defy the notion that all orphans will necessarily grow up as delinquents. “We were suspended for smoking [dagga], but then Aggressia came to talk to us and now we stopped,” said Johannes. Maluleka speculated that the reason the brothers smoked was to numb the pain or forget about their problems. “But we can see now they have stopped.”
Stein said there is little research evidence to suggest a link between the long-term effects of Aids orphanhood and rising rates of juvenile delinquency. “Rather than addressing stigma, the labelling of Aids orphans as delinquents and criminals by professional researchers and policy-makers merely serves to reinforce and perpetuate the stigma experienced by children at community level.”
She said it is imperative to redress these stereotypical images of Aids orphanhood being created and projected to arouse strong emotions of pity — but which also cause aversion, fear and moral panic. “We need to avoid well-intentioned labels of vulnerability that single out children, position them in a state of abandonment and influence the course of their lives forever.”
The brothers do not show emotion when talking about their mother or express pain that they are alone. This is a common reaction of children to the death of a parent, but could also conceal depression, hopelessness, suicidal ideation, loneliness, anger, confusion, helplessness, anxiety and fear of being alone, said Stein.
“Inability to understand and make sense of a grief experience can undermine a child’s sense of safety just as much as the actual loss involved.”
On the death of their mother, the hospice tried to get the social welfare department to make Johannes Jeffrey’s legal guardian, but Johannes is still at school and not considered eligible.
So the brothers survive on the R30 a week that Johannes makes for working in a garden, the R50 a month they receive for renting out part of their parents’ reconstruction and development programme house, and the food parcels they receive from the hospice.
The brothers are worried that their parents are angry with them for not performing a cleansing ceremony. “We need to buy one chicken for our mother and one for our father, then slaughter them, or they will become bad ancestors,” said Johannes. He worries that he will never be able to save the R50 for both chickens. “They [the parents] will think we don’t care about them.”
For children who have lost their parents, closure and mourning are sometimes an unaffordable luxury because they are preoccupied with survival, said Maraliza Robbertze, a social worker at Place of Restoration, a short-term shelter for children and women.
Many children have to cope with looking after a younger sibling and do not talk openly about how their feelings or the experience of abandonment. “Only when they are here for a while do they realise that it is okay to work through their emotions and work through their grief,” said Robbertze.
Counting the costs
Orphaned children in institutions cost the government R1 800 each a month; foster care is cheaper at R540 a child, and psychologically more beneficial. The cost of the current grant system is also escalating at an alarming rate, with the Department of Social Development reporting that the number of recipients has jumped from more than 600 000 to about 1,3-million in just four years, costing R10-billion a year.
Accessing these grants, according to child activists, is lengthy and extremely labour-intensive, a problem exacerbated by the shortage of social workers.
A joint working paper called Children in Need of Care or in Need of Cash?, from the Children’s Institute and the Centre for Actuarial Research at the University of Cape Town, argues for the progressive implementation of a universal child-support grant.
“The most equitable, accessible and appropriate mechanism for supporting children in the context of the Aids pandemic would be through the extension to all children of the child support grant mechanism that is currently in place, and for the means test that restricts children’s access to be removed.”