SOUTH AFRICA: Communities battle with explosion of AIDS orphanst

[This report is the second in a series of five special features produced by IRIN's PlusNews service to coincide with the UN General Assembly's Special Session on HIV/AIDS from 25-27 June]

JOHANNESBURG, 25 June (IRIN) - As Africa struggles to cope with the enormity of the HIV/AIDS epidemic, the grim legacy of the disease - the millions of orphans it leaves behind - remains one of the most pressing socio-economic concerns for the continent. Data from the US Agency for International Development (USAID) suggests that 19 sub-Saharan African countries will have a total of 40 million orphans by 2010, due in large part to HIV/AIDS.

In South Africa, with one of the highest infection rates in the world, nearly one in four adults carry the virus. At least one million South African children will be left orphaned by the epidemic by 2004. Before HIV/AIDS, about 2 percent of South African children were orphaned, but social workers now put the figure at about 10 percent. "It's a huge problem for us because people are dying every day," said Zodwa Mqadi, coordinator of the Agape Support Centre for AIDS Orphans outside Durban in KwaZulu-Natal.

Where public health services have been overwhelmed by HIV/AIDS, it is charities like the Agape project that are plugging the gap. The centre consists of a run-down brick house with a small wooden extension grafted on the side. Small children play in the dusty yard as elderly women from the nearby township of Waterfall stir bubbling pots of maize meal in the tiny kitchen. Despite its inauspicious appearance and meagre resources, the staff at Agape believe they are pioneers in the field of orphan care.

"The problem with putting AIDS orphans, or any orphans, in an institution is that it doesn't provide mental and emotional care and it makes the kids dependent," Mqadi, who founded the project four years ago, said. Research has shown that placing children without parents in traditional orphanages often leads to institutionalisation and an inability to cope with everyday life. "At Agape we're more of a service provider," Mqadi explained, "we give orphaned children, food, love, a place to study and play, while trying to keep them in their homes and communities."

A return visit to Agape later in the day illustrated how the centre works. Maria is nine. Along with her brother Tony, two years younger, she sits doing her homework fiddling with her neat hair as she contemplates a maths problem. The two have been atttending Agape since their mother died of an AIDS-related illness 18 months ago. After a cup of tea the two pack up their school bags, and along with a dozen other children, walk to their nearby homes. "It's tough and we're very sad, my dad left after mummy became ill, but this place helps us to survive," Maria said. Neighbours keep an eye on Maria and Tony, and help out with food and some shopping. But its the Agape project that allows them to continue living at home and attending school.

"What's happening at Agape is marvellous, it is a model for this province because it works," Nozuko Majola, orphans project head at the AIDS Foundation in Durban, told IRIN. Majola added that the project had succeeded because it grew out of the community and was an expression of a strong desire by local people to try and offer something positive to AIDS orphans in the area. Often orphaned children in Waterfall are looked after by grandparents or family friends, and Agape supports these carers as far as possible. "We're talking about 12-year-olds who are heads of household, our goal is to help that child and the other siblings have normal lives. That means doing our utmost to keep them where they are known, where they are happy and where they have the best chance of developing," Joanne, an Agape worker, told IRIN.

"People want to help, but remember we're talking here about very poor areas with high unemployment and few facilities," Majola said. Although initiatives like Agape are providing a positive model for working with urban AIDS orphans, the sheer number of parentless children due to HIV/AIDS means massive resources are needed to cope with the problem. Joanne said they currently work with 43 children at Agape, but they're only just scratching the surface.

Michela Marques de Souza, UNICEF Project Officer for HIV/AIDS believes that community capacity to deal with AIDS orphans has to be dramatically increased: "These children have the right to basic services such as health and education, as well as love and positive socialisation, the community can be best placed to deliver these essentials" she said. But she stressed that much work needs to be done in strengthening poor communities to enable them to cope.

Just outside Durban lies the industrial suburb of Pinetown, ringed by informal settlements, the area has a high rate of HIV/AIDS infections, and the number of orphans is rapidly growing. Tumi lives in a two-roomed shack made of corrugated iron in Dabeka, one of the informal settlements. She has been encouraged and supported by Pinetown Child Welfare (PCW) to foster a child. She doesn't have a job, but she says she's proud to be playing an active role in confronting AIDS: "I've fostered my sister's two little ones, it's tough but the social workers help, and I get a little money," she commented.

PCW are working intensely in poor parts of the district trying to find surrogate parents for hundreds of AIDS orphans. "We start by identifying the children while the parents are still alive, this makes the process easier," Yasmin Rajah, co-ordinator of the orphans programme at PCW told IRIN. She added that the project works with between 300 and 400 orphaned children a year, 80-90 percent of whom have no parents due to HIV/AIDS. Placing these children in foster care is fraught with difficulties and PCW works to support foster parents and identify and train potential carers.

"With particular children who are orphaned we look within the family and try and identify someone to foster, then a lot of work is needed in explaining what it's all about, because to many people fostering is still a foreign concept," Rajah said. After screening by social workers (genuine carers have to be separated from those in it for the money), the carers are trained and offered counselling around bonding with a child with a terminal illness. Before, orphans would be automatically absorbed into an extended family, but this network is rapidly being eroded by AIDS.

"Finding appropriate carers in the community unrelated to the orphaned child is proving very difficult," Rajah said. That's where the PCW support group comes, providing information, resources and support to potential foster carers. "There's still a stigma and a lot of ignorance around fostering an AIDS orphan, and we're battling to eradicate this," Nozuko Majola of Durban AIDS Foundation told IRIN. Placing older children orphaned by AIDS remains a big problem for PCW, Rajah says, and babies are fairly easy to find homes for, but getting fostering for older brothers and sisters is often impossible.

"That's sometimes when we have to separate the kids and its very traumatic," Rajah added. The institutionalisation of orphaned children remains a last resort for PCW social workers: "Nothing replaces the family, kids from children's homes generally have so many more problems in later life, so our whole orientation is about keeping these orphans in a family type structure within a community they know or relate to," Rajah said.

In Guguletu, a desperately poor township on the Cape Flats, unofficial figures suggest 20 percent of pregnant women are HIV positive. Alan Jackson, CEO of Cape Town Child Welfare, told IRIN that greater Cape Town is facing a major crisis due to the AIDS pandemic; "The growing incidence of child-headed households, child abuse and neglect, street children and crime point to the enormity of the AIDS orphan problem," he said. Jackson believes that, given the scale of the problem, traditional first world models of care such as adoption, institutional and foster care are no longer sufficient.

Along with income generating schemes, his organisation launched a successful project to reduce frightening levels of child abuse in Guguletu. Known as Isolabantwana ("Eye on the Children"), the scheme centres around training and supporting local people to identify and stop child abuse. "Isolabantwana empowered the community to deal with child abuse by giving local people legal powers as well as support, we want to extend this successful model to try and cope with the growing AIDS orphan problem," Jackson said. Plans include working through existing community structures to care for orphans on a street-by-street basis. "Having the anti-child abuse system in place in a community is a great asset, orphans are less vulnerable and more informal care structures can work," he added.