Important note: Information in this article was accurate in 2001. The state of the art may have changed since the publication date.

Reuters NewMedia - Saturday December 1, 2001
Steven Swindells

Instead the ashes of 23 babies, the youngest just a month old, will be interned at a painful and moving memorial in a modest Johannesburg cemetery on Friday ahead of World AIDS Day.

It will bring a dignified end to their brief, pitiful lives which were cut short as soon as they caught the deadly virus in their mothers' wombs. Without drugs to stop the transmission and with no money to afford even a proper burial in accordance with African tradition, the babies were left abandoned by stricken parents.

Now their ashes will add to the chilling AIDS death toll which has ravaged South Africa and the entire continent.

With more than five million South Africans estimated to be living with HIV-AIDS, the somber ceremony is a terrible harbinger of things to come.

By 2005 South Africa will have around one million AIDS orphans under age of 15, rising to about 2.5 million in 2010, according to estimates by the AIDS campaign group Love Life.

UNAIDS estimates that 500,000 children under 15 will die from AIDS this year in sub-Saharan Africa. This compares to less than 100 in the United States.

"We are in crisis," said Jackie Schoeman, a director at Cotlands which relies heavily on donations to care for the children in their final days.

"As the epidemic is getting larger and larger our 60-bed unit here isn't going to cope with the number of children needing care. There are just more and more children needing care," she said.

About 200 babies are born HIV-positive every day in South Africa while at least half of the children in pediatric wards are estimated to be carrying the disease.

ORPHANS FACE MISERY

For South Africa's growing number of AIDS orphans life will truly be nasty, brutish and short.

Many will be left with a traumatic early life, risking growing up as street children or running households in order not to be separated from their brothers and sisters.

Here they fall prey to a vicious circle.

"Orphans will probably be more susceptible to becoming HIV-infected through abuse, sex work or emotional instability leading to high-risk relationships," said Love Life which seeks to educate the young to the dangers of the HIV-AIDS.

Experts at Nelson Mandela's own Childrens Fund touring Africa's richest economy came upon growing numbers of traumatized orphans close to starvation as they struggled to survive on their own.

Children as young as eight were forced into prostitution to survive while households of children were being run by teenagers or those even younger.

Schooling went by the wayside in the fight for food and shelter while a social safety net outside the extended family was virtually non-existent.

Stigma and exclusion by their own communities because of the disease was widespread.

Cotlands (www.cotlands.org) tries to offer some humanity in the final moments of their young charges.

"We try to make sure that they don't ever die alone. Somebody is usually with them when they die and ensure that they don't experience pain," Schoeman said.

"The children that come from the hospitals are usually what we would call now end stage. There's nothing more that the hospitals can do so they are just discharged to us to make sure that they have a comfortable and pain free death."

Each of the 23 babies will have a plaque bearing their name which will be mounted on a memorial wall that already carries the names of another 80 babies that Cotlands cared for.

RAPE AND AIDS LINKED

Just when many thought the plight of South Africa's youngest and most vulnerable could not get much worse, it has with a disturbing spate of rapes committed against toddlers.

Rapes have been fueled by the myth that sex with a virgin will protect a man against AIDS or even cure him of the incurable disease.

The gang rape of a nine-month-old baby by six men this month sent the nation into shock and left health workers distraught.

The rape of an eight-month baby after she was seized from her sleeping parents has also provoked disgust and demands from protestors for the government to do more to protect the vulnerable.

The country has even lost its leading moral authority in the fight against the disease with the death last June of 12-year-old AIDS hero Nkosi Johnson.

Nkosi like no other South African had succeeded in drawing attention to the country's AIDS plight with his message of safe sex and compassion.

Taking to the podium of the world's biggest meeting on AIDS in Durban last year, Nkosi denounced his own government's controversial stance on the disease.

President Thabo Mbeki has questioned the causal link between HIV and AIDS, restricted the use of key AIDS drugs in public hospitals on the grounds of cost and safety, and listened to the advice of so-called "AIDS dissidents" who argue that AIDS is caused by recreational drug use.

Pretoria this week was taken to court in an attempt by AIDS activists and doctors to force it to allow the use of the antiretroviral drug nevirapine in national hospitals.

Nevirapine, which reduces the risk of mothers passing HIV to their newborn, is not available in public hospitals across the country but restricted to 18 pilot schemes while the government monitors resistance to the drug taken by mothers and their babies.

"The views of the president on antiretrovirals has infected the department of health and held it back from doing what needs to be done," said Mark Heywood, national secretary of the AIDS activist group Treatment Action Campaign which has led the court case against the government.

"We stand on the brink of a nightmare," Heywood said.
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