South African Press Association (Johannesburg) - November 26, 2003

The 42-year-old vagrant from Grahamstown in South Africa knows her HIV status - the diagnosis was made during a brief sober spell a year ago.

When she became incapacitated, having contracted full-blown Aids in the face of an overburdened public healthcare system, like many of the country's Aids patients, she turned to her family for care.

"We knew what kind of lifestyle she lived, so when they said she had Aids, it didn't come as a shock. Automatically, we pulled together to help her," says her younger sister Nola Elliott.

"I had to put on the rubber gloves and clean her blisters when she had shingles. It was awful. I had to make sure that she had three nutritious meals a day and that she took her TB medication and kept off alcohol.

The R600 (about $90) people like her get from the government every month doesn't cover half of what it costs to look after someone so sick," Nola said in an interview with Deutsche Presse-Agentur, dpa.

"I couldn't cope and got drained emotionally and financially, so I sent her to my mother. But, she's sleeping in people's toilets again.

"When she's sober, she refuses to speak about it, but when she's drunk, she says the virus is hers and she'll do with it what she wants.

"It's not easy looking after an Aids patient," the office clerk explains, while insisting that her family, although they disapprove of her sister's choices, will never turn their backs on Eunice.

Tens of thousands of South African children orphaned or rejected by their extended families as a result of HIV/Aids find themselves in the care of the state.

"I think its safe to say that most of the children that enter ours and non-governmental insitutions are infected or affected by HIV/Aids," says Johannesburg-based social services official Ilse Bence.

Few are ever adopted, even by families with the resources to care for ill children.

No deliberate distinction is made between children infected with the disease and those that are not, in children's homes, places of safety and foster homes.

"Unless a child becomes ill regularly, they won't be tested. One doesn't want to prejudice or discriminate against them," says Bence.

"Our community-based care programme using non-governmental organisations funded by government is our biggest effort at the moment. We find it is the cheaper, culturally more acceptable option," she says.

Under the programme that reaches around 85 000 children alone in just one of the country's nine provinces, social workers and volunteers oversee the needs of children left alone and destitute because of Aids.

"If you look at the classic adoption scenario, they're really people looking for a child that will live. A lot of the resistance is around fear of loss, far more so than the fear of infection," says Cotlands director Jacqui Schoeman.

Private sponsorships and volunteers keep afloat insitutions like Cotlands, a sanctuary for abandoned HIV/Aids infants and children, and Nkosi's Haven on the fringes of Johannesburg's inner city.

"We have lots of calls from people wanting to adopt. The first thing they always ask is 'does the child have HIV'. These people don't want a child they know is going to die," says Jane Mwase, resident manager at Nkosi's Haven.

The announcement came as a relief to many saddled with the burden of caring for Aids patients. Of the estimated 4.7 million South Africans already infected with the disease, about 400 000 have full-blown Aids.

But, with the prospect of accessing potentially life-prolonging drugs still some way off, most accept that they will have to soldier on.

Health authorities say anti-retrovirals will be available in a few dozen health districts by next December and more widely in five years.

Staff at Cotlands and Nkosi's haven say they hope that the sad picture of South Africa's youngest Aids victims will change with the advent of a national treatment programme and as more infected pregnant mothers access drugs that can prevent them passing the virus to their babies.

Queen is a suburban "sangoma" or traditional healer. About 70% of the population seek traditional remedies in the event of ill health - Aids patients are no exception.

"I have about 15 regular Aids patients. They are all in their mid-30s and forties They come from all over. Always they come for treatment when they are already very weak. Some come for my herbal mixtures even when they are also seeing doctors," she says.

"With this disease, it is not easy. It is not like cancer or a dangerous heart condition that you can't blame on someone else.

Aids patients, especially those who know they are going (to die) are sometimes very bitter," she says.

As Aids infections rose in South Africa and other parts of the region, so too did the army of caregivers in neighbourhoods, church groups and schools.Most who volunteer to nurse patients that are often from the same impoverished communities are exposed on a daily basis with the bodily fluids, the dementia, the frailty and the frustrations of caring for these terminally ill patients. -- Sapa

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