Sunday Times (Johannesburg) - Sunday 24 February 2002

'IN GOD'S hands," Babazile Shongwe of Ingwavuma in KwaZulu-Natal replies when asked how she sees her future. She may be right.

At 50 years old, Shongwe looks defeated. She has to walk 20 minutes to the nearest water supply, she has no lavatory at her dilapidated hut, she has no job, and her 87-year-old husband died two years ago.

Yet she supports five children, one of whom, Joyce, aged 16, already has a two-year-old child.

After two years of illness she is so thin she does not always have the energy to carry her home-made beer into the town of Ingwavuma to sell.

It was on one such trip that she was spotted by a worker from the Ingwavuma Orphan Care project. Shongwe was visited the next day by Dr Anne Barnard, a state doctor working at Mosvold Hospital who heads the orphan project.

The project aims to help orphans, or children under 18 who have a sick parent, in the health district of Ingwavuma, which lies between Swaziland in the west, Mozambique in the north, and the Pongola River in the south and east.

So, on a misty morning, when the dew hung on the long grass lining the pathway to her wattle-and-daub home, a sign of hope arrived, perhaps from God.

Barnard left England for Africa to work as a doctor but was soon drawn into the plight of those suffering from Aids.

It takes her half an hour to complete the interview with Shongwe, surrounded by the children as the mist drips off an umbrella held by her brother, Marcus Shongwe, a voluntary helper.

Having worked for two years at West Driefontein mine in Carletonville, Shongwe is back on his home turf where he hopes to be employed by the hospital's new home-care project, which will send 10 field workers into the community to help care for the ill.

His sister's needs are simple: money for school fees, clothing and food - and to repair her house.

Down the road we find Bongilane Nyawo, 18, who has been responsible for four siblings since his parents died when he was 13. He knows the project workers and happily jumps into our vehicle for a lift home.

His house was built by his father, who, like many men from the district, worked on the mines - and, like many miners, came home carrying HIV.

"My father was digging gold in Egoli [Johannesburg] mines before he came home and became ill," Bongilane tells us.

Last year, he passed Grade 9 despite being upset by his aunt's death in November; incredibly, all his brothers and sisters passed their exams as well. His prospects are bleak but here is hope: this boy thrust into manhood is infectiously optimistic. He hopes to work as a driver one day. His courage will carry him.

"Some are desperately unhappy, some are just cheerful," Barnard observes. "I don't know what the secret is."

In Ingwavuma, where the hospital mortuary had to be doubled in size last year, there is more than enough to do. Bongilane is just one of the 15 to 20 child-headed households in the area that are known to the Orphan Care project.

Barnard has worked at the hospital since 1997 and has headed the orphan project since October. The object, she says, was to move the focus of Aids work from prevention to helping people affected.

The Friends of Mosvold group was set up by Dr Andrew Ross in 1995 to enable the hospital to extend its work into the community, and it in turn set up the orphan project at the beginning of 2000.

Orphans are traced and recorded, state grants are applied for and processed where possible, and the children are helped with clothing, food parcels and the payment of school fees - all funded by charity donations in cash or kind.

The hospital now also employs an Aids team that provides counselling for patients before and after they are tested for HIV, and aims to offer prevention and education to the whole community.

The health district that Mosvold Hospital heads is vast, with numerous clinics in it, and the Friends of Mosvold have funded two mobile clinics that go out to different villages every day.

Transport is a permanent problem. Gugu Dubazana is one of three social workers in the Department of Social Welfare and Pensions in Ingwavuma. Although her job assessing claims for welfare requires her to do home visits across the district, she has no transport.

Stranded in a new office block in the town of Ingwavuma, she was able to process just 30 foster-care grants to families last year, but with the help of the Orphan Care project she hopes to process far more this year.

Project coordinator Johnson Gwala makes field trips with her, working with 10 to 15 families at a time to ensure that they obtain all the grants they are entitled to.

Gwala says that the attitude to Aids varies: "Since they know there is the Orphan Care project, people are more prepared to talk about it. Sometimes the work gets depressing, but what can you do?"

What Gwala does is nudge the bureaucracy to gain access to money that people are entitled to. Ordinary child care grants for the children of unemployed parents are R110 a month, but as with the foster-care grants of R420 a month, they are hard for child-headed families to obtain because an adult has to act as guardian.

"But many kids do not have birth certificates or ID books," says Dubazana, "and relatives can even fight over the custody of children because of the foster-care grants."

At present the project has about 1 200 orphans on its books, just a fraction of those living in identical circumstances nationwide. Many stay together for support; other families disintegrate.

Andrew Ross is a UCT-trained doctor who heads Mosvold Hospital and its ambitious projects, which have even extended to the building of 2 000 rural lavatories in response to a dysentery epidemic in 1994.

He looks boyishly young and unburdened by his responsibilities. Yes, he replies, his Christian faith helps.

In 1999 he and the Friends of Mosvold Hospital started a scholarship scheme to sponsor local students with an interest in health sciences through tertiary education.

"No one was succeeding so people stopped dreaming," he says. "Our message is that it is possible to get to university and pass, if you stay [HIV] negative. With that attitude you can have a dream, and students can change things."

Now four new students are taken on every year. At present there are 12 studying pharmacy, dentistry and other medical fields.

That such positive projects are carried out against the backdrop of the overwhelming problem of Aids is a miracle in itself. Doctors at the hospital feel they can't offer patients very much - and the wards are full of Aids patients.

With 36% of pregnant women HIV-positive, it's safe to assume that the epidemic will also take its toll on the skilled hospital staff - 15 out of a complement of 500 have died already.

Ross believes that there is a need to fund solutions and find a way forward.

"We have what the state provides, and get whatever else we can to fund our projects."

Ingwavuma will soon boast another project built on hope. Stembeni "Bennie" Williams and Maryna Kees, both wives of Mosvold Hospital doctors, have persuaded the Local Economic Development Fund to build premises for the Hot Girls Women's Project, which aims to provide both a place of work and a retail outlet for local women.

The large circular building is nearing completion on the outskirts of the town after three years of negotiating for funding and the use of land. It will house kitchens, wood and metal workshops, batik, silkscreening and sewing rooms, and a craft shop.

Kees says the aim is to build character and self-esteem as well as providing an income for women in an area with huge unemployment.

Once established, the project will need operating capital.

"Bennie and I have been running this project with zero capital since it started," says Kees, who had 45 women working on various crafts in her home before Christmas - and they made R7 000.

When the money comes and the women are working, the centre should become a tourist attraction, along with the grave of Zulu king Dingaan, which lies to the south of Ingwavuma.

Perhaps the king would have understood that this is just one more battle his people have to win.
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