WCRP-HIVAN HIV/AIDS Dialogue - HIV/AIDS: Urban and Rural Realities

Introducing the first of four forum gatherings for 2006, Saydoon Nisa Sayed of the World Conference on Religion and Peace (WCRP) welcomed all present, and the magnitude of the HIV/AIDS epidemic, HIVAN and WCRP are entering their fourth year of these sessions.

Presenting a perspective of rural realities and the impact of HIV/AIDS on communities in remote areas was Sue Heddon, Project Manager of Woza Moya, based about 20 kilometres out of the little town of Ixopo in KwaZulu-Natal. The Project is an HIV/AIDS community care and support programme which focuses on children and orphan intervention, home-based care, food security poverty alleviation; it originated at the nearby Buddhist Retreat Centre, and is now situated on tribal land in the nearby uFafa valley, where resources and service infrastructure are very sparse. The residents live in wattle-and-daub homes, with no water or electricity supply, and with only one rough dirt road running around the valley which becomes impassable in the rainy season. Access to water has been further diminished by the spread of Sappi forest plantations, which has, literally, sapped the boreholes in the vicinity, compelling residents to walk long distances for water and firewood every day.

Approximately 23 000 people in and around Ixopo draw from the town?’s facilities: six primary schools, three high schools, a community hall, one crèche and a courtroom where both civic and tribal authorities preside. ?“The bleakness of these rural realities is massive as one obstacle overlaps with several others,?” explained Sue. ?“Unemployment, poverty, poor health, hunger, lack of schooling, HIV infection, abuse are all socio-economic conditions that trigger and fuel each other. People feel very helpless, isolated, depressed, and, understandably, overwhelmed with the harshness of their lives.?”

To contextualise these issues within a family scenario, Sue described a particular case study located in Ntakama, one of the 10 different sub-communities living in the uFafa valley. The Nkomo family is made up of 18 members - four adult women and 14 children, all of whom were found to be highly vulnerable. The male members of the family are lost, unknown, have fled or are somewhere in cities. ?“This is typical of rural family structures,?” Sue observed, ?“as one tends to find mainly women, children and the elderly fending for themselves in and attached to a household. Within that group, individuals will come and go from time to time, so the numbers don?’t remain stable.?”

The only income available to the Nkomo family is a single pension granted to a grandmother, which brings in R780 per month. No other documentation is available for the other 17 members of the household, and two mothers have died of AIDS leaving six children to be cared for.

Two of these children were showing symptoms of HIV infection, but as they had no Identification Documents, they could not be enrolled for ARV treatment. The Woza Moya staff tried to assist with application procedures to obtain documents, grants and treatment access, but they died before they were processed through the various social systems.

?“There is also a one-year-old baby who is very sick and malnourished,?” said Sue. ?“Her gogo has resorted to feeding her flour and water because milk powder is too expensive, and it was all she had to fill the baby?’s stomach and ease her crying. The immense burden that this level of care and lack of resources places on such elderly women is often underestimated.?”

With winter coming, the project staff had given materials to the Nkomo sisters to patch up huge gaping holes in the roof and walls of their house, but, because their physical and emotional condition has left their bodies weak and plunged their spirits into the deep lethargy of clinical depression, this work has not been done.

Historically, Ntakama is the poorest sub-community in the uFafa valley; many years ago, the residents did not support the local chief, and so were deprived of resources. The current chief lives many kilometres away, never visits them, and the residents cannot afford the costs of travel to see him. Acquiring help from the tribal authorities to access social grants is problematic for similar reasons, so the Woza Moya project staff, on behalf of the community, requested that the chief provide the local nduna with an official stamp to endorse applications and affidavits required for registration and access to social grants ?– to no avail. ?“Our project has a well-equipped office with a telephone, fax and transport, yet, even with these facilities at our disposal, we struggle to communicate with the chief,?” said Sue.

In February this year, one of the orphan girls, aged eight, was raped; she was examined, taken through the appropriate procedures and the case was reported. The man who raped her had been noted to be showing symptoms of HIV and AIDS. Generally, many of the people in uFafa are unaware of their HIV status, although Sue observed that this seems to be changing with the advent of treatment availability, and more people are coming forward for HIV testing.

The Woza Moya staff document these observational and anecdotal records so that prevalence and testing trends can be tracked in some way. At one point, several people who were obviously ill and receiving care from the project submitted written proof of HIV-negative test results to the care-workers; one of the care-workers investigated this and discovered that patients were able to get HIV-negative results certificates at the Ixopo Clinic - for a fee. This finding has been reported to the health authorities.

Sue acknowledged that for the caregivers and the project workers, at times the plight of the residents is so dismal a picture that it becomes unbearable; to transcend this, they adopt a philosophy of countering the negativity with optimism, focusing on their strengths and ingenuity.

The project organises food parcels, but can only collect enough for one food parcel, for one child, per month. ?“It?’s small,?” said Sue, ?“but it?’s something.?” They also run a sponsorship programme, funded by visitors to and members of the nearby Buddhist Retreat Centre and their social networks, to fund individual vulnerable children, mapping the programme developed by WorldVision. These donations of R500 a month cover all school fees and clothes, including a tracksuit (a luxury item that boosts the children?’s sense of wellbeing and self-esteem); six youngsters in the Nkomo family are being schooled through this programme.

The full report can be accessed on the righthand side of this page.