Demographics

• Total population        100 000
• Unemployment rate    80%
• Known orphans          3200
• HIV orphans              300
• HIV females              35 000 

The town of Ingwavuma is situated high in the Lebombo Mountains in Northern KwaZulu Natal. It would be a border town with Swaziland if Cecil Macks Pass was open. The town has one main road with the Hospital, Shopping Centre and Women's Centre on the first hill and the Post Office, prison, Welfare Department, Home Affairs, Magistrate's Court on the second hill. Houses and homesteads are scattered over the hillside, so it is hard to say where the town starts and finishes. The town also boasts one of the palaces of the Zulu King complete with airstrip on its outskirts, although it is rarely used as royal residence.

In June 2000 Ingwavuma Orphan Care was formally registered as a non profit organisation. The project grew rapidly and when more funding came in it was followed by the Home Based Care Project and a HIV prevention project in 2002. These all started under the umbrella of the Mosvold hospital and Friends of Mosvold Trust, but as the demands grew and the work expanded, the organization moved out of the hospital in January 2004 into its own centre on land donated by one of the local tribes.

Ingwavuma Orphan Care does not just work in the town, but spreads its services over the 3 surrounding tribal areas which cover about 2100km2. It reaches in the north up to the border of Mozambique on each side of Ndumu Game Reserve. In the South the area is bordered by the huge Pongola Dam, and the Pongola River complete with crocodiles and hippos runs northwards up its eastern boundary. The Western side of the area is the Lebombo mountain range while the Eastern side is the sandy flat flood plains of the Pongola River.

Almost all the staff has been recruited from the communities that the project serves. Over the years the staff have grown in skills and confidence so that they are better able to support the people they serve. Many have taken orphans into their own families and see the work they do as a vocation rather than just a job.

South Africa has the greatest number of people living with the virus in the world, with KwaZulu-Natal being the worst affected province with a 40.7% antenatal infection rate in 2004.  

At Ingwavuma, everybody knows somebody or many people who have died young – with the stigma of AIDS still real, people will not often openly say that the person died of AIDS. AIDS infects all classes of society from the richest to the poorest. Even those educated in western medicine may first turn to traditional healers rather than face the truth about their diagnosis and die rather than admit they need ARVs.

Most people go to funerals on Saturdays. If there is a funeral in the neighborhood, one is not allowed to carry on with work e.g. building, gardening until the funeral is over. If families can afford it, they spend a lot of money on funerals and this partly because of the belief in ancestors looking over the family and the need to respect them. However, it leaves less money for those left behind and many end up in debt. As a result, most relatives are buried in their homestead rather than at a cemetery and it is not uncommon to see 5 or more graves in the yards at Ingwavuma.

The youngest children of parents who are dying of AIDS often get neglected emotionally and physically as the focus is on caring for their parents. Some of them are HIV positive themselves and die around the same time that their parents do. The damage of a lost generation to the next generation is incalculable and its effects are not yet fully realised.

Antiretroviral treatment (ARV) is available through the government hospital for free. However it is only reaching a fraction of the people who need it as many are too sick or poor to travel to the clinics for treatment or do not have the required identity documents.   While there are many cases of bed-ridden patients coming back to life on ARVs, there is still suspicion in the community about whether they are safe as a small percentage of people do die of side effects or starting too late and the government is failing to present the drugs in a highly positive light.

Those who are sick enough to qualify for ARVs are also able to get a disability grant. This is often used to provide food for the whole family. When the person starts to recover from AIDS, the grant is stopped and the patient and family return to hunger and poverty.

Foster care grants for orphans sometimes turn these children into a commodity with relatives fighting for custody so that they can get the grant. A grant for one child is a lot more than many families have to live off; it is poverty and desperation rather than greed that leads to this situation. Non-orphaned children or those with one parent are not entitled to this grant even though they may be even worse of economically.