Bring healthcare to children in rural South Africa

The Masoyi Home Based care organization began back in 1997 when two women, Dr. Maggie Hardman and Florence Mbokazi, realised that the HIV/AIDS epidemic sweeping the Bushbuckridge region of Mpumalanga was giving rise to unprecedented levels of human suffering, particularly among the children.

“Maggie, who was working at a government clinic in the area, and I realised that the people simply did not know what was happening, what was causing all these deaths.  No one understood the concept of sexual transmission of viruses.  There was no education, no antiretroviral medication available.  The traditional healers were also clueless, prescribing outlandish remedies.  Fear gripped the population,” explains Florence, now Masoyi’s executive director.

In the space of a few years, a new social phenomenon arose: thousands of orphans with no parents, many of them living in child-headed households, some with a grandmother, some without.  “We had to do something for the children,” says Florence.  “We could not build orphanages, so we went out to them where they lived.  At the same time, we helped the AIDS sufferers in their homes, nursing them, helping them take their meds, feeding them, consoling them in their grief when someone died.  That’s how Masoyi Home Based Care started, with just six volunteers.”

In the early days, funding was a big challenge.  Local churches donated food parcels, then corporate funding came in at low levels.  In 2003, the Starfish Greathearts Foundation entered the picture.  “Starfish made a big difference.  Initially, they provided substantial quantities of food, blankets, and clothing.   Now they fund five of our care-workers.  They are brilliant partners,” says Florence.

Seventeen years later, things have changed, some for the better, others not.  ARV’s have made the treatment of HIV disease manageable; education about safe sex has reduced transmission levels.  Because of this, the South African public largely believes that the HIV epidemic has “passed,” that it is no longer a priority.  That is most definitely not the case.  “We are left with huge social problems,” explains Florence.  “Do not for one moment think that we are over the epidemic.  Things have changed, for sure, but we are left with massive social challenges, particularly amongst the children.”

Funding remains a problem.  “International donor funding is reducing because there are new challenges out there.  Locally, many corporates believe that HIV/AIDS is no longer a priority.  This is a terrible mistake,” explains Florence.

Notwithstanding all these financial difficulties, Masoyi HBC, under the leadership of Florence and her partners, is now a substantial organization with three key activities: Home Based Care, Orphans and Vulnerable Children and Early Childhood Development. 

The HBC group continues to work with people of all ages in their homes.  Very sick people are transferred to clinics; families are helped with food, clothing and basic medical care, much of it palliative. 

The OVC group, overseen by Jabulile Themba, employs twenty-two trained care-workers, all of whom receive a small stipend.  “Each care-worker looks after at least 32 children, from birth until they reach eighteen” explains Jabulile.  “But, in reality, they all take care of more.  In total, we have well over seven hundred children in our care.”

They receive school uniforms, a meal after school each day and assisted homework sessions in addition to special care dictated by their individual home situations.  “These are the most desperate children in our community, “says Jabulile.  “Thousands of children need help but these are the most needy.  They do not have adults in their homes, at best a granny here or there.  They are at risk of illness and physical and sexual abuse.  We have five satellite centres in the region with care-workers spread all around.  We also partner with youth skills development centres providing training in skills such as sewing and woodwork, plus computer training and even music.”

More recently, Masoyi HBC realised that there are numerous creches, run mostly by untrained grannies, that care for hundreds of young children on a daily basis.  “We help improve the care that these crèche owners give the children by training them on aspects of early childhood development, crucial to the long-term intellectual and physical development of the children.  That means we are spreading our net far beyond just the kids in our OVC programme,” says Florence.

What is the real challenge now facing these communities that are allegedly “over” the HIV/AIDS epidemic?  “It is the issue of child-headed households, for sure.  This is the devastating legacy of the epidemic.  Thousands of children without parent role-models, without money, shouldering responsibilities no child should have, caring for siblings, worrying about security and at the same time trying to go to school.  I believe we have a new human tragedy in South Africa.  There are organizations like ours trying to stem the tide, but funding remains a barrier to progress,” concludes Florence.

The Keiskamma Trust, based in the tiny coastal hamlet of Hamburg, south of the port of East London in South Africa’s Eastern Cape Province, started its work before the turn of the millennium when Dr. Carol Hofmeyer arrived in the town to find a holiday cottage for her husband and herself.  Appalled by the poverty and high levels of HIV/AIDS she discovered in the area, she set about starting an arts programme amongst unemployed women in the area.  The Keiskamma Trust is the result of this initiative.

The arts programme turned out to be highly successful and this prompted Carol and her co-workers to expand their influence and start focussing on the orphaned and vulnerable children in the area.

Nearly twenty years later, the Keiskamma Trust now has a series of integrated programmes aimed at uplifting the children of the area and giving them a real chance at achieving a normal life.  One of these is through education.

The Keiskamma Trust’s education project consists of three separate initiatives, the Orphaned and Vulnerable Children (OVC) project, the Intlantsi Creative Development Programme and the Vulundlela Centre.

Nokhanyo Nkani is the education co-ordinator at Keiskamma Trust.  She explains, “Our OVC education programme in the area starts well before children go to formal school and impacts over 530 children each day.  It is well known that Early Childhood Development is a key determinant in the development of fully functional adults and the Trust has trained a group of ECD practitioners to the required national standard, which is ECD level 4.  In addition, these care-givers have been trained in diagnostic skills as well as psychological support for very young children, who are being given this essential support in three specially designed ECD centres, one each in Hamburg, Lovers Twist and Mgababa.”

The education programme extends to school-going children as well, using the same ECD facilities during term time and school holidays.   Currently, over 160 children are being cared for after school using a variety of interventions including developmental, educational and psycho-social activities as well as homework support. 

The centres provide the children with more than just intellectual support.  “Poverty is a real problem in the area and many of the children are severely undernourished.  Schoolchildren are given a daily meal while pre-schoolers also receive breakfast and lunch.  In addition, the regular measuring and weighing of children enables staff to monitor the nutritional status of those attending the centres,” says Nokhanyo.

The Intlantsi Creative Development Programme has grown out of the Trust’s close association with the arts and adds teaching of drama, crafting and singing to the children at the three OVC centres.

Keiskamma Trust not only works with young children.  Thabang Meslane is the Trust’s programme manager.  “Here in Hamburg we have the Vulundlela Centre, a computer centre that helps grades eleven and twelve high school learners answer curriculum-based exam question papers.  We also offer computer skills training to local unemployed people, career guidance for school-leavers, connection with further education and life-skills clubs for high school children.”

The needs – be they health or education – of the people of the Peddie South region of the Eastern Cape are great, but slowly the Keiskamma Trust is making inroads.  Thabang is hopeful.  “Sustainability is the key.  The quicker we can partner with communities and local structures, the sooner we can expand our reach and help more people.”