Philani Child Health & Nutrition Project
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HIV/AIDS

"There continues to be an enormous level of stigma attached to HIV/AIDS in South Africa's township communities and it takes great courage for mothers to acknowledge their own or their child's HIV-positive status or even to test for HIV."

Philani is admitting an increasing number of HIV positive children and mothers to our programmes for nutritional, social and emotional support, skills training for income generation and pre-school education, and we are committed to doing everything possible to meet their needs.

HIV/AIDS care

The HIV/AIDS education, care, and support project operates as an integral part of all Philani's programmes. We believe that the impact of HIV/AIDS on children and women must be countered in a comprehensive way, taking the social, economical, nutritional and general child health aspects into account and avoiding dealing with HIV/AIDS as an isolated vertical issue. HIV-positive children and those suffering from AIDS or affected by HIV in other ways frequently present with malnutrition and are admitted to, treated, and supported by the our Nutrition Centres in the same way as any other child suffering from malnutrition.

Philani places great importance on encouraging women to test for HIV. The Philani Outreach programme is often the first contact HIV-positive children and their mothers have with health services in our communities. Many HIV-positive children, as well as children with undiagnosed full-blown AIDS, are admitted to the Outreach programme. Once admitted, they need continuous support and medical care. Every child and mother on our programmes who is HIV positive is referred to the antiretroviral treatment programme in Khayelitsha. At present this takes place only at the state health clinics and is run by the international medical aid agency, Medécins Sans Frontières (MSF). The Philani Outreach programme and Nutrition Centres help reach, follow up and support the increasing number of people who need antiretroviral treatment. We regard treatment and prevention as closely linked and do not believe that this pandemic can be stopped without offering treatment to those needing it. Giving mothers with young children the chance to live 10-15 years longer with the help of antiretrovirals will have a significant impact on the orphan crises in the country and the very future of these communities.

Obstacles to care

Many HIV-positive mothers are too sick to attend government clinics regularly to receive antiretroviral treatment and check-ups. Many mothers, therefore, discontinue treatment and die due to this. All too frequently, Philani's Outreach workers discover critically ill HIV-positive women living in cold, wet shacks, without care at home; there are few places available at hospices and long waits to see doctors at government clinics for referral to hospices. Unprecedented in Khayelitsha, a small critical care unit would offer a vital, short-term service to women in need and this is something we hope to be able to build in the near future.

Philani's HIV activities

Philani's HIV programme includes information and education, skills training for women's economic empowerment, care of women and children at our Nutrition Centres, support for women and families looking after AIDS orphans in the community, and training of health volunteers in caring for people living with AIDS. In response to the great need for support and solidarity, we are helping to develop peer support and advisory groups, for both HIV-positive mothers and Philani Outreach workers, at our Nutrition Centres and in the community, assisted by the HIV campaign group, the Treatment Action Campaign. For those newly tested, support is given in planning how to live healthily with their condition.

HIV's stigma attaches itself even to the notion of support groups, whereas 'training' is considered acceptable. We are currently planning to implement a rolling monthly HIV/AIDS training programme for all mothers suffering from HIV/AIDS or with HIV-positive children enrolled on our programmes, to help them to become more understanding of the disease and how to live healthily with it. Experience has shown that the better educated women are about HIV/AIDS, the more empowered and strong they feel and they become the best advocates against stigma. All women completing the course would be invited to embark on a Philani skills-training programme, in order to equip them with the means to earn an income for themselves and their families.

PERSONAL STORIES

Orphans and vulnerable children

Philani's Outreach workers find many children made vulnerable by being orphaned, abandoned or threatened. HIV/AIDS is a major factor in such situations. Child-headed households are frequently found, with children as young as 13 years old caring for younger siblings and other children; in other cases, elderly women are left to raise abandoned children. In response to this situation, our Outreach workers have been tasked with collecting and recording information about such children since 2006, in order for us to review and plan how best to act. We believe in supporting women in the community to support orphans and vulnerable children in their homes, without resorting to orphanages, and see an urgent need to start a programme to address their needs.

Planning a new programme

Government grants are available to help orphans and vulnerable children, but assistance is urgently needed to access them and we are planning a new Philani programme to assist. While Philani's Outreach workers will continue to identify orphans and vulnerable children, key to this programme will be a coordinator, dedicated to ensuring that each family unit has access to financial support offered by the government. Transport will also be required to carry orphans, vulnerable children and carers to clinics for HIV treatment. Resources to improve housing for such households are important, as, particularly in the case of child-headed households, accommodation is usually temporary and of poor quality. The programme will also provide resources for the education and health-care of orphans and vulnerable children.

 
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