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Peace Corps volunteer in Lesotho before becoming
the Near East Foundation’s Lesotho Country Director,
Ken Storen well knows the hugely tragic dimensions
of the HIV-AIDS pandemic in Africa. The number
of children orphaned by HIV/AIDS in sub-Saharan Africa
is expected to more than double by 2010, requiring
one billion dollars annually to care for them, according
to UNICEF, the United Nations children’s agency. An
unprecedented “drastic deterioration in children’s
lives” will likely see more than 24 million children
face AIDS-inflicted poverty, UNICEF says. Currently
Africa is home to some 40 million orphans and that
number may shoot to 50 million in the next five years
in sub-Saharan African where 60 to 80 percent of the
cases are AIDS-related.
Tens of millions more will be made vulnerable as AIDS
slowly kills parents, stretches households which care
for orphaned relatives, and robs communities of teachers
and health care workers. Historically African
communities have cared for orphans and vulnerable children,
but relatives and neighbors have been overwhelmed by
this disease, which kills not just one parent—but
usually both. Over time families find their resources
depleted. The lifelong impact on these children
and on the communities where they live will be profound
and linger for decades after the epidemic begins to
wane, particularly given the long incubation period
of the disease—eight to 10 years.
Compelled to act in this southern African, land-locked
country he calls home, in May 2004 Storen founded a
non-profit organization registered with the Lesotho
government to improve the quality of life for infants
and families affected and infected by HIV. Presented
in the United States as Six Degrees of Separation,
it provides care to orphaned infants through a place
of safety based in Mokhotlong, Lesotho, and an outreach
program, training, and supporting families so they
can care for orphaned infants.
An elderly widow walked three hours to the district
hospital, her second such trip in three months. Mathato’s
last visit ended when her daughter, a single mother,
succumbed to a variety of infections acquired during
her struggle with HIV. She died in her early
twenties.
When the old woman arrived at the hospital, she unwrapped
her blanket to expose the tiny body of nine-month-old
Nthabiseng. The baby was severely malnourished since
the impoverished grandmother lacked the resources to
provide more than sugar water and an occasional bit
of food over the past three months. She tearfully
placed her granddaughter in the hands of Nthabeleng,
the project director, and said farewell, promising
to visit when she could.
Three weeks later, she returned to Mokhotlong town
again on foot, and this time didn’t recognize
her own granddaughter! Through feeding, care and medical
treatment, Nthabiseng had grown into a healthy baby,
no longer coughing weakly, but sitting up and smiling
while playing with a small pile of toys. Mathato continued
her visits on a monthly basis, smiling and crying tears
of joy every time she held her happy little granddaughter
in her lap.
After six months, baby Nthabiseng went home with the
program staff to be reunited with her grandmother in
a highly emotional celebration. Project people continued
to visit once a month, bringing food, training the
family in proper care, and monitoring Nthabiseng’s
health. Says her grandmother: “When I brought
Nthabiseng to the hospital that day, I thought I would
never see her again. I had lost my daughter and couldn’t
bear the thought of losing my granddaughter--she was
all I had left. Her life was saved and I am the happiest
woman alive, because I have my granddaughter. I cannot
say ‘thank you’ enough.” On October
3 Nthabiseng celebrated her second birthday, as smiley
and happy as ever.
Numerically there have been 93 home visits to provide
nutritional support, monitoring, referrals and training;
42 trips to Leribe Hospital and Motebang Clinic for
treatment, immunization, and consultation; 16 staff
trained in nutrition and medication administration;
and 20 meetings with local government officials, hospital
staff and others to create a referral network, among
other facts and figures.
Only three children sadly have died, while so many
others are now living in safe, nurturing environments,
either with Ken or reintegrated into extended families
or in foster care. Staff visited children reintegrated
into extended families at least two times per month,
providing training for their care and monitoring weight,
general health, development, and attitude. They were
reportedly adjusting well.
Although pressure exists to reintegrate all children
into their families, it was discovered in many cases
this would not be in the best interests of the child’s
welfare, indeed in some instances, extremely dangerous.
Despite training, many families have been found incapable
of providing adequate care; and others, apathetic to
the children’s needs.
Virtually all children participating in the program
have been immunized, also are being properly fed and
receiving health care. Six children among those
tested have been confirmed to be HIV positive; and
four are taking anti-retroviral drugs.
It has not been easy. Although Mokhotlong Hospital
recently opened a clinic for people living with HIV,
there is no doctor available to provide treatment and
consultation, and the clinic is rarely staffed. Consequently
health care on occasion has required a more-than-three-hour-drive
from Mokhotlong to Leribe Hospital--weather permitting.
Further, the hospital in Mokhotlong does not provide
comprehensive pediatric care, so that can mean going
even further afield to South Africa.
All staff are now trained in health monitoring, nutrition,
and baby care skills. That covered common baby infections,
especially with infants who could be HIV positive;
accurate measuring, preparation and storage of food;
and stimulating educational games for developmental
growth.
In turn they trained caregivers about basics like
hygiene, nutrition, and use of medications. Hygiene
concentrated on topics like the importance of washing
hands before handling food, boiling drinking water,
and proper cleaning of baby feeding bottles
and cups. Nutrition included formula preparation and
maintaining food diaries for better nutrition assessment.
Medication training focused on the use of medical equipment
and observing child health progress, including reactions
to anti-retroviral therapy. Importantly, each household
maintained a notebook to record daily accomplishments
about the children’s general health.
Creating a network for referrals for outreach and places
of safety has been problematic. Despite repeated attempts
to create liaisons with the Lesotho Department of Social
Welfare and the Child Gender Protection Unit, neither
has provided much support in referring children or attending
cases relating to legal matters and child welfare. To
add to the frustrations, gender protection officers often
have been placed on alternative duties and the district
social worker unavailable. In fact, most referrals have
come from community members and local chiefs; and consequently
more meetings with local chiefs, clinics and communities
are on the agenda.
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