UN health officials say South Africa is one of the countries hardest hit by HIV/AIDS, with nearly five million people believed infected. The eastern city of Durban is considered by many to be the epicenter of the country’s epidemic. Yet a small hospital center in Durban that lends support to families left destitute by the disease.
The center is called Sinikithemba (SEE-nee-kee-TEHM-bah), a Zulu word that means, “we give hope.” Opening in 1996 as part of McCord Hospital’s efforts to deal with the AIDS epidemic, it offers medical care, skills development and counseling. But Sinikithemba is hard-pressed to help all those in need. Some months it handles as many as three thousand patient visits.
Nonhlanhla Baby Mhlongo is the center’s director. She says, “It’s a very, very difficult scenario because we get many, many people who want to access the service that we provide. And we are a small hospital and people are coming from all over around Durban, even from the semi-urban areas. They are all flocking to us.”
McCord Hospital, which operates Sinikithemba, is a faith-based facility. It was founded in 1909 by American Christian missionary, Dr. James McCord. The hospital opened with the express purpose of serving the Zulu population.
Those who come to the clinic are poor, many having sold whatever they owned to raise money for medication. Not the HIV fighting anti-retrovirals, they’re too expensive. But medicine that will help them ward off opportunistic infections that attack people with weakened immune systems.
Ms. Mhlongo says, “The patients come here without any source of income. So, they join in the support group that we have for people who are HIV positive. While they are in that group, we try to teach them some skills work.” She says, “So that even if a person is at home, lonely and unable to share anything with anyone in her family, she can continue to produce something and come to us and get some cash to purchase whatever he or she wants to purchase – and also to access medication.”
The skills training offered by Sinikithemba is based on traditional crafts found in Kwazulu-Natal Province, namely beadwork. In fact, the center produces bead products for the many groups that come to Durban’s international conference center.
Dr. Helga Holst, McCord Hospital’s medical superintendent, says beadwork is an important source of income for the clinic.
She says, “There was a steady market, we thought, for beadwork. So that developed and now there’s over 350 people involved in beadwork on a contract basis. So, we give them the orders when we get them coming in. And we now get orders from different organizations within South Africa.”
But the beadwork does not pay all the expenses, and the center relies on donations and some support from the government.
Dr. Holst says Sinikithemba does not promote the use of condoms to prevent HIV/AIDS, despite widespread condom campaigns throughout the country.
“In my opinion, what can be done is to focus on prevention and condoms are not how you prevent it. Abstinence and faithfulness is. And that message needs to come through very clearly to the children and to the families,” she says.
She says condoms should be used for couples when one or both partners are infected. But she warns they are no guarantee against infection or re-infection of HIV.
For some AIDS patients, Sinikithemba is the last home they will ever know. Clinic director Mhlongo says patients may be separated from relatives by poverty and stigma.
“There are those patients who have accepted their illnesses,” she says. “But when they are very, very sick, their relatives will come and say can you please keep her longer – maybe two or three weeks. And it’s very expensive to keep a patient in the hospital. So, even the relatives are not keen to care for people who are HIV positive and terminally ill.”
It is not uncommon for families in Kwazulu-natal to lose as many as five members to HIV/AIDS in a relatively short period of time.
Workers at Sinikithemba say caring for HIV / AIDS patients day in and day out can be emotionally draining. But they also say their job, as the name of the clinic implies, is to give hope.