In the town of Empangeni (em-PAHN-gay-nee), in South Africa?s Zululand, cancer and emphysema were for many years among the main causes of death. That is, until HIV / AIDS came along. Now, people are dying in larger numbers and there?s little that can be done for them except provide themcomfort and solace. But there?s often not enough to go around.
Empangeni is located in the middle of Zululand in eastern South Africa, about 18 kilometers inland from Richard?s Bay. Poverty is widespread. The government is building badly needed small houses there, but most people still live in townships filled with the familiar Zulu-style stick and mud huts. A lack of running water is said to have contributed to a series of cholera outbreaks there, as people use local streams for both bathing and washing clothes.
HIV/AIDS ? as in many other parts of sub-Saharan Africa ? is claiming parents and chief breadwinners of families, leaving many children behind.
The Zululand Hospice Association was established in 1991 to care for Empangeni?s terminally ill. Program Director Gail Parsonage says the group provides home-based care for about 170 people in the rural areas. She says they?d like to help more people, but they simply cannot. They don?t have enough nurses.
She says, "Basically what have is we?ve got a team of three professional nurses, who then go out and train volunteers to care for the people in their community. And that caring involves bed bathing, dealing with bed sores and helping them give simple medication and anything to make that person comfortable. We don?t just go into the physical side of things. Our people are trained to be able to deal with the emotional side of dying and leaving behind a family."
Poverty complicates matters. Simply getting enough food each day can be difficult.
"The crying need is for these people in the townships," she says. "To give you an example, if we give them medication, usually they haven?t eaten. And you find that a family that?s got six or seven people ? in fact, it?s more between eleven and twenty people being fed by one person who has a job. Dependent on the money they?ve got, they will give the working person and the healthiest children the first amounts of food. And if there?s no food left over for the younger children or the sickly dying people, they feel the dying person is the one that needs it less because he?s dying anyway."
She says before you can put medicine in the mouth you need to put food in the belly.
Ms. Parsonage says many of those dying from AIDS in Empangeni are migrant workers. They travel far to find jobs and remain away for months at a time. When they return, they are often infected with the AIDS virus, which is then transmitted to their wives. When the workers and their wives die, children often must fend for themselves.
She says, "These children who lose their parents then find themselves completely on their own and most of them don?t even know where they come from and who there grandmother is and their ancestors, etc. And often we find cases where these children don?t have identity documents. And if they don?t have an identity document the state won?t provide social welfare. So, our first job is the make sure these children have birth certificates and identity documents. And then we can call in the social services and get them on their way to schools and so on. Thus, ensuring, hopefully, a productive, social person at the end of it."
The program director of the Zululand Hospice Association says eliminating poverty and improving education will greatly help in the fight against HIV/AIDS.
Gail Parsonage hopes anti-retroviral drugs will become available in Empangeni. That way, workers can live longer and support their families ? and parents will be able to guide and teach their children a little more about life.
But she?s also hoping that vaccine research in Africa and abroad will finally prove successful.
She says, "If these vaccines work, it might just save Africa. But I don?t know how long it?s going to take."
In the meantime, the Zululand Hospice Association is hoping for more trained medical personnel because, right now, there?s no shortage of work.