The

combating HIV in the AIDS capital of the world

The headquarters of the Brotherhood of Blessed Gérard is in Mandeni in the province of kwaZulu/Natal.

Mandeni’s suburb, the township of Sundumbili, was called the “AIDS capital of kwaZulu/Natal”, in the South African Magazine “Drum” in 1997. A representative test, amongst factory workers, in the industrial complex of iSithebe, already in those early days, showed a HIV prevalence rate of 88%. In January 2004 76% of the HIV tests done in Sundumbili Clinic, a government medical facility, were positive. Thus the Mandeni area has gained a sad world record which nobody is proud of and which nobody would consider suggesting for the Guinness book of records, either. The shocking fact is that the Brotherhood of Blessed Gérard is right in the centre of the pandemic and that the public and private health care systems are absolutely overwhelmed by the magnitude of patients. The Church cannot and must not stand aside shrugging its shoulders, but must mobilise all available resources. In the time since the tsunami disaster in East Asia the world public but first and foremost the church has shown unprecedented solidarity and that even today miraculous achievements are possible if everybody co-operates and contributes whatever is possible. So did the disciples in those days at the multiplication of the loaves when they contributed all they had in their hands. Christ then performed the miracle, so that everybody got what he needed. The AIDS wave in Southern Africa is a much worse disaster than the tsunami wave, because it did not cause just a single flood, but the country is permanently flooded by AIDS. The level is continuously rising and there is no hope for an ebb tide in the near future. According to UNAIDS, there are 25 million people living with HIV in Sub-Saharan Africa and nearly 2.5 million died from AIDS related diseases in 2004. Taking into account that in 2004 76% of tested people were HIV-positive in the catchment area of the Brotherhood of Blessed Gérard means that in the Mandeni area alone, close to 200,000 people are about to die from AIDS within a few years. Facing this massive disaster, which surpasses all epidemics in the past, the Brotherhood of Blessed Gérard could not sit back and just watch, but decided to do whatever is in their power, to push the tidal wave of HIV back and to support the victims of this unique tragedy. There are up to five patients a day dying from AIDS in Blessed Gérard’s Hospice alone. Thousands have been cared for through home based care, day care and inpatient care. Far more than 1000 patients have been rendered palliative care enabling them to die in dignity and peace.

According to UNAIDS (as of end of 2004) Sub-Saharan Africa is the home to slightly more than 10% of the world population, but to 60% (25.4 million) of HIV infected people worldwide. 13.3 million of these are women and 3.1 million are newly infected; 2.3 million people died in Sub-Saharan Africa from AIDS related diseases in 2004, more than 20 million in the last 25 years.

No other country in the world has more people living with HIV than South Africa with 5.3 million HIV-infected people.

The South African Broadcasting Corporation reported on 30 March 2005, that specialists estimate that by the year 2010, a total of 5 million people will have died in South Africa from AIDS. That means that in 2010, two thirds of the South African population will die from AIDS or AIDS related diseases. From 2001 until 2011 the birth rate will decrease by 25% and in the same time the death rate will increase by 33%. By 2010 seven million people in South Africa will be infected with HIV. These estimates are based on the most recent statistics from the United Nations and “Statistics South Africa”.

The increase in life expectancy, which had been noted since the middle of the 20th century, has turned around since the mid-nineties and will continue to decrease in the next two decades. In 2000 the life expectancy of a newborn South African was at 56 years; in 2010 it will be just 41 years.

Between 1997 and 2002 the number of deaths in South Africa increased by 57%; in the age group of the 25 to 49 year old people the increase was at 116%.

18 million AIDS orphans will live in Sub-Saharan Africa by the year 2010.

Every six seconds one more person is infected with HIV somewhere in the world. Every ten seconds somebody dies from AIDS somewhere in the world.

Statistical overview

* i.e. 10% of the world population live in Sub-Saharan Africa, but 60% of the people living with HIV.

[Sources: UNAIDS, South African Department of Health, SABC, HIVAN, AVERT]

The Relief Organisation of the Order of Malta in South Africa, the Brotherhood of Blessed Gérard, responded to the concentrated and enormous need of the South African AIDS pandemic in a manifold way:

1. As early as 23 May 1994 an HIV/AIDS education programme commenced.
   Specially trained educators inform the public through talks and presentations but also through the media of film, broadcasting and internet - about AIDS and how to live positively with HIV.
    
2. The Brotherhood of Blessed Gérard opened a newly built Hospice on 3 September 1996.
   It is the aim of Blessed Gérard’s Hospice in Mandeni, to bridge the gap between hospital and the patient's home. Hospitals there often have no other choice than to discharge patients before they can really look after themselves. The families are often unable to cope with the care of their relatives, because they lack the confidence, skills or facilities to do so. The Hospice assists patients, who are no longer helped in hospital because of a poor prognosis but who also cannot be adequately nursed in their own home. It is the main objective of Blessed Gérard's Hospice to care and counsel persons afflicted with HIV/AIDS, including the counselling of their families in this regard.

   The Hospice has a fourfold function:

   • Training.
     The hospice is a training centre for the public offering courses in home based care, caregivers courses, AIDS-prevention- and -care, therapeutic counsellor’s courses and First Aid training.
   • Home based Care through mobile home nursing teams.
     Mobile home-nursing teams who supplement and support the family's home based care are trained and dispatched.
   • Day Care
     The hospice is also a Day-Care-Centre for sick people. This enables the working family members not to have to give up their employment to avail themselves for nursing their relative, but they can bring the patient to the Hospice before going to work and take him/her home afterwards.
   • Inpatient Care
     The hospice accommodates inpatients and provides general nursing and special palliative care through its 40-bed inpatient unit, which makes it the largest hospice in the whole of South Africa.
     The inpatient unit is used
     • for terminal patients approaching death. Hospice Care is palliative care where cure is not possible. It is essentially holistic care aiming at the patient as an individual with a body, mind and soul and comprises therefore an effective pain control, maintaining adequate nutrition, prevention of bed rest complications, plenty of tender loving care, counselling, occupational therapy, social care and pastoral care.
     • when a patient is discharged from hospital, but the family cannot care for their relative at home. They will make sure that the patients will take their medication and get all the other treatment, occupational therapy and exercises necessary to help them to recuperate. In these cases they invite a relative to come in with the patient and train him or her on his own relative as a kind of in-service-training. These family members usually just need a few days to get used to the care of their relative and can take him or her home afterwards. Their home based care will then be supervised and supported by the mobile home nursing teams.
        
3. On 9 July 2000 the Brotherhood of Blessed Gérard inaugurated a Children’s Home, to give a home to abandoned, neglected, malnourished, abused, sick, handicapped and orphaned children, who otherwise would have no future. Many of them are HIV positive themselves and some already in the AIDS phase. Others have lost one or both parents through AIDS and if there is really nobody within the family, who could take care of the child and no foster parents can be found, the children’s home accepts them happily and renders all the loving care which they would lack otherwise. A new building which can accommodate up to forty children was opened on 15 December 2002.
    
4. Since September 2003 a totally new, large and comprehensive task was taken on by the Hospice, when the South African Catholic Bishops’ Conference decided to utilise the most capable Catholic health care facilities in South Africa to establish the “Highly Active Anti-Retroviral Therapy” (HAART) Programme. Blessed Gérard’s Hospice became the third institution in the whole of South Africa to become involved.
   
   
   offers HAART to poor AIDS patients, free of charge. This being one of the very few non-governmental, but government-approved institutions, involved in free AIDS treatment.
   Financial help is given through the support of the USA’s President’s Emergency Plan for AIDS Relief in Africa (PEPFAR), via the Catholic Relief Services Consortium (CRSC) and the South African Catholic Bishops Conference (SACBC). This funding just covers the cost for medication and laboratory tests, but a large part of the cost has to be financed by the Brotherhood of Blessed Gérard themselves. Taking into account that the antiretroviral treatment of one AIDS patient costs close to 200 US$ per month – including all expenditure for diagnostics, preparation, counselling, efficacy and adherence monitoring – it is a major strain on the financial resources of the Brotherhood of Blessed Gérard.
   There are more than 350 people enrolled in the “Highly Active Anti-Retroviral Therapy” (HAART) Programme, the first dose of antiretroviral medication was administered on 17 September 2004 and in the meantime there are more than 100 AIDS patients on regular treatment and the numbers are increasing steadily.

This page is part of the Newsletter No. 25 of the Brotherhood of Blessed Gérard

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This page was last updated on Thursday, 08 October 2009 12:07:47