Nowhere in the world are there as many people with HIV as in South Africa. And nowhere in South Africa are there as many HIV-positive residents as in the heart of Zululand in the country's northeast.
For decades, these people had no hope. Now, thanks to the Catholic Church and the U.S. government, HIV is no longer a death sentence.
"I said goodbye to my family, because I was dying," says Harriet Mthembu, who along with her husband recently started antiretroviral treatment at a Catholic church near Kosi Bay. "Now I can go to the garden and grow some vegetables and even sell some. The treatment is helping us very much."
With funding from the President's Emergency Plan for AIDS Relief (PEPFAR) and assistance from the AIDSRelief consortium—including Catholic Relief Services—the Southern African Catholic Bishops' Conference (SACBC) has brought care and treatment to 60,000 people, including 20,000 on lifesaving antiretroviral medications. The AIDSRelief program in South Africa has been so successful that the SACBC is taking over responsibility for the grant money—the first full transition to local partner management, as called for by the U.S. government.
'I Was Sick, and You Looked After Me'
At the start of the new millennium, so many people in South Africa were dying of HIV that casket construction became a booming business. The Catholic Church wanted to help, but there was little assistance to offer. Few antiretroviral medications were available and only at exorbitant prices. Across the country, dioceses did what they could, starting HIV projects to provide testing, emotional support and simple services like nutritional advice.
This all changed with the creation of PEPFAR in 2003. Teaming up with the AIDSRelief consortium, the SACBC set out to turn churches into HIV clinics.
"We started with nothing but churches and our parishioners," says Johan Viljoen, SACBC's antiretroviral program manager. "Now we've built a network of care and treatment sites that provide top-of-the-line medical care and lab services, along with compassionate home visits from trained caregivers. The Church has become a true place of healing."
Comprehensive Care From the Universal Church
Working hand in hand, the SACBC and CRS selected 14 existing HIV Church projects to become primary AIDSRelief care and treatment sites. Over the next five years, centers hired and trained hundreds of staff members to deliver high-quality HIV care and antiretroviral treatment, including HIV testing, client counseling, lab analysis, and financial and medical record management.
Five of the primary AIDSRelief sites have additional outreach centers in far-flung communities like Kosi Bay. These rural areas have soaring poverty rates and minimal access to social services. But these challenges don't deter program staff. Caregivers take clients' blood pressure by the altar, counselors draw patients' blood in church pews, and medical staff distribute monthly antiretroviral packets in the sacristy.
Blood samples are collected as needed and driven to the closest site for analysis, where a "Togatainer" often sits right out front—a full-service lab housed in a shipping container. Every site and outreach center also receives monthly boxes of antiretroviral medications for each program participant, packaged by a pharmaceutical partner in Johannesburg and sent by courier.
Placing Leadership Where it Belongs—In Local Hands
The AIDSRelief program's transition to local grant management—mandated last year by PEPFAR with a February 2012 deadline—is happening seamlessly years ahead of schedule due to exceptional coordination, teamwork and true partnership.
"We received a new five-year PEPFAR grant to continue our care and treatment activities and expand our assistance to orphans and vulnerable children," Viljoen says. "We'll be subcontracting with CRS to provide monitoring and evaluation services as well as data management guidance. Together, we plan to serve more people and strengthen government partnerships to support long-term sustainability."
One of the largest AIDSRelief treatment sites, St. Mary's Hospital, also received its own PEPFAR grant and will be responsible for all aspects of program implementation starting in March 2010. Five other sites run by the Institute for Youth Development-South Africa (IYDSA) with assistance from AIDSRelief partner Children's AIDS Fund are also taking on full management responsibility under another new PEPFAR grant.
"The story of AIDSRelief, the SACBC and IYDSA and their transition is one of partnership, collaboration and mutual respect," says Celicia Serenata, manager of resource tracking and donor coordination for the South African National AIDS Council Secretariat. "The lessons from the last five years will serve these three partners well into the future."
By enabling ordinary people inspired by their faith to provide extraordinary care, the Catholic Church in South Africa is making miracles happen every day.
"I lost two children. There was no help. There was no treatment in the clinics," says 36-year-old Thabisile Mazibuko, who discovered she had HIV in 2004. "When I started treatment in December 2007, I was four months pregnant again."
She's thrilled to report that her boy is healthy—and HIV-negative.
Debbie DeVoe is CRS' regional information officer for eastern and southern Africa, based in Nairobi. She recently visited project sites in South Africa's Zululand.