Cotlands gives hope to HIV-positive children
330 000 are infected and only 160 000 receive antiretrovirals, says 2010 UNAids report
COTLANDS staff lit 10 candles this week at their annual memorial service on World Aids Day.
Seven candles were to commemorate the seven years they’ve been operating in Somerset West as a non-profit organisation that cares for many HIV/Aids infected children in a residential hospice setting, as well as supporting other HIV-positive children in the community through their home-based programme.
Three more candles were lit in memory of the children in their care who died this year. All three children were HIV positive, and two died from measles-related complications.
It’s not the virus that usually takes the children’s lives, but another illness they contract because their immune systems are so low, said Cotlands project manager Monica Buitendag.
In the hallway of Cotlands’ hospice – which cares for up to 30 children from infancy to the age of two – is a wall of remembrance for the nearly 40 children who have died there.
But they’ve cared for nearly 900 children in that time, and many of them are living healthy lives back in their communities under the watchful eye of Cotlands’ home-based care staff who ensure the children are consistently receiving their antiretroviral therapy.
Generally, over 50 percent of the children in Cotlands’ residential care are HIV positive, says social worker Marietjie Turck. All 86 of the children in the home-based programme are on antiretrovirals.
Beyond the hospice for the youngest children, Cotlands also temporarily houses two-to six-year-olds, but those children are generally healthier and are at the children’s home for other reasons.
Throughout South Africa, of all people tested, 330 000 children are HIV positive and 160 000 of them are receiving antiretrovirals, according to this year’s UNAids report on the global epidemic.
If these children are able to continue their treatment, they can often live full life spans.
Cotlands services the whole of the Western Cape, and it all started with this hospice seven years ago on World Aids Day in 2003.
One very sick, HIV-positive four-year-old girl was admitted; her mother had already died from Aids. Her father was alive, but he was caring for his other children. Cotlands found a sponsor for the child’s medication, and she started making an incredible recovery.
Today she is a smiling 11-year-old living with her father.
“That’s why we know what we’re doing here makes a big difference,” said Heidi Hesketh, Cotlands spokeswoman.
They opened their facility about the same time as the government’s antiretroviral rollout plan started.
Because the children are now living longer thanks to the drugs, Cotlands is expanding its outreach to the community, which focuses on making sure children get their medication once they leave Cotlands, Hesketh said.
Cotlands isn’t a long-term residential facility, so children stay for up to a year before being returned to their communities, placed in foster care, or with a caregiver, or are adopted.
One of the challenges HIVpositive children face is underdevelopment, which is a sideeffect of the medication.
Because these children are living longer, but are behind developmentally, Cotlands helps prepare them for mainstream schooling once they leave.
Another challenge is sticking to the medication – making sure the children receive every dose at the right time – and that’s where Cotlands’ homebased care staff try to help.
The caregiver is responsible for getting the medication from a clinic, but sometimes the parents are ill and they can’t get to the clinic, Hesketh said.
Sometimes negligent parents may forget to give the children the medicine, and sometimes the children vomit up the medicine and parents don’t know what to do.
Home-based care co-ordinator Michelle Machelm said they needed to go out to check drug adherence every month, or some caregivers wouldn’t be efficient in giving it.
Buitendag said if HIV-positive children got antiretrovirals, “they get a second chance and they get to live life a little longer”.
But without the medication the picture was grim.
Before antiretrovorals were available, most HIV-positive children died before the age of nine, and many died before they were six months old.
According to the UNAids report, South Africa is one of the few countries where child and maternal mortality has risen since the 1990s, with Aids being the largest cause of maternal mortality and also accounting for 35 percent of deaths in children younger than five.
However, mother-to-child transmission is on the decrease. In South Africa, of the 83 percent of HIV-positive women who have received antiretrovirals, only 16 percent of their children are bor n with HIV.
HELPING HAND: One of the children who lives at the Cotlands Childrens Home in Somerset West.
HOPEFUL: One of the babies at the Cotlands Childrens Home.