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South Africa AIDS orphans overwhelm social work services

Lora Doman has 450 cases to keep track of: A daunting challenge typical amng those in social work services providing care and protection of South Africa AIDS orphans.

By Scott BaldaufStaff Writer, Staff Photographer / May 10, 2010

South Africa AIDS orphans so overwhelm social work services that Lora Doman – here taking time for some affection on a visit to one of her charges – has 450 cases to deal with alone.

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Soweto, South Africa

Lora Doman sees more human drama, suffering, and courage in a single morning than most South Africans ever see.

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Ms. Doman is not a nun, or a saint. She is one of South Africa’s 12,000 social workers, a front-line soldier in a battle to hold her country together, one family at a time, several families a day, ensuring that abused, neglected, or orphaned children have a home.

It’s a monstrous task in a country where an estimated 5.5 million people – roughly 18 percent of the population – are believed to be infected with the HIV virus.The AIDS epidemic not only kills millions of South Africans, it also orphans children. A United Nations and World Health Organization report last year estimated that as of 2007 there were 1.4 million South African AIDS orphans – a tripling of the number estimated in 2001, and the largest concentration in the world. For homes, many of these AIDS orphans must turn to their extended families – many of whom are already living in poverty – and to overwhelmed orphanages and shelters for survival.

Doman, a relentlessly positive woman who works for the Roodepoort Child Welfare Agency, meets this enormous task each day with a mixture of urgency and hope. She regularly works 10 hours a day, attending to family tragedies from the rough streets of Soweto to the middle-class neighborhoods of Roodepoort. She typically carries a caseload of 450 clients.

Doman says she realizes that even if she met with one family each workday in a year, and did nothing else, she could never keep up. As more cases arrive, she may never even meet all the people she’s responsible for.

“It’s ludicrous to think that one social worker can do all this,” says Doman, matter-of-factly, pulling into the driveway of a client on a dusty street of the informal settlement of Braamfishcerville.

“If you have a crisis,” where a child has to be removed from an abusive or neglectful home, “then you become so busy – constantly in court, doing investigations, writing reports, finding a place of safety for the child – that all the other cases that you have to handle get pushed off for later.” She turns off the engine of the car and smiles wryly, “[W]e are just putting out fires.”

• • •

The AIDS crisis in Africa has claimed 25 million lives since 1981 – equal to half the death toll of World War II. Since most of those who have died are of childbearing or child-rearing age, from 15 to 49, the impact falls hardest on the children left behind and the communities that have lost not just parents, but laborers, nurses, teachers, and others who keep African societies and economies functioning. It’s a silent demographic shift that is weakening Africa precisely at the time when the growing global demand for resources should be making the continent prosperous and less reliant on aid. At the current rate, AIDS could create as many as 35 million orphans on the continent by the end of this year, according to UNICEF. (In South Africa, only about 11 percent of children orphaned by AIDS are HIV positive.)

The fact that it is international agencies – and not the South African government – that make estimates of HIV infections and of AIDS orphans is significant. While South Africa’s current president, Jacob Zuma, has taken the country’s HIV crisis seriously, his predecessor, Thabo Mbeki, was a self-described AIDS denialist. He argued that there was no scientific link between sexual behavior and the spread of HIV, and that traditional herbal remedies were a better alternative to the latest antiretroviral treatments. His two terms in office, say AIDS activists, set South Africa back a decade in its AIDS-prevention fight.