The HIV/Aids epidemic, which infects one in nine of South Africa's 48 million people, has sown despair and fear among an estimated 200000 residents in the Qunu area, where seven people die of Aids-related illnesses every month.
But health activists and nurses at Qunu Clinic said the figure could be three times higher if families were "honest and disclosed" the cause of death at funerals.
Adelaide Madyibi, a principal at NoMoscow Senior Secondary School, sent out notices to guardians and parents earlier this year informing them that all pupils would undergo compulsory virginity testing.
"There are schools in the village where children are engaged in sex from as young as 12 and teenagers below even Grade 11 have dropped out after testing positive ... so we felt we had to at least do something," said Madyibi.
The principal has even made scholars wear beaded Aids-awareness ribbons, introduced compulsory weekly Aids awareness classes, made scholars write poems about HIV/Aids which they recite to classmates, and has created a vegetable garden at the school which provides meals for the 57 pupils.
The principal of Milton Mbekela High School, Wonga Mda, said his school's statistics showed that there were about 72 known learners out of a total of 742 who were orphaned or living with HIV-positive parents in Qunu.
"There is a crisis in the village ... and it's not an easy situation to deal with ... parents and now even learners are dying. But what can we do?" Mda said.
Although the village's cemetery appears empty, in almost every fenced-in homestead is at least one tombstones. Most indicated the age of the deceased at between 20 and 40 years.
Nurses and staff at Qunu Clinic, which was opened by Mandela in 2001, are dealing with an average of 18 new Aids patients a month.
"These new patients are people who have come voluntarily to get tested," said a nurse, who added that scores of other villagers refused or feared to be tested for HIV.
Other villagers have travelled to clinics outside Qunu and even to Mthatha Hospital Complex, about 28km away to get tested to keep their status secret.
Over the past year, about 66 people have tested positive every month at the hospital complex, which comprises Mthatha General and Nelson Mandela Academic hospitals, said Sizwe Kupelo, spokesman for the Eastern Cape Department of Health. He added that although the province had a R480-million budget dedicated to HIV/Aids, Qunu does not have accredited antiretroviral treatment.
As a result, the cash-strapped community is referred to Mbekweni Clinic about 20km away.
The nurse at Qunu Clinic said the number of patients who received antiretrovirals had increased from 23 in August to just over 30 last month.
"Other villagers, who have tested positive, just never return to get their medication ... and instead remain in denial about having the virus," she said.
Aids activist Nozuko Mbokodi, who tested HIV-positive in 2002, said villagers were scared to get tested or disclose their status because they feared victimisation and death.
The 37-year old mother of two said she had been encouraged by Mandela to disclose her status.
Mandela, who started the global 46664 campaign - named after his prison number on Robben Island, in 2003 - to raise awareness of HIV/Aids in Africa, spoke for the first time in 2002 of how he had been personally affected, losing close relatives to the pandemic.
Three years later Mandela disclosed that his son, Makgatho, then 54, had died of Aids.
At the time, he stressed that being open about HIV/Aids was the only way to stop people "regarding it as an extraordinary thing for which people go to hell and not to heaven".
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