The only thing that 11-year-old Hope* likes about school is the playground game called Ba. She struggles with schoolwork and has been unable to progress beyond Grade 2, although her nine-year-old sister, Anna, is already in Grade 3.

"Learning gives me problems," Hope whispers, her eyes filling with tears.

Their mother died of Aids three years ago. Hope is living with HIV and has had various serious illnesses.

From 2006, when she was 23, Noluthando Sithole has been mothering her two little sisters, having moved from the family home in Matatiele to Pietermaritzburg to care for them after their mother died.

"I didn't know that Hope also had the disease," says Noluthando. "She was often very sick, but our mother did not say anything. The clinic says she knew from 2003 that she and Hope were infected. They should have got treatment from that time, but my mother just kept quiet."

Hope is now on antiretroviral medication, and Noluthando says she is much healthier. But developmental delays are common in children living with HIV, and Hope may never complete school.

After moving to Edendale township, Noluthando also had her own child, a boy now aged three. The four live in one room, which, although immaculately kept, is made of mud and needs constant repairing.

"It was very difficult looking after these children to begin with," says Noluthando. "We were struggling, begging from neighbours, just relying on my son's child support grant of R240 that sometimes came and sometimes didn't."

Last year, someone told her about the children's relief organisation Thandanani, and she turned up at staff member Agnes Mkhize's home one evening to ask for help.

"Things got much easier when Thandanani started to help," says Noluthando.

In October, thanks to Thandanani, Noluthando finally got foster care grants for each of the two girls, so the family now have a stable monthly income of R1360.

In another part of Dambuza, Zachariah Mthembu sits outside next to his vegetable patch fanning away the heat. He has lost three daughters to Aids in the past four years. Now he spends his old age fretting about how to support his nine grandchildren, aged between one and 25. He grows vegetables to feed the family with seedlings provided by Thandanani.

The entire family of 14 - which includes Zachariah's last two surviving children and a nephew - depend on R3185 a month. This comes from his wife's meagre salary of R2000, half a pension and one foster care grant.

"They took away half my pension because my wife works for the government," says Mthembu.

Thandanani's Mkhize says that the family have not been able to get more grants because some of the children don't have the right papers.

To tide the family over until the grants are processed, Thandanani gives them monthly food vouchers of R600.

Thandanani's aim is to help communities and families to take care of orphans and vulnerable children, rather than removing them and placing them in orphanages.

A network of 150 volunteers in 17 communities in Msunduzi (Pietermaritzburg) and Richmond identify orphans and children living with very sick parents and report them to staff, who visit the children.

HIV has bitten deeply into the Msunduzi community, which has the worst antenatal HIV prevalence rate in the country - four out of 10 pregnant women are HIV-positive, according to the District Health Barometer.

While antiretroviral medication is available at Edendale Hospital, many people in the district are still dying of Aids, and Mkhize says her volunteers find at least one orphan a week in the four areas where she works.

Although Thandanani offers relief to over 2600 orphans and vulnerable children, the organisation is battling to sustain its funding amid the recession. Staff have taken a 20% pay cut and are working a four-day week as a short-term solution to the funding crisis.

"The recession has had a big impact on our funders because many depend on donations from individuals," says Bheki Madide, the organisation's communications officer.

Countrywide, HIV/Aids organisations are struggling to sustain their programmes because of waning support.

By 2015, a third of all South African children will have lost at least one parent to HIV/Aids, according to the latest South Africa Survey released by the SA Institute of Race Relations. - Health-e News.

* Names of children changed at Thandanani's request