The Daily Maverick told the story in July this year of how Western Cape-based NGOs like Rape Crisis were facing closure due to lack of funding. The problem isn’t restricted to any particular province: in the Eastern Cape, NGOs face a similar fate. REBECCA DAVIS looks at the case of an indispensable Aids shelter in Grahamstown.
Nomsa* is 14 years old. She lives in Grahamstown, the small Eastern Cape city famous for being the home of Rhodes University and the National Arts Festival. Outside of the university enclave and the main shopping drag, however, the majority of Grahamstown’s estimated 120,000 residents are unemployed. Nomsa’s mother, like many others, is jobless. She is also HIV-positive. This, too, is not unusual in a city where more than one-third of women who give birth are already infected with HIV. Nomsa’s mother is also an alcoholic, frequently drinking up what little money comes to the family.
Nomsa has a six-year-old sister, and when their mother goes off on one of her periodic drinking binges, she leaves the girls alone in their house, without money for paraffin or electricity. Grahamstown in winter can be bitterly cold.
When this happens, even if it’s a weekend, Nomsa now knows that she can go to the Raphael Centre on Donkin Street. There, she and her sister can receive a cooked meal, and the centre workers will make sure the girls take a bit of fuel home with them. For the past two years, Nomsa has also been a member of the support group that the Centre runs for teenagers affected by HIV. It’s called “Siyaphumelela”, we are succeeding. Before becoming involved with the Raphael Centre, Nomsa had to spend school holidays caring for her younger sister. Now that she’s involved with the Raphael Centre, she is sent to a camp where she can learn and play, while her sister is taken care of.
When Nomsa arrived at the Raphael Centre for the first time, she was “very unhappy and inclined to self-harm”, said Centre Director Jabu van Niekerk. Nowadays, she is an exuberant teenager doing well in school. “She said she hopes to become either a doctor or a soldier,” Van Niekerk said. “She was recently very pleasantly surprised to hear that she could do both.”
Jabu van Niekerk’s real name is Annalie, but very few people in Grahamstown know her as that. For more than a decade she has been “Jabulile”, we are happy. Van Niekerk returned to South Africa from exile in Canada in 1994, and held a post as a researcher for the Human Sciences Research Council until 2002, which she gave it up to move to Grahamstown to take on the running of the Raphael Centre. It was in some ways a crazy decision: the Raphael Centre had only been in existence for three years, and was only a support group for around 20 people living with HIV and Aids. But Van Niekerk “really wanted to do something more hands-on in terms of the development of South Africa”, so she packed up her life in Pretoria and set off for the Eastern Cape.
When the Daily Maverick spoke to Van Niekerk on Tuesday, she had just returned from Joza, the local informal settlement, to assess the damage inflicted on the environment by the weekend’s disastrous flooding in the region. “The situation is really, really bad,” she said. “Even for the people in the good housing, the RDP housing, because the foundations are really shallow and the water comes straight through. The only way to keep them dry is to keep sweeping the water out.” She sighed. “I’ve put out an appeal for blankets. But it’s not a good situation.”
Over the past decade, Van Niekerk has built the Raphael Centre into a resource which plays an invaluable role in the Grahamstown community. “When I first arrived, one of my questions was: If I wanted to get an Aids test, where would I go?” Van Niekerk explained. “They said, ‘You go to a doctor and you pay R200, and then you wait two weeks and get your results.’ I couldn’t believe it. I said, ‘Couldn’t I just go to a clinic?’ They said no, not unless you have the symptoms of HIV-related opportunistic infections.” Van Niekerk discovered this was quite true. One of her first initiatives, then, was to start a rapid testing service at the Centre.
It was, she said, an immediate success. “In fact, the success of the testing was counter-intuitive. People came in steady streams. Even when the seven clinics in the region eventually started offering testing, for a long time we were doing more testing at the Centre than the seven clinics combined, even though they were far more conveniently located.” The Raphael Centre once carried out an exit survey to determine why people preferred its service. “The answers came back: because of confidentiality and professionalism,” said Van Niekerk.
Unlike most testing centres, the Raphael Centre doesn’t wait for clients: their counsellors go out to informal settlements and rural communities to do home visits. “During those visits, we do intensive education, of two to three hours,” she said. “I have a theory that the 20 minutes or so that you get for pre-test counselling and post-test counselling isn’t enough – it doesn’t stick. Our approach is very thorough and very intimate. After the prevention education, we offer the opportunity to take an HIV test, and in this way we test people who would never otherwise think to get tested.”
Another programme Van Niekerk got off the ground quickly was in support of children who were either Aids orphans, infected with HIV themselves, or the children of parents living with HIV or Aids. “Children who come from a household affected by HIV have special needs,” Van Niekerk said. “Mostly, it robs them of the right to be children, because they have to take on more responsibilities.” Today the Raphael Centre supports 168 vulnerable children, ensuring that they are fed and cared for daily.
But the Centre also serves adults, providing a support-group for those newly diagnosed with HIV and advocacy services for people living with HIV/Aids. “If they have problems asserting their rights, or if their rights are harmed by stigma, we will take on their case,” Van Niekerk said. They frequently assist people with applications for various forms of documentation – particularly death certificates and ID books.
“We also take on the micro-lenders who prey on people living with HIV because they know they have access to grant money,” she said. “It’s a huge problem here. When people start falling sick and are in a crisis, these people descend and say we can advance you some money, but when the grant money comes you pay it back. And then it’s the same old story, massively high interest rates…They really are despicable.”
Over the past 10 years, the Raphael Centre has funded itself in a piecemeal way. “Like most NGOs we are too reliant on Lotto funding, because it’s one of the few funds that pay for operating costs,” she said. But this year, they haven’t heard anything back about their application. “Corporate funding is down, individual donations are down and we don’t get any government funding. The only government support we receive is the fact that we get HIV testing supplies for free.”
The Raphael Centre will have to close its doors at the end of November if it can’t find funding. And it is not alone in its financial distress. A recent survey of NGOs in the Grahamstown area undertaken by the SA Institute of Fundraising found that only 16.6% of the organisations polled had enough money to cover six months of operating expenses. Corporate donations had been cut by 42.3%, the survey found, with National Lottery funding down by 37.9% and individual donations cut by 37.2%.
“Grahamstown is like any other small town in this region, in that it has a serious HIV problem. There are likely to be at least 10,000 people (living with HIV/Aids) here. That means its problem is neither greater nor smaller than the surrounding areas,” said Dr Kevin Kelly, director of Rhodes University’s Centre for Aids Development, Research and Evaluation (Cadre). “But the bigger story here is the many small organisations which are providing essential HIV-related services which are not being appropriately supported by government.”
Social services in a place like Grahamstown, Kelly contends, are essentially provided by NGOs. “Take a town like Grahamstown, and strip away the Raphael Centre, the Jabez Centre (another HIV resource), FAMSA, Child Welfare, etc. About 20 organisations, all surviving on God knows what,” he said. “Take those out, and ask what you’ve got left. Threadbare social services, that’s what.”
Kelly said that there are between 70,000 and 100,000 small NGOs in South Africa, “all doing things which are barely recognised.” While South Africa prides itself on its social grant policy, it is these NGOs that provide vital assistance in helping people to secure ID documents and apply for the grants. “But if you look at the National Development Plan, and count the mentions of civil society – there is virtually no recognition of the contribution of this sector.”
And it’s not just the fact that NGOs are providing social services that is important, Kelly said. An often-overlooked fact is that they are also major employment providers. “The last survey, in 1999, showed that the NGO sector was employing more people than mining,” he said. NGOs also serve as incubators for innovation. “Hospice, for instance, basically pioneered palliative care for chronic diseases. And they do it at a fraction of the cost of any government department. The Grahamstown Hospice struggles along on a two-month financial situation. These are proven organisations, not dodgy, with good models and dedicated people working for almost nothing. It’s a huge national asset.”
What needs to happen, Kelly suggested, is that “the government needs to get its act together on how it’s going to support the critical social service sector. The government needs to say: what bundle of services do we need them to provide, and how can we build policy around it.” He pointed out that if the government had to create an organisation like the Raphael Centre from scratch – “Can you imagine the investment you’d have to make? And the point is, you can’t engineer this stuff from scratch. It fits where it is.”
Van Niekerk predicted trouble if the Raphael Centre has to close at the end of November. “The households that get emergency food supplies from us, and the children we support, will suffer,” she said. “In the long term, I think we would see a rise in the HIV infection rate in this community.” DM
*Name has been changed to protect identity
“Raphael Centre in dire straits,” on Grocott’s Mail
Photo by Reuters.