JIM LEHRER: Next, Ray Suarez has the last of our three global health reports from South Africa this week, the devastating impact of AIDS on children.
RAY SUAREZ: It’s early on a Sunday morning. A young girl checks her pot of corn while her sister looks on. The girls do a few quick chores, get dressed for church, wash up, and buff up their shoes.
Nothing unusual about any of that. The scene is repeated throughout the South African province of KwaZulu-Natal and around the world, with one difference: The 12-year old twins, Batkithi and Bonisani Masoko, and their 10-year-old sister, Xolisile, are on their own. Their parents both died of AIDS.
The sisters are among 15 million children around the world who’ve lost one or both parents to AIDS. And most are in southern Africa.
Health officials have begun to refer to these parentless children as “the lost generation.” In South Africa, from 1995 to 2005, the number of orphans tripled. So did the number of child-headed households, like the Masokos, who on this Sunday morning headed to church, bringing along young cousins for a long walk over hills and through valleys to reach a tiny congregation gathered in prayer and song.
Lay Minister Qoshile Mvelase knows many families in the area with children left orphaned by AIDS, some not well cared for, and said her congregation prays for the Masoko sisters.
PASTOR QOSHILE MVELASE (through translator): We realize that, when we look at them, their lives are so difficult. I feel they are all alone and not happy.
Government provides some help
RAY SUAREZ: The sisters get a government stipend available to orphaned minors. Their tiny home is sparsely furnished. As they do their homework and daily chores, a reminder of their parents is always nearby, two graves just yards from the front door.
The girls say they have each other. They seem to be getting by, with a little help from extended family and neighbors.
BONISANI MASOKO (through translator): There is a shop nearby. And if we need more things, we just ask someone going to town, and we give them money to get what we need.
RAY SUAREZ: The Masoko sisters are supposed to be under the care of an aunt nearby. When word got around an American news crew was with the girls, new food and furniture started to come through the front door.
Social worker Vusi Masinga said the government check makes claiming the orphans attractive.
VUSI MASINGA, social worker: Some they want use their grants not for the best interest of the children, but they just want to use the grant for themselves.
RAY SUAREZ: The next morning, the sisters joined their classmates at morning assembly at the Mendu school in Empangeni. Every morning, there's a hymn sing before their studies begin.
The Mendu Elementary School has about 20 families who've been orphaned by AIDS.
HAPPINESS ZIKHALI, principal, Mendu Elementary School: I'm very concerned about those children. And because they are often -- sometimes they just sleep, others they just cry, and you, "What's the problem?" "I'm hungry."
Orphans' challenges in school
RAY SUAREZ: Happiness Zikhali is the principal at the Mendu school. She sees the sleepiness and inattention that comes from chronic hunger and the acting out that can follow the death of parents.
HAPPINESS ZIKHALI: Oh, oh, sometimes they are fighting. You'll say -- sometimes when they're fighting, "Where is your mother?" We ask, "Where is your mother?" "My mother is passed away, father passed away." "Oh." And then you realize that's why there is this emotional practices that she or he is doing, fighting others.
RAY SUAREZ: The principal says she knows one reason her 300-plus students are in class at all is because they're fed at school.
South Africa's new minister of health, Barbara Hogan, admits that in the past children have been overlooked in the AIDS epidemic.
BARBARA HOGAN, minister of health, South Africa: My mother died when I was very young, of cancer. I was 9 years old. And perhaps one knows at firsthand what it means just to lose just, you know, one parent.
And when I just look, you know, just from the personal point of view of just the psychological and social effects of so many young children losing the people who care for them, you know, that you can't even calculate.
You can calculate what it does to the economy, but what this does to young people, you know, the amount of healing that's got to take place, the amount of trauma that it's inflicted. And that is, we as a nation we need to be as caring as possible, as accommodating, as reaching out and seeing in what ways, with the meager resources that we've got, we can do the healing and the looking-after and the caring for these young kids.
Daycare for the youngest children
RAY SUAREZ: For the youngest orphans, caring for themselves simply isn't an option, and many are being raised by grandparents. Here at this community care center, they have a monthly food distribution providing aid to women who at an unexpected stage in life are again raising young children.
While many orphans have a grandmother, or "grannie," to care for them, a new report by the Joint Learning Initiative on Children and HIV-AIDS says not enough is being done for AIDS orphans, since 90 percent of the costs of raising them still fall on family and community.
At the Ntambanana Community Center, providing the monthly staples of corn, beans and oil is just the start. The community center also offers a day care, where grannies and school-age siblings can drop orphaned children who depend on them.
Lindwe Masuku runs the center.
How do you find out about these children?
LINDWE MASUKU, Ntambanana Community Centre: Some of them, they live with their sisters and they give us their death certificates of their parents.
RAY SUAREZ: Here, in this small trailer, 50 orphans are cared for, all too young to attend school.
LINDWE MASUKU: In the morning, we give them at 9 o'clock breakfast. And we teach them how to hold a pen and how to write their names. And at 12 o'clock, we give them lunch.
RAY SUAREZ: Getting those two meals a day can be life-saving.
Many of the children at Ntambanana Daycare are also HIV-infected. Some are sick.
LINDWE MASUKU: We hug them. We kiss them. We take them to toilet. We do everything that parents do. If they cry, we try to wipe their tears. We make them feel as if they are at home.
Burden falls on older siblings
RAY SUAREZ: When the local high school is dismissed, siblings come and collect the young children from Ntambanana.
Nonkulueko Mjadu is 19 years old and in the 10th grade. Mjadu lost both parents to AIDS. She now cares for eight children on her own. The adults in her extended family are all dead, too.
Every day, before and after school, Mjadu walks to the daycare to drop off and pick up four siblings and her own baby, who's less then 2 years old. The walk home is about a mile.
STEPHEN BLIGHT, UNICEF, South Africa: There's a huge backload of cases that have completely overwhelmed the system, and the social workers aren't able to reach them. Families are absolutely in crisis, where kids are taking on all the duties of getting their siblings fed, getting them to school, doing all that care.
RAY SUAREZ: Stephen Blight heads up child protection services for UNICEF in South Africa.
STEPHEN BLIGHT: And if you could have auxiliary social workers who come and intervene in that family and help train the kids, provide structure to their lives, help them with budgeting, making sure people are doing homework, that could really make a big change in a household.
RAY SUAREZ: Once home, Mjadu cares for her own baby and then tends to the others. The suffering of today has already made a claim on the future.
Struggling under the burden of millions of HIV-infected adults, South Africa must face a legacy of AIDS that stretches far into the next generation, a generation that as adults will be needed to build a developing country and who carry as yet unknown scars from their families' ordeal.