TOM HAGLER: Like many of the world's port towns, Homa Bay in western Kenya lives and dies by the fishing trade. Each day its pier and processors accommodate vessels from Kenya, Uganda, and Tanzania. This international traffic has made it a center of HIV and AIDS. Tens of thousands have died here since the pandemic began over 20 years ago.
An estimated 35 percent of the province's adult population is infected with HIV. If you look around here, what strikes you is that there are old people and children, but almost no one between the ages of 18 and 45. A generation has vanished. The backbone of the labor force, the parents, have simply disappeared. The nearby village of Asumbi was founded 200 years ago on the prosperity of Homa Bay.
Today the village shares the port's fate, but while it was the movement of seafarers that brought AIDS to Homa Bay, here it was the villagers themselves who transmitted the virus, as they returned home from seasonal work as fishermen.
BERNADETTE AKONGO (Translated): People don't like to stay home. They like to work at fishing. They get AIDS when they travel, and give it to their innocent wives at home. Eventually they both die and leave the grandmothers to take care of the orphans.
TOM HAGLER: Bernadette Akongo has lived in Asumbi for all of her 83 years. In the past decade, she has seen the village lose a quarter of its population to AIDS. Four years ago, when her son and daughter-in-law died of the disease, she took in her five orphaned grandchildren.
BERNADETTE AKONGO (Translated): I have nothing, so I plant a few crops and keep some hens. I'm always encouraging my grandchildren to work in the garden, but it's not enough, so we sometimes beg from our neighbors.
EMILY ADHIAMBO (Translated): In the mornings I sweep the house, I go to the river to wash, then I go to school. I plow and weed the garden when I come back from school. In the evening I gather firewood and cook with my grandmother. Then I help with the other children and go to sleep.
TOM HAGLER: As the eldest of Bernadette's grandchildren, 14-year-old Emily is learning to run the household. Having witnessed her parents' deaths, she's aware that what she learns from her grandmother is the family's best hope of survival.
BERNADETTE AKONGO (Translated): A misfortune has entered this family. We've been afflicted with disease and poverty. I've watched my own children die, and that was very, very hard. I get tired when I work now, and I go without meals sometimes so the children will have at least a little food. It's important that I sacrifice, since I'm nearer the end of my days than they are.
TOM HAGLER: There are millions of grandparents like Bernadette around the world, most of them in Africa. Their suffering is as profound as it is hidden. So far, AIDS has claimed more than 15 million lives in sub-Saharan Africa and has left behind 11 million orphans. By 2010, it's estimated that 20 million of the subcontinent's children will have lost one or both parents to AIDS.
CAROL BELLAMY, Executive Director, UNICEF: HIV/AIDS may be most extraordinary catastrophe to hit the world ever. As it's growing year after year, as the extended family is becoming more marginalized, then it is not only a, well, financial burden, it's not only a fiscal burden, but it's an enormous psychological or social burden.
TOM HAGLER: It's increasingly apparent that the pandemic is placing a severe burden on the elderly. They struggle to protect their orphaned grandchildren, often while mourning the deaths of their own children.
CAROL BELLAMY: There isn't time left for the grandparents largely to be teaching these additional historic or cultural ways of living, because the family needs to live, just basically live. So simple skills like planting and growing crops, if not taught by the grandparents, may be taught by no one.
TOM HAGLER: According to UNICEF, the United Nations agency for children, the number of these AIDS grandmothers has surged in recent years. Their ranks are expected to rise further as HIV and AIDS continues ravaging the continent. Grandparents can't take the place of parents, but they are often all that stands between their grandchildren and homelessness.
This morning, 12-year-old Sarah escorted her grandfather to the Asumbi mission hospital, possibly for the last time. According to clinical officer Lucy Irungo, he's been looking after Sarah since her mother died five years ago.
LUCY IRUNGO, Asumbi Mission Hospital: The grandfather is probably HIV-positive. We have not tested. And the wife, that is, the grandmother, of that child died about two weeks ago, she buried last Wednesday. So now the child is all alone with the grandfather.
TOM HAGLER: And if the grandfather dies? What happens to the child?
LUCY IRUNGO: The child will be left all alone. Here the problem is serious. Since most of the children, the orphaned children are being taken care of by the grandparents, who are fairly aged, soon they will be dying.
TOM HAGLER: While the need is great, the official government's response might be described as inadequate. There's no help for the elderly or for their orphaned grandchildren. In the absence of government assistance, the task has fallen on international agencies and charities, like Help Age.
SISTER MARY PHILIP, Assistant Director, Help Age: We provide food, but the food that we provide are not enough for the grandparents and their orphans. Some are taking care of six orphans, and this one will have not really a lot of impact on them.
TOM HAGLER: The absence of assistance hasn't diminished the grandmother's determination to cope. This morning a rumor went around the village that a meal would be available to the elderly. By mid-morning, tens of grandmothers had flocked to the community center. Many came from distant towns, and while waiting for their bread and tea, they started talking. For Bernadette Akongo, the gathering gave her strength to carry on.
BERNADETTE AKONGO (Translated): I care for five children, and my strength is going, but what I found here gives me some comfort and the strength to last longer and to help these children. And if I am able and it is necessary, I will do the same for others.
SISTER MARY PHILIP: When they come to us, they just come to beg, and you see they are trying to live with that, because they can't manage their life, but they are just trying to live with that.
TOM HAGLER: What began as a gathering of the needy evolved into a sisterhood. The meal was small, but these women took comfort in one another.