South Africa Trip Notes

HOPE for HU HUMANITY UMANITY

SOUTH AFRICA

Trip Notes

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Hope for Humanity South Africa—Trip Notes

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HOPE for HUMANITY

12501 Old Columbia Pike Silver Spring, MD 20904 1-888-425-7760 hope4.com iii

Hope for Humanity/Partners in Mission Experience South Africa • Lesotho September 13-26, 2009

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Table of contents

Hope for Humanity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 South Africa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 Climate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 SDA Church in South Africa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Johannesburg . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Soweto . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Kruger National Park . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Nhlengelo: An overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Paul and Martha Mawela: Co-Founders of Nhlengelo . . . . . . . . . . . . 8 Child-Headed Households . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Maluti Adventist Hospital: Lesotho . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 The Economy of Lesotho . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 HIV/AIDS Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

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HOPE FOR HUMANITY

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ope for Humanity is the new name for “Harvest Ingathering”—the longest established Adventist church-sponsored humanitarian ministry.

Over the century of service through Hope for Humanity, hundreds of millions of dollars have been raised for programs that help people right where they are—programs that reach out to the world with the Adventist message of “wholeness,” and bring Adventists into relationships with each other and their neighbors.

The church’s interests in ministry are broad and diverse, with ministries for dozens of groups and needs. Hope for Humanity has the specific calling and ministry to serve the poor in the name of Jesus. This work is done in partnership with the church—in a shared ministry to work with people in poverty and to hold up the cross of Christ in their homes and communities.

There are many ways Adventists have worked with the poor around the world and throughout our history. The work funded by Hope for Humanity around the world is done hand-in-hand with the church, as full partners in compassionate and transforming ministry. In this way, the redemptive mission of the church can be realized, and the potential for development and transformation can be attained by the people and communities we serve.

The projects funded by Hope for Humanity are carefully initiated, planned, and implemented to be of both earthly and heavenly importance. It is the goal of Hope for Humanity to reach out in ways that meet the spiritual as well as the physical and social needs of the communities we serve. Our Partners in Mission Program is a new and empowering extension of our traditional endeavor, and it further secures our desire to make Hope for Humanity a holistic ministry of compassion and grace.

Adventists believe that every one of us can make a difference in our communities and our world. We are people of hope, and the work of Hope for Humanity is all about hope. We believe that in meeting human needs we are instruments of divine grace and compassion. And we believe that in caring for others we are living the way that God would have us live.

HOPE FOR HUMANITY

Maitland DiPinto Office: 301-680-6439 Mobile: 240-461-5884 Home: 301-384-1359 E-mail: maitland.dipinto@nad.adventist.org

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SOUTH AFRICA

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outh Africa’s name is also its location. It has a long coastline along the Atlantic and the Indian Oceans; along its northern borders are Namibia, Botswana, Zimbabwe, and Mozambique. It completely surrounds the country of Lesotho and nearly surrounds Swaziland.

The history of South Africa is significantly different from other nations in Africa because of high levels of immigration from Europe and because its strategic location made it extremely important to Western interests. Many shipwrecks occurred along the Cape of Good Hope before the first successful circumnavigation in 1488. For the next two centuries only a few small fishing settlements were established. For most of the 17th and 18th centuries, the Dutch slowly expanded into the region, eventually meeting up (and clashing) with the Xhosa people. Slaves were brought from Indonesia and India; their descendents often married Dutch settlers and became known as Coloureds.

Great Britain seized the Cape area in 1806, and many Dutch settlers (the Boers) moved north. The discovery of diamonds and gold spurred immigration. The Boers resisted fiercely, but they were eventually defeated by the British in the Boer Wars. The Union of South Africa was formed, and in 1948 the government began implementing harsh laws that became known as apartheid. Resistance, protests, and international sanctions finally led to the end of apartheid in the 1990s.

South Africa is diverse. It is sometimes called “The Rainbow Nation” to describe its multicultural diversity. It is rich in plant biodiversity, with about 10% of all the known species of plants on earth. It is also diverse economically—some centers are developed, but in other areas poverty is extreme; it has one of the highest rates of income inequality in the world. South Africa has eleven official languages and many unofficial languages.

CLIMATE

South Africa stretches between the 22nd and 34th degrees of southern latitude and hence is part of the subtropical zone. Compared to other regions at that latitude, temperatures in many areas of South Africa are rather lower. The cold Benguela current causes moderate temperatures on the West Coast, and on the central plateau the altitude (Jo’burg lies at 1753m) keeps the average temperatures below 30 degrees Celsius. In winter, also due to altitude, temperatures drop to the freezing point, and in places even lower. Then it is warmest in the coastal regions. Precipitation is to be expected mainly in the summer months, with the exception of the Western Cape which is a winterrain area.

For your tour planning keep in mind that the seasons in the southern hemisphere stand in direct opposition to those of the northern hemisphere.

Due to the height of 1753 m above sea level, the climate in Johannesburg and on the Highveld is nice throughout the year. The favorable climate is one of Johannesburg’s main attractions. Many local residents, who enjoy annual 3

holidays at the coast, would never consider living in hot, humid Durban or cold, wet Cape Town year round. In summer, the days are not too hot and the nights pleasantly cool. In winter, the nights can be quite cold, even below zero, but during the day the sun shines and lets the temperatures rise. Rainfall is to be expected only in summer from October to March. Otherwise the dry climate of the African interior high-plateau, the Highveld, is dominant.

Johannesburg gets an annual average of between eight and ten hours of sunshine per day. The weather only gets nasty in Johannesburg when the strong winds of August blow over the Highveld and the loose sands of the mine-dumps whirl through the air and cover the city in a yellow haze of dust.

In Pretoria, about 60 km north of Johannesburg, it is always two or three degrees warmer due to the lower altitude of only 1365 m above sea-level. (Usually a difference of 100 m in elevation corresponds to 1 degree Celsius difference in temperature.)

SDA CHURCH IN SOUTH AFRICA

The first SDA in South Africa was a miner from Nevada who brought a supply of tracts with him and shared his faith; as early as 1878 some had begun to keep the Sabbath because of his witness. In 1885 Pieter Wessels’ prayer for healing was answered; he began to search the Bible and discovered the seventh-day Sabbath. He discussed the Sabbath with everyone, and eventually met other Sabbathkeepers. They wrote to the GC and asked for a Dutch minister to be sent to teach and baptize them, enclosing money to assist in the expense. When the letter was read at the 1886 GC session, the assembled delegates were so electrified they rose and sang the doxology. Missionaries were sent, arriving in 1887, and within a month a baptism took place and a church of 21 members was organized. The movement began to spread—evangelistic meetings were held, churches were established, schools were built. Pieter Wessels’ father sold his farm, on which a rich diamond deposit had been found, and much of the fortune was carefully used to help the struggling church.

The Trans-Orange Conference is located in Johannesburg. It is a part of the Southern Africa Union Conference, which is a part of Southern Africa-Indian Ocean Division. The TOC was organized in 1960, and reorganized in 1969. It has 219 churches, nearly 25,000 members, and serves a population approaching 18 million people.

JOHANNESBURG

Johannesburg is the most populous city in South Africa and the third most populous city in Africa, behind Cairo and Lagos. It is the provincial capital of Gauteng Province, the wealthiest province in South Africa, and the site of the South African Constitutional Court. It is one of the newest major cities in the world. Johannesburg is the site of a large-scale gold and diamond trade due to its location on the mineral-rich Witwatersrand mountain range.

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Johannesburg is served by Johannesburg International Airport, the largest and busiest airport in Africa and a gateway for international air travel to and from the rest of southern Africa. The population of the Greater Johannesburg Metropolitan Area is almost eight million. The city is one of the 40 largest metropolitan areas in the world. The city is Africa’s only world city, a city that has a direct and tangible effect on global affairs through socioeconomic, cultural, and/or political means.

SOWETO

Soweto is an urban area in Johannesburg. The name Soweto is a contraction of “South Western Townships” and does not mean anything besides this in any South African language. In 1950, during the apartheid regime, Soweto was constructed as a self-sufficient housing project southwest of the city to accommodate the large number of people who came to Johannesburg to seek employment.

Soweto came to the world’s attention in 1976 with the Soweto Riots, when mass rioting broke out over the government’s policy to enforce education in Afrikaans rather than English. Soweto is among the poorest parts of Johannesburg, but Soweto has become a center for nightlife and culture.

KRUGER NATIONAL PARK

Kruger National Park is the largest game reserve in South Africa. It was established in 1898 to protect the wildlife of South Africa, and it is unrivalled in the diversity of its plant and animal life. It is roughly the same size and shape as Israel or Wales.

It covers about 20,000 square kilometers and extends 350 km from north to south and 60 km from east to west. To the west and south of the Kruger National Park are the two South African provinces of Mpumalanga and Limpopo. In the north is Zimbabwe, and to the east is Mozambique.

Kruger National Park has 1,982 species of plants. 517 species of birds are found at Kruger. All the Big Five game animals are found at Kruger National Park, which protects over 147 species of mammals, including African Buffalo, African Hunting Dogs, Black Rhinoceros, Blue Wildebeest, Burchell’s Zebras, Bushbucks, Cheetahs, Giraffes, Greater Kudus, Hippopotamus, Impalas, Leopards, Lions, Roan Antelopes, Sable Antelopes, Savannah Elephants, Spotted Hyenas, White Rhinoceros, and Warthogs.

There are more than 170,000 Impala in Kruger Park. There are 120 species of reptile (including Nile Crocodiles), 52 species of fish, and 35 species of amphibians. In September the wildlife population will also include a bunch of Adventist workers.

The geographical position of South Africa in the subtropical climate zone is not as noticeable on the Highveld, the central plateau, as in the Lowveld, where summer temperatures can climb above 40 degrees Celcius. Rainfall in the Lowveld averages 800 mm per annum, and falls mainly during the sum5

mer months, which results in humid, sultry weather. The rainy season usually starts in September and can last until May. The climate is much more tolerable in the dry winter months of June, July and August. Then the days are mild and the nights a little cool.

This time of the year is also ideal for animal viewing in the Kruger National Park, because the shrubs and trees don’t have so many leaves to obstruct the view. Since it hardly ever rains in winter, the game must come to the waterholes to drink in the mornings and afternoons and can easily be observed from the car. Average temperature in August is 64 F; overnight lows in the upper 40s, highs in the low 80s. Average rainfall in Kruger during August is less than 1 inch.

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NHLENGELO: AN OVERVIEW

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ith the hope of establishing an Adventist church among the Tsongan people, Paul and Martha Mawela retired to Dwarsloop, South Africa. Traditional methods of evangelism were unsuccessful, and those who opposed the new church began circulating rumors that Pastor Mawela was a Satanist, not a Christian.

Undeterred, Pastor Mawela looked for other ways to reach out. He began to observe the impact of HIV/AIDS on the young people of his community.

Pastor Mawela invited local ministers to pray with him and discuss what could be done to aid their community if they would all work together. The result was “Nhlengelo Home Based Care.”

“Nhlengelo” means “standing together against an enemy.” At Nhlengelo a community is standing together against HIV/AIDS and other issues confronting their community. Nhlengelo is a unique and special project that receives major funding assistance from Hope for Humanity and Seventh-day Adventists in the United States.

At Nhlengelo, children orphaned by HIV/AIDS, and now living in childheaded homes, receive hot meals, help with their homework, and guidance in their daily lives as they learn how to live with the impact of HIV/AIDS. Caregivers from Nhlengelo go into the surrounding communities, bringing hope and help to individuals living with HIV/AIDS and other illnesses.

Trained and led by Mrs. Mawela, these dedicated Christians provide a practical example of the grace and love of God. The people of Dwarsloop now call the Mawelas, “Papa” and “Mama.”

They are considered saviors not Satanists.

In August of 2006, the Buyi-Saselani Seventh-day Adventist church was dedicated, a realization of Papa and Mama Mawela’s original goal. Many of those who had once opposed the church attended the dedication ceremony.

The property for the church was provided by the local chief and community.

Funds to build the church came from the local conference, Hope for Humanity, and local donations.

This work is growing and succeeds because of the commitment of Papa and Mama Mawela, the caregivers, the unique partnership with the community, and the commitment of people like you who support Hope for Humanity and make possible this program to help the people of South Africa.

Jesus spent much of his ministry mingling with people—healing them and meeting their needs. It is easy to see the Spirit of God working through Pastor and Mrs. Mawela and the caregivers. Many experience the love of God and are coming to know Jesus through the commitment of the caregivers, and lives are being saved and changed in the communities where this work has been established.

Hope for Humanity is a key partner in this growing ministry in Dwarsloop, South Africa, and support from members in North America through Hope for Humanity is vital to the continued success of the programs.

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Please pray for the orphans and communities impacted by HIV/AIDS, the caregivers, Pastor and Mrs. Mawela, and the ministry of Hope for Humanity.

PAUL AND MARTHA MAWELA: CO-FOUNDERS OF NHLENGELO

Pastor Paul Mawela was born in Pretoria, South Africa. He began his service to the Seventh-day Adventist Church in 1959, and worked as a Colporteur, Pastor, Chaplain, District Director, Departmental Director, Evangelist, Ministerial Association Secretary, and Conference President. During the course of his ministry he served as Conference President in Lesotho, Swaziland, and The Trans Orange Conference. He is fluent in seven languages: Xitsonga, Sepedi, Sesotho, Setswana, Isizulu, Afrikaans, and English.

Mrs. Martha Mawela was born in Witbank, Mpumalanga, South Africa.

She began her service to the Seventh-day Adventist Church in 1961, and worked as a Teacher, Nurse Assistant, Office Secretary, Colporteur, Publishing Director, and Women’s Ministries Coordinator. She is fluent in eight languages: Xitsonga, Tshivenda, Setswana, Sesotho, Isizulu, Isixhosa, Afrikaans, and English.

Pastor and Mrs. Mawela were married in 1960 and were blessed with two children. Their daughter, Rejoice, is a teacher in South Africa, and their son, Reuben, is a director with a pharmaceutical company in Johannesburg. Reuben and his wife Zelda have presented the Mawelas with three grandchildren— Waldo, Lona, and Nyeleti—who have affectionately nicknamed their grandfather, “The Lion of the Lowveld.” The Mawelas are known as “Papa” and “Mama” to all who know and work with them—a sign of affection, respect, and great appreciation.

In 1999, in preparation for their retirement, the Mawelas moved to the Dwarsloop area of Mpumalanga, South Africa, hoping to establish an Adventist church among the Tsongan people there. (They retired from church employment in 2003.) Pastor Mawela’s efforts were met with stern resistance from other Christian clergy in the area, so he began attending the various churches as a symbol of his intention to bless and minister within the community.

Papa Mawela soon realized that nearly every weekend he was called on to participate in funeral services—and almost always the funeral was for a young adult. The staggering reality of the HIV/AIDS pandemic became suddenly clear to him. “Almost every weekend we were burying a young person, who was leaving children behind,” Pastor Mawela said in a recent interview. “One of my own church members approached me and told me, ‘Pastor, I am HIV positive.

Am I still welcome to be a member in this church?’ That gave me a challenge.

And I discovered she was not the only one who thinks that to be HIV positive is to be like a leper, you must be thrown out. There are many in these communities [who feel that way].”

Using his stature as a retired and respected pastor, Paul Mawela convened a meeting of the pastors of the Christian churches in the Dwarsloop area. The result of that meeting is “Nhlengelo,” a community-based organization formed to help take care of those affected by HIV/AIDS. Seven local clergy—led by Pas8

tor Mawela—founded the project as a practical expression of the compassionate ministry and love of the Lord Jesus Christ.

“The project is called Nhlengelo, a Tsonga name for standing together against an enemy,” explains Mawela. “So we said, ‘Well, let us stand together against the enemy HIV/AIDS and other illnesses found in the community.’”

Today the Nhlengelo project employs nearly 50 volunteer caregivers who go out each day into their communities to help those who are living with HIV/AIDS. Each day nearly 1,000 children who are living in child-headed households are provided with a warm meal. And at the afterschool drop-in center approximately 100 children orphaned by HIV/AIDS are welcomed each day for a warm meal, help with their school work, encouragement, and the loving care of Mama Mawela. Nhlengelo also serves as a training center for those who want to help in similar ways in other communities in Southern Africa.

Since 2004, Adventists in North America have enjoyed a special relationship with Papa and Mama Mawela and all those associated with the Nhlengelo project through a partnership with Hope for Humanity, a ministry of the North American Division. (You may know Hope for Humanity by its former name, “Harvest Ingathering.”) Through Hope for Humanity church leaders, pastors, and teachers from the United States have traveled to Nhlengelo to see firsthand the work of Papa and Mama Mawela. The Mawelas have traveled to the United States and were honored guests at the 2005 General Conference Session in St. Louis.

In the summer of 2006, a delegation of church leaders from Seventh-day Adventist Regional Conferences visited the Mawelas at Nhlengelo. At that time, the Adventist congregation that Pastor and Mrs. Mawela had raised up at Thulamahashe were welcomed into Khomelela, their permanent new home—a church and community center largely financed through the gifts of Seventh-day Adventists in the United States, working through Hope for Humanity. Elder Alvin Kibble preached the dedication sermon, and Pastor Mawela was joined on the platform by many of those local Christian clergy who once opposed his ministry and his plan to start a new congregation, but who now have become his partners in ministry in the Nhlengelo project.

One of the purposes of this visit is for you to see the growth of Khomelela.

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CHILD-HEADED HOUSEHOLDS

Projections indicate that the number of AIDS orphans in South Africa reached 800,000 by the end of 2005. The African kinship care system that would once have absorbed children without parents into communal life can no longer be relied upon to fulfill that function, although many child-headed households live close to their extended families and may receive limited amounts of material support. In some situations, younger children (under 5 years) are taken to live with the extended family. The older children and young people are kept together within a child-headed household.

Current figures suggest that foster parents are looking after 35% of orphaned children and only 0.1% are being adopted. A significant percentage of children orphaned by AIDS will find themselves in households headed by children.

Children who lose their parents are left alone to deal with their grief, are plunged deeper into economic crisis, and become responsible to care for siblings with little or no support from impoverished communities. Children as young as 10 years old are forced into the role of “head of household.� They are too young to assume these responsibilities, yet they have no choice.

Through the Nhlengelo project we are seeking to help these children.

Our dedicated teams of caregivers visit the children in their homes, and welcome them to our center every day. Our assistance includes a daily hot meal program, as well as the provision of staple food items like corn meal, beans, vegetables, and cooking oil. When possible, we provide charcoal, soap, clothing, and blankets.

This is the nature of the project that you will see, and that will touch your heart, at Nhlengelo. This is the ministry we invite your members to support through Hope for Humanity.

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MALUTI ADVENTIST HOSPITAL LESOTHO

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he Kingdom of Lesotho is just slightly smaller than the state of Maryland.

The landlocked country is completely surrounded by the Republic of South Africa, and it is one of three kingdoms on the continent of Africa (the others are Swaziland and Morocco). The Basotho people have nicknamed their country “The Kingdom in the Sky” due to the mountainous terrain; more than 80% of the country is 6,000 feet above sea level. About 80% of the population live in lowlands in small rural villages; the average altitude in the “lowlands” is nearly 4,700 ft.

Even a brief glance at recent statistics from Lesotho reveal a crisis of staggering proportions: There are about 2 million people in Lesotho, and in 1990 the life expectancy was 58 years. By 2005, because of the impact of the HIV/AIDS pandemic, the life expectancy had dropped to just 34 years. Lesotho has the third highest rate of HIV/AIDS in the world, with nearly 30% of adults infected (after Botswana and Swaziland). Around 330,000 adults and 27,000 children have HIV/AIDS, out of a total population of just over 2 million. Approximately 29,000 people died of AIDS in 2003, representing nearly 1.5% of the entire population. Nearly 100,000 children in Lesotho have been orphaned

by HIV/AIDS. The town of Ficksburg is located at the foot of the Mpharane Mountains in the Eastern Highlands region of South Africa. It is the only town in the region on the Lesotho border and is an important trade route between South Africa and Lesotho. The town is also known for its Sandstone Mountains and great rock formations.

Maluti Adventist Hospital was established in 1951 and is operated by the Seventh-day Adventist Church. The initial money for the hospital came from the 13th Sabbath Overflow offering in 1949, along with appropriations from the Southern Africa Division and the South African Union Conference. The hospital was expanded several times through the 1950s, 60s, and 70s. The “new” operating theater was officially opened in 1992, and there has been a continuous effort to upgrade the laboratories and overall facility since that time. Hope for Humanity has been engaged in some of the renewal and expansion projects.

Maluti Adventist Hospital (MAH) serves an area of approximately 185 square miles in the northwest part of Lesotho, with a population of about 100,000 people. The 160-bed hospital offers a comprehensive range of health care services, primarily to the 264 villages in its health service area, but also to many patients from other parts of the country who come to MAH from other areas of the country, attracted by the hospital’s reputation for quality care. The hospital is respected throughout Lesotho for eye care, the surgery center, the Wellness Center devoted to HIV/AIDS cases, and the clinics that are operated in surrounding communities. HIV/AIDS has had a devastating impact on the population of Maluti, and has changed the work of the hospital.

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Maluti Adventist Hospital has the following wards: female, male, maternity, children (pediatric), and private. The hospital maintains a large outpatient department (OPD), operating theater, eye department, physical therapy department, pharmacy, and emergency room, as well as laboratory and x-ray departments. Additionally, the hospital provides a specialized clinic (The Wellness Center) for HIV/AIDS and TB, a clinic for mothers and children (Maternal and Child Health—MCH), and a dental clinic.

Nearly 75% of the more than 5,000 patients admitted to the hospital last year for any reason were also HIV positive.

Maluti Hospital diagnosed its first HIV positive patient on February 14, 1991, and an HIV/AIDS department was started under the hospital’s Primary Health Care program. This unit is now called “The Wellness Center,” and addresses the physical, emotional, and spiritual needs of its patients and clients.

The hospital also supports a Public Health Department that has responsibility for community outreach, which includes clinics and health centers, health education, prevention, and nutrition.

There are a total of five health centers, three located in villages, one in a town, and another in the city of Maseru. The health centers are staffed five days a week by nurses who provide a broad range of services as well as referral to the hospital as necessary. The hospital also supports a network of community health workers who have been trained to provide basic health care services in their respective villages.

The health care providers working in the Wellness Center and the Public Health Department include doctors, nurses, social workers, and clergy, as well as specialists in agriculture, nutrition, income generation. Through these programs Maluti is also able to deliver life-saving service to families, widows, orphans, and vulnerable children.

There is a School of Nursing at Maluti Adventist Hospital that trains nurses who serve throughout Lesotho and southern Africa. It was established in 1958 and has graduated hundreds of registered nurses, nurse assistants, and registered midwives. The training of nurses is a key ingredient in the overall community and national health care strategy of the hospital. Through those trained at Maluti, the reach of Adventist health care goes well beyond the service area of Maluti. Nurses trained at Maluti serve in many different capacities throughout the country, from direct care in small villages to those who work in government posts in the capitol of Maseru. The School of Nursing is one of the most important ways in which the health care challenges of the future are being addressed.

Hope for Humanity is actively developing an expanded portfolio of partnership and service with the MAH School of Nursing.

The school system of the North American Division has joined with Hope for Humanity to raise money to build a new classroom block for Maluti Adventist Church School. The new block will include four classrooms, including space for classroom libraries and computer stations; a multipurpose auditorium/gymnasium; a restroom block; and space for administration and faculty.

The new school will serve as many as 140 students. The cost of the project is 12

$120,000.

Maluti Adventist Church School is key to recruiting and maintaining a qualified professional staff for the hospital, for without a proper school for their children, physicians and staff from Lesotho, South Africa, or the countries around South Africa are not able to come to Maluti to serve the communities that are under the care of MAH. The elementary school enjoys an excellent reputation in Lesotho, and it is well known that students who study at Maluti have an excellent basis for high school and higher education. These factors have combined to make the elementary school an important part of the continuing ministry that MAH seeks to secure.

THE ECONOMY OF LESOTHO

The economy of Lesotho is based on exports of water and electricity sold to South Africa, agriculture, livestock, manufacturing, and the earnings of laborers employed in South Africa. Resources are scarce—a consequence of the harsh environment of the highland plateau and limited agricultural space in the lowlands. So, Lesotho has been heavily dependent on the country that completely surrounds it—South Africa.

Lesotho is geographically surrounded by South Africa and economically integrated with it as well. Lesotho depends on South Africa as an employer and as buyer of its main natural resource—water.

The majority of households subsist on farming or migrant labor, primarily miners in South Africa for 3 to 9 months. The western lowlands form the main agricultural zone. Almost 50% of the population earn some income through crop cultivation or animal husbandry, with nearly two-thirds of the country’s income coming from the agricultural sector. The economy is still primarily based on subsistence agriculture, especially livestock, although drought has decreased agricultural activity.

Over the decades thousands of workers have been forced by the lack of job opportunities to find work at South African mines. Small, landlocked, and mountainous, Lesotho relies on remittances from miners employed in South Africa and customs duties from the Southern Africa Customs Union for the majority of government revenue. However, the government has recently strengthened its tax system to reduce dependency on customs duties.

Completion of a major hydropower facility in January 1998 now permits the sale of water to South Africa and also generates royalties for Lesotho. Lesotho produces about 90% of its own electrical power needs. Water is Lesotho’s only significant natural resource. It is being exploited through the 30-year, multi-billion dollar Lesotho Highlands Water Project (LHWP), which was initiated in 1986. The LHWP is designed to capture, store, and transfer water from the Orange River system and send it to South Africa‘s Free State and greater Johannesburg area, which features a large concentration of South African industry, population, and agriculture. At the completion of the project, Lesotho should be almost completely self-sufficient in the production of electricity and also gain income from the sale of electricity to South Africa. The World Bank, African 13

Development Bank, European Investment Bank, and many other bilateral donors are financing the project.

As the number of mineworkers has declined steadily over the past several years, a small manufacturing base has developed based on farm products that support the milling, canning, leather, and jute industries, as well as a rapidly expanding apparel-assembly sector. Asian investors own most factories. Textile exports have been hurt by the erosion of trade concessions, but appear to be expanding again Tourism is a slowly growing industry. A ski resort recently opened in the high Maluti mountains is drawing tourists from South Africa.

Lesotho has nearly 6,000 kilometers of unpaved and modern all-weather roads. There is a short rail line (freight) linking Lesotho with South Africa that is totally owned and operated by South Africa.

Significant levels of child labor exist in Lesotho, and the country is in the process of formulating an Action Programme on the Elimination of Child Labour (APEC). This is expected to be adopted in the period 2006-2007.

Until the political insecurity in September 1998, Lesotho’s economy had grown steadily since 1992. The riots, however, destroyed nearly 80% of commercial infrastructure in Maseru and two other major towns in the country, having a disastrous effect on the country’s economy. Nonetheless, the country has completed several IMF Structural Adjustment Programs, and inflation declined substantially over the course of the 1990s. Lesotho’s trade deficit, however, is quite large, with exports representing only a small fraction of imports.

Poverty is deep and widespread, with the UN describing 40% of the population as “ultra-poor.” Food output has been hit by the deaths from AIDS of farmers. The extreme inequality in the distribution of income remains a major drawback. Lesotho has received economic aid from a variety of sources, including the United States, the World Bank, the United Kingdom, the European Union, and Germany.

Lesotho, is a member of the Southern African Customs Union (SACU) in which tariffs have been eliminated on the trade of goods between other member countries, which also include Botswana, Namibia, South Africa, and Swaziland.

Lesotho, Swaziland, Namibia, and South Africa also form a common currency and exchange control area known as the Rand Monetary Area that uses the South African Rand as the common currency. In 1980, Lesotho introduced its own currency, the loti (plural: maloti). One hundred lisente equal one loti. The Loti is at par with the Rand.

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HIV/AIDS

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NAIDS and WHO estimate that AIDS has killed more than 25 million people since it was first recognized in 1981, making it one of the most destructive epidemics in recorded history. Globally, between 36.7 and 45.3 million people are currently living with HIV. In 2005, between 4.3 and 6.6 million people were newly infected and between 2.8 and 3.6 million people with AIDS died, of which more than 570,000 were children. This is an increase from 2004 and the highest number since 1981.

Sub-Saharan Africa remains by far the worst affected region, with an estimated 23.8 to 28.9 million people currently living with HIV. More than 60% of all people living with HIV are in sub-Saharan Africa, as are more than three quarters (76%) of all women living with HIV. In 2005 it was estimated that South Africa has the largest number of persons living with HIV/AIDS: 5.3 million people out of a population of 45 million people—more than 10% of the population.

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HIV/AIDS GLOSSARY Acquired Immunodeficiency Syndrome (AIDS) A disease of the body’s immune system caused by the human immunodeficiency virus (HIV). AIDS is characterized by the death of CD4 cells (an important part of the body’s immune system), which leaves the body vulnerable to life-threatening conditions such as infections and cancers.

AIDS-Defining Condition Any of a list of illnesses that, when occurring in an HIV-infected person, leads to a diagnosis of AIDS, the most serious stage of HIV infection. AIDS is also diagnosed if an HIV-infected person has a CD4 count below 200 cells/mm3, whether or not that person has an AIDS-defining condition. The Centers for Disease Control and Prevention (CDC) published a list of AIDS-defining conditions in 1993. The 26 conditions include candidiasis, cytomegalovirus disease, Kaposi’s sarcoma, mycobacterium avium complex, pneumocystis carinii pneumonia, recurrent pneumonia, progressive multifocal leukoencephalopathy, pulmonary tuberculosis, invasive cervical cancer, and wasting syndrome.

AIDS-Related Complex (ARC) A group of complications that commonly occur in the early stage of HIV infection. These may include recurrent fever, unexplained weight loss, swollen lymph nodes, diarrhea, herpes, or fungus infection of the mouth and throat.

Acute HIV Infection Also known as primary HIV infection or acute retroviral syndrome (ARS). The period of rapid HIV replication that occurs 2 to 4 weeks after infection by HIV. Acute HIV infection is characterized by a drop in CD4 cell counts and an increase in HIV levels in the blood. Some, but not all, individuals experience flu-like symptoms during this period of infection. These symptoms can include fever, inflamed lymph nodes, sore throat, and rash. These symptoms may last from a few days to 4 weeks and then go away.

Antiretroviral (ARV) A medication that interferes with the ability of a retrovirus (such as HIV) to make more copies of itself.

Antiretroviral Therapy (ART) Treatment with drugs that inhibit the ability of retroviruses (such as HIV) to multiply in the body. The antiretroviral therapy recommended for HIV infection is referred to as highly active antiretroviral therapy (HAART), which uses a combination of medications to attack HIV at different points in its life cycle.

Discordant Couple A pair of long-term sexual partners in which one person is infected with a sexually transmitted infection (such as HIV) and the other is not.

Horizontal Transmission A term used to describe transmission of a disease from one individual to another, except from parent to offspring. For example, HIV can be spread horizontally through sexual contact or exposure to infected blood. In contrast, spread of disease from parent to offspring is called vertical transmission.

Human Immunodeficiency Virus (HIV) The virus that causes Acquired Immunodeficiency Syndrome (AIDS). HIV is in the retrovirus family, and two 16

types have been identified: HIV-1 and HIV-2. HIV-1 is responsible for most HIV infections throughout the world, while HIV-2 is found primarily in West Africa.

(Note the difference between the virus that causes AIDS and the disease itself.

This is especially important to persons living with HIV infections who do not have the symptoms of AIDS.) Immune System The collection of cells and organs whose role is to protect the body from foreign invaders. Includes the thymus, spleen, lymph nodes, B and T cells, and antigen-presenting cells.

Immunodeficiency Inability to produce normal amounts of antibodies, immune cells, or both.

Interferon (IFN) A cytokine (protein that regulates immune system activity) that the body produces to fight viruses. Laboratory-made versions of IFN are used in the treatment of some virus infections and cancers. There are three main types of interferon: alpha, beta, and gamma. IFN alpha is used to treat hepatitis C virus (HCV) infection and many cancers, including Kaposi’s sarcoma.

Latency The time period when an infectious organism is in the body but is not producing any noticeable symptoms. In HIV disease, latency usually occurs in the early years of infection. Also refers to the period when HIV has integrated its genome into a cell’s DNA but has not yet begun to replicate.

Mother-to-Child Transmission (MTCT) The passage of HIV from an HIVinfected mother to her infant. The infant may become infected while in the womb, during labor and delivery, or through breastfeeding.

Multiple Drug-Resistant Tuberculosis (MDR-TB) A tuberculosis (TB) infection that does not respond to two or more standard anti-TB drugs. MDR-TB usually occurs when inadequate or improper treatment allows the bacteria that cause TB to continue multiplying Opportunistic Infections (OIs) Illnesses caused by various organisms that occur in people with weakened immune systems, including people with HIV/AIDS. OIs common in people with AIDS include Pneumocystis carinii pneumonia; cryptosporidiosis; histoplasmosis; toxoplasmosis; other parasitic, viral, and fungal infections; and some types of cancers.

People Living With AIDS (PLWA) Infants, children, adolescents, and adults infected with HIV/AIDS. Also PLWH/A Persons living with HIV or AIDS and PLWH Persons living with HIV. Precision in language is appreciated by all who are in any way affected by HIV or AIDS. Perinatal Transmission The passage of HIV from an HIV-infected mother to her infant. The infant may become infected while in the womb, during labor and delivery, or through breastfeeding.

Pre-Conception Counseling A specific type of health care recommended by the American College of Obstetrics and Gynecology for all women of childbearing age prior to pregnancy. Its purpose is to identify risks of pregnancy and childbirth for both mother and child, to provide education and counseling targeted to a woman’s individual needs, and to treat or stabilize medical conditions prior to pregnancy in order to optimize the mother’s and infant’s health.

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Retrovirus A type of virus that stores its genetic information in a singlestranded RNA molecule, then constructs a double-stranded DNA version of its genes using a special enzyme called reverse transcriptase. The DNA copy is then integrated into the host cell’s own genetic material. HIV is an example of a retrovirus.

Window Period The time period between a person’s infection with HIV and the appearance of detectable anti-HIV antibodies. Because antibodies to HIV take some time to form, an HIV antibody test will not be positive immediately after a person is infected. The time delay typically ranges from 14 to 21 days, but varies for different people. Nearly everyone infected with HIV will have detectable antibodies by 3 months after infection.

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