MOTHERS AND CHILDREN

NEONATAL CARE IN RURAL SOUTH AFRICA

Malamulela district hospital is located in the Vhembe region of Limpopo, South Africa. 200 kilometres from Polokwane, the provincial capital. Every year about 23,000 newborn babies die in South Africa (based on UNICEF data in 2010) , but the majority of these deaths are easily preventable if hospitals can improve the quality of their neonatal care.

In Limpopo Province, the Limpopo Initiative for Newborn Care (LINC) put in place to set of neonatal care interventions in all regional and district facilities.

Neonatal ICU

16 March 2011. Malamulela, Limpopo, South Africa. This little patient was due to be released from the High Care unit, when it unexpectedly suffered a setback in the form of an infection.

16 March 2011. Malamulela, Limpopo, South Africa. Every year about 23,000 newborn babies die in South Africa (UNICEF data from 2010), but the majority of these deaths are easily preventable if hospitals improve the quality of their neonatal care.

This little patient was due to be released from the High Care unit, when they unexpectedly suffered a setback in the shape of an infection.

Yvone Mabasa, mother of 4-day old twins, takes care of them in the high care unit at the hospital. Malamulela district hospital is located in the Vhembe region of Limpopo, 200 kilometres from Polokwane, the provincial capital.

Yvone Mabasa, with one of her 4-day old twins in the neonatal high care unit at the hospital in Malamulela district.

The Postnatal help desk at Malamulela district hospital in Limpopo province, South Africa.

Ntlakuso Maleke was born on 27 February 2011 weighing 1500 gram and suffering from hyaline membrane disease, a syndrome in premature infants caused by developmental insufficiency of surfactant production and structural immaturity in the lungs. Mother Olga Mtilemi (20) has been instructed in Kangaroo mother care that involves constant skin-to-skin contact with her baby and exclusive breast feeding that will save her baby's life.

Malamulela district hospital, Limpopo, South Africa.

Ntsako Molukele's son was born the previous night at 22:00 weighing a healthy 3,2kg.

16 March 2011. Malamulela, Limpopo, South Africa. Mother Nkhesani Ndleve gave birth to twins earlier that morning. A boy and a girl. In her arms is her newborn daughter while her son is receiving more care in the high care unit. With her is her own mother (in green) Modjadji Baloyi and her mother-in-law Mphepu Shuvambu.

Mothers wait anxiously to be discharged (all gave birth the previous day 15 March 2011) Altogether eleven babies were born.

Proud grannies and aunts get ready to take the new members of their families home.

Mother Eva Chauke, Father Mathye Enlani Reem and their baby Kateko (6 months)visiting at Malamulela district hospital is located in the Vhembe region of Limpopo, 200 kilometres from Polokwane, the provincial capital.

Child Protection

Lunchbox Politics

Every school day morning, Daniel* wakes early to make sure he has clean, pressed clothes to wear to school, then he carefully prepares his lunchbox.

While most 16 year olds have their likes or dislikes, Daniel harbours deeper concerns: if his skaftin or lunchbox just has maize meal and wild spinach, he fears he will be found out as an orphan.

Daniel sees other kids teased mercilessly and ostracized for being deemed orphans, “I am afraid they will laugh at me or treat me badly. I see it happen to other children.” Even those who have a parent, but are too poor to have meat with their pap, are called parentless. [read more]

I love my room. Look at my room.

15 March 2011. Thohoyandou, South Africa. Priscilla Mudau is the caregiver of her 16-year old half-brother Daniel (not their real names) after their mother died of AIDS-realted illness. Patricia inherited her mother's (RDP) house. Isibindi Circles of Care is an award-winning childcare forum developed by the National Association of Child Care Workers. It reaches thousands of children through 55 sites in eight provinces. These informal networks play a critical role in helping to identify orphans and vulnerable children, in providing psychosocial support, and in referring children to Government Services.

Daniel's Bedroom

Daniel's bedroom is in the RDP house that his half-sister inherited from her mother. In South Africa Government Subsidy housing are called RDP, referring to a Mandela era socio-economic policy framework, called the Reconstruction and Development Programme. Hence RDP. Photo by Leonie Marinovich, 2011.

Curtains

The house is located in an area near Thohoyandou in Venda situated in Limpopo province, South Africa. Photo by Leonie Marinovich, 2011.

School shoes, books and personal care items fin Daniel's bedroom. Photo by Leonie Marinovich, 2011.

Clean shoes. Photo by Leonie Marinovich, 2011.

Sunlight

A bar of Sunlight soap remains on Daniel's bed. Photo by Leonie Marinovich, 2011.

After returning from school, Daniel changes out of his school uniform into something more comfortable. Photo by Leonie Marinovich, 2011.

Electricity on demand. Photo by Leonie Marinovich, 2011.

Patriarch

A portrait of the family patriarch, wearing the widely recognized star emblem of the ZCC church on his lapel. Photo by Leonie Marinovich, 2011.

The kitchen.

15 March 2011. Thohoyandou, South Africa. Patricia Mahonyedze is the caregiver of her 16-year old half-brother Lufuno (do not use real name) after their mother died of AIDS-realted illness. Patricia inherited her mother's (RDP) house. Isibindi Circles of Care is an award-winning childcare forum developed by the National Association of Child Care Worders. It reaches thousands of children through 55 sites in eight provinces. These informal netowrkds play a critical role in helping to identify orphans and vulnerable children, in providing psychosocial support, and in referring children to Government Services.

Family

Priscilla and Daniel watch TV in the living room of the RDP house that Priscilla inherited from her mother. Photo by Leonie Marinovich, 2011.

ENVIRONMENT

FROM SOURCE TO SEA

This was a project commissioned by UNOPS that allowed us to travel as a family, from the source of the Orange river (the Senqu) to its mouth on the west coast of southern Africa.

The Orange River rises as the Senqu in the highlands of Lesotho, some 3,300 metres above mean sea level and more than 2,300 kilometres from its destination on the west coast of southern Africa. With a total catchment area of almost a million square kilometres, the Orange–Senqu River Basin is one of the largest in Africa, encompassing the whole of Lesotho and parts of Botswana, Namibia and South Africa. Its many tributaries include the Vaal River in South Africa and the ephemeral Fish River in Namibia.

The basin has a population of 14.3 million people, and the river system plays a vital role in sustaining livelihoods and stimulating economic growth. Water is abstracted for urban, industrial and agricultural use, and harnessed for hydroelectric power via several water transfer schemes and 29 large dams. The combined effect of abstraction and evaporative losses has been a reduction by more than 50% in the natural runoff of 11,600 million cubic metres per year. Demand for water is predicted to increase with economic growth and development, emphasising the urgency for effective water resource management to ensure sustainability.

The river is also important to regional cooperation, as it crosses national boundaries and – in the case of Namibia and South Africa – forms part of the border between the two countries. Furthermore, each country, by way of national legislation and international conventions, is obliged to account for water allocations to the other riparian countries. The four countries in the basin are committed to working together to protect their shared water resources, and through an agreement in 2000 established the Orange– Senqu River Commission (ORASECOM) to facilitate this.

Text by: Greg Marinovich

Interactions between the Orange-Senqu River Basin and the Benguela Current Large Marine Ecosystem. Booklet produced for UNOPS on behalf of the Orange-Senqu River Commission and the Benguela Current Commission, with the support of the UNDP and GEF.