The child-headed family phenomenon through AIDS is growing daily in rural South Africa as a whole generation of parents is wiped out. It means the older children must take on the role of parents by providing food, clothing, accommodation and caring for themselves and their orphaned siblings as no consistent State support exists for them. It means that the child head of the family must effectively raise their brothers and sisters and forgo the opportunity, through education, of wrenching themselves out of the poverty trap.

There are at least 2,500 orphans and 1,000 child-headed families that have been identified in the 50 square mile radius surrounding the Holy Cross Hospice. Our primary concern is to try to help meet their basic needs. We want to help give them a chance to be children. These children are not merely statistics, they are human beings suffering terrible psychological effects from the loss of their parents. They are hungry, poverty stricken, frightened and lonely.

Established in 2002, the sole purpose of the Holy Cross Children’s Trust has been to provide consistent, meaningful and long term support to children in a rural area in South Africa who:

  • have AIDS or are HIV positive

  • have become orphans through AIDS, or

  • are the child head of a family


Specifically, the Charity provides funding for a range of programmes and projects developed by Sister Pricilla Dlamini. These programmes currently support some 2,500 orphaned children and 1,000 child headed families in a 50 square kilometre, rural area surrounding The Holy Cross Hospice in Emoyeni, KwaZulu-Natal South Africa . The incidence of AIDS/HIV in this area is amongst the highest in the world and the region has been declared an Aids Pandemic Disaster Zone.

The Charity is focused on providing targeted support for the children in this area. In doing so, we believe we can make a dramatic impact on the lives of the children in this community. Donors can be assured that their contributions make a real difference.

The Trustees are not paid and virtually all other services used by the Trust are either given at no cost or at the personal expense of the individual Trustee. As a consequence, all funds raised flow virtually entirely through to support the programmes for the ultimate beneficiaries – the children.

The Holy Cross Children’s Trust was formed on 20th of November 2002 and was granted charitable status by the Charities Commissioner for England and Wales on 24th of January 2003 (Registration number 1095593).

Sister Priscilla Dlamini

When Sister Priscilla arrived at the Holy Cross Hospice the only operative facility was a rudimentary clinic. The hospice, crèche and training centre and the many programmes that are now run at the Holy Cross AIDS Hospice were all developed by Sister Priscilla.

The late Bishop Biyase chose Sister to establish a hospice and rejuvenate the clinic as she had gained similar experience and achieved success at two other clinics in KwaZulu-Natal. With his support and that of the Holy Cross Hospice governors and from the many donors who have been so touched and proud of her work, Sister has been able to create something very special. Her approach is a holistic, community based support system for a region that has been ravaged by AIDS.

Sister is a Roman Catholic nun (Benedictine Sisters of Twasana), a qualified nurse, has diplomas in General Nursing, Midwifery, Clinical Care and Administration, Advanced Psychiatry, Community Health Nursing and is currently doing her Masters in Psychiatry through the University of Natal. She has also attended many courses on AIDS and Family Planning related subjects in South Africa, West Africa, Germany, Italy, Austria and the UK. She has also presented papers at conferences throughout South Africa and in Europe.

The Crèche

When Sister Priscilla arrived at The Holy Cross mission, she recognized that there was a need for a crèche or Day Care centre for pre-school children. This need arose from the prevalence of the child headed families and the reluctance of the “head of the family” to leave their younger siblings while they attended school. The need also arose to allow the children to play, be children and thus escape from the predicament they face as orphans and members of a child headed family.

To deal with the immediate needs and cater for the pre-school brothers and sisters of the child headed families attending the nearby primary/secondary school, Sister Priscilla converted a shed in to a rudimentary pre-school Day Care centre which could house up to 24 children. As the number of orphans and child headed families continued to grow and the reach of the Home Based Care Programme increase, so did the need for a larger facility.

From funds received from other donors, Sister Priscilla was able to fulfil a dream by constructing a crèche that is able to cater for some 150 pre-school children. The crèche – The Bishop Mansuet Biyase Crèche – was opened in August 2004. The crèche has 4 classrooms, a central service area and is fully equipped with a playground adjacent. The children receive 3 meals a day at the crèche thereby improving their health significantly. Currently, the crèche has 120 children and is staffed by a team of seven.

One of the challenges is to provide transport for the children in this deeply rural area where there is no public transport and the very young children would otherwise need to walk long distances to attend the crèche. Initially, a 1.3 ton truck that was purchased by the Trust was utilised to transport building materials to erect houses for the children in conjunction with a programme with Homeplan, a Holland based charity. It is now utilised full-time to ferry children to and from the crèche. Each schoolday, more than 100 children are collected from 4 collection points and taken to the crèche and then returned to tto the collection points at the end of the day. Currently, another donor has made funds available for the wages of the driver.

The activities carried out by the Caregivers when they are specifically providing support to the orphans and child headed families are as follows:

  • Weekly visits to the homes of the children where there are orphans or vulnerable children in which the children are either being fostered by a member of the community or where there is a child headed family.

  • Distribution of food parcels each month.

  • Arranging for houses to be built for the child headed families whose parents have died and left them without any shelter or placing, where possible, orphans with foster homes in their community.

  • Supplying children with clothing, blankets and any basic needs.

  • Attending to the medical needs of the children; this can encompass the distribution of medication, referrals to doctors, clinics or hospitals or, in the extreme cases to the hospice.

  • Counselling those children that are HIV positive.

  • Counselling the children who have, or are about to lose their parents.

  • Providing advice and counsel on the dangers of AIDS.

  • Preparing “memory boxes” for each orphan and child headed family, thereby keeping mementos and family documents in safe keeping; the former to maintain a link to their family and the latter being critical to ultimately provide proof that they are orphans and hopefully qualify for State support.

  • Helping orphaned children get their birth certificates and the death certificates of their parents; this is necessary to enable children to apply for State grants. The Caregivers arrange for the orphaned children to be screened and referred to Department of Social Welfare so that they can obtain the grants.

  • Ensuring that the children who are the head of the families go to school and remain there; some older children refuse to go back to school as they feel that they are “adults” having played the adult role for so long.

  • Writing letters to school headmasters to have them admit the orphans in to their schools; not all orphans are accepted for free as schools have budgetary constraints and are invariably reluctant or unable to accommodate non-fee paying children.

  • Supplying, where possible, the orphans with uniforms and stationery and paying their school fees or negotiating with the authorities to have the fees waived.

  • Identifying children that are at risk of losing their parents, foster parents or child head of the family; mostly through sickness in order to ensure that care can be put in place when the need arrives.

In essence, the Caregivers are “surrogate parents” for these children.

Sister Pricilla has trained over 150 Caregivers over the last few years and, until the end of 2002, they received no pay. As a consequence, only a small number were able to afford to work in the Home Based Care Programme and those that did, could only do so for a few days a week. To truly give these children a start in life, the number of Caregivers and days worked had to increase.

In February 2003, the Trust began to provide the Caregivers with a monthly allowance of R650 (£50). This has resulted in each Caregiver being able to work full time, dramatically improving the emotional and physical state of the children. At that time, there were 13 part-time Caregivers; there are currently 23 full-time Caregivers that receive an allowance from the Trust. Significantly, the Caregivers now reach out to 2,500 orphans in comparison with 600 in 2002.

The Caregivers receive training from Sister Priscilla and from outside agencies covering many aspects such as primary health care, AIDS treatment, child and bereavement counselling, personal growth, rape crisis, yoga, palliative care, AIDS awareness and prevention and Natural Family Planning.

The performance of the Caregivers and progress of each orphan and child headed family is monitored carefully. Caregivers meet every Monday at the Holy Cross Hospice to receive on-going training, share experiences and provide their written reports and statistics. Statistics are maintained for each visit, for each child and for each child headed family and are used to help provide targeted and effective care. These statistics are also provided to Regional Hospice Care Associations, The Global Fund, State institutions and to the Trust. During the year ended December 2008, the Caregivers made some 5,500 household visits. The Home Based Care Programme remains one of the biggest projects of its kind in KwaZulu-Natal.

The Caregivers

The primary role of the Caregivers is to reach out to the community in the 50 square kilometre area surrounding The Holy Cross Hospice and provide care and support to the most needy on a structured and consistent basis. During the year ended December 2009, the Caregivers made over 5,500 visits to individual households in this community.

The Hospice

When Sister Priscilla arrived at the Holy Cross mission in 2000, the immediate and pressing need was for the provision of a hospice. The spread of AIDS was rising and the death toll in the region was mounting. At that time, Sister was fortunate that two German doctors had joined her at the Mission in 2001 to study the effects of AIDS and to assist her in the clinic.

Together with the doctors, Sister Priscilla raised the necessary funds and went about converting the derelict stables on the Mission in to a 40 bed hospice. When it was completed in 2002, the hospice could cater for couples, individual patients, children and infants thereby providing a sanctuary for the terminally ill members of the community and a place where they could die with dignity. There are no other similar facilities in the area.

The hospice is staffed by a trained nurse and periodically by Caregivers.