A young woman leans on a cane, breathing heavily as she struggles to walk across the tiny, packed waiting room at a clinic in one of South Africa’s poorest provinces. Another man – frail, his hearing destroyed by tuberculosis and aids – is carried in on a wheelbarrow lined with a blanket by his two brothers. The Mantlaneni clinic in the Eastern Cape has no running water or electricity. Set among remote rural slopes dotted with mud huts, Mantlaneni may not look it, but for people like this it is a life-line.

Health activists say it serves as a model for tackling the country’s raging aids epidemic, which the United Nations said in a report released last week showed no signs of abating. South Africa has the world’s largest number of aids cases, with more than 5 million people infected – 10 percent of the population. Two years ago the clinic became of part a groundbreaking Aids project launched in the Lusikisiki region in the Eastern Cape province by medical charity Medecins Sans Frontieres (MSF).

Now the Siyaphila La project has been hailed by regional UN officials, who have recommended that it be promoted globally as an example of “best practice”. Thirty-five-year-old Nothobile Nongqotho said not only had her health improved since coming to Mantlaneni two years ago, but thanks to the support she got there, she is ready to take medication for the rest of her life. “The clinic helped me in that they explained about the treatment,” she said in a consulting room in the brown brick building, no bigger than the average urban South African home.

“If I’m taking medication I have to take it in the way they taught me to. Now I don’t have to struggle anymore,” she said in the Xhosa language through an interpreter.Siyaphila La means “We live here” in Xhosa. Dr. Herman Reuter, who heads it, said that was exactly the aim – to ensure that people stayed alive despite their illness. Together with local health authorities and Aids activists, MSF recruited members of the community to dispense life-prolonging anti-retroviral treatment and counsel patients. Reuter said South Africa’s Aids crisis could not afford to wait for the government to find the nurses needed to do the job.

“In 10 years the Aids problem is not going to get better, it’s going to get worse. We need to start preparing for that,” he said at the MSF offices in Lusikisiki. He said Siyaphila La also defies the government’s argument that stemming an epidemic the size of South Africa’s requires a sophisticated, big budget campaign. President Thabo Mbeki’s government bowed to pressure in 2003 and announced a public aids treatment plan but activists say the roll-out of anti-retroviral drugs (ARVs) has been far too slow, costing up to 900 lives each day.

The government said in September 61,000 people were signed on to the program but activists say that is only around 12 percent of those who need the life-prolonging medication.

<B>Gershwin WANNEBURG</B>