In a country where it is estimated that one out of every five or six people is HIV-infected, a staggering number of orphans have been left behind when their parents have died during this quarter-century-long epidemic. It is estimated that there are over 12 million orphans in Africa and 1,200,000 in South Africa alone. The children that H.O.P.E. currently works to support through Ekukhanyeni are 600 orphans and other impoverished children who live in Lawley and Finetown, two “informal settlements” (shanty towns) near Johannesburg.

Many children may be HIV-infected due to the mother-to-child transmission that occurs during pregnancy or at birth, or during breast feeding, but the lack of medical care means that children are seldom properly diagnosed, and almost never properly treated. Even among the children who do have some version of adult support, the life expectancy for HIV-infected children is only five years. In the western world where children get good nutrition and drug treatment when appropriate, HIV disease is a manageable condition that most children will be able to live with long-term. Such is not the case in the informal townships. Even HIV-negative children are at great risk for not surviving childhood, just due to malnutrition and lack of proper care.

As described in About Ekukhanyeni, these children live at what is truly the bottom of the poverty ladder. If they are lucky, they have a home to go to at night, one of the tin shacks with dirt floors and no sewage or running water or heat. If they are not, they are completely homeless. If they are lucky, there is an orphan’s crèche that will take them in during the daytime hours, and at least give them their one meal of the day, a bowl of cornmeal gruel. If they are not, there isn’t even that. Some of the children who have a place in a crèche during the day will go home alone to one of the shacks at night. They live in what is called a “child-headed household” where an older child of perhaps nine or ten may be taking care of several younger siblings, with no adult at all in the household, just children taking care of children. Others will go to a shack owned by an extended family member who has taken them in because of cultural values and family connections but most often will have no money to provide food for them since they are themselves impoverished, with multiple children of their own who are already hungry.

As a result, there are millions of orphans whose small bodies are trying to survive with only that one bowl of boiled cornmeal called “pap” each day, the nutritional equivalent of living on bread and water. For anyone who understands the nutrition requirements for a growing child, that is a nightmare. And it is a nightmare that has three devastating outcomes. The first outcome of this horribly inadequate diet is simply that malnutrition kills five million children every year -- that's one child every six seconds. In about the time it took you to read that last sentence, another child died.

Every year, malnutrition is associated with half of all deaths in children under the age of five. The risk of death for children with severe acute malnutrition is estimated to be 20 times higher than that of a well-nourished child.

Although we tend to think of starving children as being the result of wars and famines, in fact, severe malnutrition is common in any country where people live in abject poverty. It is estimated that at any given moment, more than 60 million children in the world under the age of five are suffering from acute malnutrition with wasting (with low weight for height), and 20 million are suffering from severe acute malnutrition (severe enough to cause stunted growth and weight loss) and are at serious risk of death unless they receive immediate nutrition aid, including not only food itself but supplements that are rich in protein, fats, vitamins, minerals, and calories, the combination of which can quickly reverse the state of malnutrition and give the child a chance for recovery.

Children die from malnutrition because a child’s body cannot keep the heart beating without nutrients. A child’s body cannot maintain an immune response to counter infections without nutrition. A child’s body cannot recover from the diarrhea that is common in this part of the world because of parasites and contaminated water without nutrition. Tick tock. In the time it took you to read these last few sentences, three more children died.

The second outcome of this terrible lack of proper food is that children who do manage to survive have bodies that do not develop properly.

  • A child needs adequate protein to build and maintain cells, muscles and organs, to produce enzymes and hormones, to make the hemoglobin that carries oxygen to the cells, and to maintain the immune response. When protein intake is too low, immune dysfunction will result as well as weight loss and fatigue. Protein deficiency-created loss of immune function is a devastating cause of lowered resistance to infection and improper wound healing.

  • A child needs adequate fat intake to build proper brain tissue and a properly functioning nervous system, to properly insulate the body, and to serve as an energy storehouse. Essential fatty acids are just that—essential. Both the omega-3 and omega-6 fatty acids are crucial for a child’s health and proper development. When levels of fat intake drop so low that the levels of essential fatty acids in the body are compromised, there can be many negative health consequences, including skin problems, neurological problems, energy problems, and suppressed immunity.

  • A child needs adequate carbohydrates to provide energy since they are the body’s main source for this. Without sufficient carbohydrates the body will not have the fuel it needs to function well and keep all the body’s processes running efficiently.

  • A child needs adequate micronutrients to support every aspect of the body’s ability to build itself properly (creating the body’s structure) and work properly (keeping the body functioning). So to build a strong and optimally functioning body, including the immune system, the cardiovascular system, the muscles, the brain, the nerves, the bones, the digestive system, and every other cell, tissue, organ, and system in the body, a child absolutely must have appropriate nutrition at the right time.

The orphans and other impoverished children in Africa do not have these crucial macronutrients (protein, fat, and carbohydrates) and micronutrients (vitamins and minerals) in their daily diet. Even if they eat every bite of that one bowl of cornmeal gruel and lick those fingers clean, all that their little bodies get is enough carbohydrates to keep going for another day, but none of what is crucially needed for healthy development.

The end result is millions of needless deaths, and a future generation with serious mental and physical health problems due to the inadequate nutrition during the crucial developmental stages, especially during the first five years of life. Children who had inadequate nutrition at crucial times face a future with a high risk of chronic disease and a substantially lower life expectancy as adults.

The third outcome of there never being enough food for these children is that hunger hurts. The simple fact is that all of these children are hungry every day. They get up hungry. They go through the day hungry. They go to bed hungry.

The only “relief” from this comes when the end of life nears, and their little bodies shut down their appetites since continuing to feel the terrible hunger would just be too cruel. This adaptation may make their end days less agonizing in certain ways, but it makes it even more difficult to reverse the problem since it becomes difficult to get them to eat at this stage. There are no easy answers for this but an approach that combines increased intake of nutritious foods and micronutrient supplementation is the beginning of a solution. Ekukhanyeni is working towards this for the children of Lawley and Finetown.

As shown in About Ekukhanyeni one of the most important projects is the installation and maintenance of organic, permaculture gardens where nutrient-rich vegetables are grown year-round. Even small bits of available space can be enough for a permaculture food garden.

When H.O.P.E. cofounder Lark Lands, on the right above, visited the nuns at the Finetown School, she was amazed by the abundant growth of vegetables that could be produced even during this cold time of year, the very end of autumn. And the permaculture workers have even been able to keep lots of the vegetables growing throughout the winter so the children’s diets continue to be improved, even at the times of year when little else is available. Just receiving a steady supply of nutrient-rich vegetables from the gardens has yielded obvious improvements in the children’s health.

Research has clearly shown the power of nutrition to boost and maintain health. A vivid recent example of this was seen in the Ekukhanyeni orphans given improved nutrition via the food from the gardens, combined with nutrient supplements donated by the American charity MannaRelief. Suffering from severe malnutrition, many of these children had long been listless and unresponsive to caregivers and visitors. For most of them, recurrent infections and chronic problems with diarrhea and respiratory illness were a given.

Without proper nutrition, many of the children had no energy for everyday activities, and would spend much of their time simply lying on their pallets in the crowded quarters of the orphans crèches.

But there is hope when the power of nutrition can be brought to these children. In fact, the before and after results with the children given the nutrient boost from the garden-provided vegetables combined with the nutrient supplements are quite amazing. The stories of four of these children who were in very bad health are a shining example of the power of nutrition to save lives.

Note that in order to protect them, the children’s names have been changed. We provide photos of the groups of children that were included in the program but you will notice that there are no photos that individually identify the particular children with health problems. That’s because in the communities where they live, it would not be safe to identify a child in this way. Not only would that not bring help to them, it could bring harm. In the recent past in this area, a young woman was stoned to death when her community found out that she was HIV-positive. So the children are real, but the names have been changed and there can be no photos that identify these particular children.

Manopi is a little girl who is perhaps two and a half years old. Like so many of the orphans she has no birth certificate, something which completely disqualifies her from receiving any government aid. According to the caregivers at the Faith Day Care Centre, she had long been totally withdrawn and listless and weak, with a chronic respiratory infection. She would spend all day lying down, never moving around and never responding to the caregivers. In May 2006 when Lark Lands visited her crèche, she feared that Manopi was too ill to survive much longer. And she was not alone in her suffering.

Two-year-old Precious had a very swollen face and skin that always felt cold. Emotionally, she always remained distant and non-responsive, staring blankly at visitors and seldom playing with the other children.

At almost 2 years old, Manto’s legs were so weak that if she tried to stand, she would fall. According to the caregivers at the Emfundisweni Day Care Centre, her physical disabilities meant that she was unable to participate in the children’s activities so she spent most of every day just lying alone on the floor.

Themba is a thirteen-year-old boy with both tuberculosis and HIV. According to the nuns at the Declan Centre, he had long had big oozing sores all over his body, including on his face. The back of his knees were particularly bad, causing considerable pain and making it very difficult for him to walk. He had been on medication for the sores for two years, but they had never properly healed. Due to the pain and discomfort, he never used to play with the other children. Sadly, the stories of these four children are not unusual. A large percentage of the children in the crèches have such problems.

With the improved nutrition from the food gardens, these and the other children of Ekukhanyeni were being kept alive. And that’s a victory where so many children die before the age of five. But the children were not prospering. They continued to suffer with terrible problems and life-degrading symptoms, especially wounds that would not heal, terrible fatigue, ongoing diarrhea, and listlessness with lack of responsiveness to others.

Doctors Without Borders has described this problem in starving children around the world, and pointed out that food relief alone is not sufficient to restore the children’s health when they have reached this severe point of malnutrition. They need the potent boost in nutrition from supplements. [For an excellent overview on this go to: and click on Briefing Papers: Food is Not Enough: Without essential nutrients millions of children will die.]

In the spring of 2006, the American charity MannaRelief donated to Ekukhanyeni a large supply of nutrient supplements consisting of a multivitamin/mineral with added plant-derived glyconutrients. Ekukhanyeni immediately began to give the children these supplements every day. The response of these and many other children to the improved nutrition from the permaculture food gardens combined with the nutrient supplements was remarkable.

Children who once just lay in their beds are outside playing


Children who once were listless and unresponsive now laugh and happily respond to the caregivers.

Children who once just sat and stared now jump up to sing a song for visitors.

Children whose legs were once too weak to join their friends in play now dance and laugh and sing with them. Manopi and Precious and Manto and Themba are among them.


Manopi’s illness has vanished and she is strong and smiling. The speed of her recovery was amazing.

Only two weeks after beginning the nutrients, the caregivers report that she was remarkably improved. She began to play with the other children. Everyone who saw her said that her newfound energy was amazing. When Liza went to the creche two weeks after Manopi began the supplements, she ran up and grabbed hold of Liza and absolutely wouldn’t let her go. At one point, this child who had previously been weak and listless and non-responsive jumped up into Liza’s arms. She said that Manopi was so strong that she wasn’t even able to set her down because she clung so hard, grinning all the time. Every time she sees her now, this beautiful child is happy and playing, and runs to her and laughs.


Precious’ skin now feels warm; her face is normal; and she happily responds to visitors. For all the time Liza had known Precious, she had always had a very swollen face covered with white bumps and skin that was always so cold it literally felt like she had been in a refrigerator. Emotionally she just didn’t respond to others, staring blankly with eyes that seemed very “far away.”

After the first month on the glyconutrient supplements, Precious’ facial swelling had greatly decreased, the skin bumps were gone (with just a little whiteness remaining), and now she feels warm, with the normal skin temperature of a healthy child. According to the caregivers at the Faith Day Care Centre, she now has good energy and responds much better to them. Everyone who has seen Precious says that her improvement, both emotionally and physically, is amazing.


Manto’s legs now have the strength she needs to run and play so her days are no longer spent alone. For all the time Liza had known Manto, she would just lie on the floor. Her legs were so weak that if she tried to stand, she would fall. Her weakness meant that she was unable to participate in the children’s activities and so she spent most of every day lying alone.

After only three weeks of taking the nutrient supplements, Manto began to walk much more normally. After five weeks, she regained full strength in her legs, walking just like the other children. And now this child who once just lay alone on the floor, with no real interaction with others, happily plays and laughs with the other children, and responds enthusiastically to Liza and the creche caregivers.


Themba’s sores are gone, and he happily plays with his friends. After 2 years of taking medications, he had still been covered with oozing sores all over his body, and had remained in chronic pain, unable to run or play with his friends. After taking the nutrient supplements for only two weeks, the sores had almost completely healed. He is able to walk much more easily, and the pain has decreased so much that he now joins his friends playing soccer. The caregivers say that it is amazing to see this small boy who once sat alone jumping and playing outside with his friends.

And these amazing results extend to children in all the crèches. After several months with the improved nutrition from the food relief and the donated nutrient supplements, the results have truly been astonishing. The caregivers have told Liza that the diarrhea that so many of the children had previously suffered from and the chronic respiratory infections have diminished hugely. The energy level of the children has greatly improved overall. They run and play like normal children now.

The emotional well being of the children has changed dramatically for the better. It is clear to both Liza and the caregivers that even the children who had previously been apathetic and withdrawn are now emotionally engaged, playing happily with the other children and laughing. At the creche where all the children had previously appeared to be listless and withdrawn, they are now full of life and full of smiles. On Liza’s most recent visit, they jumped up and sang the national anthem for her with big grins and a joyful attitude.

Ekukhanyeni needs the additional funds to expand their nutrition support project, including installing additional permaculture gardens, adding chicken coops, and providing a steady supply of nutrient-rich supplements that can provide the potent mix of protein, fats, carbohydrates, and micronutrients to rapidly reverse advanced malnutrition, and give children’s bodies an ongoing supply of the building blocks they need to grow and develop properly.

It is H.O.P.E.’s goal to provide this funding, and try to ensure that there are countless more wonderful stories about children like Manopi and Precious and Manto and Themba whose health and proper growth is restored. When you purchase the H.O.P.E. jewelry, you are helping to create this miracle.

Hand to hand and heart to heart, we can save their lives.

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