Social workers in short supply in South Africa

In the Johannesburg suburb of Roodepoort, just north of the sprawling township of Soweto, Loftie Eton manages a small child-welfare agency that has steadily become the front lines in South Africa's troubled war on AIDS.

Here, children orphaned by AIDS find homes. Here, foster parents maneuver through the intricate process of getting legal custody of children and access to the trickle of government grants to help them keep these children clothed, fed, and in school.

The caseload at the Roodepoort Child Welfare Society has grown in the past 10 years from perhaps 60 to 80 children per year to well over 1,000. Social workers each have between 110 and as many as 400 cases to sort through, virtually all of them children who have lost parents to AIDS. The vast majority will be handed over to aunts or grandmothers, but some children simply have no relatives willing or able to take them in.

"We told the government we weren't taking any more cases," says Ms. Eton, a tall, red-haired, friendly Afrikaans-speaking woman who has worked here for a decade. She told the official for the Department of Social Services that "no social worker can handle 250 cases." "They told me, 'If you want to keep taking government funding, then you have to keep taking cases.'"

There are hundreds of agencies like Eton's around the country, technically private charities, but essentially providing a government service. All tell the same story: AIDS has left them overworked, understaffed, and unable to provide the attention their clients deserve.

A report commissioned by South Africa's Ministry of Social Development in 2005 found that the country has half the number of social workers needed to meet the minimum services to children. The shortage is particularly acute in Gauteng Province, which includes Johannesburg and the capital city of Tshwane (formerly known as Pretoria), with an average of 5,395 children per social worker, according to the study. And while the government has won praise for its commitment to children's protection programs in its current five-year plan, there are neither the resources nor the personnel in the country to implement these plans. In 2005, there was a demand for 154,000 beds in children's homes around the country, more than 10 times the number of beds available.

"It's such an incredible task to get a foster care grant," says Chris Desmond, a research specialist on children, youth, and family issues for the Human Sciences Research Council in Durban. This is especially true for poorer black families who may not have proper birth certificates, infrequent income, and who, by dint of being the largest ethnic group in the population, at 80 percent, are more likely to be affected by AIDS.

But statistics don't tell the full story of how AIDS affects children in South Africa, Mr. Desmond adds. "If you have 5.4 million people living with HIV, that's about 5-1/2 million people who may be parents [now or in the future]. They are doctors and nurses and teachers – these are people who have an impact on children's lives. When you have that much instability in a child's life, it's bound to have an effect."

South Africa's government has been working to create a strategic action plan for AIDS and a Children's Bill to make it easier for children orphaned by AIDS to find stable homes. But response depends on the availability of social workers.

"We acknowledge that capacity is an issue, and it's our first concern," says Pat Naicker, director of child and family benefits for the Department of Social Development in Tshwane. "In this country, we have about 5,000 registered social workers, and a lot of them are associate social workers, or less than professional, and we have so many children in hand."

But Ms. Naicker says that the government is taking steps to reduce the amount of paperwork required for a grandmother or other family member to receive custody of an orphaned child. Once a family gets custody, they can start receiving foster care grants of 590 rand (or $84) per child per month. "Because the value of a foster care grant is so high, it addresses poverty, so people don't need to work," she says.