A South African study concludes it is the elderly, particularly women, who are bearing the brunt of caring for AIDS sufferers and children orphaned by the disease.
In nearly three quarters of the households in Mpumalanga province it is the elderly who are the primary breadwinners, providing for ailing adult children and grandchildren from meager old-age state pensions.
Monde Makiwane of the state-funded Human Sciences Research Council says his research conducted in this South African province has also shown that two-thirds of the households are headed by women.
"So there are [many more] females who have to bear the brunt giving care and supporting younger children. And most of those females are widowed, and we know that many of them also suffer from cultural discriminatory practices, which are still prevalent in some parts of Africa, such as accusations of witchcraft, or being discriminated in inheritances," said Mr. Makiwane.
Mr. Makiwane, says that in addition to dealing with day-to-day problems of providing for families from tiny incomes, getting children to and from school, having to collect water from a communal source, and preparing meals, these elderly caregivers have to cope with the frailties of old age.
"And we must also know most of them are not in a good state of health," he added. "Most of them have also got disabilities that are associated with old age, so they have take care of themselves, they have to attend health facilities which are that good in rural areas. So it is a very sorry situation that most of the elderly have to cope with."
Black communities in South Africa have long been known for a culture of strong communal ties, never standing by when a family member or neighbor needs help. It even has a name, uBuntu. But Mr. Makiwane says the burden of HIV/AIDS is undermining uBuntu in South African communities, not least he says, because of stigma.
"Definitely stigma has got a lot to do with it," he noted. "Many people do not want to be associated with HIV/AIDS and even those households who have someone sick with HIV/AIDS, do not go about telling community members about it. They would rather suffer in silence. So the stigma has a lot to do with declining social help from the community."
Mr. Makiwane says that the findings of his research, conducted primarily in rural areas, are likely to be replicated elsewhere in South Africa's rural areas. And, he says, in provinces such as KwaZulu/Natal, which have a much higher prevalence of HIV, the burden on the old is likely to be much worse.