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The World Health Organization agrees. Its studies show that infants in developing nations who feed on formula milk are more likely to die than those who feed on breast milk. Even in developed nations, there is a growing consensus that breast milk is critical for premature babies, as well as babies with severe health conditions. The American Academy of Pediatrics says all babies should be breastfed for at least a year.

The breast milk bank of iThemba Lethu is a well-oiled operation. The ministry recruits donors from Glenridge and area churches. It screens donors for HIV and other health threats. Once a donor is cleared, it supplies her with a breast pump and plastic containers for milk. The milk is expressed, frozen, and deposited at satellite collection points around Durban. Once a week, an iThemba Lethu staffer brings the milk back to the transitional home, where it is put into an industrial pasteurizer—a gift from another donor. This precaution eliminates HIV and other viruses such as hepatitis. The milk is then refrozen and later warmed when served to babies. All of iThemba Lethu's babies are fed breast milk for their first year.

Through iThemba, two other breast milk banks have been established in Cape Town and Johannesburg. Many more are needed. Coutsoudis would like to see banks across Africa. Already, she is talking to unicef, governments, and international organizations about undertaking such projects.

The sad reality behind rescuing abandoned and orphaned babies is that every baby has lost its mother to HIV/AIDS. Holley keeps photographs of the babies with their dying mothers. "This was the day before she died," she says of a frail teenage woman holding her baby. The mother abandoned her baby, but iThemba Lethu tracked her down and arranged for a last mother-baby visit. Holley is teary, but consoled by the fact that the baby survived.

Such experiences drive iThemba Lethu's prevention ministry in Cato Manor. A remnant of the apartheid days, Cato Manor is a largely black community marked by abject poverty, severe crime, and extreme drug and alcohol abuse. Post-apartheid improvements are nominal. Locals say the police think twice before going there.

Not so with iThemba Lethu staff. Though sometimes threatened with violence, they have penetrated the township through its two schools and home visits. Their message to all children is, first, that they have a God-given destiny. They encourage students to make wise choices. Second, they teach children about how HIV/AIDS spreads and how to avoid contracting it. About 450 children are currently part of iThemba Lethu's prevention program.

Coutsoudis is not alone in advocating abstinence as the most effective way to avoid contracting HIV/AIDS. "It is the only foolproof approach," says Dr. Peggy Chibuye. The Swaziland director for the Elizabeth Glaser Pediatric AIDS Foundation, a USAID-funded prevention program in Mbabane, Chibuye says a growing number of youth are choosing to abstain. "Once young people see that they have a future, they develop the commitment to say no to sex until the right time," she says. "It works."

iThemba Lethu also counsels parents. Once a child reports a home concern or teachers observe unusual behavior, two staff members take a risky walk to the child's home. Some parents are intimidating and uncooperative. Others, however, welcome iThemba Lethu's investment in their children. Although iThemba Lethu does not evangelize adults, focusing instead on parenting issues, they've seen evident spiritual change through their successful men's and women's programs. It is these stories that keep iThemba staff going.

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December 2006, Vol. 50, No. 12