Anna Coutsoudis' story about starting iThemba Lethu, a ministry to abandoned and orphaned babies, is humbly short. A colleague at the University of KwaZulu-Natal received a Mandela Award and wondered where to give the cash grant, which had been designated for a nonprofit group responding to HIV/AIDS.

"Give it to us," she said, without thinking.

"You have an HIV/AIDS program at your church?" the professor asked.

"Now we do," she said.

Coutsoudis is the wife of one of the pastors at Glenridge Church, a professor of pediatrics at UKZN, a researcher on mother-to-child transmission of HIV/AIDS, and a conference speaker. She is also the founder of iThemba Lethu, Zulu for "Our Hope," in Cato Manor, a slum of more than 100,000 in South Africa's upscale beach city of Durban.

Glenridge Church started in 1982 and today meets above Durban's main train station. "Every Sunday at 7:00 p.m., during evening service," says senior pastor Doug MacDonald, "a train passes under the church, and the building shakes."

While iThemba Lethu remains independent, the church provides a "spiritual covering" for it, says MacDonald, who sees it as a strong expression of the church's desire to impact the community.

The ministry currently cares for six orphans, offers HIV-prevention programs, teaches adoptive parents how to integrate AIDS orphans into their families, and, most unusually, runs a breast milk bank—the first of its kind in sub-Saharan Africa.

'It Is Gold'

On Monday, iThemba Lethu staff prays together. Coordinator Glenda Algie leads. She is a Glenridge deacon who quit a lucrative marketing job to serve here. Another staffer, Liz Holley, presents children's needs. There are many, but one stands out: A child has outgrown the three-year age limit and needs adoptive parents urgently. "We are happy to have her in the home until a family is provided by God," says Algie.

But all is not gloomy. Yesterday, a family came and seemed to love one baby. Perhaps they will adopt it. Holley glows with thanksgiving.

Some needs are scary. A staff member working in Cato Manor was mugged. "We need to pray for protection," says Algie.

After prayer, Holley returns to the babies, who climb all over her. The transitional home is well furnished, with plenty of supplies for the babies' needs—thanks to donations primarily from Glenridge. The three-bedroom house in a good neighborhood is used by iThemba Lethu practically rent-free.

The ministry takes six babies at a time and works hard at placing them with families. Since it started in 2001, 31 babies have come through iThemba Lethu's home. Only two have died. The rest are now in happy homes.

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More than ten years ago, the late, legendary UNICEF executive officer James Grant released infant mortality statistics that stunned the world. "Every day, some 3,000 to 4,000 infants die because they are denied access to adequate breast milk," he declared.

The first baby brought to iThemba Lethu's home was ailing and about to become a part of this statistic. Coutsoudis would not let that happen. She knew a friend who was breastfeeding and would freeze extra milk for her baby while at work. Coutsoudis phoned. Would her friend be willing to donate some of that milk to another baby? The friend agreed. Soon three more breast milk donors were screened and recruited.

"It was an incredible thing to be part of," says Shirley Royal, one of the early donors. "The baby went from being very malnourished to thriving."

Coutsoudis believes breast milk is critical for unhealthy babies. Through research and practical experience, she's found that HIV-positive and undernourished babies on breast milk have a much better chance of survival. Breast milk is an unmatched, free natural resource available for babies throughout Africa. "It is gold," she says.

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.

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Small Successes

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.

So, too, do stories of rescued and placed babies, such as Baby N. In March 2002, a passerby noticed a parcel on a roadside wrapped in colorful cloth, which turned out to be an abandoned baby. Police took the baby to a short-term care facility. The staff estimated that the baby was two months old. When the search for the mother reached a dead end, they moved the baby to iThemba Lethu's home. Loving care and a breast milk diet revived the baby.

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One family visited iThemba Lethu and fell in love with the baby. The ministry screened the family and helped with all the paperwork required for adoption. Before long, Baby N, once abandoned on a Durban street, was moved into a loving home. More than two years later, iThemba Lethu staff still check on Baby N, and both the child and the adoptive parents are happy.

With South Africa's 5 million HIV cases, some wonder if taking only six babies at a time is too little. Coutsoudis says, "I do not want to create an orphanage where babies are just numbers." Instead, she strives to create a true home for babies and works hard on integrating them into families. Her hope is to see other churches establish similar homes, where quality care is given to a manageable number of babies.

Each small success, she believes, is worth the effort.

Isaac Phiri is a journalist living in Lusaka, Zambia.

Related Elsewhere:

Christianity Today's special section on AIDS/HIV is available on our site.

iThemba Lethu's official site has information on how to get involved as well as links to media coverage of the organization.

Other articles by Isaac Phiri for Christianity Today include:

Hope in the Heart of Darkness | With 3.9 million dead and 40,000 raped, Christians work for renewal and healing in Congo's killing fields. (July 1, 2006)
From Rape to Rebuilding | Women persevere in the Congo despite daunting obstacles. (July 1, 2006)
Born Again and Again | 'Jesus gives us strength,' says a Congolese pastor. (July 1, 2006)
Zimbabwe Nightmare | Christians try to negotiate ministry in southern Africa's most failed state. (April 1, 2006)
Sweeter Dreams | HIV infections decline in Zimbabwe. (April 1, 2006)
Zambia: President Disillusions Christians (March 2, 1998)

His work was also the subject of an Inside CT column.

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