Dying untreated and alone: 'Those I used to eat with shrink from me now'

"I'm scared that if Dad dies, we'll be all alone," says 13-year-old Mbali Mbata. Her mother has already succumbed to Aids, and her father, Alson, is wasting away in their homestead, a traditional rondavel in the desperately poor hills of KwaZulu-Natal.

"I'm scared that if Dad dies, we'll be all alone," says 13-year-old Mbali Mbata. Her mother has already succumbed to Aids, and her father, Alson, is wasting away in their homestead, a traditional rondavel in the desperately poor hills of KwaZulu-Natal.

One in nine South Africans, or 5.3 million people, were infected with HIV and Aids by the end of 2002, according to the UNAids agency - one of the highest rates in the world. In eastern KwaZulu-Natal the infection rate is 14 per cent, the worst in the country.

Alson, however, is in denial. Sitting listlessly in his home, which has a floor of beaten earth and dung, and no running water or electricity, he says his wife died because she was "poisoned". He claims to have no idea what is wrong with him, but resists the urging of Sister Hedwig Maphumulo, a nun who is a social worker at nearby Nkandla hospital, to have a test.

If he is HIV-positive, he will be eligible for welfare money, but the shame attached to the condition is such that even the official statistics may underestimate the ravages of Aids in South Africa. "Aids has created a very negative impact on people because of the stigma," says Sister Hedwig.

Lindiwe Linda, a near neighbour, has had the test and knows she is infected. She also knows how: her late husband, like Alson, was a migrant worker in a distant city. A system that keeps men away from their families for most of the year helps to spread the disease through prostitution. Ms Linda has told no one apart from her own family of her condition, but others guess from her gaunt appearance. "Those I used to eat with now shrink from me," she says.

This reticence about Aids - an issue scarcely mentioned during the current election campaign - goes all the way to the top in South Africa. President Thabo Mbeki, who is certain to win another five-year term in Wednesday's vote, long denied that HIV caused Aids, and the Health Minister, Manto Tshabalala-Msimang, persists in recommending an alternative therapy of lemon juice, garlic and olive oil, which sounds more like a salad dressing than a treatment for a condition that is killing between 600 and 1,000 South Africans every day.

The government resisted the distribution of anti-retroviral drugs until lobby groups seeking free treatment for all sufferers successfully took the government to court. Although a plan to give anti-retrovirals to HIV/Aids sufferers was approved in November, places such as Nkandla have yet to see any of the drugs. Even with an election coming up, the government dragged its feet: distribution began only when another court case was threatened.

The problems do not end there. Generic anti-Aids drugs of the kind produced in India cost a quarter of the price of those from Western pharmaceutical companies, but the ANC administration is under pressure from the US and EU to take the more expensive option.

The generic version combines the three drugs required for "triple therapy" in a single, twice-daily pill, while the Western treatment, produced by competing companies, requires sufferers to take up to 12 pills a day at different times, some with water, some without.

"That would be impossible for people like Lindiwe, given their living conditions," said Brian Woods, British co-producer of a documentary on Nkandla.

While Ms Linda is clinging on despite having received no anti-retrovirals, as Mr Woods filmed, Mbali Mbata and her seven-year-old brother, Sne-Themba, lost their father.

At the present rate, South Africa will have two million Aids orphans like them by the end of the decade.

"The Orphans of Nkandla", BBC4, 10pm, Tuesday 13 April