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Vaccines: A Top Priority for Global Health

Vaccination Week in the Americas Goes Global

On the Brink of a Watershed Moment for HIV Vaccine R&D

Reflections of a Lifetime Dedicated to Public Health Advocacy - In Memory of Beth Waters

A New Angle on Pediatric HIV/AIDS in Swaziland

Photos and story by Jon Hrusa

I've been taking pictures for the Elizabeth Glaser Pediatric AIDS Foundation since 2004, photographing donor trips in South Africa, Tanzania and Swaziland. I've visited many Foundation-supported health clinics, and I've always known that the Foundation's mission is to eliminate pediatric HIV and AIDS. But it wasn't until November 2009 that I fully understood how that goal can be achieved.

In recognition of World AIDS Day (Dec. 1, 2009), I wanted to tell the story of a family living with HIV in Swaziland -- the country with the highest HIV prevalence on earth. Through my relationship with the Foundation, I was introduced to Mfanzile Dlamini (28), his wife Zanele (24), and their 13-month-old daughter Phiwa. Mfanzile and Zanele are both HIV-positive, but Phiwa has thus far tested negative thanks to the Foundation-supported prevention of mother-to-child transmission (PMTCT) services that she and her mother received.

Living in South Africa, HIV/AIDS has become an accepted fact of daily life. Before I met the Dlaminis, I knew that people with HIV needed antiretroviral medications (ARVs) to stay alive. When it came to prevention, I'd heard a lot about the "ABC" campaign - Abstinence, Be faithful, Condoms. But I knew very little about preventing mother-to-child transmission of HIV. When I thought of pediatric HIV/AIDS, I usually thought about helping the children who already have it, rather than preventing them from getting it in the first place.

The reality hit me as the Dlaminis were sitting outside their one-room house, with Phiwa crawling around in the dirt: This child's parents are HIV-positive, and she is HIV-negative. The Foundation's work helped bring this about. And if every mother living with HIV had access to the same services that Zanele received, there would be no more pediatric AIDS. It was mind-blowing.

I photographed the Dlaminis for nearly three days and witnessed every aspect of their daily lives. Despite dealing with extreme poverty, life-threatening illness, and social stigma from their HIV status, the Dlaminis are a family just like any other. They work hard and their lives are difficult, but they like to eat and laugh and play with their daughter.

I was particularly struck by the relationship between Mfanzile and his little girl. In the health clinics I've visited over the years, I usually see babies with their mothers. But Phiwa gravitated to her father as well as her mother. I'll never forget the afternoon that Phiwa ran into the hut to wake Mfanzile, who slept during the day because he worked as a night watchman. I was very moved by this intimate moment between father and daughter.

My time with the Dlaminis left me feeling grateful and incredibly humbled. As a photojournalist, I tend to enter a situation, shoot it as I see it, and move on. My camera is a barrier between me and the emotions on the other side of the lens. But since the Dlaminis welcomed me into their home for several days, I had time to put my camera down. I played with Phiwa and talked with her parents. I saw them as people rather than subjects.

On my last day with the Dlaminis, I went with them to the plot of land they farm. While Mfanzile and Zanele toiled planting seeds, Phiwa played next to me in the field. Mfanzile took a moment away from work to pick up his daughter, and I was there to catch it. There's so much hope in this photo - Mfanzile looking up at Phiwa as he lifts her toward the sky. It sums up my feelings about this project and the admiration I have for the Foundation's work.

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Jon Hrusa is a staff photographer for the European Pressphoto Agency, based in Johannesburg, South Africa. He has been partnering with the Elizabeth Glaser Pediatric AIDS Foundation on photography projects since 2004.