Organisational Profile

SOUTH AFRICA’S CHILDREN – A GLOBAL VIEW

 

Every year in South Africa 22 000 children die before they reach the age of one month and 75 000 children die before their fifth birthday.

These deaths — 260 per day — are caused by pregnancy and childbirth complications, newborn illnesses, childhood illnesses, HIV and AIDS and malnutrition. The HIV status of the deceased is unknown in half of all reported deaths.

In a joint report published by the Department of Health, the United Nations Children’s Fund (UNICEF), the University of Pretoria, Save the Child and the Medical Research Council (MRC), the above causes are referred to as the “Big 5” and the authors call on all sectors to assist in tackling these issues in order to achieve the Millennium Development Goals for maternal, newborn and child survival and towards combating HIV and AIDS by 2015. Poverty is an important underlying cause of death relating to the Big 5 health challenges.

As part of our efforts towards this initiative, Cotlands’ programmes focus on health, poverty alleviation and nutrition. However, we have also added education as a critical component, because we believe education is a basic human right that provides the foundation for children’s lifelong learning and work opportunities.

 

Other facts about children in South Africa:


In 2006:

Total number

KZN

Eastern Cape

Gauteng

Western Cape

Number of children

(under 18 years)

18 243 000

(of which 1/3 is under the age of six)

3 817 000

1 118 000

2 720 000

1 571 000

Maternal orphans

619 000

156 000

113 000

76 000

37 000

Paternal orphans

2 481 000

605 000

562 000

269 000

143 000

Double orphans

668 000

218 000

141 000

47 000

17 000

Total orphans

3 768 000

978 000

816 000

392 000

198 000

Child headed households

122 000

37 000

31 000

0

0

Children living in poverty*

12 342 000

2 678 000

2 458 000

1 342 000

636 000

Child hunger#

2 859 000

655 000

630 000

355 000

193 000

Child deaths due to HIV/AIDS

44 663

15 209

6 392

8 282

1 434

Children receiving ART

25 318

6 992

3 007

6 383

2 144

HIV prevalence among pregnant mothers

29%

49%

29%

31%

15%

Ref: South African Child Gauge 2007/2008 (UNICEF).


* Poverty is defined as a household income of less that R1 200 per month. Poverty impacts on how a child’s basic needs are met and is often closely related to poor health, reduced access to education and environments that compromise personal safety.

 

# Hunger is used as an indicator to monitor the extent of food insecurity among households with children. Children who are nutritionally deprived are vulnerable to cognitive and other developmental impairments that include lower intelligence, poor educational outcomes, stunting, wasting and a diminished capacity for work in adulthood.


OVERVIEW OF COTLANDS

 

Seventy three years ago, Dorothy Reece, a nurse, found an abandoned baby on the doorstep of her home in Mayfair, Johannesburg. She decided to take this baby into her own home and this single act of compassion led to the creation of Cotlands, which over the years has grown into a national organisation caring for more than 3 700 children and their caregivers every month.

 

Today Cotlands offers a variety of residential and community-based programmes to meet the needs of vulnerable children. These programmes include paediatric hospices, places of safety, home-based care projects, nutrition and early childhood development centres. Because all these projects offer holistic care to children, each project has several components, including medical, physical, psychosocial, educational and emotional care, as well as antiretroviral treatment (ART) programmes.

 

As each new component was added to our spectrum of programmes, we began to realise that for these interventions to be sustainable, training and support also had to be offered to the primary caregivers. Cotlands’ ultimate goal is to equip families to care for their children at home and to achieve this we must ensure that these families have the appropriate skills and sufficient resources. We have therefore continued to add more components to the services on offer – elements like support groups, income-generating projects, food gardens, counselling, material aid, accessing of social grants and orphan care.

 

The result of these efforts has led us to the definition of our current mission: to provide exceptional models of care to children and their families, by empowering them to improve their quality of life through specialised interventions and sustainability projects.

 

This trans-disciplinary, multifaceted approach demonstrates its effectiveness daily. Families that are floundering, children who are terminally ill, babies who have been abandoned – are all dealt with in a caring and professional manner that swiftly addresses their needs. The results prove that we really are making a difference

 

SCOPE OF COTLANDS SERVICES


ACTIVITY

Average monthly total 2007*   

Average monthly total 2008

Monthly projected average for 2009

Received physical care (residential and community based)

1 210

907

1 000

Received educational support

not recorded

330

450

Received psychosocial care

not recorded

423

500

Received antiretroviral therapy (ART)

167

224

250

Deaths

3

1

0

Received nutritional support (community based only)

236

1 308

1 600

Orphans – total number

319

251

300

Number positive orphans

145

101

160

Number of negative orphans

174

139

140

Home visits

368

874

1 000

Number of secondary beneficiaries (siblings, parents, grandparents, other relatives etc.)

1 226

1 867

2 200

Average monthly total

-

4 200

4 900


* Discharges were not recorded in KwaZulu-Natal– adjusted in 2008

Education and psychosocial care statistics were not recorded

 

COTLANDS’ GROWTH

Annual expenditure over the past five years:

2005

2006

2007

2008

2009

R 13 879 100

R 15 468 993

R 17 882 080

R 21 353 588

R 25 710 044*

* Budget

Staff complement over the past five years (as at 31 March):

2005

2006

2007

2008

2009

169

198

203

241

283



COTLANDS’ SUCCESSES AND CHALLENGES

Cotlands measures success against the quality and quantity of service we are able to provide, our response to identified community needs, the financial stability of our organisation, the sustainability of projects and our national footprint. To demonstrate that we are offering a quality service, Cotlands has applied for and received full accreditation from the Council for Health Service Accreditation of Southern Africa (Cohsasa).

 

Among our most notable successes is the holistic approach to care, which offers children a comprehensive range of services that addresses all their needs. Although this does reduce the number of children we are able to serve, we believe it is better to use the resources available to help fewer children well, than more children ineffectively. This holistic approach is expensive, but at Cotlands we firmly believe that it is a privilege to be called upon to help a child in need. Our response must be to make sure that we give each child the most effective help possible. We now need to turn our attention to the primary caregivers of our beneficiaries, empowering them with the resources they need to care for their children independently of Cotlands.

 

One of the achievements we are most proud of is the introduction of ART. At our Gauteng hospice, ART was introduced in mid 2002. In the previous year, 82 children died in this 18 bed in-patient unit and we felt we could no longer wait for the government to roll out these drugs. Once we knew there was an effective intervention, the increasing number of deaths was difficult to tolerate. In 2002, the year Cotlands introduced ART as an organisational expense, 51 children died and this number has steadily decreased. In 2008 only two children passed away in the hospice of AIDS related illnesses.

 

Right now, the main challenge facing our organisation is sustainability. Cotlands’ expanded scope of services has placed additional financial demands on the organisation and we are sensitive to the need for good stewardship in managing these challenges. We cannot enter a community to offer essential services, only to withdraw a few months later because funding has run out. We have therefore implemented a number of sustainability processes.

One such intervention is financial planning with processes that include budgeting and forecasting. Over the past few years Cotlands has showed a less than 5% variation from our expenses budget. This has been achieved by ensuring that tight controls are in place, expenditure is closely monitored and that all unusual expenses are approved by the Finance Committee.

 

The second process was to budget for a surplus, even if it meant running the risk of creating a perception among our donors that Cotlands receives too much funding. The surplus exists to ensure sustainability of our services — a measure which is essential for good governance. A reserve fund has been created and the target for this reserve was established through an actuarial valuation to determine our current liability in respect of the future costs of caring for our children.


Cotlands has a track record of economic and efficient use of resources, service excellence and measurable achievements, all part of our commitment to good governance. Audited financial statements, as well as non-financial assurance reports outlining the organisation’s scope of work, are available to donors on request.

The third sustainability initiative has involved developing a broad donor base. Cotlands draws its income from a sound spread of resources: government, corporates, local and international trusts, bequests and individual giving.

 

With these processes in place, we hope to move towards attaining financial sustainability for Cotlands and we are very grateful to the many donors who have contributed so generously to our organisation over the past 73 years. With this kind of buy-in and support, we can work towards providing a more secure future for the children entrusted to our care.

A major challenge confronting Cotlands is succession planning. For Cotlands to continue to grow and for the culture of the organisation to be retained, we must have staff available to take over from the existing management team when the need arises. The challenge lies in the fact that once staff members are groomed for key positions, they are often lured away by the corporate sector, which offers far better remuneration and other benefits to employees. We are in the process of revisiting salaries and benefits in order to retain staff, but as a non-profit organisation, it is unlikely that as we will ever be able to compete with the corporate sector.

MONITORING AND EVALUATION

All Cotlands programmes are monitored through the use of statistical data, as well as via monthly progress reports submitted to the Child Development Committee. These reports discuss results in relation to project objectives. Staff also undergo quarterly performance reviews and supervision reports are submitted by the project manager to measure the impact and efficacy of the project.


Finances are monitored by measuring performance to budget, which is submitted monthly to the Finance Committee for review. Quarterly or six monthly progress reports are submitted to donors or on request.

FUTURE PLANS

 

Cotlands holds an annual strategic planning session to revise the organisation’s goals and direction and to ensure that our programmes meet identified community needs.

 

At the last planning session we reviewed all project goals and objectives to ensure that each service offers holistic care. Four components were identified which must be present in each project: psychosocial intervention, health care, education and sustainability. The emphasis varies with each project. For instance, health care is the primary focus in the hospice and home based care services, but the other components must also be available to beneficiaries to ensure that families are served holistically. These can either be offered by Cotlands, or in partnership with other organisations

.

Cotlands will continue to operate in the five provinces of South Africa we already serve – Gauteng, Western Cape, KwaZulu Natal, Eastern Cape and Mpumalanga. In the light of the current economic climate, expansion plans are minimal, restricted to ensuring that all the components are incorporated into each of our existing services.

 

CONCLUSION

In partnership with other NGO’s, local government and the private sector, Cotlands is committed to filling the medico-socio-economic gaps in communities by providing a range of services that will ensure vulnerable children receive the help they desperately need. We’re also working to provide food security, to reverse the spread of HIV/AIDS, to create jobs and to foster self sustainability.

 

Yes, this is an ambitious vision. But the fact that Cotlands has not only survived, but expanded substantially over the past 73 years, encourages us to believe that, with the help of our wonderful supporters, this vision is indeed achievable.



Jackie Schoeman

Executive Director