Rhodri Phillips meets a grandmother in Uganda, whose harrowing story provides a timely warning of the scourge of HIV and Aids.

He looks at how the epidemic could develop and the role of the charity World Vision in tackling the crisis. Pictures by Tim McGuinness.

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Every year for the past two decades this frail 70-year-old grandmother, has had to bury either a child or a grandchild, she has lost to Aids.

The graves of Teresa Naturme's seven children and 12 grandchildren killed in the epidemic are marked by piles of stones on the small plot of land she owns.

As she walks around the graveyard she points to a heap of stones, significantly smaller than the others.

This is where Teresa buried a grandson, killed by the illness before he reached his first birthday.

Heavy rains have washed three of the graves away.

But there have been so many deaths Teresa is not sure which ones are missing and she can no longer recall who died when.

Only one grave is marked by a wooden cross - Teresa tells me all the others have been destroyed by termites.

"Death is so pathetic. It has been a devastating experience losing them all," she says sadly. "I am used to having children and grandchildren all around. Now I am so lonely. The only noise I hear is the noise of animals."

Teresa walks with a limp - she says her legs hurt her - and her eyes are empty.

The walls of her hut are cracked and damp and a small broken mirror hanging on the sitting room wall is the only obvious possession.

Teresa's son Leo was the first to die, aged 30, in 1982.

"At first I did not discover it was Aids which killed my son," she explains. "I thought he had died of a fever or some other illness. When I discovered, it was a devastating experience. I had sleepless nights.

"Everyone who has died since has hurt just as much. I have prayed for them all."

One daughter and five grandchildren live with Teresa in her two-bedroom hut.

Her grandchildren stare blankly. One granddaughter has a rash and white blotches on her shaven head, and her brother's stomach is bloated through hunger.

Most children in Uganda respond to a smile or a wave from a stranger but these children's faces give away no emotions.

None of the children's HIV status has been tested, even though there is a risk they have become infected during pregnancy. Although tests are free and quick Teresa says she cannot afford to travel to her nearest health centre five miles away - the taxi fare is £1.

Teresa is too weak to fetch water and her grandchildren aged between two and five are too young.

If one of her neighbours is unable to help her get water from a pump three miles away she says her only option is to go back to bed and sleep.

The situation in Uganda is not as gloomy as it was a decade ago - infection rates have dropped from a high of 14pc to the current figure of about 6pc.

But while families like Teresa's continue to be affected by the epidemic there is no room for complacency.

Canon Gideon Byamugisha, who works with charity World Vision Uganda, says: "If we can continue with the amount of effort we have put into fighting Aids, there is no reason we cannot defeat the illness. But we cannot rest."

Other countries in sub-Saharan Africa are reaching crisis point. The latest United Nation's Aids report which was published last week reveals that one in four people in southern Africa is infected with HIV.

In the worst hit region of sub-Saharan Africa, almost 60pc of adults living with HIV are female, while in Botswana, Lesotho and Swaziland, rates are still in excess of 30pc among pregnant women.

Annabel Kanabus, director of international HIV and Aids charity Avert, says: "A lot more people are going to die in the next decade. It is going to be a problem not just in the health sector but also in sectors like education and security.

"We will see teachers, doctors and soldiers die. That is going to have a serious impact on the infrastructure of countries."

Infection rates in South Africa, Zimbabwe, Botswana and Zambia are more than 20pc and rising.

The number of fresh diagnoses continues to rise in the UK as well - infection rates rose by 20pc in 2003 compared with the previous year. According to the UN report, HIV is the fastest growing serious health problem in Britain.

Mark Graver, spokesman for HIV and Aids charity Terrence Higgins Trust, says: "If we do not recognise that HIV and Aids are fundamentally part of our public health then we are merely storing up future problems.

"Some people would say that day and that crisis has arrived already.

"We are seeing more HIV positive people than we have ever seen."

World Vision is working in Uganda and nearly 100 other countries to break the desperate cycle of poverty and ignorance which has fed the Aids epidemic.

Teresa's family and many others in Uganda are just about surviving, but World Vision wants them to achieve independence.

Their mission is to help communities become self-sufficient.

Christine Uwamahoro, who works for World Vision Uganda, says: "People grow what they can. They are subsistence farmers. We are trying to help them become sustainable so they can do more than survive.

"For example, if you buy a family a goat, that can provide a source of milk which can generate a regular income.

"We are educating them about nutrition and teaching the children so they have a future."

World Vision has built schools in Uganda, where children learn about the dangers of HIV and Aids from the age of five. Thanks to World Vision and other international charities children in Uganda have hope.

Their parents have survived by growing just enough to eat, but the children The Journal met had aspirations to be doctors or teachers.

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