To call Hamburg a small rural village is not to exaggerate. It has just fewer than 100 permanent residents and no real road sign indicating the turn off to it. It can only be reached by dirt roads that can range from smooth to almost impassable depending on how much rain there has been. Despite this people are willing to travel hundreds of kilometres and for many hours from nearby cities to be treated here.   
  The patients are treated with medication known as antiretrovirals. These do not cure the patients but suppress the virus in their blood, which allows their immune system to recover. Antiretrovirals is a long-term treatment as the patients will need to continue taking the medication as long as they are alive. It also needs to be strictly regimented as if one lapses in treatment it can allow the virus to build up immunity and they would become less effective. The treatment centre spends many hours teaching and explaining how and why one should use antiretrovirals.
  Patients of the treatment centre gather with members of the local community to dance and pray. Although the treatment centre is largely secular most of the patients and the community are christians and they use this as a way to keep the patients spirits high.
 Saturday is salon day at the treatment centre. On these days volunteers from the nearby villages come to the treatment centre and treat the patients to hair care and other pampering.
  Peter, a volunteer from England, helps an incapacitated patient perform exercises to prevent his muscles atrophying. The centre relies quite heavily on foreign aid for both staff and for financial means.
  Treating HIV & AIDS is not confined to the physical and medical; another integral aspect is psychological counselling for all those living with the virus from the patients themselves to their family members and partners. Here, Babalwa, an orderly at the treatment, counsels a Fezeka, whose husband has been diagnosed with HIV. Fezeka will also need to undergo testing to see if she has become infected. It is emphasised that with antiretroviral treatments it is possible to live a life just as if one was not infected.
 Staff at the treatment centre.
  The patients are treated with medication known as antiretrovirals. These do not cure the patients but suppress the virus in their blood, which allows their immune system to recover. Antiretrovirals is a long-term treatment as the patients will need to continue taking the medication as long as they are alive. It also needs to be strictly regimented as if one lapses in treatment it can allow the virus to build up immunity and they would become less effective. The treatment centre spends many hours teaching and explaining how and why one should use antiretrovirals.
  In these images Rachel, a Canadian nurse working at the treatment centre, shows Luleka, a young mother from a neighbouring rural community, some of the skills of motherhood. The child is named after Rachel as she was responsible for her birth on the side of the road after they were unable to reach the medical centre in time. Thanks to her ongoing treatment with antiretrovirals, Luleka who is HIV positive did not pass on the virus to her child. South Africa’s HIV and AIDS epidemic has had a devastating effect on children in a number of ways. There were an estimated 330,000 under-15s living with HIV in 2009, a figure that has almost doubled since 2001.
  Luleka looks on as her mother encourages baby Rachel to stand. This image was taken over a year later and thanks to Luleka’s treatment with antiretrovirals found both Luleka and Rachel healthy. Unfortunately, Luleka was finding the transition to single motherhood (the father has passed away) rather difficult and had on two occasions asked Rachel to adopt the baby.
 Nurse at the Hamburg Treatment Centre.
  This patient had been bedridden within the treatment centre for over 6 months due to a combination of opportunistic infections and tuberculosis. After returning home for a brief period he returned he returned where I photographed him being examined after developing a large growth on his chest, which was diagnosed as an advanced case of lung cancer. He passed away not long after these images were taken.
  This patient had   been bedridden within the treatment centre for over 6 months due to a combination of opportunistic infections and tuberculosis. After returning home for a brief period he returned he returned where I photographed him being examined after developing a large growth on his chest, which was diagnosed as an advanced case of lung cancer. He passed away not long after these images were taken.
 The treatment centre has a vegetable garden that it uses to feed the patients that come to the centre. Here the gardener stands with all the rainwater they collected, which they will use to water the vegetables.
  Poverty is a serious problem in Hamburg and the neighbouring communities. Hamburg itself has a population of just under 100 and most of those rely on government grants and pensions.
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