At 78 years old, Phendukine Sithole says she's "too old to be a mom again." She had eight children of her own, then grandchildren.
But because her family, like so many in South Africa, has been ravaged by HIV-AIDS, Ms. Sithole finds herself raising four great-grandchildren, aged 7, 10, 12 and 17, all on a paltry income of 1,500 rand a month (about $150 Canadian).
"The gogos are suffering," she says quietly, using the isiZulu word for grandmothers.
They are not suffering in silence any more though.
On the contrary, the gogos have become a social and political force, an increasingly vocal army of older women who have received little credit for holding families together as the HIV-AIDS pandemic has ripped through the social fabric of sub-Saharan Africa for more than three decades.
To date, more than 35 million of the 78 million people who have contracted HIV-AIDS have died. More than half of those deaths have been in sub-Saharan Africa, home to only 5 per cent of the world's population.
One of the results is a never-ending stream of orphans in their wake.
According to Unicef, there are an estimated 18 million children worldwide who have lost one or both parents to AIDS. Eighty per cent of these children are in sub-Saharan Africa.
Some are in orphanages, some are in child-led households, but the vast majority of orphans are adopted informally by family. Because AIDS has killed so many young adults, children often end up with their grandmothers.
"Grandmothers do what needs to be done," says Ilana Landsberg-Lewis, executive director of the Stephen Lewis Foundation. "There are legions of older women – many of them HIV-positive – who have a grassroots health and social welfare system, and [are] experts on raising traumatized children."
She says that, like many people marginalized by HIV-AIDS, what the gogos need is not charity or pity, but recognition of their rights and more support.
In early 1996, seeing the immense responsibilities African grandmothers were shouldering, the foundation launched the Grandmothers to Grandmothers campaign, and invited 100 African grandmothers to Toronto, along with 200 of their Canadian sistren, and a movement was born.
Cwengekile Myeni, head of the Hillcrest AIDS Centre Trust in Durban, South Africa, says she returned from that meeting inspired. She started a support group for grannies that, among other things, teaches them "income-generating skills" like dressmaking.
But the most important aspect of the movement is that the gogos have realized that they are not alone, and they can share their experiences and lobby for help, financial and otherwise.
Before the 21st International AIDS Conference, which took place this week in Durban, South Africa, the grandmothers staged their own gathering, which drew more than 300 elders and featured sessions such as "how to support and care for an HIV-positive grandchild," "grandmothers' human rights," and "gogo empowerment."
Most of all, they shared practical tips, such as how to talk to their children about safer sex, condoms, circumcision, the management of HIV medications and other matters that weren't talked about in their day.
"Raising children at 60 is not the same as doing it at 20, and it's not the same during AIDS as it was before AIDS," Ms. Myeni says.
"The gogos love their grandchildren, but the children have a lot of needs they can't meet. It's hard to do it with no money."
The support groups help grannies apply for government aid, and they are pushing to have subsidies for foster parents and grandparents increased and for old-age pensions to be increased to 3,000 rand monthly ($300).
Zdowa Ndolvu, head of the Siyaphambili HIV and AIDS Support Group, has become one of the most dynamic and outspoken activists.
"We stand here as guardians of our country's future," she said in an impassioned speech to a rally that saw more than 1,500 grandmothers take to the streets of Durban. They carried sign with slogans like "I care, do you?" and "Khuluma gogo" (isZulu for "Speak up granny").
Ms. Ndolvu lost two children to the epidemic: Her daughter died of AIDS in 2000 and her son took his own life in 2001, after he learned he had tested positive. "He left a suicide note saying he didn't want to be a burden," she says.
At the time, Ms. Ndolvu was already a volunteer with the Treatment Action Council, the South African group that pressed the government to make treatment available and essentially shamed pharmaceutical companies into dropping drug prices in developing countries, but she got involved in the gogos movement as well.
Like many of the grannies, Ms. Ndolvu is herself infected with HIV. "Don't forget, we have our own health challenges, but our grandchildren always come first," she says.
But what Ms. Ndolvu is most proud of is that the granddaughter she raised, who is now 23, is HIV-negative.
"That's why we're doing this, to end the epidemic, to make a better world for our grandchildren."