The local government provides drugs free of charge to Bowy House, where Natasha has spent most of her life and has come to regard its caregivers and children as her family. Staff there recently drove her on a seven-hour journey over mountains and dirt roads to spend time with her mother, who is dying of AIDS. Natasha has an extended family in her dusty village, but her father is unable to care for her. The village has no electricity and no schools.
She adores weekends at the beach, being pushed in a stroller and feeding the ducks. In summer she and her friends chase through the garden sprinklers, despite the risk of catching cold.
"In general we forget that they are ill children. They are naughty and full of mischief but when we see how quickly they can have a setback it reminds us that they aren't normal,'' says Lombaard.
She knows how to defend herself against Luvo, a boisterous 3-year-old boy who also looked like a famine victim when he arrived at Bowy House and now revels in annoying the girls. And she thrashes in fury when Lombaard, her surrogate mother, has no time to pick her up.
The home is an example of the localized care that many experts say should be Africa's model. The government pays for the medication, but Hester Veldsman, who founded Bowy House, relies entirely on private donations and struggles to meet monthly expenses of US$9,500 and is always grateful even for donations of diapers and groceries.
And what happens when communities don't care or can't cope?
In Zimbabwe, about 1.3 million children - or one in five - are classed as orphans and 100,000 live in child-headed households, according to UNICEF estimates. Zimbabwean President Robert Mugabe's confrontation with the West has caused humanitarian aid to plummet and families are collapsing under an inflation rate heading toward 4,000 percent.
Zimbabwe's official media regularly report on children being raped by HIV-infected men who believe sex with a virgin will cure them.
Similar abuse has been reported in impoverished Lesotho and Swaziland, where AIDS has slashed life expectancy to the mid-30s and left an army of orphans vulnerable to exploitation. School enrollment rates for girls have dropped as they quit to care for younger siblings and sick parents or simply can't afford the fees.
In Zambia, the AIDS-related death of parents and grandparents coupled with migration to cities has left many rural children with nobody to care for them. Faith-based organizations are struggling to fill the gap.
In Cape Town, a church-based charity called Act of Grace plans to use some 150 shipping containers as emergency shelters for AIDS orphans.
Bowy House founder Veldsman even now is overcome by tears when she thinks of the 5-year-old boy for whom her home was named, and who died months before AIDS drugs became available.
She counts Natasha as one of her victories.
"The doctors gave up on her, and I said, 'No, we can't give up,''' said Veldsman.
Aside from the medicine, there was one other vital ingredient in Natasha's survival, Veldsman said: "Tender loving care.''
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