Gete and her son, Dawit, live in a makeshift hut in Shiro Meda, a slum on the edge of Ethiopia’s sprawling capital city, Addis Ababa. Both have H.I.V., the virus that causes AIDS. Dawit’s father died of the disease five years ago. And though AIDS is not uncommon in Addis Ababa – one in six adults is thought to have it – those who suffer from the disease are stigmatized. Gete cannot use the communal clotheslines to hang her washing, as her neighbors believe – wrongly, of course – that her clothes might spread the disease. Children in the neighborhood will not play with Dawit.

But Dawit is not friendless. He is one of 58 children who attend the Shiro Meda Day Care Center, more than half of whom are H.I.V. positive. Here the children receive instruction, have a regular meal and play. Shiro Meda is one of three day care centers run by the Addis Hope Program, which serves over 200 of Addis Ababa’s poorest children.

Many are children of women who have been abandoned, raped or, in Gete’s case, widowed. While providing a refuge for preschool children (ages 4 to 7), Addis Hope also trains mothers in entrepreneurial activities.

The program was founded in 2001 by Ruth Girmay, a former teacher at the Nativity Cathedral School in Addis Ababa. Helping the less fortunate has been a constant of her life. The daughter of a retired Ministry of Agriculture administrator, she used to give what little spending money she had to beggars outside her church.

Ruth, 28, said a dream she had as a teenager about St. Francis of Assisi inspired her to devote her life to helping the less fortunate. At first, she rented a small room to take in 15 children, whose mothers were making ends meet by begging or prostitution.

Ruth, a Catholic, then turned to De La Salle Christian Brother Gregory Flynn, who helped solicit funds from donor agencies. Brother Flynn also helped her navigate the bureaucratic hurdles in establishing her program for children. It took two years for the Addis Hope program to receive the proper certification from the government.

There is a great need for such programs in Ethiopia, a country of 75 million, half of whom live below the poverty line according to the latest United Nations survey. More than 50 percent of school-age children do not attend school. AIDS accounts for 30 percent of all adult deaths, and two million children have been orphaned because of the disease.

Shiro Meda student Tirusew, 6, is H.I.V. positive as are his parents. His mother, Athlay, tends to the home, while his father, Melkamu, who is blind, begs for a living. He brings home about 50 cents each day, which also supports two additional children from Melkamu’s first marriage.

The family share their two-room home with another family, who are also H.I.V. positive. Mulukan, 5, also attends Shiro Meda. Her mother, like Melkamu, is blind and begs for a living, while her father is disabled and rarely leaves the house. They share their room with another four-person family. And a third family sometimes spends the night in the same room.

When living in such circumstances, a day at one of the Addis Hope day care centers provides some relief. Children are recommended to the program by community leaders. Still, unless they gain access to antiviral medication – which is not provided by Addis Hope – their lives may be short. Nonetheless, Melkamu appreciates what the program is doing for his son.

“We are very happy he goes to the Addis Hope center, where he gets good food, clothes and an education,” he said. “I want all my children to go to school. I hope they will do much better than me.”

In a prominent red-light district of the city, the Piazza Day Care Center offers a haven to 81 children. It is a three-room hut, including a small kitchen, with a tiny yard that boasts a swing, a slide and a simple latrine. Here, Nigsti teaches children Amharic and English, science and math. She instructs them in ethics and reads them stories. It is an excellent head start to the instruction the children might get if they are lucky enough to enroll later in government schools.

Genet, a single mother, drops off her 4-year-old son, Eyoel, at Piazza each day, before she returns to the streets to sell gum and tissues. They do not have a home and end up sleeping on friends’ floors most nights. That night, they would improvise, sleeping under a sack they had fastened, like a lean-to, to another home.

Genet was born in Eritrea but was displaced by the war with Ethiopia. She ended up in Addis Ababa when she was 15 and shortly afterward became pregnant. After a couple of years, Eyoel’s father abandoned the family, and now Genet concentrates on providing her son with a better life. “I will sacrifice everything I have for him in order to see him get an education.”

Though Addis Hope’s main emphasis is on children, the program is also trying to improve the lives of mothers by providing grants for small entrepreneurial activities.

Tirhas, a 40-year-old widow, used her grant to start a vegetable kiosk at a local market. She has already saved $40, deposited in a program-mandated savings account and, along with seven other women, is planning to start a larger business.

“The eight of us have agreed to work together and buy some land and open a small grocery, where we will sell soap, bread, fruit and vegetables,” Tirhas said. “Finally, I will be able to stand on my own two feet.”

Her son, Mikias, graduated from the Piazza center and is enrolled in a state-run elementary school. “If it were not for Addis Hope, my son would still be running around the street,” Tirhas said.

With so much work to be done, Ruth said she is willing to put off starting her own family. As for her own needs, she draws a modest income: Staff salaries for Addis Hope amount to less than 10 percent of the monthly budget. She could be earning three times as much working for a similar international agency in Ethiopia.

Instead, Ruth devotes her full attention to Addis Hope. She hopes to expand it to care for 1,500 children. And she is starting a new center to train teachers. “I will train them myself in psychology, counseling and working with children with special needs,” she said.

Meanwhile, she is also the national president of the St. Vincent de Paul Society and spends what little free time she has visiting AIDS patients and the mentally ill. For Ruth, inspired by St. Francis’s example, there is always work to be done.

Based in Wales, photojournalist Sean Sprague is a frequent contributor to ONE, covering India and Africa.