by Sr. Cecily Bourdillion  MMM     Zimbabwe       23.03.2022
cecily bourdillon in Malawi resizedI arrived in Lilongwe, capital city of Malawi, central Africa, in September 2001 having been assigned to Chipini Health Centre. Sr. Christine Lawler drove me to Chipini. This was a five-hour journey on the one highway in Malawi, linking north to south. Chipini is a small village, twenty kilometres into the countryside from the highway. In 1989, MMM was invited to Chipini to build and administer the Health Centre for Zomba Diocese. Christine was the sister-in-charge and I was to take over the supervision of the Primary Health Care (PHC) programme.
The human immunodeficiency virus (HIV) which, over time, causes acquired immunodeficiency syndrome (AIDS) pandemic had hit Malawi. There was no treatment, nor was there a means of verifying the diagnosis available in Chipini. People were dying, mostly young people, with the well-recognised major and minor signs of HIV/AIDS. The only response we MMMs at Chipini could give was to care for those with the infection in their homes. Volunteers were trained and the home-based care programme (HBC) was initiated.

Herbal treatments and nutrition became our key weapons complimenting the basic medicines used for the various illnesses that debilitated, and finally killed, patients with HIV/AIDS.
Chisomo (not her real name) was the first patient I was called to see in her home. Chisomo was very ill, confined to her bed, a mat on the floor. She was weak and wasting away. Her husband had already died with HIV/AIDS and, two weeks later, Chisomo died leaving three young children. Fortunately, they had a grandmother who could take them into her small, and already full, home and share with them her meagre food supplies.
We began a clinic for those patients with signs and symptoms suspicious of HIV/AIDS and developed regimens of treatment for the various ailments.
Then the test to diagnose HIV/AIDS was introduced. Testing was voluntary. There was a stigma attached to HIV/AIDS due to its sexual transmission. Few people wanted to be tested. A campaign of education began. Although there was no treatment there were benefits in knowing one’s HIV status. Those with the infection qualified for nutritional care, free treatment for ailments, care and schooling of orphans and the home-based care when confined to bed.
Then came the good news that, at last, definitive treatment for HIV/AIDS was available in Malawi. Better again it was close to us at Zomba Central Hospital. This was thanks to the persevering research of doctors, scientists, pharmacists and others all over the world.
We could then refer patients who tested positive for HIV to Zomba Central Hospital for treatment. There was an urgency to increase the testing to catch the infection at an early stage. This was a big step forward, but even to get the patients to Zomba for initiation of treatment and for their monthly treatment was a challenge. The journey up the mountain road had to be paid for!
A non-governmental organization (NGO) had opened a HIV/AIDS unit at Zomba Central Hospital. The team offered to hold a fortnightly clinic for patients with HIV infection at our Health Centre in Chipini.
This worked well, and so it was decided to start a pilot study to research ways and means of treating patients with HIV in their own locality through the Health Centres in the country. Training programmes for staff working in Health Centres were organized and Chipini became a satellite HIV/AIDS Centre, conducting its own clinics under the supervision of the Zomba Team. Serious problems were still referred to Zomba.

The HIV/AIDS programme in Malawi had a good start. Lessons learnt through the successful control of Leprosy and TB influenced the setting up of the Malawi National Programme for the management and control of HIV/AIDS.
The on-gong training programme, the three-monthly submission of statistics, the three-monthly supervisory visits by expert teams and above all the regular distribution of the necessary anti-retroviral medicines (ARVs), the up-dating of regimens and the continued education programme on behaviour change ensured that gradually there appeared a ray of hope in the dark world of the HIV/AIDS pandemic.
With the support of generous benefactors, we were able to open an HIV/AIDS and home-based care unit. This was a purpose-built building with waiting space, consulting rooms, treatment areas and medicine store. Palliative Care clinics were also held here.
Advances were made in the management and care of pregnant mothers with HIV infection and their babies. No longer were babies born with the infection acquired from their mother.
The falling number of deaths of young adults due to the treatment and the care they received meant that they continued alive and active with their children, not leaving them orphaned. Adults were able to return to work and support their families. No longer did the patients with HIV/AIDS need home visits. This allowed other patients to be admitted to the HBC programme and patients with chronic conditions, cancer, sufferers of stroke, could now benefit from the Home Based and Palliative Care Programme.
The clinics that began as a stage on the journey to death were now clinics of people restored to health, vibrant with energy and with their dignity restored. They knew that they would have to take the medicines always, but they also knew that they were effective.
It was a privilege to have been involved in this journey that eventually brought SEEDS OF HOPE to people threatened by the killer infection, HIV.


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