Malawi 1998

International staff: 11 National staff: 52 HIV infections threatens youth Malawi has one of the highest incidences of AIDS in Africa, which it targets under a national prevention programme that began in 1992. HIV/AIDS is the main focus of MSF's interventions in Malawi. Teams in Mwanzi, Chiradzulu and Thyolo districts (pop. around one million) are involved in treatment and prevention. MSF renovated the hospital and a number of dispensaries in Thyolo, and initiated a primary health care programme. Lacking sterile and transfusion material, and providing no STD treatment, the country's impoverished hospital structures encouraged HIV transmission. MSF therefore trains hospital staff in hygiene and sterilisation techniques, supplies protective and other medical material, and training in its use, and monitors blood collections and transfusion practices. Drugs are provided to treat the opportunistic infections affecting AIDS sufferers and condoms supplied. Other AIDS-related hospital activities include training supervision and teaching staff to offer psychological support. Prevention activities cover incinerator construction, improving health structure sanitation facilities, and drilling boreholes for health centres and local communities to reduce the incidence of water-borne diseases and improve access to safe water. "Anti-AIDS clubs" are formed to propagate prevention messages, and high risk groups are particularly targeted to persuade them to modify risky sexual behaviour. MSF made an emergency intervention in March 1998 in Blantyre and Thyolo in response to a cholera epidemic. MSF was also asked to assist in an outbreak of plague.