Malawi: Community volunteers are backbone of AIDS home care

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The virus is taking a toll on an already crippled health system, and the government lacks the economic resources to deal effectively with the epidemic. MSF has HIV/AIDS projects in two southern districts. Caring for AIDS patients in their homes In the district of Thyolo, a comprehensive, holistic approach to AIDS care and prevention has been in place since 1997. This home-based care program began with the establishment of voluntary counseling and testing at the hospital in Thyolo and several area health posts. A network of 120 community volunteers was then trained to follow patients through regular home visits, supervised by a doctor and nurse from the community. As of July 2001, over 600 patients were receiving regular home care through this system. Social mobilization and advocacy are also important elements of the program, as are care and referral of children orphaned by AIDS. Also in Thyolo, MSF works to improve referral, diagnosis, and care for people with tuberculosis (TB). Cases of TB have tripled in Malawi over the last ten years, an increase linked to the spread of AIDS. Mothers and babies get antiretrovirals At the hospital in the district of Chiradzulu, MSF focuses on hospital-based treatment for AIDS patients, who make up 70% of admissions. In summer 2001, MSF received permission to extend this care to include antiretroviral treatment, with treatment for the first patients beginning in August. In May 2001, MSF received authorization to begin giving mothers and babies the antiretroviral Nevirapine, which helps reduce mother-to-child HIV transmission. Mothers receive the medicine 72 hours before delivery, and babies in the three days after birth. In Thyolo and Chiradzulu, public information campaigns, reaching schools, prisons, and the general public, are key to MSF's work. A separate HIV/AIDS program in the district of Mwanza finished in December 2000. Emergency response to floods In early spring 2001, severe floods hit 14 out of Malawi's 26 districts. MSF provided emergency medical aid and water and sanitation services in several areas, and across the border in isolated areas of Mozambique. In the districts of Thyolo, Mulange, and Phalombe, MSF has been involved in cholera prevention activities since 1996, benefiting a total population of 850,000 people. International staff: 18 National staff: 122