Malawi photo gallery - HIV/AIDS

Almost a million of the near ten million inhabitants of Malawi are HIV-positive - and many of them die of Aids daily. In August 2001, MSF began to treat HIV/Aids patients in the district hospital of Chiradzulu in the south of the country with life-extending antiretroviral medicines. Large posters are used to call on people to protect themselves against HIV infection by using condoms. But those infected can no longer be helped by these. antiretroviral (ARV) medicines are needed in orderto survive. ARVs hinder the multiplication of the virus and can dramatically increase the life span of those affected and improve the quality of life so that the people are able to lead a fairly normal life, work and take care of their children. 25,000 people live in the district Chiradzulu and are cared for in the district hospital. MSF has set up an HIV clinic there. More than 500 people receive antiretroviral medicines and new patiends are added every day. Along with the ARV treatment is also psycho-social care as well as a comprehensive educational program. Beyond that, the co-workers take special care of HIV positive pregnant women. Around 20% of the pregnant women in Chiradzulu are HIV positive. Women who are expecting children are encouraged to be tested during pregnancy, because with simple medicinal treatment just prior to and after the birth, the mother-child-infection rate be decreased from over 30% to under 15%. Every week in the hospital there are educational events for pregnant women, in which they learn about HIV, means of infection and possibilities for treatment. It takes courage to be tested, because people with HIV/Aids are still stigmatized in Malawi - as in many other countries - and often excluded from society. An important part of the work of MSF is in encouraging people to deal openly with the topic. Songs sung by women to encourage one another and to show one another that they are not alone. Malawian counselors explain to patients about the meaning of HIV: the virus attacts the so-called CD4 cells in the body, which are part of the body's own immune system. While the virus multiplies within the cell, the CD4 cells are destroyed and their number decreases and the body is susceptible to infections such as tuberculosis, fungal infections, pneumonia or encephalitis - so-called oportunistic infections. It is also the job of the counselor to educate the patient about the possibilities of an antiretroviral therapy. It causes the number of CD4 cells to increase again and thus the immune system is strengthened. Not all HIV infected people need medicines immediately. Therapy is started when the patient is either in the advanced stages of the HIV infection - that is in so-called Aids stage - or the C4 cell number is less than 200 per microliter. CD4 levels are tested regularly in the laboratory. ARV medicines are only effective when taken reliably and throughout the life of the patient. Three different compounds are combined with each other; a single tablet contains all three compounds, so that the patient normally has to take only one tablet mornings and evenings. The patients in Chiradzulu take the tablets at least as regularly - and reliably - as patients in western countries. Close cooperation between patients, counselors and doctors is the key to the success. Samuel K. is 29 years old. He worked in a tobacco factory until he became sick the first time in 1998. Since then he has suffered from recurring diarrhea and has lost about 16kgs. Until March 2000 he tried to earn his living by himself but he has become too weak. He now lives with his brother who takes care of him. Samuel was tested HIV positive in January 2003. Meanwhile the CD4 cells in his blood have been measured: they are at 178/microliter. The doctor has suggested that he begin ARV treatment. The theater group of HIV positive patients in Chiradzulu fights the social stigma. Once a week the members tak to the road to educate the population in surrounding villages about HIV. With theater pieces and songs written by themselves, they encourage people to be tested and for communities to be more accepting of those infected with HIV. Most of them take ARV medicines and have a second chance at life. Months ago completely weakened they came into the HIV clinic. Now they have enough strength again to carry their experiences further. Education and prevention go hand-in-hand.