Chiradzulu: Complicated HIV clinic days
Malawi

Daily struggles of the most vulnerable

Malawi was heavily affected by the HIV epidemic in the late ’90s and now has one of the most successful and innovative HIV programmes in southeast Africa. HIV prevalence has dropped from 15.2 per cent in 2003 (UNAIDS) to 10.6 per cent in 2016 (MPHIA). By mid-2017, 714,691 people living with HIV were taking lifelong antiretroviral treatment.

Yet HIV is the leading cause of death among adults in Malawi and 28,000 new cases are expected each year. MSF has been involved in the HIV response for years and today works in Chiradzulu and Nsanje, two districts in the Southern Region. We support the health ministry in meeting the health needs of particularly vulnerable people: children, adolescents and women living with HIV, severely ill people failing first-line antiretroviral treatment, and female sex workers.

Nsanje: Sexual & reproductive healthcare for sexworkers
Seasonal sugar plantation workers are among the clients of Malawi’s sex workers, who are 5.4 times more at risk of contracting HIV than the general population. MSF, in partnership with the Ministry of Health, runs a programme aimed at developing a model of care for female sex workers.
Luca Sola
Nsanje: Sexual & reproductive healthcare for sexworkers
Mundidelanji, a 30-year-old sex worker from Ndogo village, Thyolo district, receives an HIV test at MSF’s clinic at Bangula Trading Centre. More than 1,000 sex workers are enrolled in the programme in Nsanje.
Luca Sola
Chiradzulu: HIV care for adolescents
Anna Laison, 16, is HIV-positive. She lives in Chiradzulu, where MSF has worked with the Ministry of Health to support HIV patients for 18 years. A four-year handover process is underway and MSF now focuses on hard-to-reach groups, including adolescents with HIV and patients in need of second- or third-line antiretroviral treatment.
Luca Sola
Chiradzulu: HIV care for adolescents
Debora Njala, 18, has been HIV-positive all her life, as she was infected through mother-to-child transmission. She also has tuberculosis. Here, she waits for her consultation with an MSF mentor at the Mbulumbuzi Health Centre in Chiradzulu.
Luca Sola
 Chiradzulu: Prevention and early treatment of cervical cancer
Women at Milepa Health Centre, Chiradzulu waiting to be screened for cervical cancer. Malawi has one of the highest rates of cervical cancer in the world, yet only 10 to 20 per cent of women receive early screenings, and no preventive vaccinations or treatments exist. In collaboration with the Malawi Ministry of Health, local and international partners, an integrated approach is being developed for women aged 9 to 49 years in urban Blantyre and Chiradzulu districts. Starting with strengthened screenings and early treatment for pre-cancerous lesions, the project will soon include Human papillomavirus vaccinations and treatment for cervical cancer.
Luca Sola
Nsanje: Mentoring and material support
Chiradzulu: HIV care for adolescents
Alfred, 18, is an MSF patient. He is HIV- and TB-positive.
Luca Sola
Chiradzulu: Complicated HIV clinic days
Gloria Chipasula, 11 years old, HIV and TB positive patient.
Luca Sola
Chiradzulu: Prevention and early treatment of cervical cancer:
MSF cervical cancer nurse Nellie with 23-year-old Liness (right) during a consultation at Milepa Health Centre.
Luca Sola
Nsanje: Treating advanced HIV
MSF nurse Stonald tests Seleman, 62, for HIV at Nsanje district hospital. Seleman tested positive at a health centre but didn’t believe the results. He came to the hospital for a second test, which confirmed that he is HIV positive. He is still not convinced by the results.
Luca Sola
Nsanje: Treating advanced HIV
Emmanuel who is from Nsamera Mozambique arrived at Nsanje district hospital with advanced HIV and related opportunistic infections cryptococcal meningitis and TB. In 2016, nearly 30 per cent of patients treated for HIV arrived at the hospital in such severe stages of immune failure that they died within 48 hours of admission.
Luca Sola