Chimwemwe’s Check-up-by Melissa Aberle-Grasse

The Moyo (non-private) HIV/AIDS clinic at Partners in Hope now serves about 500 clients each week.For most clients, it is life-saving treatment, whether it’s testing for HIV, treatment of infections, or antiretroviral medication (ART, the medicine that slows the effect of AIDS in the body).

Yet much of what keeps clients alive occurs outside the clinic door. Each day, a Malawian living with AIDS makes difficult choices in order to stay alive or to maintain a family.

Follow Chimwemwe Disi, age thirteen, on her trip across town to the Moyo clinic.Just a monthly check up… yet there are so many obstacles along the way on her journey.

It’s Thursday, so Chimwemwe keeps her strict school morning routine.Waking before dawn in her two room house, she quietly leaves the bed where her mother and eleven-year-old brother Amos are still sleeping.She grasps one red and one blue plastic basin and trudges to the edge of her yard to fill them at a spigot.

Returning to her front step, she stirs a few smoldering coals on the one-pot grill on the ground.After adding a few fresh pieces of charred wood, she fills a tin pot with water and sets it over the coals.

At age thirteen, she is in charge of the household.Her father died of an unidentified cause five years ago; her mother ‘Amai’ Disi, a school teacher, has been recurringly sick for a year.Amai Disi has refused to get tested for HIV, saying she doesn’t believe medication will help her.

On her monthly clinic visit day, Chimwemwe takes extra care to leave food for her mother.Pouring hot water for tea into plastic cups, she adds ground corn, sugar and groundnuts to the water.Muscular arms rhythmically stir the corn pudding smooth.

She fills one dish for herself and Amos and covers another for her mother.

The rest of the routine is always the same:Wake her brother, wash the dishes, and smooth her hair.Gather their notebooks in a plastic bag, and leave at 7:00 with Amos for the ½ hour walk to school.

At about 11:00 a.m., Chimwemwe requests permission to leave early from the headmaster of the school.She walks along rain-rutted dirt roads and paths until she reaches the familiar gate of the Kaggwa Catholic Parish.

In January, 2006, Chimwemwe came to the parish seeking help.PIH partners with the parish to provide HIV testing and counseling.Because the site was in the neighborhood, Chimwemwe’s aunt managed to bring the girl to get tested one day without her mother’s knowledge.Miriam Nkuka, PIH’s outreach coordinator, followed up, getting Chimwemwe ART.

After a year of mentoring Chimwemwe and visiting her home, Miriam finally convinced her mother to allow Chimwemwe to get antiretroviral treatment.

Soon Patuma, a twenty-one year old friend, meets her at the gate. Since Chimwemwe’s mother refuses to take her to the clinic, Patuma serves as Chimwemwe’s companion.Every person receiving ART must have an accompanying adult who attends appointments and agrees to support the daily medication regimen.

While they wait, they share a banana and some peanuts.This will sustain them until supper, when they can prepare food again at home.

Together they ride the minibus about a half hour to the center of town.Neither can afford a second bus ride, so they walk the next hour to reach PIH.Some months, one of them is sick with a virus or skin infection.Then the walk may take two or three hours.

Yet every month, Chimwemwe looks forward to reaching the sunlit reception room at PIH.A friendly nurse greets her, and there’s clean, cool water to drink.

Usually, she sees her favorite doctor, Mr. Kelvin Rambiki, the director of the Moyo clinic.He checks and treats infections, and together they count out the pills she needs for the next month.He recalls first meeting Chimwemwe in December, 2006.

“At first, she was quite weak and had painful sores on her leg.She wouldn’t look at me or talk with me, said Mr. Rambiki.“Now, we joke together and she’s mostly healthy.”

Chimwemwe’s journey to her monthly check-up shows her own ingenuity and strength.It also shows a network of community support that includes her local church, friends, and Partners in Hope staff.

There are several programs of Partners in Hope that reach out into communities, to support HIV-positive clients and prevent HIV-infection through testing and education.

The key activities include:

  • Free, anonymous testing for HIV in a supportive, Christian environment.Having a testing site in the neighborhood gets Chimwemwe, and hundreds of others like her, in the door.PIH now provides free testing at thirteen sites in unreached areas in and around Lilongwe.

  • Support and educational groups for children and adults living with HIV.At the clinic and in communities, PIH conducts seminars and support groups for those living with HIV and their families.At Kaggwa Parish, Chimwemwe is now a peer leader in a support group for HIV+ children.She especially likes teaching younger children how to cook nutritious food like porridge with ground nuts, and she is a role model for her excellent school work.
  • Nutrition education—In 2007, PIH began a partnership with local ‘permaculture’ trainers who share techniques for growing native local nutritious foods with low-cost, locally sustainable methods.At demonstration garden at the clinic, enthusiastic visitors sample local greens or practice conserving water.