Chilombwe HIV/AIDS Activities: June 15

On Monday, June 15^th, we travelled an hour and a half to the shores of Lake Malawi, to a village called Chilambwe. We were destined to see an HIV testing center, anti-retro-viral (ARV) dispensary, hospital, and school. But first, we had to get there!!

This panorama shot shows the view of the gathering villagers of Chilambwe from our table of honor!

Our driver Jonathan skillfully guided our van down a paved road we have travelled many times in the short time we’ve been in Malawi. Then, we turned down a dirt road, and then another, and then another, each progressively worse. Eventually, we ended up on nothing more than a trail through the bush, with grass all around us taller than the van. Seeing how thick the grass was, we asked our driver what sort of animals lived in the area. He replied that just last week a woman had been killed by a python when she climbed on top of a rock in the dense grass to try to obtain better cellular service. It was on top of the rock that she met her demise.

We travelled through some of the most difficult terrain I’ve ever driven through, with boulders sticking out of the road all the way across, with the only way through over the top. Up and down we went, over teeth-rattling terrain, crossing rickety old bridges made out of simple, thin lumber supplies. We were brought to an abrupt halt by a bridge that had been destroyed by floodwaters earlier this year. We had no choice but to proceed, across the river bottom and through the flowing river, which was quite small and calm due to the dry season (thankfully!).

We asked our driver if he travels this road often, to which he responded yes. It turns out that he is the one sent out as an “ambulance” driver to the hospital. Mzuzu has the nearest main hospital to Chilambwe, so any serious medical conditions require transfer to Mzuzu. There is no ambulance service here, so sometimes in the middle of the night Jonathan will have to make the arduous journey to pick up a gravely ill patient. He is the one sent because the hospital is run as a partnership between the Diocese of Northern Malawi and the Malawian government. Jonathan is employed full-time by the Diocese to do that sort of work, as well as drive people like us around.

Soon, sights of beautiful lake Malawi graced the horizon, indicating that we were close to the village. When Katherine and I arrived at Chilambwe, we were greeted by Fr. Edward. He is in charge of a parish of around 1200 villagers, and volunteers at the hospital and HIV testing clinic. He would be our guide around the village for the day. First, we went to the HIV testing clinic, where we were ushered into a room with 6 women, Fr. Edward, and a male nurse. The nurse explained to the women what was going to happen. Then Fr. Edward and the nurse donned gloves and drew blood from the fingertips of their first patients. After changing gloves, they proceed with the next patient, repeating for the last two. The nurse also distributed female condoms to the women, and explained how to use them and the importance of doing so. These women that we saw were all pregnant; the clinic especially encourages pregnant women to be tested so that if they test positive special precautions can be taken with the fetus while in the womb and when the baby is being born. However, all women and men are encouraged to be tested regularly, especially if they are at risk.

Since the HIV test takes 15 minutes to produce results, we walked across the hall and spoke with the nurse who distributed ARVs (antiretrovirals) to the patients who test positive for HIV. She explained the different forms of ARVs that are given to different patients: babies, children, and adults. The drugs are provided completely free of charge, as is the testing, by the Malawi government. The patients have to return to the clinic each month, however, to obtain more drugs and to be counseled on proper hygiene so that the virus isn’t spread to those around them, along with how to best live their lives so that the medications will work, such as limiting the use of alcohol. Usually, patients at risk for secondary infections are also given a free supply of antibiotics to take.

We then returned to the testing room to examine the test results. One of the six women had tested positive according to the results. A follow-up test would be performed shortly, the nurse said, to confirm the results. At that point, drug therapy would begin immediately if HIV is confirmed. On the ride back to Mzuzu, I remarked to Katherine what a privilege it was to experience the testing along with these women. They allowed us into what could be a life changing moment in their lives. In the U.S., this experience would likely have never occurred for us as undergraduates, and certainly not by simply waltzing into the room as we did.

After leaving the HIV testing clinic, we proceeded out to what appeared to be the center of town. There, what appeared to be nearly 500 students from the primary and secondary school were gathered, along with church members, medical staff, and school staff for a performance on HIV/AIDS. It turns out that these topics are discussed regularly in Malawian schools: sex, pregnancy, condom use, HIV, AIDS, rape, prostitution, etc. It was wonderful to see both students and adults talking so openly and eloquently about such important topics. We heard poems from students, testimonies from HIV positive men and women, songs from church ladies, and a skit. Katherine and I were treated as visiting U.S. dignitaries, and were seated in proper chairs at a table covered with a white tablecloth amidst everyone else sitting on the ground, on benches, or on tree stumps. It also seems that this entire little assembly/menagerie of performances was put together just for us. What a terrific honor!!

Next we went to Fr. Edward’s home, where all of the village leaders, including the head teacher, nurses, village headman, along with Katherine and me, were treated to a lunch of “local chicken” (aka the chicken pecking around under your feet a couple hours ago!), rice, and cabbage, typical Malawian cuisine. After finishing our lunch, we were sent off, again as visiting dignitaries with a gift of a wooden globe carved by a local artisan. What a wonderful learning adventure and cultural experience in Chilambwe!

The male volunteer nurse taught Derek and me how he conducts HIV/AIDS screenings when he is at the clinic by a finger prick method.

Father Edward also volunteers at the HIV clinic and helped to perform the screenings while we were there.

The test strips shown are all negative (one red line) except for number 3, which is positive (two red lines).

The Chilambwe chapter of the Mothers' Union performed many songs, dances, and even a skit for us.

The primary school choir

A few men from the parish performed a comedic skit for us to encourage nondiscrimination against HIV/AIDS positive community members!

From left to right: Mothers' Union Representative, Parish of Chilambwe Secretary, Head of the Home Care Ministry, Katherine, Derek, Father Edward, Father Edward's Wife who is also part of the Mothers' Union