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Malawi
In Malawi, most MSF activities are focused on improving care and services for those living with HIV/AIDS — a population numbering more than one million adults and children. Although the government has plans to scale up HIV/AIDS services, in reality, 90 percent of public health facilities lack the capacity to offer even the most basic health care. MSF cares for people living with HIV/AIDS, and provides treatment with life-extending antiretroviral (ARV) medicines to 6,900 patients. In the southern district of Chiradzulu, MSF is working with local and national partners to provide comprehensive HIV/AIDS care through the district hospital and 10 community health centers. Activities include voluntary HIV testing and counseling, education and awareness-raising and treatment for opportunistic infections. Since 2001, MSF has provided patients with free ARV medications. For the past two years, an average of 200 new patients have been added to the ARV program each month. (MSF has temporarily halted new admissions to the program while it develops new criteria to ensure that the quality of care remains high amid spiralling enrolment.) Currently 4,000 patients are receiving ARV treatment through the Chiradzulu program. The MSF team visits each health center in Chiradzulu twice a month and runs training sessions for local nurses to enable them eventually to run these centers autonomously. Tasks normally performed by doctors, who are in short supply in Malawi, as in the rest of sub-Saharan Africa, will be delegated to nurses and health workers. MSF launched its first HIV/AIDS program in Malawi in 1996, in the southern district of Thyolo, a mainly rural area where an estimated 500,000 people live. Today, that program is implemented largely through cooperation with local partners, ranging from the district hospital to small community groups. More than 2,250 people are now receiving ARV treatment there. MSF teams try to involve traditional medical practitioners in AIDS-prevention and ARVtherapy programs as well. In addition to HIV/AIDS care, the MSF team in Thyolo works to prevent and respond to other health needs, including malnutrition, cholera and malaria. In July 2004, MSF began a new HIV/AIDS project in the eastern part of the Dowa district in central Malawi. The team provides diagnosis and treatment to HIV-positive residents of the area, including those living in the Dzaleka refugee camp in the southeastern part of the district. Estimates suggest that approximately 8,500 people there are living with HIV/AIDS, and 1,500 are in immediate need of ARV treatment. Operating out of one hospital and nine health centers, the team gives medical care to HIV-positive patients and works to increase access to treatment. MSF plans to enroll 60 new patients each month so that approximately 800 people will be receiving needed care, including ARVs, by the end of 2005. MSF is also carrying out prevention activities throughout eastern Dowa district. MSF has worked in Malawi since 1986. |
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In Thyolo province, an HIV-positive woman must spend a lot of time under a mosquito net donated by MSF due to her frequent bouts of malaria. Photo © Gaël Turine