Malawi rolls out ARV programme

The country, one of the worst hit in the southern Africa, is now targeting 70 000 such people, up from 46 000, who are currently receiving free ARVs. Two years ago only about 4 000 people were on the programme. Now up to 150 000 are in need of the treatment. “We are doing immensely well with our ARV programme. We hope to increase the number of patients accessing anti-retroviral therapy to at least 70 000 by December 2006,” Biswick Mwale, the executive director of the National Aids Commission, told journalists. Malawi, where the pandemic has cut life expectancy to 36 and 85 000 people die of Aids-related illnesses every year, has been receiving financial aid from The Global Fund to Fight Aids, Tuberculosis and Malaria. The poor country first launched its programme to give free Aids drugs in 2004, financed by the Global Fund at a cost of US$196 million. Malawi will increase outlets dispensing drugs from 87 to 126 across the country, including hospitals that serve the army and police, which have been hit hard by the pandemic. Mwale said the number of Malawians going for voluntary Bottom of Form 2 HIV tests had doubled to 500 000 in the last two years. “It is encouraging and we are making good impact,” he said. Still a taboo subject in the conservative landlocked country, wedged between Tanzania, Mozambique and Zambia, some 900 000 Malawians are living with HIV or Aids where the prevalence rate is 14 percent, according to UNAids. Meanwhile, an experienced midwife in one of Scotland’s biggest maternity units, Linda McDonald was in Malawi recently, and said her experience of the health system there was beyond her imagination and is now mobilising resources to return there and help out. The 46-year-old told journalists that she was not prepared for what she witnessed on a recent visit to a baby ward in Malawi. She said the smell of death and disease shocked her to the core in what was the most ill-equipped, dirty and understaffed maternity unit she had ever seen. She now plans to return to the Bottom Hospital in Malawi’s capital Lilongwe with an ’80 000 lifeline for the beleaguered unit. Working with the Malawi Underprivileged Mums charity, Linda has helped put together a recipe book and a calendar, which has raised tens of thousands of pounds since its publication in October. The recipe book has been endorsed by Sarah Brown, wife of Chancellor Gordon, who gave birth to son John at Simpson’s. Linda is now planning to release a second calendar featuring mothers from Malawi and their children. She is also including a flyer to advertise the calendar in the payslips of all 183 000 National Health Service of Scotland employees. Linda, a midwife at Edinburgh Royal Infirmary’s Simpson Maternity Centre, returned from Malawi last month. “It’s one thing being told about the problems and another thing being there,” she said. “The smell is the first thing to hit you and then it’s the number of people – you have to step over them. Women put a black bin bag on the bed with a piece of cloth, give birth and then have a cold shower afterwards.” A woman dies in childbirth every week in Malawi while babies die or are stillborn every day. One of the first changes Linda made was to donate a fridge to the hospital, where dead babies can be stored before they are buried. Before, they were discarded in the hospital sluice. Linda said: “The contrast is so huge you cannot possibly take everything on board. They have got one midwife to 43 babies. They have got three staff on a shift at the labour ward, where we have 12. And they have twice as many babies to deliver.” Linda believes it’s just as important to educate people in Scotland and hopes her work can highlight the difficulties in Malawi and inspire others to help. She added: “When you go to Malawi, it’s something you can’t do once. It’s having a finger on the pulse. You have got to have contact. What you have got to do is work with them, suggest things, try to get them working as a team.” In November 2005, Jack McConnell signed a formal agreement to provide Malawi with official government help and support. The pact effectively twins Scotland and Malawi in a collaborative pact designed to use the former’s wealth and experience to help lift the African country out of poverty. Malawi’s main city, Lilongwe, is named after David Livingstone, the Scottish missionary. Mike Pringle, the Edinburgh South MSP, set up Malawi Under-privileged Mothers (MUMs) and hopes to help build a new maternity hospital in Lilongwe. There are only 2 200 nurses working in all of the country’s public hospitals, serving a population of 12 million. Pay and conditions are desperately bad, so many of Malawi’s nurses and midwives leave to work overseas.

June 2006
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