Joan
D’Souza of the European Coalition of Positive People (ECPP) explains
to Martin Flynn about an initiative to help Aids orphans in Malawi
The HIV and Aids epidemic in Malawi is compounded by poverty, ignorance and lack of healthcare.
Out of a national population of 11 million, an estimated one in 10 people in the country is now living with the disease. But the real picture is probably even worse.
Malawi’s National Statistics Office says that 139 people die from HIV/Aids every day and most of these are in the economically productive 15 - 49 age group. The vast majority of those with the disease cannot afford medications and over 70 per cent of hospital beds in the country are occupied by HIV patients who have few drugs and little hope.
The southern region of the country - Mulanje district - is particularly poor and the Aids orphans in the area need urgent help. That is why ECPP is helping set up a local centre to help the children with some of the basics of life.
Joan D’Souza of ECPP explains: “We’re working with orphans in seven centres and we’ve managed to complete one building at one centre. It’s a place where the orphans can meet, be provided with a meal and some basic support. They don’t actually live at the centres but live within the community. Some come for after-school activities and the little toddlers come to the nursery.
 The orphan centre in Mulanj |
“Three hundred and fifty children come to just one centre and, in total, 2,000 come for help to the centres in seven separate villages. A local committee runs the centre, and we have helped by funding the completion of the building at the main centre at Kumwamba.
“ We raised the money through charity walks by about 800 Roche employees in Basle in Switzerland as well as two walks by Roche staff in the USA - in Nutley in New Jersey and Palo Alto in California. We also have private investors who have helped as well.
“ The reason we are working in Malawi is because of the connections our executives have had with the country over the years. The HIV prevalence in the country is estimated between 15 and 18 per cent but we suspect it is much higher because testing is patchy and reliable statistics difficult to come by.
“ We saw for ourselves that there was a need for urgent assistance, particularly for the children whose parents have died from the disease.
 ECPP' Joan D'Souza |
D’Souza describes the key problems of the Mulanje district: “Even though there’s limited HIV testing available, there’s no treatment and home-based care, and until the end of 2003 there was no self-help group in existence. There’s little prevention work, drugs to treat opportunistic infections or to prevent mother to child transmission.
“ Last year the director of the local mission hospital told us he was against the use of condoms because he said they promoted promiscuity. Most churches in Malawi say it’s because of bad behaviour that people are getting HIV and Aids.
“ Only last month a nurse came out publicly as HIV positive and all the others said ‘How dare you say that you are positive’. Now four others have also come out and have set up a little self-help group that meets once a week.
 ECPP's Colin Webb |
“ There’s still a terrible amount of ignorance, stigma and discrimination in the community. They have a song which goes: ‘Look at that walking corpse’ and people sing it if they suspect someone has HIV or Aids.
“ There’s a number of factors causing the rapid spread of the disease in Malawi; one is of culture. If a husband dies, often his brother inherits the dead man’s wife.
“ There’s also circumcision. When a boy is circumcised he is told to go out and have sex with anybody in order to test his manhood.
“
There is a need for HIV awareness programmes in Mulanje. There’s very
little information about how HIV is spread and how to prevent it. The radio,
every day declares ‘Aids kills’ but it doesn’t explain about
transmission or how to prevent it. They don’t explain that it’s
OK to touch someone with HIV and therefore fear and discrimination builds up
further.
“ Last year there was a terrible famine in Malawi and people were dying of hunger. Who would buy condoms rather than buy food to feed their family? Yet many Christian churches preach against condoms and promote behaviour change and abstinence as a way of stopping the disease.
“ Then there’s the strong power of the traditional healers who cut the skin of patients with razor blades and rub in herbs. They then use the same blades over and over again. They’re also using the same old equipment for birth deliveries.
“There are limited drugs available and people just can’t afford them. We spoke to one doctor and all he had was paracetemol and a few other pain killers and antibiotics. No antiretrovirals or even anti-fungal drugs.”
Are cheap antiretrovirals available?
“ Maybe in the capital or the north of the country, but to my knowledge not in the south. With a general election coming in Malawi this summer all the politicians are concerned about is getting the vote out. Some of the opposition politicians are beginning to talk about Aids and are promising universal healthcare, but we’ll have to wait and see.
“ There is supposed to be healthcare in Malawi. You can go to a district hospital, see a clinical officer and get a prescription but often the pharmacy will say ‘Sorry, we don’t have the drugs’. In the big towns like Blantyre there are pharmacies but you have to pay. And people can’t afford to travel when their only income comes from a little patch of maize.”
So how does Malawi compare to somewhere like Uganda, for example?
“ When you compare Malawi to Uganda you see that Uganda is a shining example of where HIV education, prevention and treatments can work at slowing the course of the disease. Even talking openly about sex in Malawi is almost impossible.”
What are your hopes for the Aids orphans in Mulanje?
“
We want the children to have a clean and safe place where they can all gather;
places where they can have a meal and find some help and support. We see babies
coming in when their mothers have died and there’s no one to look after
them. The centre is building a library for the children and we hope that some
will be able to go on to secondary school. We’ve talked about testing
them, but the question we have been asked is: ‘what do you achieve by
testing them if you can’t treat them?’ But on the other hand, if
we knew who was positive we may be able to allocate resources efficiently in
supporting the children.”
What is the future for ECPP and its projects in Africa?
“ The first priority for us is to set up a clinic in Malawi and provide the basic healthcare, also to commence operations in Mozambique. We want to try and get HIV information about awareness and prevention out to the rural communities.
“ Then we need to fight against stigma. Because it’s often ignorance which makes people discriminate against others. To be told you’re a walking corpse in a song can be even worse than physical violence.
“ Access to treatment is vital too, but antiretroviral drugs may not be the first priority when people can’t even feed themselves. I wish it was just as simple as the price of the drugs.”
ECPP also runs projects in Russia and Ukraine and is involved in lobbying European Parliament members and the EU Commission.
The European Coalition of Positive People (ECPP), 2 Whitehorse Mews, 37 Westminster Bridge Road, London SE1 7QD. Tel: 020 7401 9942. Website: www.ecpp.co.uk
