Dying of HIV unknowingly, quickly

Noises of jubilation fill the air whenever a baby is born in the areas of traditional authorities Mchiramwela and Mkhwethemule in Thyolo District. For some households, however, the sense of elation is soon replaced with sadness as children, billed as leaders of tomorrow, succumb to death, thanks to the HIV virus that, not known to the babies and their parents, eats them from within. But, as RICHARD CHIROMBO writes, this state of affairs could be short-lived.

It could be by fluke or design, but the truth is that there is a piece of art that hangs on one of the mango trees leading to Ndalama Nursery School, Traditional Authority (T/A) Mchiramwera, in Thyolo District.
The artwork depicts a baby, perhaps between the ages of six months and one year, trying to jump into an endless lake.

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Whatever thoughts impressed the mind of the artist who came up with the work of art, what comes clearly is that the artwork portrays the human being as— although touted as the master of the earth— a diminutive creature, dwarfed by the vastness of natural phenomena such as lakes and mountains the size of Dedza, Mulanje or Zomba.
Shora Kauluka, technical assistant at a community-based organisation called Chipembere Communty Development Organisation (CCDO) in the area, is one of the people who have been impressed by the artwork.
“I think a lot of thinking went into that work,” Kauluka says. “At the same time, I think the artist was short-sighted, in the sense that he or she promotes the idea that the only things that cast man in the light of a diminutive creature are physical features such as lakes, mountains, elephants and things of that nature.
“What visual artists often, and sadly, forget is that some things that cast man in the light of a diminutive creature are tiny. I am talking of viruses and bacteria. In T/As Mchiramwela and Mkhwethemule in Thyolo District, for example, the real giant has been HIV, a tiny, invisible virus that causes Aids. People, especially children, have been succumbing to it without knowing it. HIV is the giant of our time, and not lakes or mountains.”
Kauluka , therefore, treats the artwork with an almost good-humoured contempt.
The truth is that the creator of an artwork never really knows how people will interpret it, or whether it makes any difference in society.
But Kauluka could be right on HIV being the tiny giant that eats through the fabric of good health, slowly but resolutely.
In the areas of the T/As in question, a sense of oppression is everywhere. Just that there is no physical force, like a lake or mountain, that is responsible for this state of affairs; it is something from within; something that cannot be felt through the sense of touch. That something is HIV.
At first, according to Kauluka, HIV created a sense of fear among people of Thyolo District. Those were the days of stigma and discrimination which, in the past, and according to Health and Population Services Minister Atupele Muluzi, were [stigma and discrimination] being fuelled “by ignorance”.
In those days, the days of stigma and discrimination, the individual living with HIV instantly became a prisoner of conscience.
As such, the individual living with HIV felt isolated, haunted by the fear of being ‘found’ out. Even among his own family members and peers, the individual never quite belonged.
“But this changed. Those with HIV are no longer subjected to stigma and discrimination. Treatment, in form of antiretroviral (ARV) therapy, is commonplace. These is no reason to be ashamed of one’s HIV status,” Kauluka says.
However, having passed the stage of stigma and discrimination, having passed the stage where ARVs were not free and in short supply, the people of Thyolo find themselves in a precarious condition.
The enemy, this time around, is ignorance of one’s sero-status, a development that has seen dozens of children die of Aids-related complications without knowing it.

At the moment, two community-based organisations that are working on an HIV and Aids project targeting children in Thyolo District have bemoaned increased cases of children who are diagnosed with HIV and Aids “too late”.

CCDO, which is implementing the ‘Accelerating Children`s HIV/Aids Treatment Initiative’ in T/As Mkhwethemule and Mchiramwela in Thyolo District, has, meanwhile, urged stakeholders to intensify efforts aimed at promoting identification and continuum care for children whose parents are HIV-positive.

CCDO is implementing the project in consortium with Umodzi Youth Organisation (Uyo). Shy Ali, Executive Director for Uyo cites laxity, in terms of sensitisation campaigns, as one of the factors that have led to people failing to know their HIV sero-status, hence increasing cases of preventable deaths, especially among children. 

Kauluka says it is disheartening that cases of children who are born with HIV without knowing it abound in the Southern Region district.

These are the sentiments he raised during a Paediatric HIV/Aids Awareness Campaign Open Day at Ndalama Nursery School, T/A Mchiramwela, in Thyolo.

“Although Malawi has made great strides in ensuring that those who are HIV infected have access to ART (antiretroviral therapy), there has been slow progress in terms of the number of children accessing ART services,” Kauluka said.

A Ministry of Health and Population Services report indicates that less than 40 percent of HIV-infected children in Malawi are accessing ART.

Kauluka adds that HIV infection tends to be progressive and fatal among infants and children who have no access to ART.

According to the Department of HIV and Aids, approximately 20 percent of HIV-infected infants die by the time they clock three months, a development attributed to failure to access treatment.

It further says 50 percent of infants and children die before reaching their second birthday while 75 percent die by five years of age, all this because they either had no access to ART or discovered that they needed treatment “too late”.

“In an effort to reduce paediatric HIV and Aids-related deaths among infants and children, CCDO, under its health programme, is carrying out the ‘Accelerating Children`s HIV/Aids Treatment Initiative’ through which we seek to identify HIV-infected children and link them to care and treatment in health facilities in Malawi, particularly in Thyolo District.

“Our organisation— in partnership with various stakeholders— wants to reduce the mortality rate among HIV-infected infants by as much as 75 percent upon ART initiation. The project is directly working with 20 community-based organisations and 10 Health facilities in targeted areas,” Kauluka says.

The National Aids Commission indicates that Thyolo is one of the districts with the highest adult HIV prevalence rates in Malawi, now pegged at 22.4 percent.

“Sadly, children are ignorantly dying of Aids-related complications because their parents do not take them for HIV testing, hence getting wrong treatment in their localities. Parents believe in getting treatment from herbalists, thereby putting lives of children at risk,” says Marcus Chonde, one of the community members in T/A Mchiramwela.

Mkhwethemule has, meanwhile, lauded the impact of the project, saying it has sparked health-seeking behaviour among residents of the district.

“We all have a role to play to ensure that no life is lost to HIV,” Mkhwethemule says.

The traditional leader says it is not “on, especially because we have made strides in ensuring that people have access to life-prolonging drugs, know their HIV sero-status, among other things”.

As part of the project, community volunteers have received bicycles for use in their community outreach programmes.

One only hopes that, moving forward, HIV will not put spanners, such as ill health and even death, into the wheels of progress.
That is the only way those affected can travel back to normal living.