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The immigration officer at the border didn’t expect Elias to live very long, so he wrote the word “forever” in his passport.  He and his brothers were returning to Malawi to get the medical attention he desperately needed.  What that officer had seen was a gravely ill man, weighing just over 100 pounds.  He was too weak to walk, talk or eat.  He remembers being placed in a wheelchair, his head propped up for him, his powerless legs lifted to put his feet on the footrests.

His brothers convinced Elias to get tested for HIV.  He remembers feeling afraid, but he was willing.  After learning that he tested positive, his sister encouraged him to get help at the Partners in Hope Medical Center (PIH).  He recalls the kindness and respect shown to him at his first appointment.  The nurses and doctors gave him food and his first dose of anti-retroviral medication (ARVs) for AIDS.  Most importantly to him at that point was the “light” given him…the hope that, with treatment, he could still have a future.

After an early battle with meningitis, he began to improve on ARVs.  He put back on some of the weight he’d lost, and he noticed that he felt much stronger. He attended the classes offered at PIH, which included information on nutrition, gardening and the importance of adhering to the medication regimen each day. 

Elias spoke of this time in his life being more than a physical recovery; it was also a spiritual one.  He remembers feeling guilty about a girl he may have passed HIV onto.  He imagined her parents taking him to court, ending up in prison.  Then, in his mind, he stood before a door.  He ‘heard’ a voice saying, “You have been forgiven.  With your HIV, kneel down and receive God as your Savior.”  He responded with a sincere and grateful heart that day.

With his renewed health, and gratitude for God’s forgiveness, he determined to tell his story to others.  He has met with several pastors and gotten invitations to speak in their church services.  He tells people, “With HIV, it doesn’t mean it’s the end of your life.  When you know your condition, it’s the start of your life.”  People find him afterward and thank him for his honesty.  He says, “There are even pastors who have become open about their own HIV status.  This makes their followers free to talk as well.”

Elias has lost many friends to AIDS.  “People are too shy about HIV, especially youth”, he says.  “They refuse the help they need.  They worry about what people will think of them.  They assume they’re dying.  If we don’t talk with them about HIV, we are just spoiling their futures.”

Today, Elias weighs 175 pounds and radiates health and enthusiasm.  He would say that he has a new lease on life, that he has “power to work” and earn a living.  He has a deep purpose, that of encouraging others to know their HIV status, get the help they need, and get on with life.  He said, “If I’m afraid to talk, I won’t help this world.”

Olive had lived through the pain and rejection of divorce, but even tougher times were ahead for this former member of Malawi’s Parliament. Two years later, a chronic cough led her to seek medical help from her brother, a clinician at Dowa Hospital. Observing how sick she was, he encouraged her to be tested for HIV. The news that she was indeed positive came as a huge blow to Olive. She told me, “I felt shattered, and I wept uncontrollably for nearly an hour.” The emotional wounds from the divorce were behind her, but she now had to face the reality that her husband had left her with this deadly virus.

There was much stigma around HIV then. She feared that her reputation would be ruined. She didn’t want people to be disturbed by her news. She didn’t want their pity. Soon she became too sick to work and had to quit her job. She could not have anticipated the response that her son would have after hearing the news of her illness. A 22-year-old husband and father of two young children, he took his own life. Olive felt that her life was falling apart. She remembered her brother who had died of AIDS three years earlier, before treatment was available in Malawi. She thought she too was dying, and even asked God to take her.

She became a patient at the Partners in Hope Medical Center (PIH), where the staff showed her much love and care. She told me, “One of the nurses, Anna, spreads hope to us. She welcomes us and treats us with warmth from her heart. She even dances and jokes with us.” The doctors treated Olive with ARVs (AIDS medications) for a year. However, her CD4 count (blood test indicator) was still very low and she was having side effects to the standard Malawi ARV regimen . At that time, this special regimen was not available at PIH, so she had to be transferred to the government program. She was very happy when PIH was later able to offer these medicines for free as well, and she returned there for her care.

It takes a big effort for Olive to get to PIH. In the rainy season, the dirt roads in her village turn to mud, so the buses cannot get close to her home. She walks about 12 kilometers to get to the main road! However, she feels it’s worth it, because she trusts PIH. She knows that her case is complicated, having changed her medication regimen several times already. She pays close attention to symptoms and side effects, coming to the medical center when problems arise.

As I listened to Olive share her story, I could see that she has joy in her heart. She is deeply grateful to the Lord and to PIH for saving her life. She says her faith has deepened because of her AIDS. Her real hope is in Jesus. I asked her if she has been able to forgive her husband (now deceased) for the trouble he caused her. She replied, “You know, he caused me to lose my health, my job and my son. There is still some resentment, but God is healing me.”

“I see a lot of hurting people, overwhelmed by HIV,” said Olive. “I try to encourage them, to give them hope. I tell them that HIV is like hair. Though you shave it, it will still come back. Instead, look after it. [You can] let it control you, or you can control it. Even with HIV, life can still be bright.” Olive talks with people wherever she goes, encouraging them about their HIV and telling them about the love of Jesus.

When I asked Olive to tell me one message she would want to give to others living with AIDS, she said, “Be holy and faithful. Pray without ceasing. Expect the Lord to do His part.” One of the Bible verses she clings to reads: “For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future.” (Jeremiah 29:11). Olive tells people, “There is still life after HIV.”

“Rabecca’s story is not finished yet”
She held tightly to her walking frame on wheels, taking each step with care, as she came to meet me. My first impression of Rabecca was made by her smile and the warmth in her eyes. However, as she began sharing her life’s story, her smile left her face, and her eyes revealed much sadness.
At the age of eighteen, Rabecca’s life changed dramatically when her mother died and her father sent her and her five siblings away. Soon afterward, perhaps in search of love and daily survival, she got married and became pregnant, giving birth to a daughter named Isabelle. Sadly, she then learned that her husband was not faithful to her, having had sexual relationships with many other women. The STI’s (sexually transmitted infections) he passed onto her, and the loss of trust, motivated her to divorce him. She chose to return to school with hope for a brighter future. However, she was unable to give her studies the focus needed, and she failed her exams.
At the age of twenty-three, she got married again, hoping to begin a new life. She and her husband got jobs at a local “health training center”; he worked as a health surveillance assistant, and she worked as a research assistant, doing two nutrition studies. She felt she had the beginning of a stable family life at that point. However, the emotional pain leftover from her previous marriage made her cautious about having children with this husband. After observing the kindness he showed to Isabelle over two years, she agreed to have a child; their son, Henry, was born a year later.
When Henry was one year old, Rabecca began getting sick, having unexplained rashes and fevers. She became aware of her husband’s reckless living, including “womanizing, drinking, and sleeping in beer halls”. She feared that he might have passed HIV onto her, so she made the decision to get tested. Her fears were realized when she was told she was indeed positive. She had her children tested too, then learning that little Henry had also been infected with HIV.
Rabecca was unable to afford the AIDS medications (ARVs) at that time, for it was before the Malawi Government provided them for free to hospitals and clinics. She became sicker and, a year later, was diagnosed with Tb (tuberculosis). She went through Tb treatment, but it failed, because her immunity was too weak.
Her husband continued his wild behavior, though his wife grew sicker by the day. He was even caught in adultery with another man’s wife. He narrowly escaped being killed by her husband in a fit of rage. Though a village chief was consulted, he was not willing to intervene, so Rabecca informed her husband’s employer who helped them relocate to another town. Though he could have taken the opportunity for a fresh start, he continued in the same pattern of sexual immorality there.
One day, a nurse at the health center where he worked noticed how sick and frail his wife and young son had become. She arranged for a visiting doctor to come and examine them the next day. He recognized the seriousness of their condition and recommended that they begin ARV treatment immediately. He explained to them that there was serious risk involved; he would normally address their other infections first, but they may not live long enough without the ARV treatment. In fact, he told her that she had a 50/50 chance of survival.
Both Rabecca and two-year-old Henry began their fifteen-day starter pack of ARVs. On day four, Henry complained of pain in his stomach. This continued for the next three days, and very sadly, he died on day seven. Rabecca hadn’t prepared her heart for this, so the shock was followed by intense grief and depression. This was complicated by pain in her head, side and feet, perhaps side effects of the ARVs. She was physically and emotionally unable to care for her daughter, Isabelle, so she sent her to live with her sister.
Rabecca’s husband provided a little money for food, but wasn’t around to really care for her needs. Instead, he continued in his careless behavior, staying out late each night. After a month or so, Rabecca felt even sicker, so she phoned her sister for help. She came and brought Rabecca to her home, and then to the hospital three days later. She was diagnosed with Tb (again) and meningitis. She slipped into an unconscious state, and remained that way for four days.
When she woke up, she was unable to move. She was confused and unable to remember things. She went through Tb treatment again, and began a slow, tedious process of recovering her strength. After three months and some physical therapy, she could get to a sitting position. It took much patience and determination from her and her caregivers to work toward each milestone. She had many setbacks along the way, including a serious bedsore that remained for a year, and a period of vomiting that lasted 4 months. Though extremely weak in body, she had the drive to face each day, never giving up.
Her husband visited her after a while, and she could see that he was not healthy. She encouraged him to get the medical help he needed, but he refused. His brother tried to convince him as well, but failed. His choice to deny his status and refuse help eventually cost him his life.
Rabecca is now a patient at Partners in Hope and is much stronger and healthier. They have provided a modern walking frame which enables her to be more independent. She is making progress with the help of her physical therapist who clearly loves her, and she has regained the weight she’d lost. Life has dealt her some big blows, but she has pressed on. She’s not a quitter. On the contrary, she talked about her desire to live on her own, to have some kind of employment, and to support her teenage daughter again, evidence that she has hope for her future. Rabecca’s story is not finished yet.

“HIV divides, but it also brings people together.”
Losing her father when she was a teenager impacted Emma’s life more deeply than she understood then. Her longing for a sense of family and security lead her to join a group of girls who took her further down a path of despair, for they were prostitutes. The next seven years in this lifestyle would prove to cause more pain, guilt and disease than she could have anticipated.
Years later, a severe headache and stiff neck sent her to a doctor for help. Treating her with antibiotics dealt with the acute problem, but there was something much more serious and life threatening going on in her body; it just hadn’t yet been exposed. Three years later, it was the pain of shingles, a fast heart rate, and weakness that drove her to the doctor again. And it was then that she had an HIV test. . . . . she was positive.
She had 3 young sons by that time, with no husband/father to care for them. How would she manage? She turned to her mother and sisters for assistance, only to have them push her away, saying that she would have to deal with this alone. Thankfully, she did have some friends who stood by her, and they continue to do so to this day. In her own words, “HIV divides, but it also brings people together”.
Alone in her house one day, still suffering from the shingles, and very low in spirit, she watched a TV pastor talk about Jesus. He encouraged viewers to surrender the pain of their past, and to receive His forgiveness and love. As though he was talking to her personally, she responded by tearfully confessing her sins to God, handing over the guilt she carried from her past, and receiving the peace that she so desperately needed. She then began attending the church she had belonged to years before, but as a new person, a forgiven one. Over the next several years, she grew in her faith in Jesus, and her love for Him.
Though she was HIV positive, her immune system remained strong enough to hold off the need for treatment. In fact, ten healthy years passed by. During that time, she shared her story in many churches, schools, hospitals, and with individuals in her home. Emma shared the hope that she had found with countless people, including groups of teenage girls, warning them of the risks of bad choices that can impact their futures. She said to me, “If someone had taught and warned me about the dangers, I never would have gotten involved in prostitution.” She doesn’t want other girls to suffer like she has.
Just a few months ago, her health declined, and it was suggested that she see a doctor at the Partners in Hope Medical Center (PIH). She learned that her CD4 count (blood test indicator) was down to 12! Given that patients often begin treatment when it drops below 250, this was quite alarming. Dr. Jansen did recommend beginning antiretroviral therapy (AIDS medications), and she has regained her health and strength since then.
Soon after her initial appointment with Dr. Jansen, her youngest son began showing signs that he too might have been infected with HIV. She convinced him to come into the medical center with her, explaining that knowing the truth would be very important for his health. After having some pre-test counseling, he bravely agreed to have a blood sample taken. Moments later, Dr. Jansen came in to talk with Emma and her son, giving them the sad news. He recalls, “I was moved, seeing the tears well up in this 9-year-old boy’s eyes and then roll down his cheeks.” He talked gently with him, relieving some of his fears, explaining that kids with HIV can live fairly normal lives. He encouraged him to continue reaching for his dream of someday becoming an accountant.
Emma was deeply grateful for the way that Dr. Jansen handled the situation, telling me, “Our friendship with him made it easier. We trust him.” For her son’s sake, she maintained her composure during the doctor visit, but then went to a nearby restroom to cry. The weight of regret was heavy on her as she accepted that the virus would have been passed from her to her innocent son at the time of his birth.
Though she lives with the harsh realities and consequences of her past, Emma doesn’t live a sad, sickly life. She lives under the umbrella of God’s love and forgiveness, with freedom from guilt and fear. She often prays, “Lord, it’s because of You that I live”. Deep peace and joy radiated from her beautiful face as she spoke. She said, “The whole world might not know me, but God knows me. My name is written in the Book of Life”.

“His small physical frame betrays his inner strength.”
Henry greeted me warmly and welcomed me into his living room, eager to share his story. The sincerity in his eyes and the gestures of his hands, often placed on his chest as he spoke, told me that this would be no ordinary visit. What he would describe to me about living with AIDS, losing his precious wife, and struggling to support his two teenage children, would understandably bring about hopelessness and despair. But as I listened, I observed something very different.
The ambitious life that he’d known over his adult years, including working as an insurance salesman, running a mini-bus/taxi business, owning a butcher shop, and playing piano in a classy hotel, suddenly changed. He grew very sick, having fevers that wouldn’t go away, becoming weaker by the day. The fevers puzzled the doctors. His brother then suggested that he seek help at the Partners in Hope Medical Centre. It was soon discovered that he was HIV positive, and that he was suffering from Tuberculosis (Tb). He was admitted to a hospital to undergo Tb treatment for one month.
While in the hospital, with his wife at his bedside every day, he grew even weaker. This was partly due to the sores that lined his throat (a common symptom of AIDS), making it painful to swallow even water and a thin porridge. He remembers his weakness and labored breathing making it impossible for him to even sit up in bed. His wife feared for his life. But, God had given him assurance that he would not die then, appearing to Henry in a vision. He clung to this hope with confidence, trusting completely in the Lord he had come to know and love deeply. Over that month, all of the other patients in his hospital room died. Others were admitted in their places, and they died as well. Still, Henry held to the words that Jesus had given him.
He was later discharged to his home, but still extremely weak. He depended on his wife’s help for the very basic needs of daily living, even carrying him on her back to take him to the outside toilet at their home. But, sadly, she died very suddenly due to a heart problem. The day she died, family members brought her body from the hospital back to the house. Too weak to walk, he had to be carried to the side of her coffin to look in at her face, saying his last goodbyes. Henry experienced intense grief in the months to follow, but he trusted that the Lord had purpose in this, that He would bring something good from her death. The tears in his eyes as he spoke of her revealed his love and his pain.
As time went on, and he continued his HIV treatment, he became healthier. However, his legs remained very weak. His doctor could not promise that this would improve. Henry encouraged him, saying that he trusted the Lord to make him strong again. Only a month later, he was walking. These days, he walks long distances, even 7 or 8 kilometers at a time!
Henry’s deep joy and gratitude for God’s personal touch on his life were contagious as he recalled some of the ways He has provided for his needs. He says that he is free from worry and fear, a result of fully surrendering his life to Jesus. His desire and prayer is to share about his faith and hope with other Malawians, people living in villages who despair about their futures.
There is a unique peace about Henry, something that few people experience. His small physical frame betrays his inner strength. As I listened and observed, it was evident that this man is not dying from AIDS; no, he’s living with AIDS. . . . . .really living.

Gratitude for life. . .

that’s what the man expressed to Perry as he greeted him that Sunday morning. He was one of many patients who had nearly given up on life. His wife had died, and he was so frail that he could no longer walk. But there he was, healthy again, his perspective on what’s important forever changed. Observing this man pray and sing praises to the Lord in our church’s worship service is more than heartwarming. His story is one of many that add to Perry’s passion for his job here in Malawi. It’s about people getting off their deathbeds, returning to work, resuming the care of their children. It’s about offering hope to the nearly hopeless.

I still remember my first contact with Madalitso*, a 35 year old man who works with a large organization in Malawi. His was not an uncommon story… a young, previously healthy man who came with the diagnosis of a “stroke”. Like many others I have seen, the left-sided paralysis was not due to a stroke, but due to a serious fungal infection that can be seen in AIDS patients (toxoplasmosis). Despite the seriousness of the diagnosis, Madalitso was grateful to know the truth. With proper treatment for the infection, and then antiretroviral therapy for HIV, his symptoms improved greatly.

Six weeks later, Madalitso was back to work with a new perspective on life and his work. Get this. . .he works doing community education about HIV/AIDS. Now he can speak of it ‘first hand’ with a new zeal to help others. At a recent visit, Madalitso said that he was grateful for his HIV infection because it helped him understand what is important in life and has brought him closer to God.

What an opportunity to make a difference in people’s lives physically as well as spiritually! Our motto at PIH is “Christ’s love in word and deed”. Our staff is trained in offering spiritual care for our patients in a way which respects their beliefs but brings great comfort during a difficult time.

*Not actual name

Chimwemwe’s Check-up

The Moyo (non-private) HIV/AIDS clinic at Partners in Hope now serves about 500 clients each week. For most clients, it is life-saving treatment, whether it’s testing for HIV, treatment of infections, or antiretroviral medication (ART, the medicine that slows the effect of AIDS in the body).

Yet much of what keeps clients alive occurs outside the clinic door. Each day, a Malawian living with AIDS makes difficult choices in order to stay alive or to maintain a family.

Follow Chimwemwe Disi, age thirteen, on her trip across town to the Moyo clinic. Just a monthly check up… yet there are so many obstacles along the way on her journey.

It’s Thursday, so Chimwemwe keeps her strict school morning routine. Waking before dawn in her two room house, she quietly leaves the bed where her mother and eleven-year-old brother Amos are still sleeping. She grasps one red and one blue plastic basin and trudges to the edge of her yard to fill them at a spigot.

Returning to her front step, she stirs a few smoldering coals on the one-pot grill on the ground. After adding a few fresh pieces of charred wood, she fills a tin pot with water and sets it over the coals.

At age thirteen, she is in charge of the household. Her father died of an unidentified cause five years ago; her mother ‘Amai’ Disi, a school teacher, has been recurringly sick for a year. Amai Disi has refused to get tested for HIV, saying she doesn’t believe medication will help her.

On her monthly clinic visit day, Chimwemwe takes extra care to leave food for her mother. Pouring hot water for tea into plastic cups, she adds ground corn, sugar and groundnuts to the water. Muscular arms rhythmically stir the corn pudding smooth.

She fills one dish for herself and Amos and covers another for her mother.

The rest of the routine is always the same: Wake her brother, wash the dishes, and smooth her hair. Gather their notebooks in a plastic bag, and leave at 7:00 with Amos for the ½ hour walk to school.

At about 11:00 a.m., Chimwemwe requests permission to leave early from the headmaster of the school. She walks along rain-rutted dirt roads and paths until she reaches the familiar gate of the Kaggwa Catholic Parish.

In January, 2006, Chimwemwe came to the parish seeking help. PIH partners with the parish to provide HIV testing and counseling. Because the site was in the neighborhood, Chimwemwe’s aunt managed to bring the girl to get tested one day without her mother’s knowledge. Miriam Nkuka, PIH’s outreach coordinator, followed up, getting Chimwemwe ART.

After a year of mentoring Chimwemwe and visiting her home, Miriam finally convinced her mother to allow Chimwemwe to get antiretroviral treatment.

Soon Patuma, a twenty-one year old friend, meets her at the gate. Since Chimwemwe’s mother refuses to take her to the clinic, Patuma serves as Chimwemwe’s companion. Every person receiving ART must have an accompanying adult who attends appointments and agrees to support the daily medication regimen.

While they wait, they share a banana and some peanuts. This will sustain them until supper, when they can prepare food again at home.

Together they ride the minibus about a half hour to the center of town. Neither can afford a second bus ride, so they walk the next hour to reach PIH. Some months, one of them is sick with a virus or skin infection. Then the walk may take two or three hours.

Yet every month, Chimwemwe looks forward to reaching the sunlit reception room at PIH. A friendly nurse greets her, and there’s clean, cool water to drink.

Usually, she sees her favorite doctor, Mr. Kelvin Rambiki, the director of the Moyo clinic. He checks and treats infections, and together they count out the pills she needs for the next month. He recalls first meeting Chimwemwe in December, 2006.

“At first, she was quite weak and had painful sores on her leg. She wouldn’t look at me or talk with me, said Mr. Rambiki. “Now, we joke together and she’s mostly healthy.”

Chimwemwe’s journey to her monthly check-up shows her own ingenuity and strength. It also shows a network of community support that includes her local church, friends, and Partners in Hope staff.

There are several programs of Partners in Hope that reach out into communities, to support HIV-positive clients and prevent HIV-infection through testing and education.

The key activities include:

  • Free, anonymous testing for HIV in a supportive, Christian environment. Having a testing site in the neighborhood gets Chimwemwe, and hundreds of others like her, in the door. PIH now provides free testing at thirteen sites in unreached areas in and around Lilongwe.

  • Support and educational groups for children and adults living with HIV. At the clinic and in communities, PIH conducts seminars and support groups for those living with HIV and their families. At Kaggwa Parish, Chimwemwe is now a peer leader in a support group for HIV+ children. She especially likes teaching younger children how to cook nutritious food like porridge with ground nuts, and she is a role model for her excellent school work.
  • Nutrition education—In 2007, PIH began a partnership with local ‘permaculture’ trainers who share techniques for growing native local nutritious foods with low-cost, locally sustainable methods. At demonstration garden at the clinic, enthusiastic visitors sample local greens or practice conserving water.

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