Malawi starts distributing ARVs to those in need

Malawi has begun the distribution of anti-retroviral (ARV) drugs to about 100 000 adults and 20 000 children living with HIV. Figures from the National Aids Commission show two million out Malawi's 12 million population are HIV positive.

President Bingu wa Mutharika's secretary for Nutrition and HIV/Aids, Mary Shawa, says that almost 90 000 children across Malawi have HIV. She says most of the children contracted the virus through mother to child transmission.

Shawa says the government has now established 144 delivery and service centres, up from 36 in 2004, to deal with mother to child transmission. Currently 100 000 HIV positive people in Malawi are already on AZT, paid for by the Global Fund initiative against Aids, malaria and TB.

An estimated 14% of Malawi's 12 million people are infected with HIV/Aids, with about 240 people dying of the disease each day. More than one million children have been orphaned by the epidemic.

The women and children who made me cry

Yesterday we biked about 25km out to visit another orphan caregiver group that my NGO has organized. It was a hot, dry, dusty ride out there and we are pretty exhausted when we arrive. We are placed in a small room and dozens of small, wide-eyed children in tattered clothes file in to greet us. Then the women in the caregiver organization come in to perform a dance to welcome us. They took us out to the community maize field where the maize they grow goes toward the orphans, either feeding them directly or sold to provide school supplies and school fees for some of the older children. The group is caring for 43 orphans and the maize is not enough. The group built a beautiful pig kraal and the agreement was that, after building the sites, a partner agency would provide husbandry training and 4 pigs (one male and 3 females). This is the same project that was undertaken by my NGO at 15 other sites in our catchment area for OVC groups. We completed our part of the bargain and all of the kraals were completed by October; however the “partner” organization who committed themselves to this effort has not come through with either training or livestock. So the pig kraal is currently used as a preschool area for the younger orphans who are not attending primary school yet and the OVC group is struggling to care for these children. We visit with the children in the kraal and they sing for us and show us some of the figures they are making with mud and clay. They are packed into one of the sections of the kraal so tightly there is no room to move. I wondered if they always sat in there like this or if they are just gathered into one small place for our visit. I suspect it is easier to control the children when their movement is so severely limited, but it can’t be much fun for them or conducive to learning much.
After meeting with the children, we have a more formal meeting with the village headmen and the OVC group. The women tell us of their accomplishments and their struggles to provide not only for the orphans, but also for the elderly and disabled, some of whom were also present at the meeting. As I look out over the crowd, I am moved again by how much the women in Africa take upon their shoulders. The women hold this continent together, but just barely. They are so pleased to have me there, in their words a “humble white woman who would come by bicycle all the way out there to just visit with them. “ Well, in a rare moment I may sometimes approach humility, but probably not often enough. I start to get choked up. It just comes on me sometimes when I least expect it and it is just one more reason public office is not for me. I struggle to retain the tears, dabbing tissue at the corners of my eyes. God, don’t let me cry. I know my turn to say something is coming up and there is no way for me to bow out. I search my mind for happy or funny memories, anything I can latch on to that will stem the flood. The strategy works only briefly and intermittently. My time comes and I stand. Henderson stands next to me to translate. I start to say something about the women in Africa, how they are holding up Africa, how it is through their strength that anything survives here. Then my throat closes. I stand there knowing that to utter another word is to allow the torrent of tears to flow and I cannot do that. I am not ashamed to cry, but one never knows how that will be interpreted here. They are strong and they expect the same of me. A few tears leak out the corners of my eyes and everything is quiet and still. No one moves, no one breathes. The moments seem an eternity for all of us while I can neither continue nor sit down. Eventually the worst of it passes and I finish, talking about the ravages of HIV, the necessity to get tested and treated, the need for pregnant women to get antenatal care and testing to protect their unborn children and prevent more children from being orphaned, the importance of caring for those children already orphaned. I sit down exhausted.
After the meeting was over, I greeted a man sitting on the ground holding a cane. He was slender and small, dressed all in white, with some gray showing in his beard. He shook my hand with a noticeable tremor. He told me, the shakiness in his hand recapitulated in his voice, that he and his wife are both HIV positive and how difficult it is for him to get to the nearest clinic, which is quite some distance, to get ART for both of them. Governments make a big deal about the fact that ART is free in most places in Africa now, but free doesn’t take into account that they are not widely available and the cost, not only in terms of transport cost, but in terms of physical demands where transport is not locally available and you have to walk miles to even find transport, is higher than many can pay. So, many will die.
I rode back to town wondering if there is a way to come up with some pigs for this group. I also wondered how I can leave when there is so much that can be done. I told Julie I would never come back to Malawi because all eyes are on Malawi and there are countless NGOs and governmental agencies tripping over each other, few making any tangible difference in places like this small rural community. Every time I go into Lilongwe and see all the cars, with their organizational logos plastered on the doors, I become nauseated. I pass all the new buildings in the capital that house the major aid organizations that cost millions to operate, and I want to rip my hair out. Everytime I go to the restaurant even in my small town and see another group eating there because they are attending yet another workshop, resentment boils up in me. But when I get out into the rural area, where most of the people are living, and see how much they are doing with so little, I am awed and I want to help them do more. And even if I could put behind me the poverty and difficulty these people face in their everyday existence, the faces of so many orphaned children will haunt me in my sleep.

Hundreds of university students spend summer vacation as volunteers abroad

For Liu Yi-shin (劉宜鑫), a junior at National Taiwan University, the past few weeks were perhaps the most unforgettable part of his summer vacation.

Liu spent two weeks at the Home for the Dying in Kolkata, India. a charity founded by Mother Theresa that houses some 40 homeless people of all ages with physical disabilities.

"I found the hygiene conditions there unbearable right as I stepped out of the plane," Liu said. "A lot of modern urban infrastructure is absent. Piles of trash just pile up along the roads and smell horrible."

In addition, Liu and 16 companions arrived in Kolkata during India's monsoon season. But the group was not discouraged by what they saw.

"You have to personally experience poverty to be able to help these people," Liu said.

During their two-week stay, Liu and the others did house cleaning and laundry and helped physically challenged residents in their daily lives, he said.

"Because of the lack of modern equipment, things as simple as doing the laundry are not as easy there," Liu said.

Liu was among 300 Taiwanese university students who spent part of their vacation as volunteers abroad.

With help from the Ministry of Education and the National Youth Commission, these students from 17 universities nationwide worked in a variety of projects in developing countries such as India, Myanmar, Vietnam, Indonesia, Malawi and Cambodia.

Although Liu doesn't speak any Indian languages, he didn't feel communication was problematic.

"You know what they want if you look into their eyes and pay attention to their gestures," he said.

Liu said he is more confident now about facing life's challenges.

Lee Chia-ju (李佳儒), a third-year student at Taipei Medical University, spent part of her summer doing volunteer work in Malawi.

Lee said she helped with filling prescriptions, teaching Malawians about health issues and doing administrative work.

One of the most unforgettable moments during her stay there was when her team ran short of several medicines, she said.

"All we could do was give medication to the most seriously ill patients. We could give the others only vitamin pills," Lee said.

Lee said she was saddened to see the enormous gap between the health care available in Taiwan and that in Malawi.

"How can there be such a big difference when we're all living on the same Earth?" Lee asked.

Minister of Education Tu Cheng-sheng (杜正勝) lauded the students' contributions to humanitarian work on Friday.

"When I was a kid, Taiwan was a poor country with terrible hygiene conditions and medical care," Tu told the students at an event held to recognize their volunteer work abroad.

"Back then, we received a lot of international aid," he said. "Now that we've passed that stage, it's our turn to help."

Most of the volunteer programs only lasted a few weeks. Tu said the Cabinet would discuss extending the service period and promoting overseas volunteer programs as an integrated part of the country's education.

Tu said that the amount the ministry offers in subsidies to college students serving as volunteers overseas during summer and winter vacations would increase to NT$9 million (US$273,000) next year from NT$4.6 million this year.