June 2017

Family Unity in a Malawi Village

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Community Mobilization

One day, John Ja, heard the clapping of hands at the entrance of his small compound, indicating the arrival of visitors. As the chief of Malengatanzi village in central Malawi, John frequently receives official guests. On this day, Lucy and Martha, two HIV testing counselors with the Foundation for Community and Capacity Development (FOCCAD), were conducting door-to-door tests in the area.

FOCCAD is a community-based organization supported by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) and ViiV Healthcare.

“Usually we come to the village unannounced,” says Martha. “We come straight to the chief and we tell him why we are here. Most of the chiefs invite us to do the HIV counseling and testing.

“I was excited about it,” says John.  “I told them that they can start with me here at my house—that I should set an example. Thereafter you can go to the other houses for the testing.”

John and Malia, his wife of four years, received counseling about HIV on the spot and had their blood analyzed with a rapid HIV test kit. John’s test came back negative, but Malia’s was positive for HIV, making them a serodiscordant couple. As a pregnant woman, she was immediately concerned not only for her own health, but also for the health of her unborn child.

“I was really hurt to learn my status,” says Malia. “I wondered what would become of me and my child. And I was worried that my husband would divorce me. Usually when there is a discordant couple there is a breaking up of marriages—especially if the wife is the one who is HIV-positive.”

Malia was previously married, but her former husband has passed away. She does not know how she became infected with HIV.

“When I found that she was HIV-positive, I did not act in a harsh way,” says John. “I just gave her support.”

Malia and John quickly put their shock aside and focused on the health of their unborn child. Lucy and Martha transported Malia to the local health center in their car and immediately enrolled her on antiretroviral (ARV) therapy. They also counseled her about the protocols of prevention of mother-to-child transmission of HIV (PMTCT). They told her that if she followed the recommended drug regime throughout pregnancy and breastfeeding, her child was highly likely to be born HIV-free.

“Ever since I started taking my ARV tablets, I have not missed a dose,” says Malia. “Our son, Cephas, is healthy. So far his HIV tests have been negative.” Cephas is now 10 months old. Malia and John plan to take him back to the hospital for another test when he is 1 year old—and again at 18 months for his final infant HIV test.


As a chief, I play a part in giving HIV support to people in this village. 


“As a chief, I play a part in giving HIV support to people in this village. I appreciate what FOCCAD has done for us—monitoring different aspects of HIV and health like they do through door-to-door counseling and testing.,” says John. “I go with my wife to the hospital. When she is sick, I go alone and pick up the refill for her medication.”

“I appreciate that I have a loving husband,” says Malia. “Sometimes when I think about what has happened to me—living with HIV and having an HIV-free baby and a supportive husband—I think that this is a remarkable situation. It will make me very happy to see that our child remains HIV-negative.”

“I am living happily with my wife,” says John. “Whatever she does for me I like, and I like to do things for her. I thank God that we are living happily.” He picks up Cephas and smiles. “I hope that my son can be a medical practitioner so that he can pass along the good news about health to others in the village.”