Building Relationships, Gaining Inspiration: A GHC Fellow Reports from Malawi

By Andrea Garces | May 3, 2013

A meeting with village chiefs in Kudoko Village, Malawi to talk about HIV prevention and antenatal care for pregnant women and their families.

EGPAF

Andrea Garces is a Global Health Corps Fellow working with EGPAF in Malawi. She writes about recent site visits and how small communities are encouraging men and women to take part in efforts to eliminate pediatric AIDS.

As an American Global Health Corps (GHC) Fellow who has worked with EGPAF in Lilongwe, Malawi for the last nine months, not a day passes that I don’t learn something new. It can be as simple as a new phrase I learn in the local language of Chichewa; other times, I get to learn more about the struggles and joys of life in Malawi from the Malawian perspective, or travel in the field with my EGPAF colleagues conducting capacity-building and technical assistance work with local organizations. My work has given me the unique opportunity to learn from the communities we serve, build my leadership skills, and do my part to eliminate pediatric AIDS in this country.

Through a project supported by the ViiV Positive Action for Children Fund, we work with six different community-based organizations (CBOs) in Malawi. One of our recent site visits was with Kanengo AIDS Support Organization (KASO), which aims to address the human rights and needs of women, girls, and children – especially those infected and affected by HIV/AIDS, poverty, and injustice. Richard Yohane, the executive director of KASO, and Michael Mwandira, programs manager, came out to greet us as we arrived in their gated office area in Kanengo. Their office building resembled a small house from the exterior, and their warm welcome matched the space. We sat in the common area of their multi-room office and discussed how to improve the tracking of project objectives to improve services to those living with HIV and also help to prevent mother-to-child transmission of HIV (PMTCT).

On another visit to Area 25 Health Centre, we discussed the ways in which a lack of HIV test kits is a big challenge across the country, and talked about the need for male involvement in order for PMTCT to be effective. We also talked about strengthening the referral system and developing a tracking system to ensure that referred clients get and use the services they need. KASO and Area 25 Health Centre are committed to working together to help each other achieve their shared goals, and EGPAF will provide technical assistance to help build and strengthen their relationship.

We proceeded to one of KASO’s projects in Kudoko Village. We drove along a very bumpy, unpaved stretch of road before we reached the village. We met a few of the KASO volunteers that worked in the village, and they led us inside to a meeting with six of the village chiefs. The chiefs sat side-by-side on a long bench, standing to greet us when we came in. Michael translated our conversation between Chichewa and English. When asked about how they support the objectives of the ViiV CBO Project, they talked about how they jointly advocate that every woman have antenatal care (ANC) and that husbands should escort their wives to the health center; both of these recommendations are now in the village bylaws. They also encourage women to deliver at health facilities for life-saving services, and they have put a penalty in place if a delivery takes place in the home. There are door-to-door counseling services in the village, encouraged by the chiefs.

Later, we met with the three Mother Groups who were sitting in sunny areas outside of the building. The Kudoko Village, Ngwangwa Village, and Chimwaza Village Mother Groups discussed how they conduct door-to-door visits for pregnant women and lactating mothers, encouraging pregnant women to go for HIV testing and counseling (HTC) with their husbands and practice exclusive breastfeeding. They also urge pregnant women living with HIV to breastfeed for up to two years, breastfeeding exclusively for the first six months before adding food.

Once we completed our discussions with the three mother groups, we met with a final group behind the building in a shady area under a tree. They were a group of about 20 HIV-positive women, some of whom were holding their babies, and they spoke about how they received continuous education at the hospital to learn how to take care of themselves and their babies. Some of the women use their personal stories to help mobilize other women living with HIV and AIDS, and have formed support groups in their villages. They advocate for women and fight against stigma and discrimination.

From there, we walked back to the main area in front of the building and watched a drama performance by community members; one way that KASO shares information on HIV and PMTCT with the community. One of the chiefs then thanked us for coming, and mentioned again the need for an ANC clinic closer to the village than Area 25. Members of the village sang as we walked to our car.

This experience reminded me why the work we d o and its impact is so important. In one day, we were able to discuss technical indicators and the role of community health centers, and to work with community members whose own lives and those of their children were saved by education and health services. Elizabeth Glaser’s legacy lives on through the work conducted in Malawi through the empowered health-focused leaders, KASO, and the village chiefs, and through the research and technical assistance conducted around PMTCT. I am proud to be a part of this work and to see it firsthand, and I know that further interventions will eliminate pediatric AIDS in Malawi.

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Global Health Corps

Global Health Corps (GHC) pairs intelligent and passionate fellows with organizations that require new thinking and innovative solutions. They provide opportunities for young professionals from diverse backgrounds to work on the frontlines of the fight for global health equity. GHC currently partners with placement organizations in Burundi, Malawi, Rwanda, Uganda, the United States, and Zambia.