On Tuesday, Violet came to the DREAM centre of Mthengo wa Ntenga (Lilongwe). She was with Faith, her daughter, who was just 18 months old.
Faith is one of more than 100 children to be born on the programme of vertical prevention run by DREAM in Mthengo wa Ntenga. When her fourth daughter was born, a few months after she discovered that she was HIV-positive, Violet certainly needed faith – her daughter’s namesake – and she wanted to entrust herself and her child to people who would be able to lead them both out of resignation and despair.
Violet came to Mthengo wa Ntenga on 19 October 2005. She had intended to go for a normal check-up at the local prenatal care clinic. This is a maternity centre which, like the majority of such centres in Malawi, is short of personnel and facilities. Given these shortages, the personnel of these centres often just check the weight of the pregnant women and prescribe iron salt tablets to treat anaemia, which is widespread among people living in countries where malaria is endemic. According to regulations in force in Malawi to prevent the spread of HIV, it is meant to be obligatory to proceed also with an HIV test but unfortunately the necessary kits are frequently not available in rural areas. In Mthengo wa Ntenga, however, thanks to the support provided by the DREAM centre, it is possible to do the test.
Violet listened carefully as the women waiting for their check-up were told how important it was to take the test. She had not been feeling too well for some time: she had a persistent strange cough and frequent fevers. Certainly she was worried… for a Malawian woman to discover that she is positive when tested is a tragedy. Your world falls apart and in a flash, your life is no longer what it was. As soon as the rumour gets around that a woman is HIV-positive, everyone starts to look upon her differently, children will no longer play with her offspring and there are not a few husbands who leave their wives, confirming that they are the cause of the malaise.
That day, however, DREAM workers and campaigners did not stop at explaining what HIV was and how it was transmitted. They were talking about the possibility of treating the disease and said it was possible for an HIV-positive woman to give birth to a healthy child if she followed treatment carefully. Violet screwed up courage and decided to take a test.
And it was the dreaded response: the test was positive. These are terrible moments, when the future induces fear: “How will I manage to return home? What will my husband say? What will happen to my children?” But encounters with DREAM support, encourage and pave the way for new hope.
After the test, all those women who are positive are gathered by specialized DREAM personnel into small rooms that are well kept and well equipped. There is time to talk, without hurrying. Infected people have the opportunity to express their fears, to listen to the stories of those who have already lived through the same experience. They receive practical advice, suggestions as to how to explain the situation to their relatives. They are offered the opportunity of an appointment and treatment for their relatives too.
Free access to treatment is guaranteed, together with medical examinations, laboratory tests and –if necessary – home care and food packages. In a word, you are assured that someone will be by your side in the struggle against the virus, to support you in treatment and to help you.
After the discussion, Violet went back home less worried. She spoke to her husband, then to other relatives and after a week, she returned to the DREAM centre to begin treatment, to start vertical prevention and to save the life of the baby that was to come.
As the days passed, the initial fear and anguish faded to give way to the faith, friendship and serenity that are drawn in at DREAM centres.
And perhaps this is why when the time came to deliver her child, the name of the beautiful baby girl who was born, weighing more than three kilos, was already decided: Faith. Faith that she may be free of AIDS, that she may grow up happy and may become an adult in a world that is less unjust than the one in which AIDS treatment is available only for an meagre minority of infected people.
At the DREAM centre, we watched Faith grow month after month. She came regularly throughout the 18 months for check-ups with her mother. Each time, we checked her growth and weight, and gave her mother advice about hygiene and good nutrition for the baby before and after weaning.
On Tuesday last, Faith turned 18 months, the right age to make a definitive test to determine with certainty whether the HIV virus was present in her blood or not. As usual, Violet came on time with her baby; she was moved and elegant. Expectations were good because all the tests and check-ups made in the past year and a half had yielded good results, showing that Faith had escaped infection, as is the case with 98% of children born on the DREAM programme.
This time, going to the testing room did not cause anguish and, as foreseen, the test definitively confirmed that Faith was the umpteenth child of the Mthengo wa Ntenga DREAM centre to be born healthy to an HIV-positive mother. When Violet learned the result of the test, an impromptu party got under way as she wanted to go around the whole centre, showing her healthy baby to the other patients, to the staff and even to the laboratory technicians who had paved the way, through their work, this small miracle to happen.
Then she went away happy, with Faith in her arms. Truly Violet’s faith that her baby would be born healthy was well and truly answered.
But faith continues to be nourished. While Faith grows healthy and strong, even Violet’s faith is continuing to grow, in the certainty that she has found boundless friendship and can continue to get treatment, to remain healthy and to see her four children grow up.