by Julie Karfakis
I had visited many health facilities during my time as a Global Health Corps Fellow in Malawi, nearly all of them described as being ‘very far away,’ so I didn’t think much of it when preparing to travel to the Thekerani Health Center. Bessie Nkhwazi, the mothers2mothers (m2m) Thyolo District Manager in Malawi, wasn’t kidding when she warned me about the distance—after almost two hours in the car on a precarious, mountain-top dirt road, we arrived.
We were greeted by Charity Chiteuwe, the site coordinator who runs the m2m program at the Thekerani Health Center, which opened in November, 2013. Charity works with Mentor Mothers, who are recruited, trained, and employed in understaffed health facilities throughout Malawi. Charity and the Mentor Mothers work together to provide education, peer support, and treatment for HIV+ women while also working to protect babies who have contracted HIV from their mothers. This work is all part of m2m’s vision of eliminating pediatric AIDS, empowering women, and creating health and hope for mothers and babies, their families, and the greater community.
Women receive vital information at Thekerani to prevent mother-to-child transmission of HIV, along with consistent support throughout pregnancy, birth and post-partum. Thekerani sees an average of 8,840 people per month, and 57 percent of those patients are women of child-bearing age (according to the Ministry of Health). The facility’s rural location makes crucial education, support, and follow-up much easier for patients. Charity maintains contact with her clients after their babies are born and encourages them to bring their children back to the facility for HIV testing at 6 weeks, 12 months, and 24 months. Determining a child’s HIV status is critical so they can be put on life-saving treatment if they test positive. Without treatment, about one-third of children infected with HIV die by their first birthday, and half die by age 2. Sadly, in 2012, only 35 percent of children exposed to HIV received a test by the recommended two months of age.
When I asked Charity about testing for HIV-exposed children at Thekerani, she smiled shyly. “For 11 months [November, 2013, to September, 2014] we didn’t have any children test positive,” she proudly answered. “To go for that long without any children testing positive, I know that our prevention of mother-to-child transmission program is going well…. We work together with partners and facility staff to solve problems, and it makes me happy that it is working!” Charity then told me about how many women appreciate and acknowledge her work and role in the community; at times, women will even follow her to her home for additional information and support.
Although I didn’t want to pry, I was curious what happened in October, 2014, when the 11-month streak of negative HIV tests for children came to an end. Charity explained that Thekerani is a referral site, which means women travel far distances to deliver their babies there, even as far as Mozambique. This was the case that October, when a woman who had not gone through m2m’s prevention program gave birth at Thekerani, resulting in the baby being born with HIV. “It made me very sad,” Charity told me. “This woman did not have the information she needed.”
Charity and the staff at Thekerani remain optimistic about the future and their impact on reducing the rates of HIV. Charity recognizes the challenges of her work, yet she sees the difference she is making. “I like my job very much. Each day I help people and I know that I am helping to save lives.”
Charity and the other Mentor Mothers are playing an integral role in making sure no child is born with HIV in Malawi. One facility, one village at a time, they educate and empower mothers living with HIV. These determined women understand their individual successes are part of a larger achievement, one which belongs to their community and country.
A longer version of this piece was originally posted on Huffington Post’s Global Motherhood.
Julie Karfakis is currently a Global Health Corps Fellow at mothers2mothers in Malawi. Julie has an MPH from George Washington University and completed a fellowship in Eldoret, Kenya, where she designed and conducted a qualitative research study on postpartum family planning. She most recently worked for John Snow, Inc. on the Maternal and Child Health Integrated Program (MCHIP), where she collaborated with the Immunization Team and multiple country programs in East and Southern Africa and Central Asia.