However it is also a trade centre, that is, a centre with a commercial vocation, of exchanges and of contacts, situated along the lengthy road linking the north and south of Malawi, exactly half-way between Lilongwe, the capital, and Blantyre, the commercial heart of the country. And it is also, albeit on a modest scale, a railway hub for merchandise and passengers.

As is true for all places of passage and movement of people, AIDS reaches worrying levels of prevalence here, between 15 and 20%, much higher than what would be expected in a rural area (2-5%).

Balaka thus combines “city” problems – that is, a high prevalence rate of HIV – with rural problems, namely dispersion of the resident population in Savana bush country, with difficulties of access to services.

This is why Balaka presents a further challenge in the framework of the struggle against AIDS conducted by DREAM in Malawi.

The new centre and new laboratory, newly opened in the health compound that will also house a maternity clinic, present an answer to ever increasing demand. Today, the centre of Balaka has around 1300 patients on its books, 200 of who are children, and it supports the DREAM satellite centres of Kapire and Namandanje (both situated around an hour and half by car from Balaka, a journey to be undertaken mostly on dirt road. Each centre has something over 100 patients).

Recalling that the centre of Balaka was opened in December 2006 with less than 100 patients, one becomes aware of the rapid growth of DREAM in this context. The news of free antiretroviral therapy has spread rapidly across the neighbourhood and 2007 saw new patients approach the reception desks, around a dozen a day, anxious to have new hope of treatment and of healing.
This prompted the decision to expand the size of the centre and to equip it with a larger, autonomous laboratory.

The new centre has been heartily appreciated by patients because of the ample space there is, and the verandahs that serve as waiting areas, where activists take time to chat with the many people who turn up every day, asking to join the programme.

But it is above all the laboratory that has made the difference. The growing influx of patients – and hence of blood samples – called for a new structure. It was no longer possible to transport blood samples, twice a week, to the laboratory of Blantyre (which is two hours by car from Balaka, but three and a half from Kapire). Thanks to the new laboratory, it will be possible to carry out tests of biochemistry and hematology every day, and soon, CD4 lymphocyte counts will be possible too.

The laboratory also houses a new area for VCT (voluntary counselling and testing), where rapid HIV diagnostic tests are carried out for all who want, together with thorough counselling, which draws attention to the range of services offered by DREAM in case of a positive result.