It is under preparation the 8th panafrican DREAM Formation Course, which will take place from July 12 to 22 in Blantyre, the largest city in Malawi, and which will continue for one more week with a field training in the DREAM centres of Blantyre and Lilongwe.
One hundred people are going to take part in the course, which is particularly addressed to English-speaking Africa, a part of the continent where the presence of DREAM has consistently grown in the past year, through the empowerment of the centres of Tanzania, the opening of the Malawian and Kenyan centres, the agreements for a forthcoming start of the treatment in Nigeria. The people who will attend the course are coming from Malawi, Tanzania, Nigeria, Kenya, Lesotho, Liberia, Eritrea, and, for the first time, from India.
Besides the formation course for the various professionals involved in the DREAM centres (physicians, biologists, nurses, lab technicians, pharmacists, and coordinators), a formation course will be held for a delegation of women of the association of DREAM activists of Malawi, whose role is crucial to obtain an effective compliance to antiretroviral therapy by the patients of the Programme, through their activity of visits and health education, mainly in the rural areas of the country.
As we reach the village of Mpothe, about 20 minutes away from the hospital of Mthengo wa Ntenga, we immediately meet well-known faces. The chief of the village and James welcome us, we are a familiar presence at last. There have been indeed several meetings, but today’s occasion is a special one. Today, for the first time, we are here for HIV testing in the village. In Malawi, like many other Sub-Saharan African countries, 80% of the population lives far from the cities, in small villages, from which it is often difficult to reach the larger towns. The people in these villages meet a lot of diifficulties in accessing health services, mainly present in the large centres. Moving is not easy, and very expensive, often too much for the poor resources of Malawian peasants. Some among our patients must walk even for three hours to reach the hospital. In such conditions, people often give up treatments, except when the illness is so severe that there is no other choice left. Very often, it is too late and the treatment, mainly as far as AIDS is concerned, cannot have a positive effect any longer. That is why we have decided to go toward these people, and we have chosen Mpothe as our first trip.
A numerous crowd is waiting for us, among whom mainly women of all ages, longing for doing the HIV test, to know if they have the infection. All are registered by the activists first, then the test is performed with the assistance of a nurse and a counsellor, who has a talk with them at the time of giving the response. Everything takes place around and inside the only brick building of the village, serving also as a church. The atmosphere is serene, all is made orderly and without troubles. Fifty-one tests in a morning, and five seropositive people who will access our centre tomorrow to receive the treatment. The promise of the treatment has made everything simpler and calmer. It is not a condemnation to be aware of being seropositive, but the first step to be cared for and to fight the illness. Finally, the people in the village give us freshly toasted peanuts and fruit as a gift to show their gratitude. The next appointment two weeks later with other 25 people: only one will result positive to the test for HIV infection.
We leave, giving one more appointment, with the sensation of having walked another step forward to a more widespread access to the treatment, and a better awareness that there is an answer against AIDS.
Over the last few days the ceremony for the signing of agreement between the Community of Sant’Egidio and the Congregation of Teresa Missionary Sisters took place at the community’s offices in Rome. The signing of the agreement to implement DREAM in Angola is the result of two years of discussion and negotiation, of visits to the area, of staff training and collecting of funds.
Angola, just a few years after the conclusion of the civil war which devastated the country, is going through a serious economic and social crisis, despite the enormous source of natural riches that lies beneath the country’s surface. Moreover, AIDS continues to attack the active population, thus obstructing the implementation of reconstruction that the country so badly needs.
The meeting in Rome with the Community of Sant’Egidio convinced those managing the Congregation that it was possible to put into effect a concrete and efficient action plan to stem the epidemic and give back the hope and human resources needed to get the country back on its feet. The following visit to the DREAM centre in Mozambique carried out by the health staff working with the Teresa Sisters reinforced that conviction.
With the aim of opening a DREAM centre also in Angola, doctors, laboratory technicians and nurses from the hospital of Cubal in the south of the country participated in specialist courses run over the last two years in Mozambique.
The hospital in Cubal is already an effective structure, having operated for years in the specialist cure of patients with tuberculosis and children with malnutrition. Recently it has obtained the authorization from the Ministry of Health in Angola to operate as an AIDS treatment centre.
Our hope is that Cubal also becomes a pilot centre for the treatment of HIV, a point of reference for those who want to participate in the dream of resurrecting Africa.
Edward turns slowly in the direction of his home, on the outskirts of Lilongwe, the capital of Malawi. His heart is full of despair. The streets are dusty and lined with low-roofed houses made of mud and brick, the usual poverty. But they are also buzzing with people and life, men and women who go about their daily business, walking, talking, laughing. Edward, however, doesn’t participate in the life that surrounds him. He is ill. He has AIDS.
By now written out of the script that is life, he is a man without hope. He is unemployed. He who in his youth had the fortune of being able to study and completed secondary school. He who obtained a good job as a mechanic. In Africa it is normal to lose your job to AIDS. And consequently your friends ad social status too. Edward, in fact, doesn’t have any friends, they all disappeared on the discovery of his condition. Now they can’t even look at him, they’re scared. At best, some try a little compassion. This is why Edward is going home, it’s a good place to die. Where else can he go? There is nothing more that can be done. How can he find a job to earn money to survive in his condition? The virus has damaged his body terribly, making him weak and almost blind at just 38 years of age. It won’t be long before he can’t see and then he won’t even be able to walk by himself.
Edward discovered he had AIDS on the 25th April. He was often ill and was asked to do a blood test…the result was positive. Edward had been infected by the virus HIV and his immune system was already seriously compromised. A huge shock to the system, but Edward decided to fight, he hadn’t given up yet. On learning the result he started a treatment programme offered by the government. But instead of improving, his condition worsened…. day by day. So what else was he supposed to do except go home and wait for death to end his suffering?
But Edward’s story is not destined to end in death…at least not yet. Thanks to one of those miracles that can happen also in Africa, his destiny is one of hope, of cure, of life.
As Edward lies on his back on a mat on the floor, without expecting anything from anybody, suddenly something happens. Joseph, a distant relative, goes to visit him. Joseph had heard about his condition and the previous year had participated in the DREAM programme training course for laboratory technicians in Maputo, Mozambique.
And so Joseph, after having attended the training course, started working in the molecular biology laboratory in the hospital of Mthengo wa Ntenga on the outskirts of Lilongwe. That laboratory is the first opened by DREAM in Malawi and is the only one in the country where patients don’t pay for the sophisticated tests needed to monitor and treat AIDS. Joseph came into contact with many people, many sick people and saw that, thanks to antiretroviral therapy, AIDS is not a death sentence but a disease which can be treated and kept under control.
Joseph who was taken aback by the sight of Edward in such a terrible state ( he hardly recognised him) advised him to go to the DREAM centre in Mthengo wa Ntenga. There he would be able to be treated in the same way as patients are treated in Europe or the United States, free of charge. And as he is too sick to work he would also be given food to aid his recovery.
Edward is convinced by Joseph’s heartfelt advice and by the possibility of being treated and getting back his dignity. He decides to make the effort to go to the DREAM centre. But it isn’t easy. There is a long stretch of road to walk and then a minibus into town. It’s about 1600 kwacha for a return ticket which is more than a dollar. Moreover, there isn’t any way that Edward could make the journey by himself, he is practically paralysed. At least one or two volunteers would be needed to take on the responsibility of accompanying him. But the prospect of finding hope again is worth all this and more. Edward doesn’t want to die anymore now he has cultivated a dream of recovery, a dream of life.
Edward arrives at our centre on the 31st of October 2005, he is helped to take a seat in the waiting room and then he is seen by a doctor who takes a blood sample in order to restart therapy and prescribe treatment for the numerous opportunistic infections that afflict the patient’s body.
Edward, in fact, has a terrible cough, caused by tuberculosis, lesions on his head and body, a wound in his right armpit which is infected and needs to be cut into in order to drain the puss. He also has pain in his muscles that prevents him from being able to walk alone. Despite being over one metre and seventy centimetres in height, he has lost so much weight over the last few months that he weighs less than 50 kilos. For this reason he receives food over the days to come, until his next check up.
At the beginning Edward came to the centre every two weeks, his condition was such that required strict medical control. After a couple of months, however, he started to get better. In the area where he lives people could hardly believe it, he started to walk and see again. In February Edward came for his check up alone, he no longer needed someone to accompany him.
Today Edward is another person. In the middle of March he came to the centre proud of having convinced his wife to do the test and begin the assistance programme that is DREAM. He remembers with us his story and thanks us for the therapy which has allowed him live again. Today he sees his future as hopeful and less lonely, he has found someone to fight the battle for his health with. We talk for a long time. His wife tells us how until a few months ago she didn’t think her husband could possibly get out of his desperate situation. On the contrary, she was petrified also for herself. After the disease had set in, Edward had tried on many occasion to convince his wife to take the test but she hadn’t wanted to. She was scared of getting the confirmation that the terrible disease that was plaguing her husband would one day plague her too.
But when she saw that her husband was getting stronger again day after day, her fear started to subside, leaving room for the conviction that it is important to know and to face the test result, especially if there is the certainty of treatment and assistance at the DREAM centre today and in the future.
Edward’s wife did the blood test and then went home with her husband. We see them walking away from the hospital, around the market streets just outside the centre. They are still ill but there is hope in their step as they walk. They walk together, with an air of calm, towards a future that is longer and brighter than they imagined only a few months before.
In my view, today it is of great importance to ask ourselves questions together about the role religions may play in the struggle against AIDS, especially as regards Africa and poor countries. HIV infection cannot simply be relegated to being just another of a category of health problems; still less can it be limited to the scientific questions it raises. AIDS presents a dramatic threat to the development and very future of the continent. AIDS questions and challenges the hope of millions of people and their families. Unfortunately, millions of other young adult lives – the most important age group from the perspective of income and the family – have already been consumed by the raging fire of the epidemic. Most worrying is the reality that far from being extinguished, the infection maintains all its driving force: a very recent UNAIDS report, from 2005, reveals that the incidence of new infections is still higher than the death rate, at a rate of 0.8 million units: 3.2 million new infections and 2.4 deaths.
Well, this difference is only a little less than that recorded in 2002, revealing that the epidemic trend is not slowing down. Moreover, AIDS must not be seen only in terms of the victims it kills, but rather in the context of the chain of consequences linked to these deaths. When a young adult dies in Africa, at least one orphan is “born”: there are more than 16 million today. When a young woman dies, the lives of all her children are at risk. And there are no reliable statistics on the deaths of infants somehow related to the decease of their fathers or mothers. The same UNAIDS report further states that by 2020, the workforce of four African countries will be slashed by more than 30%, while those of many others will be reduced by between 10 to 20%. This fact cannot but have repercussions for their Gross Domestic Products, from which two percentage points are deducted per year because of the disease. A study by the World Bank undertaken in 2004 calculated that the GDP of countries like South Africa could actually be halved within a few decades.
Faced with such terrible news, that often induces fear and provokes resigned or simplistic responses, as Christians and believers, we felt challenged. It is the challenge of evil to the good news of the Gospel, to its force of good and healing, a challenge to loving the life of each and every person. We asked ourselves, as men and women of faith, if it would be possible to work today for a modern miracle of healing and liberation from evil. Thus was born DREAM, Drug Resource Enhancement against AIDS and Malnutrition, a programme to fight against the pandemic, designed and managed by the Community of Sant’Egidio since 2002. In six African countries – Mozambique, Malawi, Tanzania, Kenya, Guinea Conakry and Bissau – more than 25,000 HIV-positive patients are miraculously alive, thanks to DREAM treatment. Soon, other countries too will see the emergence of centers run by the program, especially Angola, Congo and Nigeria that has very recently signed a general implementation agreement. There is a widespread notion prevailing in public opinion: that a victory over AIDS is exclusively linked to scientific research and the discovery of some “magic bullet” – a vaccine or a drug – that will resolve the problem once and for all. However it is not so, as those getting into the inextricable tangle of related problems will realize. The first of these problems is doubtless that of poverty: individual poverty, which implies not only that a person cannot pay for treatment, but also that he/she is unable to physically access treatment centers. Further, poor people do not have a culture and fundamental concepts geared towards prevention, nor can t
A photographic exhibition on the work and results achieved by the DREAM programme will take place at the Museo di Roma in Trastevere, piazza Sant’Egidio, from the 4th to the 28th May. The photographs were taken by Graciela Iturbide, a highly accredited Mexican photographer and the exhibition contributes to the 5th edition of the International Photography Festival promoted by the Council of Rome.
The photographer, famous in particular for his sensitivity towards the social conditions of women, focuses his attention on patients from the DREAM centres in Maputo and Beira. The photographs, in black and white, give testimony to their struggle and victory against AIDS, their victory being expressed by their hope, health, in their role as mothers and at work. In short the exhibition shows how these women got their life back.