Malawi, January 28, 2018
By Cliff Kawanga
At the height of hunger crisis few years ago, a lot of people cried for support.
Despite a lot of cassava or sweet potatoes in their household, some of them still lined up to receive free maize that the government was distributing. In a year when maize had failed, the farmers indeed had cassava and sweet potatoes as options. It is not quite surprising that in Malawi, food is nsima and those who claimed to have no food actually meant they had no maize from which fl would be made.
The many interventions in Malawi – which have lessened the burden of HIV and Aids – are founded on the availability and uptake of life-prolonging drugs.
An important aspect of such interventions is nutrition which, according to Dream Programme, should be embraced by all the stakeholders in the health sector as well as traditional leaders and the communities.
Dream Programme’s Country Coordinator Roberto Lunghi said nutrition is a key component in addressing the challenges in the health sector.
“This is where we should start from. We need to impart this knowledge about nutrition and we believe every stakeholder will play a role moving forward,” said Lunghi on the sidelines of nutrition training organised by Dream Programme in Blantyre last week. The training attracted participants from Dream Programme centres across the country and district health facilities.
Dream’s National Nutritional Coordinator Dyna Tembo said there is need to look at the nutrition side in the course of implementing other activities.
“Eating well is key to maintaining strength, energy and a healthy immune system. In addition, because HIV can lead to immune suppression, food safety and proper hygiene are concerns when it comes to preventing infections. This is the reason we gathered here to share the emerging issues based on the evidence from the communities in which we work,” Tembo said.
She emphasised that although focussing on the right food quantities is very important, food safety is crucial.
“You cannot talk about nutrition while ignoring hygiene. We urge our clients to follow the few basic safety rules when preparing and eating meals,” Tembo said.
She said the knowledge the participants acquired is key in meeting some of the targets set.
“Expert clients play a very important role because they are in direct communication with the patients. They follow up on patients and visit their homes when they miss appointments.
“Most importantly, the expert clients are involved in homecare. For patients who have problems with drug adherence or have poor nutrition conditions, the expert clients go to their homes, spend time with them to learn how they prepare their food, to see the hygienic conditions in the homes and then teach them on the correct ways of food preparation,” Tembo said.
One of the participants was Dowa’s Assistant District Nutrition Coordinator Precious Mlotha who said patients’ nutritional needs are assessed before meeting the doctors. “What we are doing in Dowa is quite remarkable. Regardless of the type of disease one is suffering from, we believe assessing the nutritional needs will go a long way in promoting healthy living in the communities,” he said.
He said that people might have a lot to eat but there is knowledge gap which they want to fill.
“We have learnt a lot and if we work together, we will soon count the benefi Everyone should own the initiative. In the past, the communities were at the receiving end but now they are actively involved,” he said adding that addressing nutritional needs is not the responsibility of the hospitals alone.
Another coordinator from Mangochi’s Kapire Dream Centre Alexander Mbewe said every food is important but there is need to consume the right quantities.
“Food helps the body to function properly. It is an important aspect in HIV/Aids because it protects the clients from HIV/Aids complications or opportunistic diseases,” he said. He said it was encouraging that most people appreciate the importance of good nutrition. “Few years ago there was a misconception that some diseases like diabetes or hypertension were for the rich only. This is slowly changing because people now understand that everyone can suffer from these diseases and good nutrition has proved to promote healthy living,” he said.
At the time the Dream Programme started in Malawi, the focus was on Drug Resource Enhancement Against Aids and Malnutrition with the aim of pulling resources together and enhance the fi against HIV and Aids.
After years of feedback from clients and efforts by the Dream Programme to do more, it was suggested that the neglected diseases, including non- communicable diseases, would erode the gains made in HIV and Aids interventions.
Dream now bears a wider meaning, Disease Relief Through Excellent and Advanced Means (Dream 2.0). With Dream 2.0, there is more focus on obesity which leads to cardiovascular diseases.
“Over-nutrition is as important as under-nutrition which poses the great threat to an individual’s health yet it is usually overlooked. So the training also focused more on over-nutrition,” Tembo concluded.
Women around Phalombe district have been told the importance of going for screening for cervical cancer, which is one of the deadliest diseases in the world.
A week long campaign has been launched in the district and is expected to run from 6th to 10th November 2017 with support from Disease Relief through Excellent and Advanced Means (DREAM).
The organization’s National Coordinator for Cervical Cancer Dr Hawa Mamary Sangare told Malawi24 on Saturday during the launch at Nazombe Primary School ground that it is important for women to go for screening since cervical cancer is a dangerous diseases.
“It is alarming in all the districts here in Malawi, we saw that there is need to go step by step and here in Phalombe we are helping the district health office to screen women,” she said.
Meanwhile, Phalombe District Health Officer (DHO) Ketwin Kondowe has said they are expecting to screen many women during the campaign.
“We are very optimistic that more women during the campaign will be screened in all the eight centres we have put in place.
“Cervical cancer kills but if the woman is screened earlier and she has signs and symptoms of it then she can be helped in time,” said Kondowe.
Meanwhile, Senior Chief Nazombe has commended DREAM for the initiative saying this will help women not only from his area but most parts of the district to know their health status.
“Let me thank DREAM for coming up with this initiative on screening cervical cancer, our women here will really be helped,” she told this publication.
Nazombe then asked women to flock to the centres in large numbers during or after the campaign since this is very vital to their daily lives.
In Phalombe the campaign will be done in centres within three Traditional Authorities namely; Nkhulambe, Jenala and Nazombe. Women in the reproductive age group of 15-45 are those expected to go for screening in the selected health centres. DREAM is a global health care which aims to lessen non-communicable and communicable diseases.
TOTAL Malawi has invested in a solar project worth K300 million as part of its corporate social responsibilily initiatives for support delivery of quality healthcare in the country. The project contructed with funds from Total Foundation, wlll provide sustainable power to benefit communities under Sant’Egidio’s Children Feeding Centres aand Dream Centres across the country.
Speaking in Blantyre at a ceremony to mark the completion ofthe project, Total Malawi Managing Director, Seggie Kistasamy said the initiative will promote the use of clean energy in light of prevaling electricity challenges in the country. Director of Dream Africa, who manages the centres, Giorgio Barbaglia, applauded Total for the project support. Barbaglia said the support will improve operations at the centres.
Noorjehay Magid, is a doctor and clinical manager of the DREAM program for fighting HIV in Mozambique. Behind the white coat is a woman of faith with a strong humanitarian streak. She exercises her profession with the idea that “to treat the sick it is not enough to be doctors, you need to have human feelings.” In recognition for her work she has been given two awards; “Woman of the Year” of Italy in 2006 and the “Klaus-Hemmerler” award of Germany this year for her humanitarian work in the area of HIV / AIDS. At the age of ten she decided to become a doctor as it was the dream of her grandfather, a focal point of her life.
Tell us your story, it was your grandfather who influenced you in the choice of your profession, correct?
Yes, when I was ten, my grandfather was admitted to what is now the Central Hospital of Maputo, following a cerebrovascular accident (stroke n.d.t). There he was treated by a doctor called Manuela Santos, and was very impressed. So much so that one day while we were visiting him, he called us all close to tell us that he hoped that one of us grandchildren would become a physician to help patients in need. Moreover, something more had hit my grandfather’s attention and had motivated his admiration: the fact that he was being cared for by a woman, seeing a woman as a doctor.
This struck him?
In the Indian tradition which I grew up in, after a certain age the woman was expected to begin building a family; it is a very rigid tradition. His experience in Mozambique made it clear to my grandfather that women could also have other tasks in society.
Have certain tradition interfered with your professional work?
Some have interfered. I come from a very religious and conservative family; so much so that I only have the diploma of the 4th year of high school and then a medical degree. At the time, Muslim women could study only up to the fourth year and then had to stop to get married. Even though my destiny was this, with the support of my family and my determination firmness, I managed to study. Unlike today, there were not that many Muslim women in school.
Where did you get the strength to go so against the culture?
From my mother. She faught against everything and everyone so that I could study and so that I could become what I am today.
You have won two prizes; “Woman of the Year” of Italy in 2006 and the “Klaus-Hemmerler” prize of Germania this year for your humanitarian work in the area of HIV/AIDS. Does this mean that the wish of your grandfather has been accomplished?
Yes. I did not count on it. If he were still alive I am sure he would be very proud. I woud like to however extend the credit to my colleagues and all the patients of DREAM, all of whom in their own way, are fighting for their life.
Is there still taboo and stigma around HIV/AIDS?
First, let me say that I was the first woman to work with the Community of Sant’Egidio to introduce antiretroviral treatment in the country in 2001. Today the taboo and stigma have been drastically reduced. Before it was really terrible. They would call me secretly and whisper that there was a patient in the department X, in the bed Y with HIV / AIDS who needed assistance. Prior to the introduction of antiretroviral drugs in the national health system I was recording up to 5 deaths per day. When antiretroviral drugs were finally introduced in 2004 things began to change. Today everyone is doing the test and can start treatment. However, it must be remembered first of all that treating an HIV-positive person cannot be reduced only to the administration of drugs, but rather that the patient finds in his doctor a human being who he knows is listening to him.
Five deaths per day? Must have been frustrating …
Without a doubt. I was putting into practice everything I had learned at school, but notwithstanding so many patients were dying.
Doctor, do women continue to be the greatest victims of HIV/AIDS in the country?
Unfortunately yes. But today the statistics are relatively encouring, for example recent data on the vertical transmission of the virus is quite positive. To our satisfaction, last year (2015), in the DREAM Centers of the Community of S. Egidio, not a single child was born HIV-positive, meaning that all of the seropositive pregnant women were able to give Birth to seronegative children, thanks to the treatment administered by DREAM to these women. Today it is inconceivable that a child be born with HIV because the treatment exists and is available.
During their pregnancy, what difficulties did the seropositive women face?
Many times they are afraid of being obligated to tell their partner their condition. Naturally, we tell them that this depends on them. They can speak to their partner as well as not. The most important thing for us is that these women are cogniscent of their health.
Is there any religious ritual that you do every day?
I pray a lot, I dedicate a majority of my remaining time to my work. All of my patients have my cell number; I am available for them 24 horus a day. They know they can call me or send me a message whenever they want. If I am ever out of the country, we speak through Whatsapp.
Are you a woman of faith?
Yes, I have always been, and I work with different religious congregations: with the nuns of the Psycho-Social Rehabilitation Center in Mahotas, I help in Father Bosco’s education on HIV/AIDS, and in the women’s college of Katembe. Twice a year, I go to the House of Joy, a social institute of the Nuns of Mother Teresa of Calcutta.
What is one episode that will always remain with you?
In 2006, in the General Hospital of Machava, there was a 17 year-old patient who always came to hervisits with her mother, who was also seropositive. A couple of days before Christmas, the girl came to her visit by herself. She had just lost her mother. The nurses had put her last in line, so that I could dedicate all of the necessary time to her. Once she came into my office I told her to take any one of the dolls that were there. She refused. She then came close to me and told me that the only thing she wanted was to have her mother back. It was completely shocking! All she could do is cry.
You have many patients, doesn’t this take away from the possibility of being with your family?
No. I also have time to be with my family, it is then that I recharge my energy for my work.
Who is Noorjehay Magid? Noorjehay Magid was born in Maputo; she is the oldest of three, with two brothers; she comes from a family of Indian origin and tradition. Dr. Noorjehay is a woman with a sweet and spontaneous smile, which makes her extremely joyful and kind.
She was raised in an extremely conservative family, which has made her an extremely determined woman. Religion has always accompanied her, so much so that she easily and immediately gets invovled in acts of charity when she can. Since 2007 she participates in the annual Prayer for Peace held by the Community of S. Egidio in Europe.
She studied Medicine at the Eduardo Monlane University, where she graudated from in 1998. She began her career as a doctor in the National Health Care System, where she continues to offer her services to this day. At the same time, shehas worked with the Community of S. Egidio since 2001 and is currently responsible for the DREAM Program in Mozambique.
Dans un entretien avec notre reporter, la coordinatrice du Centre Dream qui s’occupe de la prise en charge des personnes vivant avec le VIH/Sida en Guinée, Fatoumata Sylla a relaté en quelques mots, les difficultés traversées actuellement par ce centre ouvert en 2006 grâce à la communauté Saint ’Egidio. Avant de lancer un appel à l’aide.
«Depuis l’ouverture de ce centre, nous sommes dans le cadre de prise en charge gratuit. Nous menons des campagnes de sensibilisation de dépistage et des activités de prise en charge des personnes vivant avec le VIH/Sida sur le terrain. », a-t-elle entamé. (continue)