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Category Page: Storie

A story from Mozambique
To be elderly in Africa: the generation that takes care of the future

We meet Joana, an old woman from mozambique, since the beginning of the DREAM story in Maputo. We in fact begun to attend her house – or rather her hut made of pipes and mud – from 2001, even before Machava opened, the first of the DREAM centres in Africa, when the Community of Sant’ Egidio didn’t yet have in Mozambique an outpatient clinic, or any laboratory …. The cures were not fully available, there was a lot of suffering and desperation, even if you could already breath that friendship between european volunteers and suffering africans that would have been then realized and improved with DREAM. 


At first, in those days, we met Luis, the son-in-law of Joana, the husband of her daughter Julieta. Already very sick, Luis the first patient we attended with an accurate and faithful house assistance until the end, until death. 

After his funeral it became natural not to leave that relationship that was born with his stretched family, very numerous, even more that also Julieta was sick. And so, one time after another, we began to go to Joana. 

Joana’s house was always full of people, a lot of women, many children and few men. Joana stood out among everyone, like a sort of mother, like the true reference of sons, grandchildren and great-grandchildren. The reason was simple: her age. 

An unknown age, as not even Joana herself knew exactly how old she was, but certainly very advanced. At least eighty were the springs of Joana, when in Africa you are considered "old" at fourty. For this reason no one called her with her name, they all referred to her with the name avó, that is to say grandmother. 

Going to Joana, at Matola Brook, was not simple. The village is rather distant from Maputo town, about an hour by car, and the last bit of road is a long strip of mud. The house, then, is very poor, formed by two environments that at night become large beds made of pipes and materials on which a group of fifteen people sleep. The kitchen is outside, with a large saucepan where they cook the nsima (flour of corn mush) or rise. There is no water and or even electricity. The bath is not very far, made of four walls of pipes covered with old and worn out materials. In this rather poor context Joana is a really special woman. When she saw us she stood up, she smiled at us and began to speak like a train.

She wouldn’t stop for a moment, but the problem was that she talked to us in shangane, the southern Mozambique spoken language, and not in Portuguese …. We couldn’t understand a word …. But no, we learnt two words, very slowly: makinina, which means medicine and kanimambo, which means thank you.

With time, in fact, on the mouth of Joana the words makinina and kanimambo were repeated more and more often as Julieta first, and after other four members of this large family of this grandmother from mozambique then, were tested for the HIV virus and, having a positive result, started the I DREAM treatment. 

Now, it was not granted, or without meaning, that Joana spoke a lot of medicines…. On the ground, in front of the hut, on the capulane – as called in Mozambique, the typical African cloth –  grasses, roots, seeds, animal legs, stones, shells, bones, were stretched out … well, the weirdest things, all left to dry under the warm African sun. It was Joana herself that used them. To “heal". She was in fact a curandeira, that is to say a traditional healer. People came from long distances to ”be treated” by her. It was all her life she did that work and was thanks to it that she managed to feed all. 

Well, even Joana, this traditional healer, that had her “own" medicine, slowly understood that AIDS can be treated only with DREAM medicines (or with other similar ones, obviously …), and for this reason she was very careful her daughter and the other persons of her family under treatment with us took the right pills and at the right time. Joana saw too many people die, and unfortunately also her sons and daughters, grandchildren and great-grandchildren (for them the antiretroviral treatment arrived too late), in order not to perfectly know the incommensurable value of those pills that were really able to cure and to save. 
Now 14 people live in the house of Joana. Almost all of them are children, entrusted like many other African children to a grandfather or to a grandmother, the only relatives that survived the terrible epidemic of AIDS. Many mothers, many fathers are not here any more, and it’s up to grandmothers like Joana, the eldest generation, to take care of the youngest, to take care of their future, the future of whole countries. Joana is worried for them, and is affectionate towards their small lives, and hopes that at least next year is will be possible for them to attend school. We will see how to help them …. 

The story of Joana is – as it seems to us – an emblematic story. An elderly woman, that has suffered a lot, that lived poorly, that has trusted for long time a traditional knowledge, to the force of the parental connections. A woman that has never complained, that has kept fighting, that has gathered courage, that has put all her energies to make it.  A woman on whose shoulders was the weight of many difficulties – and few are the men that helped or supported her-, from those small ones of day to day life to the bigger ones of history, of the Portuguese colonialism, of the terrible and bloody civil war, of AIDS. But anyhow she resisted. For herself, and for the younger children. 

This elderly woman is Joana …, but is also Africa, the oldest of the continents (humanity was born between those forests and those savannahs, and we all come from an old grandmother like Joana, she is the Lucy of the anthropologists, or Eve, if we want), a continent that has confronted with enormous difficulties but has however managed to reveal an incredible energy, an enormous reserve of life and strength.   Joana can be the image of Africa. Of an Africa that resists, that knows how to, if needed, change its age, that doesn’t surrender to its future, but rather takes care of it with love and with trust.

Women in Africa are Africa, without them all is impossible. Generation after generation they continue to carry out the sublime and difficult mission to protect and continue life.  Joana entrusts her own forces, but also her new friends. She sais she is not tired: she is happy, because her family is treated. Joana, the curandeira, does publicity to DREAM, to the makinina that helps her effort to take care of life and the future of her beloved.
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An interview with Pacem, former DREAM activist and currently coordinator of the centre of Mthengo wa Ntenga (Malawi)

How and when did you meet DREAM?
I met DREAM in August 2005, after taking an HIV test and getting a positive result.
I felt fine really. At the time, it was my husband who was seriously ill. I tried to push him to see a doctor, I encouraged him, telling him how important it was that he get treatment. But he didn’t want to, he was scared. So I decided to take the first step myself, to take matters into my hands, because I loved my husband’s life. I did it to help him. It was a way of making him understand that he could find out about the state of his health, that it wasn’t too complicated, it wasn’t a problem.
And instead that check-up was a shock for me, a terrible trial. I was HIV-positive, I had AIDS. I would be dead soon. After the check-up and the test, the only thing I could think was: “This is the end of my life!”
I informed my husband that I was HIV-positive. It wasn’t easy for me at all, nor did it prompt him to go to see a doctor himself, although he really was very ill. On the contrary, understandably, it made him even more afraid. But I didn’t lose heart, I didn’t give up. I continued to encourage him and to insist. I informed myself a bit, here and there, and so I told him some stories of people with AIDS, who had started a treatment and who were better.
Finally my husband accepted to go to do the test. I accompanied him for the appointment and I was with him when they told him he was HIV-positive. Poor man, he was desperate!
A very difficult period of our life started then. Problems of health, financial problems…
My husband was sick and we had to find money to get the antiretroviral treatment from the state hospital, medicine costing 2500 Malawian kwacha [11.50 euro as per the current exchange rate]. We did our best to save my husband’s life, but it wasn’t easy, even more so because at the same time, they told me that I had to stop breastfeeding my daughter immediately (in fact I had a girl, who was not even a year old, and I was breastfeeding her). For me, this was all extremely difficult. What could I give the baby to eat? All the meagre money we scrimped and saved, served to buy medicine for my husband.
It was at this time that one of the doctors at the state hospital told me about DREAM. I had screwed up courage and explained my, our, situation to him: the fact that we couldn’t make it, that we needed to be helped. Then he showed me the way to the DREAM centre.
 
What struck you about DREAM?
First of all, I was welcomed very warmly. It didn’t seem like a hospital to me there! This was both, so to speak, from the outside, the actual structure, and because of the people I met that day, in that centre. They were special somehow, people who declared they were ready to help me in anything I needed for my health.
I was registered and appointments for blood tests and medical check-ups were fixed for me. Then I started to take antiretroviral treatment too, which my husband had already started doing.
Then I found I was no longer afraid of appointments, of medical check-ups. Meeting doctors, nurses, patients, all well-disposed towards me, I started to feel encouraged, to be more serene. I started thinking that the fact that I was HIV-positive didn’t really mean a death sentence in itself. I realised more and more that if we received the proper treatment, all we people with AIDS could still have a life ahead of us.
As soon as I started taking the treatment – or, rather, after a few weeks – I saw a big change in myself. Before I was totally unable to work, I couldn’t even do the housework. Everything made me tired and seemed to be a big bother: I was tired day and night. The medicine restored my strength; it gave me back the energy to do what I needed to. But it also, I should add, restored my confidence in myself and in my capabilities. 
So, when my daughter did the test too and turned out to be HIV-positive, I was worried about her – that’s obvious, only natural – and I was worried to learn that now all the members of the family were sick. But at the same time, I did not feel desperate. I had gone for counselling and so I knew that something could be done, that this was not the end.
My daughter was really very sick but in her case too, as soon as she started the treatment, she began to get better, to play and to grow normally. There was no comparison to how she had been in the past.
I would also like to add – coming back to myself – that the enormous change I noticed in myself, compared to the past, wasn’t just me, a personal thing. It could be seen from the outside too. People no longer recognised me, compared to previously, and they admired – I could almost say – the spectacle of my transformation, the fact that I was better. That is, not only the fact that I was better…. they admired the fact that I could climb out of the abyss into which I had fallen, that my recovery was profound to the extent that I was able to turn to others with words of hope, encouragement and strength.
 
What is it that DREAM has done for you?
I would simply say that DREAM lifted me out of nothingness and has brought me to where I am today, to what I am now. Actually, I had a simple but extraordinary experience, a fundamental one: I went from the nothingness of death to the fullness of life, life for me and for others.
It’s as if DREAM fought for me, so that all this would happen, so that life would start coursing within me once again. DREAM gave me back life, it restored my hope, it gave me all the courage a person needs. Or at least, the courage I was seeking, the courage which I had never received as yet, but which I discovered I had, even if I was – and still am – an HIV-positive person and as such marked by vulnerability.
It is my entire life that has changed because of the DREAM programme. And it is thanks to this change that yesterday I was an activist and today I am a coordinator.
 
What is the importance of activists within DREAM?
The activists fill a very important role in the programme.
They are the eyes and ears of our centres, but also the legs and hands of our patients. They are the people who can best pick up the problems and the requests of those who turn to our centres, because they are in close contact with the patients. And, at the same time, they are the means through which the same patients may keep in continuous contact with DREAM. If at some point that contact is disrupted, the activists undertake to re-establish it, going to search for those who no longer come, going to seek out those who are experiencing concrete difficulties, going to explain better what is not entirely clear.
This is the meaning of the work of health education undertaken by all our activists, in the centres, in people’s homes, during counselling at Mthengo, and in villages in surrounding rural areas. The activists are serving the patients when they teach them something, when they enable them to learn more about their health, about the medicine they are taking, and the appointments they should keep.
In reality, health education is one of the things that changes the life of people, and hence of our patients, most of all. Many people cannot even imagine how influential – for better and for worse – personal hygiene and nutritional choices are in the life of each one of us. Many people are unaware that it’s possible to improve their diet or the conditions of cleanliness of their home, and above all, they do not know that all this can be decisive, in a positive way, for their life. Well, all this is explained – by the activists – when patients are welcomed into the DREAM programme or while they are waiting at the centre. And this makes all the difference for very many people. By conducting health education, we have discovered that we can win the interest, respect and affection of many patients.
 
What does it mean to be a DREAM activist?
Being a DREAM activist means bearing witness to others, of what you have lived, of what you have seen. This is the main difference between someone who is a DREAM activist and someone who is just a DREAM patient.
When you bear witness and your testimony is effective, a patient can really start to believe that there is a future, for him or for her. He/she can start to have faith in the fact that if he/she starts the treatment, everything will be alright.
It should be said, on the other hand, that the testimony we give is aimed not only at patients. It is aimed at involving people out there too, those who are not infected, so that they may change their views about those who are HIV-positive.
I believe that we should stand up more. We should bear witness in a loud voice to what we hold within, to what we have received, to what we have understood. We should unequivocally take the first step, to be the first, before anyone else, so that others too will be able to take a step towards us.
 
What are the biggest difficulties facing those working as activists?
Here in Malawi, traditional beliefs persist in villages, in rural areas. Unfortunately, for example, there are people who are accused of witchcraft. This is the first and the biggest problem.
Many people need to be educated specifically about what being HIV-positive means, and what AIDS is. They don’t believe there is an HIV virus. They think people can be “cursed” by someone else, that there is a “witchcraft” that can make you sick, that this can happen when someone wishes you ill or wants to take advantage of your death to the extent that he convinces or pays a “witch” to strike you. So in a village, if someone is sick, people don’t think he may be infected in some way, but that others were envious of him, or that they think they can seize his assets once he dies.
The first consequence of such ignorance of the true causes of disease means that for treatment, instead of going to hospital, people go to a “traditional doctor”. They go to someone who will help them get better – that’s what they think – by using methods like those employed by the “witches”, to counter them. This is a very widespread practice, much more so because the “healers” are found in every village and hospitals are not; and much more so because traditional medicine costs much less than pharmaceutical drugs.
This practice, however, creates enormous difficulties for those seeking to press ahead with the struggle against AIDS – like us in the DREAM centres, for example – because it means that not a few patients come to health centres, and to us at DREAM, only when they are already experiencing extreme problems, when they are really very, very ill. Often, in the village, the option of visiting the nearest health centre is considered to be the last resort, the alternative tried only after all other paths have turned out to be dead ends.
 
What can be done for this world of villages?
A lot, without doubt. And we are taking up this challenge.
To counter all these problems of culture and mentality, which I have just referred to, we are carrying out a widespread health education campaign, especially in villages near the DREAM centre of Mthengo. In Mpote village, for example, where we organised proper “conferences” in the open air, in collaboration with the village leader, to explain to people what is known about HIV and how one can get infected, but also to let them know that it is possible to get better if people look to get treatment.
I believe these lessons have produced important results. After conducting much health education, we observe with joy that an ever increasing number of people are coming from villages to get tested, to find out their state of health. Before our lessons, it was quite rare for someone to come to us spontaneously. DREAM has saved many lives. Now the villagers are starting to understand, to realise. Beliefs in “witchcraft” are losing ground, and many are having faith in what can really save them.
 
What kind of health education do you undertake at DREAM?
Health education that involves the patients. What we are concerned with is involving the patients.
To this end, during the health education sessions, patients can intervene, discuss. Ours is a work group where patients can contribute their doubts, their concerns and their problems. What is of interest to us is that they tell us what they are feeling, what they are thinking… for example, what are those things that should be improved, or to be precise, if they have problems to come to the centre, if they are still facing discrimination in their village. What’s more, our health education is not abstract. If we see that some patients are not very interested, that they are getting distracted… well then, we change the topic scheduled for discussion for the day, because we must be sure that we make one and all want to listen. Or else we change our approach, our way of reaching these patients. Our aim is that the patients understand exactly what it is that we are trying to explain to them.
Definitely our objective – as DREAM – is not just to treat those who are sick. We want to win over the patients, to gain their attention, their life, to make them get involved and to involve them in a shared hope and work.
 
So this is more than just health education?
I always tell the activists with whom I work that their main efforts must go towards building a strong friendship with the patients they know, because for us, they are something more than just sick people needing support and treatment, they are friends!
Our patients must be able to put all their trust in the activists. They must be able to know that if they tell an activist something, she will keep the secret no matter what. They must be able to count on her – or on him – in any situation. They must feel that this person can give them hope, that he/she can give them all the courage they need, that he/she can sustain them in times of need. This is why the first thing to be done is to build a stronger friendship.
Thanks to such friendship, many patients end up by seeing their being treated in a DREAM centre in a very different way. They understand that beyond the medication, they have found a family; they have found friends to talk to, mothers, brothers, sisters. They understand that they have found someone with whom they can search together for the answers and solutions to their questions and difficulties. Together.
 
Being together is a characteristic of DREAM: together with sick people… together with the activists. How was the “I DREAM” movement of activists born, and what is it?
The movement was born as “Women for DREAM”. It was born from listening to patients, especially women, emerging as an answer to their need to be together, to support each other. It was born from listening to their opinions, their considerations, seeking to draw their points of view on different matters, and then trying to meet those same needs which came up.
At first, we had a large number of women joining, and only a few men, but with time, we saw an improvement, namely a growth in the presence of men, and now many men are members of the movement.
I believe that this is a very important fact. It is a sign that people are starting to understand what the movement really is about, they are starting to see its usefulness and its fruits.
 
But how do you work concretely?
First and foremost, we work very much in villages. Someone from “I DREAM” asks village leaders for permission to talk to people gathered together in assembly. Permission is given and it is from here, from these meetings, that everything is born. A particular relationship is born, established between DREAM and its activists on the one hand, and a given village and its people with HIV on the other.
Many have said they were touched and encouraged by the meetings that we organised. This is good reason for us to be proud and without doubt an enormous responsibility – because we have patients coming from around 50 villages – but, I would like to add, it is also an extraordinary opportunity. If we have a dozen patients in a village, well then, we can understand much better the reality of that village, we can get to know more about its dynamics and its difficulties, especially the dynamics and difficulties of HIV-positive people in that given reality. All this, in its turn, allows us to be able to intervene more efficiently to improve the situation, to change established attitudes or mentalities, specifically to give concrete support to people, to those who are infected.  
This is because it is not only a matter of doing counselling but also and especially, of providing support when someone is sick. If there is a DREAM network in a given village, we get to know quickly if there is a certain patient who is unwell in that particular place, and so we can help him/her. 
The beautiful thing is that it is the patients themselves who put in motion the process to help other patients. Then again, we have seen how our patients always want to be involved in what DREAM does. Whenever some initiative is taking place, they want to be informed and to participate, as happened, for example, on 1 December, when World AIDS Day was celebrated. A very large number of our people with HIV have let us understand, and they tell us so directly, that they want to be with us, to work with us. They don’t want just to receive news, in a passive way, from the government, they want to take part. If for example, someone from DREAM comes from abroad, from Europe, to visit our centre, many patients offer to take part in the welcome arrangements, to organise everything. What I want to say is that our people with HIV don’t just want to be told that someone is coming from abroad; they want to be concretely involved.
For them, all this means living a personal witness, it means showing their gratitude for the support that DREAM has given to all of us!
 
I imagine that your work is a source of great satisfaction, given that you come directly in touch with all these results…
Our work is really a bundle of good news today already, but also, I would say, in the perspective of tomorrow. Now we are seeing and touching some results, but we can discern others for the future too…
The activists of DREAM work to change the future. The men and women whom we know, call into question the traditional way of perceiving gender differences, because they get involved in the same manner, men and women, they show that they are equally interested and committed. They call into question, in a way I believe to be revolutionary, the usual resigned and acquiescent attitude to life, because they are ready to take steps themselves. And they make their village in its entirety take steps ahead, by being the first to change their own mentality and thus bringing about change, slowly, slowly, in the traditional mentality that is inhaled in the villages.
It is from this point of view that many of the men and women of the Movement have said they are ready to take on more responsibility, to take DREAM more to their villages, as well as to bring their villages more towards DREAM.
Above all, they do so by witnessing to all that the Community of Sant’Egidio is doing for them. Because many of these patients came here to Mthengo when they were really ill, and today, after have been given all the treatment and support that they needed, they are very well. They want to communicate all this to everyone they meet.

Do you have any story to share with us?
I can give the example of an activist, Veronica, who used to come here from her village on her bicycle, for treatment. She is a woman who used to come from really far, from more than 25km away [the story of Veronica is also alluded to in the video “Viva l’Africa viva” (“Long live the living Africa”) on the homepage of the DREAM site].
Well, after we saw that Veronica was among the most faithful members of the programme, that she was very scrupulous regarding the treatment, that she never missed her appointments, we talked to her, asking if it would be possible for her to use her bicycle to take care of other patients too, and to save their lives as well. Veronica was enthusiastic about the proposal, which allowed her to make herself useful, to live her gratitude concretely, and to be close to many people who face the problem of being too far away from our centre of Mthengo…
Another of the activists who I could tell you about is Alice Mogumu. After seeing how she took care of her newly born daughter really very well, we thought that she could be particularly well suited to encouraging other women to look after their newly born babies, that is to say, to teach them how to wean their babies better.
Today Alice is an example for many women belonging to our programme. Her daughter did a test and she is one of many babies who turned out to be negative. Her previous child is a source of courage for pregnant women, showing that it is possible to have an HIV-negative son. The authority of Alice comes not from her age – she is one of the youngest activists we have – but from the fact that she wants to commit herself seriously to saving lives. This is what makes her so brave and precious, what makes her a bridge of hope between the patients and us.
 
What work is undertaken by DREAM centres as regards mother-to-child prevention?
Since 2004-2005, when the DREAM programme started in Malawi, we have been insisting on the fact that an HIV-positive, pregnant woman can give birth to an HIV-negative child, as long as she starts therapy immediately.
But even if we have always said this, even if we have always insisted on it a good deal, at first, it wasn’t easy to convince the pregnant women who we met. There was no evidence to back what we were saying: no child, until then, had taken a test and turned out to be negative.
The first big step forward occurred when a handful of women started to trust. Their trust prompted them to take antiretroviral therapy properly, to breastfeed their children until they were six months old, as they had been told to do, and then to stop. All the pregnant women, who followed the prescriptions of the doctors to the letter, had perfectly healthy children.
These children gave us the example that we needed. Thanks to them, to the fact that they are well, we can tell other women, who are really desperate at times, that if they take properly all the medicines assigned to them, morning and evening, their child won’t have any problems.
 
What does all this bring to your mind now, looking not only at today, but also at the future of DREAM?
The future of DREAM – as I see it – lies in becoming ever more deeply rooted in and covering all of Malawi, in opening centres in many villages, so that more people like Pacem, Veronica, Alice, will be able to have access to hope and to therapy. This, after all, is the commitment that DREAM is already carrying out as we speak.
But now, discussing the present and future of DREAM, and its past too, starting from the fact that we were talking about mother-child prevention, I was remembering that some days ago, we organised a party to celebrate together because a group of babies tested negative for HIV.
For many women, this was a very beautiful day, the proof that they had done well to start therapy, a prize for their trust and their courage (because still today, unfortunately, some women opt to leave, they do not accept to start treatment). This party was a celebration of the victory of trust. Many women would have said to themselves: “I really fought hard, I did my best to save the life of my child, and he/she actually didn’t get the virus, he/she is free!” There is a beautiful, absolute power of truth, in this trust, in this joy.
And then I think of myself, the mother of a girl of who is HIV-positive. A few years ago, it was really bad for me. But the other day, I celebrated with joy together with my friends, because their children tested negative. When I was pregnant, there weren’t the opportunities that there are today, the DREAM programme wasn’t so entrenched yet… But now that the DREAM programme is here, we must fight for many women and for many children, for their lives.
After all, DREAM is a guarantee of life even for our HIV-positive children, because they are treated, they receive therapy and decent care. Thanks to the Community of Sant’Egidio, we know that our children will have a future, that there is as yet life for them; that for them everything is possible.
And so it’s the same, we must celebrate the children who tested negative and those who, although they are positive, enjoy life and good health. And we must be aware of two things: of the strength of many women, because they have really done so much for their children, and of the power of the love of DREAM, because our work has really improved and we can say that we have attained great successes.
When I see patients who are very ill, or really desperate, what comes to mind is the beginning, when I too turned up, very sick, for a medical appointment at the DREAM centre. And so what I can wish for these patients – with considerable understanding, with great sincerity – is that they may become as I am today. And as for the suffering and the despair that they are experiencing, I wish for them that it may disappear, so that, as we are celebrating and tasting the good fruit of DREAM, the same may happen to them too. That we may enjoy the fruits, all together, because DREAM has truly taken on our lives, it has given us much.
So may all those who are sick rise up and bear witness, and struggle for others. Because I don’t see the reason why many in Malawi should die when there is treatment available, when they have the opportunity to have more care. Thus, all that I know is that we can and we must fight for them.
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Jane’s speech at the opening of the 12th DREAM training course

Firstly, I would like to thank the Community of Saint Egidio for giving me this opportunity to speak today on behalf of my fellow HIV activist; this is rare opportunity to stand in front thy delegates, for this am very thankful.
To begin with, my name is Jennie Mphande, born 34 years ago and a widow. I have a 14 year old daughter and I keep other 5 relatives .I got married in 1992 .My husband became sick towards the end 2000.We went to MACRO in January 2001 and we were both tested positive, unfortunately my husband died in 2004 of pneumonia.

Things started getting tough for me after his death, I had to move to the house he bought though not completely built. Towards the end of 2005, I got very sick which lead to my own dismissal from my work as a teacher in a certain private school. I knew even I become better, the owner will fire me.

I stayed at home without any thing to do and was being admitted in the hospital frequently and thought I will die, Especially when the best friend to my husband came with the advice and I quote: Why cant you go back to your home village you are just wasting your time living in town without a job and moreover you don’t have money, children are suffering, just sell your house, nowadays if the husband die next is the wife”Mlamu, umenewo ndi mtengano”

My neighbor, who happens to be a dream client was concerned with my sickness and advised me if we could go together to DREAM centre. It was my first time to hear about DREAM. When we arrived at DREAM I realize there was still hope for me. I still remember the warm welcome I received from an Italian dream staff, who asked me, how do you like your new family? And I answered what family? She said Dream. It is very good but I am not sure if it’s real. What do you mean? She continued, I said I have never seen this beautiful hospital just being offered to HIV patients.

The next appointment was that I was offered a job as an activist. Dream has been a blessing from God because when I came, the people were and are still eager to understand my HIV situation.
To work as an HIV activist has been my happiest moment. Dream has saved my life physically and socially, I am strong and able to take care of my family. Now I am contributing to save the lives of other patient’s am always happy to work with Dream and let the world know that we are children of God, who love and care for each other and that being HIV its not a death sentence, but the beginning of new life with a dream.

My gratitude will forever go to the community of Saint Egidio who trained me as V.C.T Counselor. My work is carried out in some antenatal units of the health centre. It is aimed at testing the pregnant women, preventing mother to child transmission. And after, the women are brought to the centre where are treated according to the protocol of dream. Throughout pregnancy, the contact with the dream is opportunity because women are encouraged to do a test with advice, encouragement and assurance they will receive treatment and in hope that they will have a health child free of HIV, often without support of the husband who might be dead, absent of work and many reasons.
My work is challenging especially to women who understand what dream is, when I talk to them and prefer coming to our center and get the therapy but they meet many hindrances like;
1. when they disclose their status to the husband some are divorced.
2. some are accused of bringing the virus into their marriage
3. some refuse to be tested in fear of their husband
4. some even stop taking the ARV therapy in fear of their husband this may result to poor adh

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An interview with Lidia Lisboa, DREAM activist, Director of Matola 2 Nutritional Centre, Mozambique

My experience with DREAM started out sadly and is now full of joy.
In 2002, my husband, the father of my daughter Albertina, died. Shortly afterwards, she started to feel ill too. Very ill. So much so, she stopped studying: she couldn’t even walk anymore!
We went to one hospital after another, but it was difficult to find treatment and I didn’t have enough money. In hospital, one doctor, a woman, told me that if I had money, it wouldn’t have been difficult to treat Albertina. But I didn’t have all the money she asked for, I couldn’t earn enough with the jobs I usually did, and it was highly unlikely that I would find someone to lend me the money. After my husband’s death, I didn’t have any more money. The company he used to work for didn’t give me anything and what’s more, his family came home to take everything of any value: they left me practically empty-handed! I was very worried: finding 10 meticais to buy Paracetamol for Albertina was a problem. I even tried to sell my house to get money to treat my daughter, but I didn’t manage to do so.

The only thing I had left was hope, hope in what seemed to be impossible. And then something happened. The doctor who had told me about the existence of a treatment – albeit a costly one – got to know about the opening of a new health centre. She told me to turn to the Community of Sant’Egidio. I didn’t know anything about it, I had never heard of it.
Anyhow, I went immediately to the DREAM centre. I was a bit apprehensive when I walked in, but there was no problem at all. Albertina was registered and did a blood test. And they told us they would start treatment soon. I was so happy, but everything was so strange: it was all free! When I went to the centre and read “Nao se paga”, it seemed plain impossible to me. And yet that hope I had nurtured within, against all odds, had not been in vain… today I can say that the salvation of my life and that of my daughter was literally given to me as a gift.
But my new-found faith was quickly put to the test. I went back to DREAM almost immediately because my daughter was very ill: she could manage neither to sit up nor to eat. Desperate, I asked the doctors if they could do anything for us. I talked to someone working there, who came home with me, and we decided to take Albertina to hospital. They gave her blood transfusions and discovered that she had tuberculosis. Thanks to the treatment she received at hospital, my daughter recovered quickly. She was very anaemic too, but she managed to recuperate anyhow. She spent two months in the hospital of Machava, and it was nice because many friends from the Community went to visit her. She felt much better; happy with all the attention she was getting, she wanted to live and to be well.
As soon as she was discharged, Albertina started to take antiretroviral treatment. From then onwards, she improved all the time until, in 2004, she returned to school and a normal life. Now she is committed to realising her dream, to continue studying. She doesn’t want to look back and to think about the lost time, or to give up because she is sick. She doesn’t want to stop; she wants to press ahead with her studies. We have triumphed over the disease and so we can triumph over everything we come across from now on.
At first, when I came to know DREAM, I was worried above all about my daughter. She was so ill! I had also taken a test and knew I was HIV-positive, but I was not as unwell as she was, I felt fine. 
However, when Albertina started to take treatment, as I watched her gaining weight, starting to play again, resuming the normal activities of one her age, growing to the height she is now, I understood better what it means to fight against AIDS. It shouldn’t be ignored, it should be faced. The fact that my daughter got better opened up a path for me as well.
I started to take antiretroviral treatment too. I suffered a bit from allergy at the start, but then it passed. A pill in the morning and another in the evening… now I am well. And what’s more, I have new friends, new prospects.
Today my life is not the same as it was, it’s better. I have found strength and hope which I didn’t have before, even when I was not yet sick. I have discovered new energies, a strength of love which makes me love many, I would say very many.
Today I am the Director of the Matola 2 Nutritional Centre of the Community of Sant’Egidio. Every day, 800 children eat at the centre, children who are hungry for food but often also for affection. Many of them call me ‘mother’. They want to be cuddled, to be listened to, to be bathed, to be dressed. I am really like a mother to them. It is something beautiful for them, but for me too. It is such a beautiful reality that it seems almost like a dream. It is the dream of love that I can give to so many children.
Here in Africa, children often come last. People don’t manage to spend time with them, there are too many problems. One needs above all to worry about working, about getting the food and clothes needed for the entire family, so playing with a little girl, showing affection towards a little boy, may appear somewhat superfluous. But we don’t want it to be like that at the centre. Here, together with other activists of DREAM, we are like so many mothers, who want to show love and to take care of these children, of every aspect of their lives. We work at the Nutritional Centre, we handle long-distance adoptions. We know each child by name; we know each family and its problems.
In recent months, I got to know one little boy better. Jerson was abandoned, and he always came to the Nutritional Centre, especially to me. He called me ‘mother’. He was searching for shelter and protection, because his face was disfigured due to illness, and so the other children kept him at arm’s length. I thought: “Albertina is well now; our house is small, but not so small that we cannot welcome a little boy.” So I talked it over with Albertina and we decided to take him home. Today he is like a son to me and a brother to her, we are looking after him and he is already much better. He has gained weight; he plays and goes to school.
Ah, and talking about school, I am going too: I have started studying again in the evenings. I am in the same class as Albertina, but she goes in the morning. It’s as if I have rediscovered new youth. There is a curiosity in me to know, to understand, to study. There is cultural interest too. I owe this to the Community; I have been to Europe twice, to Rome, and I have understood that the world is large – it’s not only about my experience and that of my neighbourhood.
My life is now rich with friends, with affection, with so many things, and I have the desire to share this wealth with others. I want to help many children. By helping them, I am supporting and protecting the future of my country, a country I love. It is a country in peace however it has lived through war, a war that lingers in my eyes and my memories. When I think of the saddest things of my life, I always think of the war, which I lived through as a child, and of my sickness, and Albertina’s. But today there is peace in Mozambique, and we are fighting AIDS too, and we want to continue struggling against it.
I am fine. But I don’t just want to nurture my joy. This joy was a real gift, as I have already said, but now it is I who can give. I have received freely and I want to give freely. I can truly say that my experience with the Community has taught me about the beauty of giving, the beauty of a gift. Today, I want to live this beauty in my turn, the beauty of giving, and the beauty of giving hope to many who are still crushed and conquered by evil.

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Malawi – The story of Violet and Faith, a child born healthy to an HIV-positive mother

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.


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A story from Malawi – Brilliant, the shining light of life

I see him. At last he has come out of hospital… I ask him how he is and he replies in a thin voice and with a beautiful smile: “I’m fine, thanks, I’m very happy. What about you?” I answer him: “I’m fine too, thanks! You’re very kind. I’m happy to see you again.” He is worried about me; he asks me how I am!

Brilliant says he is happy. Happy about what? He is 14 but he looks like he is eight, and he is sick, very sick. He is our patient, a young patient at the DREAM Centre of Blantyre of Malawi. He cannot walk because he has practically no muscles left. He is so skinny that you can count his protruding bones, covered by just a paper-thin layer of skin. For months, he has been afflicted by diarrhoea and vomiting.

But he is happy. He left hospital and came to the DREAM centre for tests and to pick up his medicine. He is happy first and foremost because he feels better. And he is also happy because it pleases him to see all those who love him and who welcome him so tenderly. He is even happy enough to wait his turn to see the doctor; the important thing is that he does not have to go back to hospital. With us, he feels safe. He does not complain about anything. Ultimately, he is happy to be alive.

His name is Brilliant, and he is a living miracle. This is what Piero says, one of the Italian doctors who accompany Malawian employees of DREAM in their work.
Here, everyone knows Brilliant and loves him. He is very well known at DREAM. We have not known him that long; we met him when he was already rather ill. But we dedicated ourselves to him passionately. Hilda, a campaigner at the centre, follows him up at home and in hospital. She talks to his parents, helping them to hope, always telling them that Brilliant truly shines, that he is worth as much and more than a gem.

We work and pray so that he may continue to live, that he may be better. We have given him a ball; it is something he has wanted for years. We would all love to see him play and run after that ball. Hilda firmly believes that one day Brilliant will become the most important man in Malawi and the whole world… for us, he already is.

Our heart breaks in two when we look at him, but Brilliant pieces it back together for us with his smile and hope, giving us feelings of gratitude and joy, of the joy of life itself. For Brilliant, it is enough just to be alive, but our health is never sufficient for us. Faced with Brilliant and his lovely smile, I want to affirm strongly, never to forget, that for me too, it is enough just to know that he is alive.

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