Living positively amid Covid-19

Maurine Phiri was diagnosed with HIV at the age of 10, but the 25-year-old has lived with the virus that causes Aids for over a decade.

During the period, she has witnessed dramatic declines in its annual death rates from over 64 000 to about 13 000 since Malawi Government rolled out free treatment in 2005.

However, she fears for her own life as she recently received just a third of her periodic top-up.

“During my last visit in April, I got just enough drugs for one month instead of three months. It appears the supply chain has been disrupted by Covid-19, the novel coronavirus disease discovered in China five months ago” she recounts.

Covid-19 transmission has grounded flights and immobilised cargo ships, leaving Maurine worried that the country could be running out of the second-line pills she takes daily to stay healthy.

The young Malawian fears that this could roll back the gains that have transformed the Candlelight Memorial—today—from a day of mourning lives lost to HIV to celebrating innovations helping infected persons live longer.

But Dr Charles Mwansambo, the chief of health services in the Ministry of Health, says the supply of the single most important weapon in the fight against HIV has survived the disruptive Covid-19 pandemic.

But Maurine has to make frequent trips from her Chilinde hometown to Kamuzu Central Hospital to replenish the drugs which boost immunity until HIV can neither be detected nor transmitted. The return trip, worth about K1000, exposes her to financial hardship and the risk of contracting Covid-19 transmitted through droplets from infected people on the way.

She narrates: “When I get sick, health workers tell me to go and buy some prescribed drugs from drugstores. If this is happening in the capital city, what about rural communities where health facilities are far apart and undersupplied?

“Not all of us get support from our parents. With high youth unemployment rates, we’ve to get out there and hustle harder though it further makes us prone to coronavirus.”

In her words, Maurine visualises persons living with HIV becoming poorer and silently contracting Covid-19 as they squeeze themselves in congested modes of public transport on the frequent journeys to refill the essential drugs.

Recently, she caught “a terrible cold” some onlookers mistook for Covid-19 infection. From her experience, she says HIV-positive persons now nurse “fear of two viruses” with the slow-evolving HIV and the fast-spreading coronavirus.

“When I catch a cough, it means the soldiers in my body are overpowered, which disproportionately affects people with low immunity and chronic diseases vulnerable to Covid-19,” she explains.

The girl, who helps her peers and adolescent girls in her township to live positively with HIV, urges people diagnosed with underlying conditions to stay safe by minimising movement and avoiding crowded settings.

But as some stay home to prevent coronavirus infection, hunger and poverty could be deepening.

Dr Mwansambo says government has embedded social cash transfers in the national Covid-19 response to ensure vulnerable groups, including people on HIV treatment, don’t slide into abject poverty.

“There is a potential risk to lose the gains we have made because people with HIV and other underlying conditions are particularly at risk of Covid-19, but we have instructed health workers not to neglect all conditions to prioritise Covid-19,” he says.

Mwansambo indicates that the country has adequate ARVs and essential medicines.

“We have modified the way we work so that one gets enough ARVs for six months to reduce the frequency of top-ups. So, it’s an anomaly that the case in point got just enough for one month. She deserves more,” he says.

Mwansambo reveals that only reagents for viral load testing were disrupted by travel restrictions necessitated by Covid-19 transmission, but the country received a planeload on May 4.

Health facilities have also extended working hours to reduce overcrowding and all admitted patients are allowed only one guardian, with everyone required to wash hands with soap at the entrance.

However, Maurine urges the government to deploy “hidden hands” to supply balanced diets and drugs to HIV-positive people compelled to stay home.

She states: “The court stopped government from imposing a lockdown, but we still have to stay home to stay healthy. “The ARVs promote a healthy life, but nutritious food is the best medicine. How, many can afford a balanced diet after losing jobs and business opportunities because they have to stay home to safeguard their lives?