Effie Chiwale was immediately put on treatment when she was diagnosed with HIV in 2011.
The immunity of the 38-year-old woman in Nkanda, Mulanje, was low.
However, she had to walk up to 10 kilometres to access antiretroviral therapy (ART) services at Mulanje District Hospital or Mulanje Mission Hospital.
Her long travels mirror the plight of thousands of Malawians living with the virus which causes Aids.
“I used to wake up as early as 4am and walk for almost two hours,” she says. “Afterwards, I had to wait for more hours queuing for drugs. But I refused to quit because I believe HIV is not a death sentence.”
At her age, Chiwale had seen many people dying of the pandemic.
Her first husband succumbed to opportunistic infections having refused to take the immunity-boosting drugs, she says.
She does not want to die the same way.
“I will die when my time comes, but I want to live long for the sake of my children,” she asserts.
Her determination is turning her into a living testimony of the life-saving story of antiretroviral drugs (ARVs).
According to National Aids Commission (NAC), nearly 901 000 Malawians are living with the virus and almost 533 000 of them are receiving ARVs.
The commission estimates that the drugs have saved up to 260 000 lives since 2004.
Chiwale is a living testimony, she says. The woman enjoys robust health and has become one of positive voices in her Demula Village having openly declared her status.
She advocates change of mindset to end stigma and discrimination.
The woman is playing a pivotal role in awakening her rural community to the importance of HIV testing and adherence to ART if found positive.
In this way, she is central to lessening the impact of the pandemic.
At least 17 in every 100 people in Mulanje are living with the virus.
This is almost twice the national HIV prevalence estimated at about nine percent and it makes Mulanje the second worst hit district after Thyolo.
According to district health officer Khuliena Kabwere, 38 000 people out of 65 000 diagnosed with HIV in the past two years are registered for ART.
This means nearly 27 000 of them are not yet on treatment despite receiving counselling to start right away.
“Almost all of them have information regarding HIV and Aids, but adherence to ART is a major challenge,” he says.
He reckons bringing ART closer to communities could encourage many to receive treatment.
To close the gap, health workers at Mulanje Mission Hospital are running 12 mobile clinics reaching out to 72 villages in Chikumbu, Nkanda and Mabuka areas.
The outreach clinics are part of a three-year project which offers improved services for Aids and basic healthcare through community empowerment and local democracy.
In fact, the health workers visit each of the villages twice a month, distributing antiretroviral drugs, other essential medicines and information as well as modern family planning methods and childcare services.
The initiative is being run by Malawi Health Equity Network (Mhen) with funding from Edinburgh Medical Mission Society (EMMS).
At the centre of the intervention are village health committees trained to sensitise community members to HIV and Aids issues, including their health rights and why they should seek medical attention in time.
Chiwale, who was elected chairperson of Demula’s committee, said: “I no longer excuse myself from work to travel to Mulanje to get my medicine. I need no more than 30 minutes to get to the outreach clinic and back. There are no queues.”
In her mind, project implementation officer Sheilla Chilowa envisions thousands of people getting tested and receiving treatment.
She encourages men to accompany their expectant wives to health facilities.
“We realised that a lot of men were shunning the clinics for fear of being spotted by fellow villagers. Many men were dying silently, leaving women and children vulnerable and at-risk.”
Mhen executive director George Jobe is upbeat that the locals no longer have to travel long distances to get ART services.
The country needs such strides to meet World Health Organisation requirement for people to travel no more than 8km to get to the nearest health facility, the activist says.
“Health issues are human rights issues. It is high time Malawi started adhering to global recommendations,” he says.
Easy access to ART is vital in achieving 90:90:90 target to put HIV and Aids under control.
Countries across the globe envisage 90 percent of all people living with HIV will know their status, 90 of those with diagnosed HIV infection will receive sustained antiretroviral therapy and 90 percent of all people on ART will have viral suppression by 2020.
Jobe urged government to abide by the Abuja Declaration which requires countries to ensure 15 percent of the national budget goes towards healthcare delivery.n