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| DREAM Program boss Francisco Zuze |
"Now, I am going to take your blood samples for analysis," he adds.
This is how the journey began for Simwera. He got tested and diagnosed HIV positive. His health continued deteriorating drastically despite the fact that he had been going to the clinic for treatment whenever he felt ill. But things never changed.
This is when the clinician thought of diagnosing Simwera again to detect whether the patient could start taking the life-prolonging drugs--ARVs. Unfortunately for Simwera, the clinic close to him does not have essential equipment that can analyse the blood samples. So to fulfil his duties, the clinician collects the blood samples and keeps them for some days waiting for transport to Mzuzu Central Hospital where there CD4 count machines which can screen the viroload in the patient.
It is only after screening the blood samples that the right medication or the type of the ARVs that can be administered on a particular patient. Such is the situation in the whole northern region where only Mzuzu Central Hospital (MCH) has the most needed equipment in the fight against HIV/AIDS. All the districts in the north rely on MCH equipment for analysing blood samples which is essential in the administration of ARVs on each patient.
According to Mrs RC Ng’ambi, HIV/AIDS Coordinator for St. John’s Hospital in Mzuzu, the situation is so pathetic that very few patients are put on ARVs because their blood samples have not been returned to their respective district hospitals and clinics for consideration on antiretroviral therapy.
Ng’ambi explained that in normal circumstances, every patient is tested and his blood analysed to detect the viral load (the amount of viruses in the body) so that right prescription can be given. She said CD4 count machines are very essential in the fight against HIV/AIDS everywhere in the world.
“Special laboratory equipment, that is, CD4 count machines, are very important in the fight against the scourge. Otherwise we would be fighting a losing battle,” she said.
“What we do is that when we collect the blood samples, we put them into special filter papers, and this blood collection is known as Dried Blood Specimen. And this blood has to be analysed to detect whether a particular patient has reached a stage where he can start taking ARVs. Unfortunately, the whole of north, it is only Mzuzu Central Hospitals with such facilities,” she explained.
Ng’ambi added: “You can imagine how big the job is for staff at MCH! All blood from Chitipa, Karonga, Nkhata Bay, Mzimba and Rumphi flooding to MCH. Do you think people can get the services in time? I doubt. Because what I know is that it also takes time for the results to reach Chitipa or Karonga due to transport problems. Sometimes the results get to the clinics when the clients had died already.”
Ng’ambi also said there is need for speedy provision of the equipment in district hospitals and clinics so that all patients stage1 and 2 on World Health Organisation’s Staging System and cannot qualify for ARVs can be considered for the therapy.
“This is only possible if there are CD4 count machines. Otherwise these patients will miss the opportunity to ARVs, and this would cause unnecessary and untimely deaths among Malawians especially villages who cannot afford even a transport money to MCH to get the services. It is easy for these people in town with cars. They can just drive to a clinic of their choice to get the services. But what about rural poor people?” she asked.
“That is why we are saying we desperately need the CD4 count machines in the rural areas (hospitals/clinics)” stressed Ng’ambi.
Department of HIV/AIDS and Nutrition Principal Secretary Dr. Mary Shaba concurred with Ng’ambi that north lacks capacity in the fight agaist HIV/AIDS. However, she differed with Ng’ambi on the assertion that only northern region is hit by this problem. Dr. Shaba said in an interview the problem of CD4 count machines is countrywide saying currently the country has only 16 machines which are not enough to cater for the country ailing population.
Shaba, however, said people in the north should not panic because plans are already underway to install CD4 count machines at Mzimba Hospital. She said the advantage of this equipment at this hospital is that it will also have satellites and mobile clinics to reach out to rural Malawians who cannot afford transportation means to referrals.
“For example, in Karonga we have identified two places, i.e. Kameme and St. Anne’s Hospital. Services at these hospitals will cater for people around Karonga. But we cannot manage to provide every district with the equipment at one go because there are a lot of other factors that need to be considered,” she said.
“We need to train the staff who will run the equipment. The purchase of the equipment itself needs money. So people should not think that we are doing nothing on the problem, but that we cannot do it at once,” she observed.
Dr. Shaba hinted that currently the department has lined up two plans regarding the same problem. She explained that the first plan would be to install CD4 count machines in all district hospitals and then extend the service to the rural hospitals.
A Catholic non-profit making charity organisation, Community of Sant’Egidio through its Drug Resource Enhancement against Aids and Malnutrition (DREAM) Program said it realized the need for not only CD4 count machines but also Molecular Biology Laboratory which would also provide Viral Load Services in the north and will soon provide the same at one of the region’s hospital.
Community of Sant’Egidio National Administrator Francisco Zuze told the reporter in an interview DREAM Program through Project Malawi Network which is coordinated by the Department of HIV/AIDS and Nutrition in the OPC will establish the facility at Mzimba District Hospital which will also act as a referral for other rural hospitals and clinics.
Zuze said he believes Malawi cannot win the battle against HIV/AIDS without essential Laboratory equipment. He also said the Community of Sant’Egidio’s DREAM Program will continually support district hospitals across the country through training of Laboratory technicians and donation of equipment where possible.
“It is in this line that soon we will be donating CD4 count machine to Ntcheu District Hospital,” he announced.
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