Malawi / Abwenzi Pa Za Umoyo

In early 2007, PIH and its newest partner organization, Abwenzi Pa Za Umoyo (APZU), started treating patients and training community health workers in the southwestern corner of Malawi, one of the poorest and most densely populated countries in Africa.

The Clinton-Hunter Development Initiative (CHDI) targeted Malawi as a country desperately needing a rural health project to address the devastating HIV/AIDS epidemic in the region. About 14 percent of Malawi's adult population is infected with HIV and hundreds of thousands of children have been orphaned by the disease.

CHDI asked PIH to replicate the rural initiative programs that have proven so successful in delivering HIV treatment and comprehensive primary health care in Rwanda and Lesotho. The Malawi Ministry of Health directed PIH and CHDI to the impoverished rural area of Neno, and in early 2007, the partners began to implement an ambitious plan to combat the disease.

Like PIH’s other projects, APZU combines treatment for HIV patients with comprehensive, community-based health care and programs to combat the conditions of extreme poverty in which disease takes root, including hunger and lack of access to clean water and decent housing, schools and livelihoods.

Work for APZU began at the Neno Rural Hospital, a district health center about four hours drive from the capital city of Lilongwe. From Neno and ten other rural health centers, APZU serves about 100,000 people spread over an impoverished rural area about half the size of Rhode Island.

	A hospital grows in Neno, Malawi

Immediately after arriving in Neno, APZU renovated the wards, water system, pharmacy and laboratory at the existing hospital to fill the gap until a new district hospital could be constructed. Within a few months, the outpatient facility was functioning well and the number of patients served mushroomed, from approximately 50 to 100 patients per day to between 200 and 300. By October, construction of the new Neno District Hospital was more than 50 percent completed and renovations were nearing completion at two other health centers in Magaleta and Nsambe. Work to renovate health centers in Chifunga and Lisungwi has also begun.

In addition to improving health facilities, APZU has focused on expanding the workforce for HIV testing and treatment. By tripling both the hospital staff and the number of trained HIV testing counselors, APZU has extended HIV testing from just five health centers to all ten centers in the district. By November 2007, more than 170 community health workers had received comprehensive training and had been hired to visit as many as six HIV and TB patients daily to ensure adherence to treatment, monitor side effects and socioeconomic needs, and accompany them to the clinic.