When an MBC crew visited Lora (not her real name) at her small house in Masasa, Mzuzu City, they were expecting a tough story. However, nothing prepared them for the depth of pain that awaited inside.
Lora, 26, is HIV-positive and currently on tuberculosis (TB) treatment. On top of this, she has a stomach tumour and a one-month-old baby to care for. As she spoke, clutching her infant with tears streaming down her face, she recounted the struggles she has faced since her diagnosis.
“My relatives and husband abandoned me immediately after my HIV and TB results came out. I’m left alone with my baby,” Lora said, her voice cracking with emotion.
“I take 12 tablets every day and, as you know, these drugs require good nutrition. I have nothing to eat and I need to breastfeed my baby, but I can’t because I’m so weak and hungry. Sometimes I fear my baby will get sick as well,” she added.
Her guardian, who is also her neighbour, has been her only source of support and lifeline.
“Lora has been with me since she started getting sick. I’ve been providing her with the little I have, such as food, and taking care of her baby, but it’s not easy,” said the guardian.
The crew also met 19-year-old Memory (not her real name), who is three months pregnant and living with HIV and TB co-infection. Unlike Lora, Memory’s greatest fear is not illness alone, but rejection.
“I’m anxious about telling my parents and relatives about this condition. I don’t know how they will react, since most people consider TB and HIV co-infection as a death sentence,” said Memory.
With the help of health workers, Memory is learning how to protect her unborn child.
“When I was diagnosed with TB, it was hard for me to accept. But I was advised to adhere to my medication to protect my unborn baby,” she said.
At Mapale Health Centre in Mzuzu, nurse Lusekero Munthali acknowledged the challenges faced by women in such circumstances but explained that these cases are rare and that the facility is managing to provide the required care.
“Mostly, we are stressing screening at all entry points of the facility, including antenatal, family planning, maternity and OPD clinics. We are following all precautionary measures, especially to protect babies from contracting HIV during breastfeeding,” she said.
Meanwhile, Zione Sapuwa, a field officer for Paradizo TB Patients Trust in Mzuzu, highlighted the organisation’s efforts in active TB case finding.
“In TB case finding, it’s our first time to identify such cases. We are trying to support them and ensure they adhere to drugs,” she said.
Public Relations Officer for Paradiso TB Patients Trust Harriet Kakhobwe said under a project being implemented in partnership with a Norwegian organisation LHL International in some districts of the central and southern region of Malawi, they regularly encounter women with TB/HIV co-infection who are also pregnant or breast feeding and most of them are facing serious food insecurity.
“These cases are common particularly in low income and urban poor communities. A recent case that we recorded is from Chimbalanga TB Club here in Lilongwe, where the patient requested food support and baby milk during the course of treatment.
“Under the project, we are able to provide nutrition and patient support including food assistance to such women based on assessed need and we encourage treatment adherence support through TB clubs,” said Kakhobwe.
National TB and Leprosy Elimination Program’s Senior Disease Control Officer Dr Sam Chirwa said, “NTLEP is striving to ensure vulnerable groups get the care they need, protecting both mothers and babies.”
Health activist Maziko Matemba emphasized the need to introduce TB services at antenatal clinics.
“Integrating TB screening and treatment into antenatal care is a game-changer for Malawi. Let’s make every clinic a TB clinic, and protect our pregnant women and new mothers,” he said.
Lora’s struggle and Memory’s quiet fear reflect challenges that some women across Malawi face; Illness compounded by stigma, poverty and abandonment.
As Malawi pushes towards achieving the 2030 targets in eliminating TB and HIV, one issue to consider is whether help will arrive on time for the underprivileged to fully recover and build their families.
By Meclina Chirwa & Doreen Sonani
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