Helle Poulsen-Dobbyns has undertaken over 20 field placements as a Nurse, Project Coordinator and Medical Coordinator in countries including China, Malawi, Pakistan, Papua New Guinea, Sri Lanka, Indonesia, Nigeria, Palestine and Somalia.
I was first sent to Malawi with Médecins Sans Frontières in 1997. The year was spent working with children who were affected by HIV/AIDS. We barely had enough medication to treat their symptoms, never mind the source. As I watched the children die one by one, I became increasingly frustrated and angry. It was a heartbreaking year wrought with feelings of impotence and sadness. I moved onto my next posting with Médecins Sans Frontières in China but my connection to Malawi was strong. When I heard that a new pilot programme for treatment of HIV was being trialed in Chiradzulu (in the southern part of Malawi), I chose to return and it has been a choice I will never regret.
The Médecins Sans Frontières programme was set up in the local district hospital. Chiradzulu was chosen because it has an HIV infection rate of approximately one in four people. Both a treatment and a prevention programme were up and running by the time I arrived. We offer the drugs free of charge (at a cost to Médecins Sans Frontières of $30 per patient per month). HIV patients are treated with antiretoviral drugs and HIV-infected pregnant women are offered a short course treatment when they commence labour. Their babies are given Nevirapine syrup within 72 hours of birth to reduce the transmission of HIV from mother to unborn child. Recently, there was much celebration when one of the first babies in the programme was tested after 18 months and found to be negative! Sadly, his mother was not alive to hear the news.
Although our work in Chiradzulu is starting to make a difference, there is still so much to be done. Having set up a working model for HIV/AIDS treatment and prevention in Chiradzulu, we now hope to show the government of Malawi that they can afford to offer free or low cost treatment to all of their people in all districts. Though critics of our programme have told us that patients would not be able to follow the strict drug regime or return for clinical follow-up ("they don’t even own a clock, how will they know what time to take their pills?"), we have found, without exception, that patients not only adhere to the strict regimes but also walk up to three hours to keep their clinic appointments. We’ve come a long way since my first tour in Malawi. But we still have a long way to go.