Home Based Care

As she giggled, sat on the floor and played nervously with her feet, I knew exactly how she felt. Estere had told us her favourite subject at school was English, but when we asked her a question in a language she didn’t understand, she only looked away and smiled. I know what it’s like this ‘not speaking the language’ business, and it’s tough sometimes. Especially with letters grouped together that my mouth refuses to co-operate with, like ‘Nd’ and ‘Ts’ and ‘bw’ (and no tsunami doesn't count).

food supplements, vaseline & moringa powder.

our fridge. as a daily reminder.

heading to Naocha.

 At fourteen years old Estere looks good, healthy. If you didn’t know you wouldn’t know, just how ill she’s been. And I hesitate to tell her story in the fear of doing it an injustice, as I only spent 5 maybe 10 minutes in her presence, as she sat on the floor of her grandparents house, shyly smiling up at me.

Estere.

And if I haven’t got this message across yet then I am probably the worlds worst Ambassador, but the HOPE in Orange HOPE is an acronym, and the H of the HOPE stands for Home Based Care. At many a school and youth group I would say, “and that’s exactly what it sounds like – we go to those who are too sick, or too poor to get help otherwise”. And that’s certainly true, but that’s only the half of it, and really only scratch’s the surface.

kind, passionate, volunteer hands.

saw a chameleon! made my life!

heart melter.

reality.

I feel like this post is all over the place, but it goes a little something like this. SIM Malawi partners with the Africa Evangelical Church, which has – I believe, something like 180 parishes’ all up. In the villages where our Home Based Care programs are situated, around 20 volunteers from each parish are chosen and trained up. Once a week these volunteers go out in teams and visit those in their community who are in the program and have a certain need. 

grand-children of a patient.

Need can mean a lot. Most, but not all are HIV positive. Most, but not all are on ARV treatment. Some are very sick, some look very well. Some are children, some are partners, some are grandparents, and some are families.

 

family photo.

one of the incredible volunteers.
& her munchiken.

from house to house we go.

Once a month the beneficiaries receive supplies; like food supplements, soap, paracetamol and moringa powder (made from this incredible tree in Malawi which, if you believe the blurb, contains seven times the Vitamin C in oranges, four times the calcium and two times the protein in milk, four times the Vitamin A in carrots, and three times the potassium in bananas – and looks a little bit like a packaged drug).

kiddo's.

way too adorable to handle.

.

I appreciated all the orange.
& his dancing.

& all the kids!

everything is possible with God!

Each week, those within the program are then visited by one of the incredible volunteers, who sits with them, chats about how they’re going – provides any additional medicinal support, like extra vitamins, additional nutrition, that kind of thing – and then prays, and opens the Bible with them. It’s a way to meet both physical and spiritual need, to offer encouragement, friendship, love and support, in the understanding that true, real and everlasting HOPE can only come through Christ. It’s people in the community reaching people in the community. It’s tangible, practical, actual love (my beloved Galatians 5:6b!).

But I knew most of that before I came. And then there is Estere.

 

us.

At 6 years old she’d lost both her parents, and siblings to HIV. Now an orphan, her health book states she’d been 'chronically ill since birth'. Flipping through it briefly, it was full – tuberculosis, pneumonia, all sorts of suffering. She’s 14, and well (relatively speaking) for the first time in her life. Where at 14, I worried about rare pokemon cards and lip smackers, she – clearly an incredible fighter, has gone through more then I can possibly imagine. Shy and beautiful, she has very gentle eyes. 

She wasn’t at school that day because she had to take her monthly trip to the hospital for her cocktail of HIV medications. She wore a T-shirt branded with the stripes and stars of the USA.

I met another girl at 13, also in the program yesterday. She looked great also. And, as Jacky – one of the missionaries here who heads up the HOPE for AIDS Malawi programs - told me, it’s a shame that I don’t get to stay for longer, to see the full ‘before and after’ effects that the Home Based Care program can truly have. I met a young man for example whos entire face, upon meeting him the first time, was covered in pussy, oozing, bulbous sores. Now, he’s strong and able to go back to work.

walls & lives within them.

breath-taking.

I met a woman yesterday too, who showed me the scars on her arms. A history of a horrible, mystery skin condition that covered her entire body and caused her great pain, what they thought at one point was leprosy, now simply believed to be just another side effect of having HIV. Point being, with care and medication and greatly improved nutrition, she got well. There is hope, and healing and goodness; both in this life and the next everlasting.

she's a treasure.

the aftermath.

& with some of our wonderful volunteers!!

 Reality is though, not every story goes like these. And in a country where 1 in 7 are infected with the virus, it’s often awful and heart breaking and real and overwhelming. 

We went into one home, armed with nutritional supplements and Vaseline, to visit Mary, a grandmother, and her 9-11 year old grand-daughter (at a guess). Mary is, again at a guess, in her 70’s or 80’s, she is incredibly frail and frighteningly thin. She is weak, exhausted, not having the energy to pull herself up from the floor. There was great pain and suffering in her eyes. She'd been vomiting all morning, and said she had no appetite. Food makes her ill and upsets her stomach, a reality which makes her increasingly thin, increasingly weak. Her mouth is full of ulcers, perhaps a cancer, full of swelling either way, and swallowing, let alone talking or drinking, is almost unbearably painful. And there her beautiful grand-daughter sat by her feet, in an old worn school uniform, quiet and still – staring at me with those big, brown eyes. Reality is that her grandmother, although this ill, although this burdened, is the breadwinner of the family. It’s just the two of them. And by breadwinner I mean that she has no choice but to make her way to the market each morning, a feat in and of itself, and beg. There is no one else, there is no alternative, and it breaks my heart. 

please pray.

I too was talking to a doctor from the UK last night, who is working in the local Government hospital. Not only was she telling me about the horrendous working conditions, and the complete absence of necessary medication – like insulin for example – but she asked me if I, if we, could help. She has three brothers as patients, one in his early twenties, one in his late teens, and one at school. AIDS orphans, the three of them have been living together for some time – the oldest, now HIV positive,  having been the breadwinner. However his health has taken a major turn for the worse, and she suspects he has weeks, maybe less, maybe more, to live. Problem being as part of his sickness he has become paralyzed from the waist down, and his lower half is covered in large, awful, un-treatable, weeping sores. He can not care for, let alone move, himself any longer and thus the second brother now acts as his full time carer. What then is the future for this family? Does the third brother, just a kid, come out of school and get a job to feed them all? The doctor asked if we could put them into our Home Based Care Program. There is so much need.

masterpieces.

This then is the reality of HIV. It too often effects and kills the working and the strong, the parents, the breadwinners and the very young and most vulnerable. It casts societies into turmoil, with grandparents caring for young children, and siblings caring for one another. And in a country where there is 1 doctor for every 50, 000 people, and where 75% of hospital beds are taken up by patients with HIV, these types of situations – these realities, are repeated, tragically, over and over and over again.

over & over & over
again.

My heart is (perhaps understandably?) all over the place this week. I’ve been on just two morning visits, out of many that happen in several villages all over the place, each and every week here. I have been shocked by the realities of this awful, living virus. But too, I have been encouraged immensely by the work of HOPE for AIDs, bringing comfort, help, Truth, prayer and value to people in need.

beloved.

The H in HOPE, a vital, important, encouraging, life-giving ministry.

I have so much to be thankful for. 

Praise be to the God and Father of our Lord Jesus Christ! In His great mercy He has given us new birth into a living hope through the resurrection of Jesus Christ from the dead, and into an inheritance that can never perish, spoil or fade – kept in heaven for you, who through faith are shielded by Gods power until the coming of the salvation that is ready to be revealed in the last time. 1 Peter 1: 3-5.

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