by Betsy Trumpener
One Wednesday morning in February, at the Area 25 health clinic on the outskirts of Lilongwe, Malawi’s capital, an exuberant local nurse named Alice Banda helps Margaret Boniface deliver her second child. The nurse wraps the newborn in a colourful cloth and urges him onto his mother’s breast. Then Banda tries to figure out how to get the baby off to the hospital in time for the newborn-size dose of antiretroviral (ARV) drugs he needs to protect him from his mother’s HIV.
Banda is wearing a starched white uniform and a lacy nurse’s cap that’s pinned to her small black braids. She steps outside and pauses briefly to add her voice to the singing of some three-part-harmony health education songs about breastfeeding, AIDS and birth control. In one song, a village elder warns a young girl named Mary to take care, because there’s AIDS out there. “Aidsie, Aidsie, Aidsie,” Banda sings, along with the other nurses, swaying and clapping. They sound beautiful. Then she steps back inside, into an HIV counselling room, to find out why hunger is haunting Mary Mangani.
Mary is 26. She looks tired and has sores around her mouth. Her fat-cheeked baby nestles in her lap, leaning against his mother’s African National Congress T-shirt. Baby Laurence is now seven months old and he’s still HIV-negative. Mary wants to wean him now so Laurence will remain safe from the virus in her breast milk. But she doesn’t have enough food for her baby at home to replace her milk.
“She’s worried about the baby going hungry,” Alice Banda explains, translating from Chichewa into English. “The baby could be starved, so she’s worried.” Does Mary herself have enough to eat? She does not.