Vito Chiwala is 36 years old living in the rural village of Mwandoma, Malawi. In 2001, his legs began to give him problems. Not being able to walk prevented him from going to work on the farm and his wife became his caretaker and the primary breadwinner of their family. Unable to work, Vito and his family faced financial struggles that led to a food shortage in their home. After visiting the Partner In Health’s sister facility in Neno at Chikonde, southwestern Malawi, he was diagnosed with HIV and Kaposi Sarcoma.
What Vito’s story teaches us
Kaposi Sarcoma is a rare type of cancer that develops as a complication of HIV infection in people who have tested positive for HIV. As a person living with both a chronic condition like HIV and an NCD such as Kaposi Sarcoma, Vito’s story illustrates the need for integrated models of care. The Integrated Chronic Care model that PIH has piloted in Neno, Malawi takes into account the common needs that HIV and NCD patients, including routine appointments, disease progression monitoring, side effects, adherence, and laboratory follow-ups. An integrated approach provides efficiency in services and a patient-centered approach for Vito and others like him in settings of poverty.
Following Vito’s visit to the hospital, he was able to receive treatment and a change in medication – it took some time but doctors were finally able to figure out the appropriate medication, which allowed his mobility to improve. Vito says “Some doctors shame their patients, but [my providers] won’t shame you in any way. They didn’t shame me, their patient, at all. They were happy and free with me. Which give me hope that I could get healed.” Vito receives clinical care at the hospital and assistance close to home from community health workers. Although not in as full capacity as he was before, Vito is able to walk and work on his farm again.