We had an incredible day visiting people with HIV/AIDS. All ten of us met and engaged with that special someone God put in our path for a purpose, and are forever changed by the divine appointment.

The youth on our team–Martha, Kristen and Libby–are especially good in action. Spiritually mature, ministry focused, and incredibly gifted. Their parents would be so proud to see and hear them leading songs, introducting themselves, talking to folks at the AIDS clinic, playing soccer with orphaned youth! and even handing out hygiene kits at the district prison!!

Our first visit today was FOMCO—one of the Orphan Care feeding centers where CitiHope provides nutritional meals. The community-based organization has about 150 cartons of high-protein vegetable soup mix left to feed over 200 children (ages 1-12) one meal a day for the next five months.

FOMCO means Friends of Mzuzu Community Orphans and is run by one director and many volunteers. Guardians (friends and family members) bring the orphans in their care to the center for their daily meal. Some of the volunteers teach the younger kids their alphabet and songs, and the older kids a craft.

At least 40% of the 200+ orphans here today are believed to be HIV infected. This did not bother us until we observed a little girl whose leg was badly bleeding. We also noticed several kids whose hair had turned red, or was falling out, or evidenced other signs of disease and malnutrition. Most of the kids, however, were normal, happy, wonderful kids eager to engage with visitors, learn a new song, and draw pictures with the school supplies we brought them.

Is pouring down rain today, and the grounds were too muddy to eat outside, so over 200 kids were crowded in a small brick room that literally was crumbling. The male volunteers intended to build a new and bigger building in back once materials were available. I offered to supply the tin roof once the structure was in place.

As the kids were eating, I focused on the images in the back of the room: an old CitiHope box where new supplies had been delivered months ago, guardians keeping a watchful eye on their foster kids, and wooden coffins—both adult and children sizes, made by carpenters nearby for daily use. The infant mortality rate is not calculated, since babies who die in child birth are usually not recorded. But children under five who die of preventable diseases are 20%, according to Dr. Joseph Yu who heads the Rainbow (AIDS) Clinic. That’s 1 out of 5 kids in Malawi will die before they reach the age of five!

Coffin-making has become the #3 industry in Malawi, Gabriel told me. (Agriculture and fishing are # 1 and #2.) One of the micro-enterprises at FOMCO is coffin-making in the wood shop. “You make coffins for the children you can’t save, so that you can save the ones you can,” I remember hearing on my September trip to Malawi.

We visited Mzuzu Central Hospital and Rainbow AIDS clinic after lunch.

Taiwan Medical Mission, headed by Dr. Joseph Yu, built and operates this District Hospital, and is progressively turning the responsibility over the government. The Rainbow Clinic is one of 120 VCT clinics in Malawi.

As we toured the clinic, Dr. Yu explained the protocols and procedures for Voluntary Counseling and Testing. Today, only 10 persons took the ‘rapid test’ which detects within 10 minutes the presence of HIV antibodies in the blood stream. The results are the same every day: 40% of those tested are symptomatic and test +. Since the ARV program started in Malawi in 2004, over 4,500 patients have been treated. There are over 80,000 known cases of AIDS in Malawi, Dr. Yu informed us, and the infection rate in Malawi is estimated to be 14% by the World Health Organization (WHO).

Dr. Yu asked us all to go outside into the waiting area and talk with some of the outpatients waiting to be seen by the staff. Trintass was there, a widow, HIV patient and volunteer with 2 kids who are +. I spoke with Martha, who was separated from her husband, who said she was a “vender” who worked along the road between Zambia and Malawi. She asked to be hired by CitiHope so she could buy nutritional food, without which her ARV drug treatment would not be effective in managing AIDS. She said she had relational skills and could serve as a receptionist or something. Others have similar encounters to share. We hope and pray our ‘ministry of presence’ raised hope in those living with HIV, coming regularly to the clinic, who must sometimes think they are alone and forgotten by family and friends.

Taiwan Medical Mission has developed a nutritional program for their most malnourished patients, as determined with a body mass and proportionality assessment. Not every HIV patient qualifies for the program, only the neediest. Volunteers produce and prepare a soy bean protein-fortified mix for common maize. Soy mixed with maize 4:1 can eliminate harmful enzymes and avoid diarrhea.

‘Nutrition is tied to medical treatment, and without it, ARV and other medical interventions are in vain,’ we heard over and over from medical staff. I’m more convinced than ever that CitiHope’s essential task should be food security moving toward agricultural development. I’ve seen first-hand how our protein-fortified milk and vegetable soup mix, and other nutritionals, have made the difference between life and death in sub-Saharan central Africa.

Our final stop before dinner was a return to FOMCO to play soccer with the orphaned youth. We had challenged them to a game, had designed and brought with us 30 FOMCO Soccer Team uniforms, and were ready for a game (hoping we would not be crushed). We wore CitiHope shirts and the youth were delighted with their jerseys, and predictably, they won. Trinity, Dennis and Don were the stars of our team. I played, kicked the ball once, and did not hurt our team too badley…and had a blast.

But it was great to seize the time to break the dependency cycle and relate to the kids from FOMCO on a level playing field. “The best partnerships,” Rev. Levi told me, “is when you don’t carry me and I don’t carry you, but we walk side by side.”

That’s why we need to move from food and medical aid to agricultural development and pharmaceutical management in equal partnerships with communities that have resources as well as needs in Malawi. In the meantime, we’ll continue bringing nutritional food and life-saving medicine to the most vulnerable sectors of society.