Malawi: Funding Woes Strangle Malawi's HIV and Mental Health Services

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"After being discharged, the patients continue their antiretroviral treatment within their communities. Only those who are around our catchment area come back to access antiretrovirals here," said Bwanali.

She was quick to say Zomba Mental Hospital personnel do follow up on patients to make sure they are taking their HIV treatments at home, but due to limited resources they do not cater for patients outside their catchment.

Coping with mental illness and HIV

Patients face several challenges as they cope with mental illnesses and HIV. Bwanali said: "Some patients on antiretroviral treatment are reluctant to swallow their drugs and we have to do everything to persuade them to do it. We also sometimes experience shortages of HIV test kits."

Also, despite the fact that food is available for all patients at the facility, highly nutritious food such as peanut butter for sick patients is scarce.

"Patients who are HIV positive with mental health disorders need nutritional support. We do not get any in our facility and we are appealing to well-wishers to help," said Bwanali.

Apart from providing HIV patients with ART, medical personnel at the facility also educate patients with HIV prevention messages.

Dual treatment

Some patients admitted to the facility test HIV positive while receiving treatment, as Zomba Mental Hospital ART clerk Misheck Matoga explains.

"First these patients receive treatment and therapy for their mental health disorder. After they have stabilised, there is a lengthy dialogue with them before we conduct testing and counseling on treatment," he said.

Matonga added that compulsory testing is against patients' human rights.

Apart from Zomba Mental Hospital in the old capital, Bwaila in the capital Lilongwe is the only other institution that treats mental health, but on a smaller scale.

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