By Violet Ikong

Rosine Buchunga* said she tears up each time she thinks about the past six years, during the course of which she escaped conflict in the eastern region of DR Congo, found her way to Dzaleka Refugee Camp in Malawi, agreed to become the sexual partner of a fellow refugee to avoid starvation, and ended up as the single mother of a child who has human immunodeficiency virus (HIV), the virus that causes AIDS, an incurable disease that attacks the immune system. 

Dzaleka Refugee Camp is located in Malawi’s Dowa district, and serves as home to over 50,000 refugees from Burundi, Democratic Republic of the Congo, Ethiopia, Rwanda, and Somalia. These refugees depend on the United Nations World Food Programme (WFP) for their food, and monthly cash assistance from the United Nations Refugee Agency (UNHCR). However, because these agencies are underfunded, food rations and cash assistance are insufficient and many refugees turn to other sources to avoid malnutrition and starvation. 

In Buchunga’s case, when a fellow refugee promised her financial support if she would be his sexual partner, she opted in. However, she said that this was the beginning of an unending nightmare for her because within a few months, she became pregnant, and when she broke the news, the partner abandoned her. She hasn’t seen or heard from him since. 

Five months after her baby’s birth, in September 2019, Buchunga went to a health facility in Dowa, convinced she had malaria. There she learned that she was indeed sick – not with malaria, but with HIV. The news came as a shock, and she was immediately beset by fears – that her daughter, Priscilla, had contracted the virus from her and that they would face discrimination if other refugees learned about her status. 

Worldwide, about 39 million people were living with HIV in 2022, and 37.5 million of them were adults, mostly women like Buchunga, according to data from the Joint United Nations Programme on HIV/AIDS (UNAIDS). Experts argue that conflict and displacement put women and girls at higher risk of contracting the virus than their male counterparts, though anyone can contract the virus. 

Worldwide, about 39 million people were living with HIV in 2022, and 37.5 million of them were adults, mostly women like Buchunga, according to data from the Joint United Nations Programme on HIV/AIDS (UNAIDS). Experts argue that conflict and displacement put women and girls at higher risk of contracting the virus than their male counterparts, though anyone can contract the virus. 

New reality 

Buchunga soon discovered she was right to be afraid. Her daughter tested positive for HIV two weeks after Buchunga got her results. Blessing Godspare-John, a registered Nigerian nurse and midwife, said that little Priscilla’s diagnosis was not surprising. 

“HIV can be passed from a positive pregnant mother to her child through the placenta and body fluid, as well as during the process of birth. A child can also contract the virus through breastfeeding. Every pregnant woman must know her HIV status to enable an effective plan of care by medical experts to suppress the viral load and ensure the unborn child doesn’t get the virus as well,” Godspare-John said. 

But the absence of adequate health intervention in the refugee camp resulted in Buchinga’s  daughter contracting the virus. “As a mother, it was profoundly distressing to discover that my child had acquired the virus [HIV] from me, and I blamed myself for that, and I went into depression,” she said, fighting back tears. 

Health workers placed Buchunga and her daughter on antiretroviral treatment (ART), and they advised that Buchunga do everything she could to boost her immune system, such as eating healthy meals. But for a mother living off donations, adhering to that instruction was difficult. According to the World Health Organization, weight loss and undernutrition are common in patients with HIV, and can accelerate disease progression as well as increase morbidity and mortality. 

Mitigating HIV-related challenges in the camp 

Many humanitarian organizations run health programs in refugee camps to help reduce HIV prevalence, and support survivors to manage their condition and avoid its developing into AIDS (acquired immunodeficiency syndrome), which is a result of untreated HIV. 

The interventions are usually in the form of free medicines to survivors, and HIV/AIDS awareness programs, but Schadrack Kabila, a social worker and Congolese refugee in the Dzaleka refugee camp, noted there are problems with the way HIV survivors, especially children, were supported in the camp. Kabila said that many people living with HIV were isolated. Some parents keep their children from playing with other children who have the virus.  

“They [adults] don’t care that the children are innocent victims; they go ahead and discriminate against them,” Buchunga said. 

Also, parents are not taught how to take care of their HIV-positive children, Kabila said: “Children living with HIV are usually left behind and not given the same support as adults living with the conditions. As a child protection agent, I got tired of seeing them suffer that neglect in addition to discrimination.”  

This combination of neglect and discrimination is what inspired Kabila to establish the Agapao Foundation, a child-focused HIV organization, in 2019. The foundation carries out awareness exercises in the camp to preach inclusion, educate refugees about HIV/AIDS, and help combat the myths and misconceptions they hold about both diseases. 

In addition, to support the nutrition needs of children living with HIV, Agapao provides free food items bimonthly to the parents and guardians of the children. Buchunga is one of 30 parents who are current beneficiaries of this food program from the foundation. 

And Agapao’s team regularly visits the homes of HIV-positive refugee children to engage with their parents and provide them with guidance, counseling, and information about caring for the children. The team also checks with parents to ensure they are keeping up with their children’s medicines and medical appointments. 

To further empower parents, the foundation involves them in income-generating activities, such as the local production of peanut butter and the making of local soap, which they can sell, to use the proceeds to take care of the children. 

Promoting social inclusion 

About 300 children are currently enrolled at the Agapao Foundation’s learning center in the camp, intended for children both living with and without HIV. Currently, 70 of the children are living with HIV – including Priscilla, who is now 4 years old. The children are taught to read and write, sew, knit, play chess, and make play toys. They also sing, recite poems, build bonds of friendship, and do what kids do best – play. 

“One of the objectives of the center is to integrate the children into society and encourage inclusion. One way we do that is by organizing activities that involve those who are HIV-positive and those without the virus coming together to learn and play,” Kabila said. 

Agapao’s center opens from Monday to Friday and runs two shifts: the morning shift, which runs from 8 a.m. to noon, and the afternoon shift, which runs from 2 p.m. to 4 p.m. All children at the center are taught by team members of Agapao Foundation.  

Resolute amid drawbacks 

Buchunga takes Priscilla to the Agapao inclusion center daily, and the little girl enjoys the activities there, especially playing with her best friend, Blessing*, who is HIV-negative but shares a strong bond with her. “I once contemplated giving up on my child out of frustration. I’m glad I don’t feel that way anymore. I’m particularly excited to see her excelling academically due to efforts from teachers at the Agapao inclusion center,” Buchunga said, with a smile. 

But the going is hard for everyone involved, and the program lacks adequate funding to do as much as Kabila wishes they could to support the children and fight discrimination. Nonetheless, despite the obstacles, the Agapao Foundation remains resolute in its pursuit of an inclusive refugee camp for HIV-positive children. 

To contact Agapao Foundation, email [email protected]. 

*Names changed to conceal the identities of the individuals.