BASICS Expanding HIV Testing and Counseling to Lake Chirwa Basin, Malawi

BASICS Expanding HIV Testing and Counseling to Lake Chirwa Basin, Malawi

A Health Surveillance Assistant offers HIV-Testing and Counseling (HTC) in a Resthouse Room at Sombi


Picture trees, water, mountains, mud, birds and fish. This is Lake Chirwa -- the second largest of the five lakes in Malawi and the main habitat of small fish called Matemba. The lake offers a trading opportunity for fishermen from many walks of life.

Lying in the southern region of Malawi, Lake Chirwa is a wetland for people of three districts: Phalombe, Zomba and Machinga. All these people have frequent contact with Mozambique as they lie near the bordering frontiers. The lake lies some 50km from Zomba District Health Office.

For years, most people living across Lake Chirwa in Zomba district have had little or no opportunity to learn their HIV status. To get tested, they have to travel long distances on water to get to the mainland in Zomba or Phalombe district, or even travel to Mozambique. A few travelers from within and outside the basin have had an opportunity to get tested in other external facilities, but they have not been able to honor the second visit after three months. HIV Testing and Counseling (HTC) services are not available in areas on the lake and beyond it.

Slugging through the mud and green waters of this wetland, staff from the government and the USAID-funded, Management Science for Health-led BASICS project traveled four hours across the lake and shore to offer hope by way of HIV testing and counseling. They spent three days in the lake area, offering services to the people of Chisi Island and Lungadzi, Ngotangota, and Chinguma.

Mrs Maloya, PMTCT Coordinator answers a question from an audience member during a participatory drama performance: “There is no need for divorce! When one of the married couples is HIV positive you can still live together and have sex; only that the sex should be protected by using condoms.”


The village-to-village HIV testing and counseling campaign is organized by the Zomba District Health Office with technical and financial support from the BASICS project.

Its goal is to reach every village so that people know their status, how they can prevent further infections, and how to take care of themselves if they test positive.

The Lake Chirwa region was targeted because in most of the areas there are no facilities and not enough health workers. Without any clinicians or nurses present, these health posts are manned by Health Surveillance Assistants who are not trained in HIV counseling and testing.

Over the course of the three days, 332 people were tested and 34 were found to be positive.

Jessie lives in Lumela Village along the Banks of Lake Chirwa:

Jessie Bande and son, Felix, live in the Lumela Village along the Banks of Lake Chirwa


“I am Jessie Bande and my son here is Felix. I am on ARVs. Felix was first tested for HIV in Mozambique and they advised that I go again after four months. I found the opportunity today in Malawi because I moved from Mozambique. They have tested him, he’s fine and I can have my peace now-Felix is fine.”


Chimwene lives in Sombi Village along the banks of Lake Chirwa, about five kilometers from Mozambique:

Chimwene lives in Sombi Village along the banks of Lake Chirwa


“I am Chimwene and I am 17 years old. I have been having doubts about my health and dreamed for a chance to get tested.  I somehow misbehaved somewhere and have been having some great depression. I can say I wasn’t healthy. Now am going to be.  This is a great opportunity because I have been tested without spending anything on transport to go to the mainland. Going to the mainland also means spending more days out. All those are costs that we have saved through this campaign.”

Chancy Mauluka is behavior change communications officer for the Basic Support for Institutionalizing Child Survival (BASICS ) project in Malawi.