Hope amid Malawi's Aids crisis

Last year, the BBC News website published pictures of the village of Njoho in Malawi, highlighting its battle against the HIV epidemic. Patricia Lucas from the World Food Programme returned to see what had changed.

Aids severely affects the school - but they still find the time to play

Despite local estimates suggesting the HIV prevalence rate remains close to 50%, it is possible to find signs of hope for the village of Njoho in its ongoing struggle with Malawi's HIV/Aids pandemic.

Last year, Sister Josephine of the Nsanama Convent was pessimistic, warning of villagers' fatalism in the face of HIV/Aids.

"Too often, they have anger in their hearts and voluntarily destroy their and other people's lives by behaving as if nothing has changed," she said.

Six months later, Sister Josephine's outlook is more comforting.

"What I find positive now is the awareness of needs among the leaders, the sense of family in the community," she tells me.

"The children now no longer feel shy to say: 'I am an orphan.' People want to help each other."

Burden

She means people like shopkeeper Lazarao Chitimble and his wife Juliane, who are raising HIV /Aids orphans together with their own four children.

Last October, Mr Chitimble had adopted four orphans. When I arrive at his small store next to Njoho's main market, I discovered the number has risen to five.

The shopkeeper must now supplement his takings with extra casual labour to pay for his family's needs.

"It's a burden to bring up so many," he says. "But we see no difference between the children we take in and the ones that were born to us."

In 2005, Chief Ajasi Mphawa was ruing the day he became head of Njoho. Today, he proudly talks of running twice monthly community meetings to monitor how families are coping with HIV/Aids.

"We have had training in how to avoid the disease and how to care for our orphans," he says.

These meetings inspired Njoho parents to set up the day-care centre for young children highlighted in last October's gallery. Out of the playgroup's 92 children, 41 have lost their parents.

Sadly, I soon learned that every heart-warming story in Njoho is followed by a reminder of the cold reality of everyday life.

Orphaned twice

The day before my visit, Margaret Gunde, 21, was laid to rest in Njoho's ever-growing cemetery.

It seems like yesterday that Margaret had sat on the veranda of her hut, and told the story of her mother's death from tuberculosis in 1999.

These children have lost their parents and now their older sister

Aged 14, Margaret had been left to care for her brother and sister with little more than her late mother's "advice on how to look after my siblings."

Now, I wonder, who will advise her own daughter, seven year-old Chifuniro, as well as sister Judy, aged 14, and brother Hope, 17?

The death of their older sister has left Judy and Hope orphaned for a second time.

"Margaret took the same care of us that a mother would give," says Judy, holding a photograph of her sister.

"Now I don't know how we will live."

Illness

Late last year, Sister Josephine persuaded local chiefs to donate land so HIV/Aids-affected families like Judy's could grow food.

"There was great enthusiasm," she says.

Mr and Mrs Chitimble are caring for five Aids orphans

"Then people began experiencing the real problems of HIV/Aids: the high number of sick adults and young orphans, who cannot work in the fields."

Until recently, Njoho's efforts to stem the spread of HIV were hampered by a lack of adequate medical facilities.

The local Nsanama Catholic Hospital is not equipped to give HIV tests or distribute anti-retroviral drugs.

Instead, out-patients with Aids-related diseases are sent to a district hospital 10 km away. Most villagers cannot even afford the bus fare.

But in a further sign of a community fighting back, Nsanama will this month launch a new HIV/Aids programme introducing voluntary counselling and testing for HIV, a clinic for the prevention of mother-to-child transmission, and free transportation to an anti-retroviral clinic.

Zione Kaunda has one concern: how will she and her two fellow nurses handle the extra workload?

The antenatal clinic alone receives more than 180 patients per day.

Education

Juliana Kantazi, the deputy headmistress at Njoho's primary school, believes a long-term solution to the HIV/Aids pandemic lies in education rather than medicine - but the disease continues to deny access to the very pupils in need of awareness training.

One-third of her school's 746 pupils are orphans; many abandon their studies so they can take casual labour to help support their families.

Nurse Zione Kaunda is not sure she can cope with all the Aids patients

"If we see that a child has stopped coming to school, we go to their homes to see the reason," says Ms Kantazi.

Dorothy Yasin, 51, confesses that she has sometimes pulled her three grandchildren out of school to work her small patch of land.

The acre of maize she planted this year failed and her family's fate rests on a small field of millet.

If this harvest is poor, Mrs Yasin, a widow, wonders how she will feed the grandchildren.

In Njoho, poverty leaves no safety net for the chronically ill or elderly.

Adversity

Wathipa Mkushiwa is blind. He relies on his granddaughter, Zione William, 36, for all his needs.

To visit the local clinic, he sits on a bicycle pushed by Zione's husband. The trip takes an hour each way.

The 10-strong William family's harvest will only last for three months

This year the William family harvested 300kg of maize, enough to last the family of 10 for only three months.

They are dependent on WFP food aid for survival.

Yet here again, Njogho brings a story of hope out of adversity.

Sheikh Shokoma, the head of Njoho's Muslim community encourages Muslims and Christians to look after chronically ill neighbours and distribute food.

"People here don't have anything extra," he says. "But everyone gives a little because they have the compassion to help."