Tuberculosis Infected Her Spine. Her Hope for Her Future Remains.

An invisible intruder was coursing through Regina Chingwalu's adolescent, growing body. The rod-shaped cells of Mycobacterium tuberculosis, which cause tuberculosis (TB), had progressed beyond Chingwalu's lungs, where most cases of TB remain.

Instead, the bacteria traveled through Chingwalu's bloodstream, eventually settling in the bones of her spine, making a home there and slowly eating away at her vertebrae and bones until Chingwalu, who was 14 years old at the time, could no longer walk or stand.

To get to school, Chingwalu's mother carried her step after strenuous step until, eventually, this mode of transport became unsustainable. Chingwalu dropped out of school, losing hope of progressing through her education and achieving her lifelong goal: becoming a teacher herself.

Chingwalu is one of many people in Malawi whose lives have been irreparably changed by TB. Despite being detectable and treatable for decades, TB is still the world's deadliest infectious disease. Abwenzi Pa Za Umoyo (APZU), as Partners In Health (PIH) is known in Malawi, works every day to prevent this unnecessary suffering and death.

When TB Diagnosis and Treatment are Accessible

Chingwalu's family had already been connected to care at APZU, with community health workers (CHWs) regularly checking in on their household.

But when APZU CHW Mussa Madziataika visited Chingwalu's home in Neno District on August 12, 2022, he was startled at the sight of her. Once a lively young girl, her health had rapidly deteriorated.

Medical intervention needed to happen-now.

In Malawi, 21% of people are undernourished, meaning their bodies do not have the caloric intake they need to function. But though Chingwalu was emaciated, it was clear that she was experiencing something beyond only malnutrition.

Madziataika reported the case to his site supervisor, Samuel Jackson, who escalated it to then-PIH Nutrition Coordinator Charles Marshal. During his visit, Marshal recognized that Chingwalu needed more than nutritional support. He referred her to a trained physician, where she was enrolled in physical therapy, but her condition still worsened.

Chingwalu was later referred to PIH-supported Lisungwi Community Hospital, situated in the Malawi's remote southern region, approximately an hour car ride from her home. It was at this facility where Chingwalu was diagnosed with spinal TB, also known as Pott's disease.

Fortunately, TB is both treatable and curable with a strict regimen of antibiotics. Chingwalu took her medication diligently, making a remarkable recovery by September 2023. Soon, she regained her energy and grew strong again.

Yet, her legs still would not work. The infection had eaten away at her spine during a critical stage of her body's growth and development, damage that could not be reversed and would impact her ability to move for the rest of her life.

She was referred to APZU's TB expert, Dr. Dimitri Suffrin, for a comprehensive assessment where she was diagnosed with paraplegia, a complication associated with spinal TB, and was immediately enrolled into physical therapy.

The Impact of Comprehensive Care

In Malawi, there are fewer initiatives aimed at supporting people with disabilities, making it more difficult to access mobility tools, and in turn, to socialize and earn a living. So, when Chingwalu was ultimately diagnosed with paraplegia, APZU worked to provide her and her family with the comprehensive care she needed, from nutrition to housing to direct cash transfers and a wheelchair. Through it all, Madziataika stayed involved, watching the once sick girl regain her strength and begin to enjoy life again.

With her wheelchair, Chingwalu could now be mobile again, meaning a return to her school-and to her dream of becoming a teacher.

"She will always cause problems at home if I do not escort her to school," Chingwalu's mother shared with PIH. "So, I push her wheelchair to school in the morning and pick her up in the afternoon. I thank God for the grace to give us this wheelchair because my daughter's dream is back."

Since returning to her studies, Chingwalu has taken her Malawi Primary School Leaving Certificate of Examinations (PSLCE) and was selected to attend a secondary school far from her home. Today, the APZU team is actively working with her family to find options to allow her to continue her education.

Chingwalu and her family continue to receive monthly food support, medications, regular medical examinations, direct cash transfers, and more as they explore education options.

TB is a disease of injustice. Scientists and researchers have known how to treat and prevent TB for decades, making it virtually eliminated from the world's richest countries. When TB patients have access to quality treatment and social support, lives are saved, and dreams are fulfilled. Families can attend graduation ceremonies instead of funerals.

Yet still, millions of people contract TB every year, leading to over 1 million preventable deaths annually.

Despite the immense challenges she has faced over the past four years, Chingwalu still hopes to fulfill her dream of teaching one day. She watched the "passion, patience, and care" of her own primary school headteacher, and wants to make the same impact on other children's lives in the future.

"Her tenderness made me want to be exactly like her someday," Chingwalu said. "I also hope to impact other students and help them build a better future for themselves."