In the rural area of Neno District, Malawi, where poverty and limited access to healthcare often dictate the course of a child’s life, two young people are rewriting their futures against all odds. Alex Captain and Regina Chigwalu, both living with physical disabilities have been lifted by the strategic, timely support of Partners In Health (PIH) Malawi through its innovative programs, like ASPIRE, that go far beyond medicine. PIH Malawi implements the ASPIRE Project under its Program on Social and Economic Rights (POSER). POSER is built on a foundational that medicine and clinical interventions alone are not enough to resolve the complex challenges faced by patients and their households in settings of extreme poverty. By addressing the social and economic inequalities that place vulnerable clients at increased risk of illness, PIH Malawi works daily to interrupt the cycle of poverty and disease.
The story of Regina Chingwalu and Alex Captain
Alex Captain is a 19‑year‑old from Matope Catchment Area in Neno District. Born into a family of four as the third child, Alex defied the odds from his very first breath. Living with paraplegia, a condition that left him unable to walk, Alex lost both his parents in 2014, and together with his siblings went on to live with their aunt, who already cared for several children. The family survives on seasonal farming.
During primary school, Alex frequently missed classes because his aunt or brother was not always available to carry him, especially when they lacked a bicycle. Despite this, he remained an exemplary student. His teachers noted his discipline, intelligence, and consistently strong academic results. In 2021, Alex joined the Matope Teen Club, a PIH initiative supported by the ASPIRE project that brings together adolescents across Neno District to learn life skills, self‑care, and healthy living. Through this program, he began to envision a future beyond his immediate challenges.
In 2022, PIH provided Alex with a wheelchair, which improved his mobility, enabling easier access to healthcare, education, and Teen Club activities. After completing his education at Kasupe Primary School in 2024, Alex was selected to go to Matope Community Secondary School. However, accessibility remained a major challenge, as the school lacks adequate facilities for students with disabilities. Later that year, he sat for entrance exams for a church‑run institutions and got accepted to start learning at the Henry Henderson School of Excellence (HHS) in Blantyre.
Despite this good news, the tuition fees was daunting (over USD 500 per term). However, Alex remained determined, and he applied for a bursary at the institution and was awarded full tuition support. However, his family still could not afford basic needs such as groceries, clothing, transportation, and upkeep.
George Muhone, right, a POSER officer at PIH Malawi, visits Alex Captain, 19, at his school in Blantyre. With support from PIH, Alex is thriving academically and pursuing his dream of becoming a doctor or journalist.
Joseph Mizere / PIH
When he reached out to PIH again for support, the organization stepped in and offered the needed help. “We provided school materials to enable him to report for school at HHS in September 2024. We felt obliged to assist after looking at Alex’s background, his ambition, and his courage for education. We believe he will continue working hard in his academic journey,” said PIH Malawi’s Primary Health Care Director, Dr. Dimitri Suffrin.
Before Alex left for school in 2024, PIH had already supported him and his family with a disability‑friendly house, ensuring he could get in and out without difficulty. Additionally, the family received five goats through the Pass‑On Goat Seed Program under PIH’s POSER initiative, to promote economic empowerment at the household level.
Today, Alex is fully focused on his education and continues to excel. “I am grateful to PIH for stepping in to support my education. I am determined to achieve my dream of becoming either a doctor or a journalist. I will continue working hard at school for myself but also as a token of thanks to all those supporting me,” said Alex.
Dr. Dimitri Suffrin, right, PIH Malawi’s HIV and TB Program Director, visits Regina Chingwalu at home. After PIH helped identify her spinal tuberculosis, Regina received treatment, but the late diagnosis resulted in paraplegia.
Joseph Mizere / PIH
For Regina Chigwalu, a fellow Teen Club member at Matope, fell ill in 2021 and was taken to Matope Health Center, where the cause of her declining health could not be identified. As her condition worsened, the then PIH Community Health Worker Mussa Madziataika noticed Regina’s deterioration and reported the case to his site supervisor, who escalated it to the former PIH Nutrition Coordinator Charles Marshal. During his visit, Marshal recognized that Regina needed more than nutritional support. She was referred to a trained physician, where she enrolled in physiotherapy sessions, but her condition worsened. She was later referred to Lisungwi Community Hospital in Neno, where she was diagnosed with Spinal Tuberculosis, also known as Pott’s disease.
Although Regina completed her TB treatment in six months, she developed paraplegia as a complication of the disease. This made her lose her mobility and depended entirely on her mother, Eneless Mwase (aged 45), to carry her around. This forced Regina to drop out of school in 2023, just before her Primary School Leaving Certificate Examinations.
In 2024, Regina was referred to Dr. Dimitri Suffrin for a comprehensive assessment. Following his recommendation, PIH provided a wheelchair to restore her mobility, renovated her family’s house with iron sheets and a cemented floor, and offered food and cash support through the POSER program.
Regina Chingwalu, center, and her mother, Enres Mwase, left, receive a home visit from Dr. Dimitri Suffrin, PIH Malawi’s HIV and TB Program Director. PIH helped identify Regina’s spinal tuberculosis and connect her with treatment, but the late diagnosis resulted in paraplegia.
Joseph Mizere / PIH
In his remarks, Rajiv Chikhwaza, Head of the Neno District Hospital Rehabilitation Department, said: “TB complications like paralysis are not always predictable, but they become manageable when patients present early. Every case of back pain must be investigated with X-rays to rule out Pott’s disease, and if paralysis sets in, all possible causes must be explored. Early physiotherapy referral can prevent further deterioration.”
He added that real challenges often lie beyond the clinic. He disclosed that most patients in Neno, who mostly depend of seasonal farming, struggle to afford transport to attend rehabilitation sessions and access assistive devices. Unfortunately, missed follow-ups only worsen disabilities. He commended PIH for the timely assistance which brings immense relief to caregivers and improves patient outcomes. He also requested all relevant stakeholders for sustained joint planning and a readily accessible fund to meet rehabilitation demands without delay.
With these interventions, Regina returned to school, completed her primary education at Kasupe Primary School, and was selected to attend Chiwale Secondary School. She now dreams of becoming a teacher, inspired by her former head teacher.
“My head teacher, Mrs. Banda, inspired me to become a teacher through her passion, patience, and care,” explained Regina.
“She ensured every student understood her lessons and welcomed questions. Her kindness made me aspire to be like her and help students build better futures.”
A Call to Sustain the Momentum
These two are among the several adolescents that PIH is empowering in Neno District through the deliberate, strategic interventions of PIH Malawi’s ASPIRE project under its Program on Social and Economic Rights (POSER). However, our effort is not sufficient to reach every needy student and we call upon all relevant stakeholders to join us in supporting the youth in Neno. We believe that with timely, holistic support and joint effort, we can overcome the deepest barriers of injustice and inequality, which have a direct long lasting impact on the health of the community members.
