Esther Sakara is forty years old. Her face is drawn, and her eyes distant. In her thin arms she holds her two year old daughter, whose gestation brought Esther the news that she was HIV positive.

“When I was pregnant, I had a routine AIDS test at the clinic, and they told me I was positive. I couldn’t believe it, as I hadn’t felt sick,” she says.

“When I came home and told my husband, he refused to believe it either, and told me to forget about it, that the test must be wrong.”

Soon after she gave birth, Esther began to feel unwell, and went to be tested again. The diagnosis confirmed her fears, but her husband was still in denial and refused to be tested himself.

Esther’s husband is a drinker, and has a woman in another village. He has abandoned her for this other woman, and has hidden the fact that his wife has HIV from her. He is afraid to tell her, because the likelihood is that he has passed on the virus to her also.

“I am sick all the time now. I get bad coughs, bouts of weakness, and stomach upsets. I am not on ART (Anti-Retroviral Treatment), because I became too weak too fast to travel to the clinic.”

The Zambian government introduced free ART for all those who need it back in 2006, but infrastructure is a huge problem for people who need transport to treatment centres, especially the poor in rural areas

“When I was healthy, I was a strong woman, and a farmer. Now I am weak, and I can’t go to the field anymore. Last year, I was still able to cultivate a small area at the edge of my field, but all that food has gone now. I have no support financially from anyone in the village, and I have to beg to feed myself and my children.”

“I am sick all the time now. I get bad coughs, bouts of weakness, and stomach upsets. I am not on ART (Anti-Retroviral Treatment), because I became too weak too fast to travel to the clinic.”

When her daughter was born, she was given prevention of mother to child transmission (PMTCT) treatment, and Esther hopes that this was enough to prevent her contracting the virus, though she does not know for sure. “I don’t know what her status is now. I am afraid she might be positive, but I am too weak to carry her 3km to the clinic, and I cannot afford the transport.”

“I don’t have any support here. There is no support group for HIV positive people like there is in some other villages. A few of the women tried to set one up, but they couldn’t organise it. We talk together sometimes, but mostly I feel very alone.

“I suffer stigma from other people, they tease me. The few times I have been to the clinic in the past, I have seen many people who are HIV positive like me, but here in the village, people tend to hide their status from others if they can.”

Esther’s biggest concern is for the future of her six children. One is married, but the other five are all under the age of 14, and she does not know who will take care of them.