SHE tested HIV positive in 2001 and in 2011 she was told she had cervical cancer.

Even though 44-year-old Estella Mbewe has not had it easy, her determination and hope to get better and fulfil her purpose in life keeps her going.

For years, she was sickly with different illnesses and was even referred to as aba bo dwala (the one who is always sick).

But today, she is on her feet. Also, she underwent radiation and chemotherapy to treat her cancer.

She is currently working as a programme officer in the information education and communication department at the Network of Zambian People Living with HIV.

"I live in Mandevu and I grew up there in Mandevu. My parents are both dead. I am the third born. We were seven but four of them have since passed on. I am a widow. I don't have any children. I got married in 1989 immediately after I completed grade 12. I knew of my HIV status in 2001. Since 1990 I was like on-off with a lot of illnesses. I had three bouts of TB and then again three bouts of herpes zoster. It was on-off illnesses, where I would just be most of time, sick at home and if it means being okay it would just be for a week (and her relatives took care of her). Most of the time I was mostly inside (the house) and most of the people in the family used to say 'aba bo dwala' (the one who is always sick) because then they knew that I was a sickly person and there was nothing that I could be able to do within the family because all the time I was the one who needed care. So in 2001 after my husband died, I realised that I think I needed to know of HIV status," she says.

She says after her husband's death, she went for an HIV test in Chawama.

"You had to wait for quite a long time once they take your blood sample ... I was like, 'why did I have to come here? Did I have to? Maybe I don't need to get my results, maybe I should go back home and come another time.' But I said, 'that is why I came here', so I took courage. The counsellor went through the pre and post test and things like that and she gave me the results only to see it was a plus sign and I was like 'okay, I am HIV positive' and of course you don't react there and then. The reaction only comes when you go home. It's like you're asking yourself, 'when did this happen'?" she says.

"Where did I go wrong and you want to bring the blame and all those processes that you will be able to go through and you would be saying 'why me God"' And then I was thinking that what would happen to me if I had to die today, I don't even have a child, who is going to remember that there was a Estella around because in a community they always talk about amake chite because they left a child, that's how they are going to remember you. So there were all these things that were coming on and I think the post-test counselling really helped because I was told to go back after a week to see the counsellor."

Mbewe says when she went back to see the counsellor, she enquired where she could find other HIV positive people to share her experience with and she was referred to Kara Counselling, Hope House in Villa Elizabeth, where she was helped in different areas.

She says she decided to publicly come out during the World AIDS Day commemoration in 2004 and for her that was the beginning of her living positively.

Mbewe says her family has been supportive of her.

She says another thing that helped was the formation of a women's support group called Lusapila, meaning (we are still live).

She says she has been on ARVs since 2004.

She recalls that in 2009, she started experiencing abdominal pains.

"What used to happen was that after I would have my menses, once I complete them, I would find that the discharge we have as women is bloodish and I was like 'what is this?' After some time it would stop and then come again after some time. But then I think the critical part came in 2010 when I experienced heavy bleeding and to me it was like this has never happened to me and I think with the information they were talking about women accessing pap smears within the clinics, I thought I would try it," she says.

"I think they had opened a few satellite points where women could do the pap smears but for me I had to go to UTH which was the Centre of Excellence where I had my pap smear done. It is a simple diagnostic process where even you are able to see what is really happening within your cervical and I was told there were white patches and from those things the nurse who was conducting the process said they would not be able to tell whether it was cancer or not, meaning they needed to carry out further screening. They did a biopsy and got a sample and went to do some tests. But I think what was encouraging was that it takes six weeks to get your results. After six weeks I went to check on my results and I was told that they were not back and I went again, I think I went three times, but still they told me that the results were not out and you know with the business schedule we have as women I forgot about it," she says.

She says a year elapsed after taking the pap smear.

"I passed through there and only to find the person there telling me 'where were you?' I said 'I was here' but then I said 'that is why we leave all the details so that if there is anything you are supposed to call to say, 'Estella, I think you are supposed to come to the clinic.' But they didn't call me so that is how I relaxed, thinking all is well.' She said my results were not okay I needed to go to B11 where I needed to see the gynaecologist who will start the whole process. She said it was cancerous but did not know because a long period had elapsed and that is how I went to do the bookings and I started attending the clinic at B01," she says.

"At B01 they did the staging then I think what happened was that I was not told at what stage it was. They told me it was cervical cancer and I think what I was told was that they needed to remove my uterus so I was like, 'Okay, removing my uterus!' I was not comfortable and for me it was like our providers should be providing more information so that as a client you are able to understand your situation so that in as much as you would want to make a decision of what treatment you would want to take, it will be very helpful."

Mbewe says a date was booked for the operation to remove her uterus but she did not feel comfortable and therefore did not go for it.

She says she later experienced heavy bleeding again.

"So when I went back I was asked where I was and since I had taken long they didn't know where it was. So when they did a physical examination and I was told that it was getting to stage 2 B because the time I was there it was stage 1 B, meaning removing of the uterus wouldn't work at that point and I had to undergo chemotherapy and radiation. I was told that I had to take medicine that had to boost my blood cells because with chemo my blood cells would be destroyed because they do not choose which ones were bad or good. It would mean that I had to recover by taking a lot of blood boosters and eating the right foods," she said.

She says she went home and thought about the stories she had heard on chemo.

"But I said 'what is this?' I went through HIV and with the long period I was sick and now I have to undergo radiation with chemo. So what will happen to me? And with the CD4, I was saying it will affect my immunity, so will I be able to cope with it? But I think with the encouragement I got from my workmates and family, it sort of helped though I was scared because I didn't know what would really come out of it," she says.

Mbewe says she started her treatment last February and it was for 28 days.

"It was more like how they do the x-ray; they would pass the x-ray on my abdomen, they would do a bit of staging and stimulating on the actual part where they would pass the rays of light. I went through that and I would be going every day so the people that would come out of town from Lusaka would need to be admitted at UTH because they would be like coming every day but those within Lusaka they needed to be coming every day which is Monday to Friday, except holidays and weekends," she says.

She says for the chemo, she was supposed to have two treatments through the IV fluid but she only had one because her white cells were low.

"So immediately I had the first one, it was quite a bad experience because immediately after the first chemo, I had diarrhoea that started and was not stopping. Inasmuch as I would go back to the clinic and they would give me medication, but still... it makes you weak so either you start vomiting or you have diarrhoea, so depending on the person's immune system or how they would respond to the chemo, that's how it is," she explains.

"People were telling me that my hair would fall but it didn't but you are just expectant because they give you the side effects of what to expect, so what really affected me was the diarrhoea. During the day it was fine but in the night it was really bad. I was looking at my body and saying I am already a slim person and with this, what will happen to me, maybe I will die any time. And you find that even the people coming home you look at their faces, instead of encouraging you, they are sort of giving stories of how their relatives died, so it was discouraging but then I would thank the people who were coming in who were sort of on the spiritual side."

Mbewe says she completed her treatment in March and had her first review in May.

"So for now what will need to be done is going through the tests to find out what the treatment has done but for now I am fine because I don't have problems but I have to accept the changes like I was expecting to get into menopause around 50 but now it's early menopause because of the radiation, so meaning that you need to understand and agree that these are the changes that will happen to my body, so sometimes you get some bloating here and there," she says.

"The review was more on the physical part but I would go for another review in August where I might go for the pelvic ultra sound or if it will mean doing another pap smear to see how the treatment worked meaning the doctor will be the one to decide on that."

She advises women not to be afraid of testing for cancer.

"More especially if you are HIV positive, you are more susceptible to getting these infections, so I would really urge women that we have these outlets out there that are being provided by the government and they are free of charge, so go there and have your bodies examined because the earlier you go, the more you are able to prevent these cancer cases we have. We need to take up this and start going for pap smears so that we do the screening and checkups as regularly as possible. The chemo didn't really affect the treatment but once you are on treatment you have to tell the health provider. I told them that I was HIV positive and was on treatment," she says.

"I will be going to do my CD4 because I think at some point after being ill with the cancer it sort of like dropped because it was at 590-something, then it went up to 354 so really maybe I don't know whether it was stress because I was told I had cancer but I would need to go back and check how it is doing now because with the treatment of cancer it affects your immunity or CD4."

She says Zambia has made a lot of strides in the fight against HIV and AIDS but there was need to reach out to more people.

Mbewe says people still do not want to know their HIV status meaning there was need to do more in that area and also making treating more accessible to people who really need it in the hard-to-reach areas.

She says there is need to do a lot on sexual reproductive health with regard to children and young people living with HIV as the country was moving in the line of prevention and people living with HIV have their role to play in further preventing the spreading of the virus.

She thanks workmates and family for being there for her and encouraging her.