Now, she regularly draws crowds of up to 20,000 and is attempting to perform a miracle: unseat the powerful coalition that has ruled Malaysia since it gained independence from Britain in 1957. With only rudimentary weapons she is facing a Goliath in a battle that few expect her to win. But they are watching with fascination and growing respect.
Seated on a sofa in her spacious but modestly furnished house in one of Kuala Lumpur's leafy suburbs, she laughs when she recalls the moment she realised what her future might hold. "We were at a rally and my husband said, 'If anything happens to me, then Azizah will take over.' It was unreal to hear him say that, he hadn't really discussed it with me."
Anwar had been sacked by his former friend and mentor, the Prime Minister, Mahathir Mohamad. Anwar and his wife were touring the country, calling for reformasi, inspired by the uprising that had ousted President Suharto of Indonesia. A few months later, when Anwar was arrested, 46-year-old Dr Azizah took over the campaign, joining a long list of Asian women who have inherited a political role from their fathers and husbands.
A serene, warm-hearted woman, Dr Azizah has withstood much: allegations that her husband betrayed her with both sexes, his violent arrest by masked gunmen, the sight of his bruised and beaten face and the news last week that he will be behind bars for the next six years. She has remained dignified and calm throughout. "I controlled myself because I would have broken down," she said. "Anwar told me not to be sad, to be brave."
Her main selling point, she believes, is that she is both a trained doctor and an embattled mother. "I am seen as a maternal figure with a maternal instinct. I will rise up and protect my family and I think that can be transformed into political will to change. People have sympathy for me and my position translates into what is wrong with the system. I only wish I had more political acumen, could be a better orator. Caught unprepared I can only make the best of it, which I think is also my appeal. I speak from the heart and have even seen grown men cry."
Dr Azizah, who recently launched the National Justice Party, knows the odds are against her: she faces a huge political machine that has money, experience and a cowed media behind it. Her main weapon is public outrage at Anwar's treatment, which she says has opened people's eyes to injustice and corruption.
"Traditionally people would vote for the status quo and stability. We are going for a clean, effective government - not instability. The system has worked for us but we have to remove the repression." Her party has adopted a "multi-ethnic" label and its success depends on attracting votes from Malaysia's three main ethnic communities: Malays, Chinese and Indians. The two main opposition parties, one fiercely Islamic, the other mainly Chinese, are sharing a platform with her.
"We have not glossed over the differences, we accept they exist. The exciting thing is that we have come together on common ground, with common goals." Never seen without her headscarf, Dr Azizah describes herself as a pious Muslim, drawn to her husband by his deep religious convictions.
"He was very Islamic and I felt that we could have a good life together. My parents were not so happy because he was considered anti-government but they got over it."
The as yet unproven allegations of sodomy and adultery, which Anwar has been found guilty of trying to cover up, caused pain as they would in any household. "We are not angels, we are humans. I looked at my husband's relations with me and decided no letter should be used to destroy my happiness. I knew from then that they were trying to break us. I do not believe the allegations and nor do our children. They know their father."
Now Anwar sits in a jail that he helped to construct. "The irony is that he approved the allocation of funds for the building," says Dr Azizah, summoning a smile in the midst of her grief.Reuse content