CONTENTS | ANB-BIA HOMEPAGE | WEEKLY NEWS
by William Tayeebwa, Uganda, October 1998
THEME = AIDS
Many Ugandans were only just getting over
the horrors experienced during Idi Amin's regime,
when the HIV/AIDS pandemic showed its ugly
face in the 1980s
Entire families were wiped out in the badly hit Southern district of Rakai. Hundreds of children were left orphans. Many of them then depended on relatives, the majority of whom were helpless grandparents. Hundreds more, with nobody to fall back on, trekked to urban centres to constitute a generation of street children.
Prophets of doom, the world pessimistically predicted that half of Uganda's population would be HIV-positive by the year 2000. But this was not to be.
The 1986 new government of Yoweri Museveni was not only confronted with a crumbling economy with virtually no social infrastructure, but also the inescapable reality of the HIV/AIDS menace. In the President's own words: "Right from the time the National Resistance Movement (NRM) government came into power in January 1986, HIV/AIDS was recognized as a problem to be faced and solved. An all-out-war was openly declared on HIV/AIDS instead of sweeping it under the carpet pretending the problem did not exist." President Museveni castigates countries which suppressed the HIV/AIDS problem for what he calls "flimsy reasons like protection of the tourist industry."
From the outset, the government of Uganda adopted a multi-sectoral approach to HIV/AIDS prevention. President Museveni was personally instrumental in setting up The Uganda AIDS Commission and The AIDS Control Programme (ACP). "We embarked on a preventive programme based on arming our people with factual knowledge on HIV/AIDS, instead of fear and rumours," he says.
Currently, the government encourages and supports all organisations and institutions who have put anti-HIV/AIDS programmes in place. This governmental support has born fruit.
According to the HIV/AIDS surveillance report published in March 1998, Uganda's HIV infection rates among Sexually Transmitted Diseases (STD)s patients in all major hospitals country-wide, have been declining. Statistics from the country's referral hospital in Mulago show that rates have declined from 44.2% in 1989 to 30.2% in 1997.
HIV infection rates among antenatal clinic attenders (ANC) have also been declining in all selected antenatal clinics country-wide.
Dr.Joshua Musinguzi of the Epidemiology Surveillance Unit under the AIDS Control Programme said that data from HIV infection sentinel surveillance sites, continues to show declining trends in the urban sentinel sites and stabilisation in the rural sites. He hastened to add that cases were still high and therefore the need for increased effort to improve and sustain existing AIDS control initiatives.
According to the same ACP surveillance report, a cumulative total of 53,306 AIDS cases was recorded as of 31st December 1997. 92.7% were adults aged 12 years and above. And of the cumulative total of 49,432 adults, 46.2% were males while 53.8% were females.
The report further shows that the overall means age for adult AIDS cases was 34 years for males and 30 years for females. There is a statistically significant difference in the mean ages of males and females in the 15 to 19 year age group ratio of approximately 1:6.
Mrs.Sophia Mukasa is the director of The AIDS Support Organisation (TASO), a local Non-Governmental Organisation (NGO) started in 1987. She notes that the reasons for the onslaught of AIDS in Uganda are varied.
"It is true that Uganda's civil unrest for two decades is a contributing factor," she says. "But our social-cultural practices such as female circumcision, polygamy and inheritance of widows are responsible for the high infection rates among females."
Mr.Sam Wangalwa is the Kampala branch manager of AIDS Information Centre (AIC). He says that low incomes, coupled with low education levels were responsible for the increasing infection rates in rural Uganda. He adds that poor health facilities and rigidity by rural folk to adopt new practices such as the use of condoms, contribute to the spread of HIV/AIDS in rural areas. The AIC strategy is to deliberately target rural areas through a combination of interventions in schools and local communities.
The Philly Lutaya Initiative of People Living with AIDS (PLI/PWA) is such a project launched by both TASO and AIC, whose aim is to promote behaviourial change in communities by using PWA volunteers who have gone public. They are trained in communication skills to share their life experiences, particularly with youth in and out of schools.
The effort of dozens of civil society organisations and associations is complemented by a concerted one provided by religious organisations.
The chairman of The Uganda Islamic Medical Association, Dr.Kajimu Magidu says that The Uganda Muslim Supreme Council facilitates The Family Education AIDS Project Through Imams (FEAPTI), to preach behaviourial change.
"We urge Imams to go to Muslim homes to teach people how to effectuate Islamic rituals such as the washing of bodies before burial." he says. "We also urge Muslim couples to be tested for HIV seropositivity before consummating their marriage," he adds.
The Uganda Muslim Supreme Council also mobilises Muslims in Uganda to give alms to AIDS orphans and widows on a regular basis.
Rev. Gideon Byamugisha is the Church of Uganda's director of HIV Prevention and AIDS Care. He says the Church of Uganda is involved in all national programmes on HIV/AIDS prevention, counselling and care. He said that material support to orphans and widows is handled by The Church Human Services (CHUSA) component. CHUSA also facilitates activities of Safeguard the Young From AIDS project (SYFA), whose goal is to educate youth about positive living, through drama, seminars, discussions, debates, educational video or films and personal experiences shared by people with AIDS.
Bro.Dr.Daniele Guisti is the director of The Uganda Catholic Medical Bureau under The Uganda Catholic Secretariat. He says there are dozens of community associations, clubs and organisations in practically all parishes in all dioceses to combat the HIV/AIDS pandemic.
Bro.Daniele notes that local Christian units, provide immense care and support to people infected and affected by the HIV/AIDS scourge. The Uganda Catholic Secretariat provides moral, spiritual, financial and material support to all bone fide church organisations and associations fighting HIV/AIDS. He adds that in all Catholic founded hospitals country-wide, there is a care unit for people living with HIV/AIDS.
The AIDS Widows and Orphans Funds Support (AWOFS) is a project under the home care unit of Nsambya Catholic hospital. Since widows and orphans are the most vulnerable in society, AWOFS provides material and moral support in form of food, clothing and shelter to the most needy of them. And to promote self-reliance, AWOFS provides vocational training in carpentry, brick-laying, tailoring and mechanics to able orphans.
Widows are given loans to start small money generating projects such as poultry and gardening.
The National Community of Women Living with AIDS (NACWOLA) until recently shared the same premises with AWOFS in Nsambya hospital. NACWOLA's national director, Mrs.Beatrice Were, says women feel the urge to be united on issues pertaining to sexuality, marital rape and self-empowerment through income generating activities.
She explains that NACWOLA, operational in 18 of Uganda's 45 districts with a membership of 40,700 women, is an organised demonstration against the dehumanising effects of HIV/AIDS.
Mrs.Were radiates with joy when she talks of NACWOLA's nascent "Memory Project for Children". She says that the project is about passing on vital information in a memory book, to AIDS orphans or children of infected mothers, by the mothers themselves before dying.
"We hope that the memory project will enable mothers living with HIV/AIDS to make their children appreciate the reality of AIDS in their families," says Mrs.Were. She adds that children would possibly be motivated by the memory book of their deceased mothers to participate actively in the fight against HIV/AIDS.
All the aforementioned civil and religious organisations battling HIV/AIDS would be lame if it were not for the financial and technical support provided by a dozen foreign NGOs and donor agencies. The outstanding example is the Joint United Nations Programme on HIV/AIDS commonly known as UNAIDS.
UNAIDS is a co-sponsored programme which brings together UNICEF, UNESCO, UNFPA, UNDP, WHO and the World Bank, in a common effort to fight HIV/AIDS. In Uganda, operations of UNAIDS are being coordinated by the WHO country representative.
Each of the six co-sponsors of UNAIDS, runs programmes alongside the Ugandan government in an efforts to combat the pandemic. All UNAIDS co-sponsors are crucial to the monitoring, planning, evaluation, management and Research on HIV/AIDS related programmes.
The Joint Clinical Research Centre (JCRC) and The Uganda Virus Research Institute (UVRI) have received immense support from donors to carry out research on AIDS and AIDS related conditions including treatment and prevention.
Dr.P.N.Mugyenyi, the JCRC's director, says that the research centre has limitless scope in the field of drugs' trials, and has facilities to carry out studies in other medical areas. The JCRC's helpline is a telephone facility aimed at serving people who may need to discuss any aspect of HIV/AIDS anonymously and confidentially with a counsellor.
Medical and social workers continue to provide the badly needed support to people living with AIDS and their dependants.
Mildmay International Care Centre is a UK-based specialist referral centre for people living with HIV/AIDS, which started operations in Uganda, in September 1998. The Centre is designed to provide advanced study and research opportunities for participants from all over Africa and the developing world. The Centre will open a residential AIDS hospice and a continuing care unit where staff will focus on the training of health care professionals, and the demonstration of good clinical practice.
Dr.Cissy Kityo of the Joint Clinical Research Centre says that specialised care centres like Mildmay, are welcome in Uganda, since the concern of Ugandans is currently to prolong life rather than waiting for a cure. Dr.Kityo was alluding to the disillusionment of Ugandans over the "anti-AIDS" drugs brought into the country in November 1997.
Dr.Dorothy Ochola-Odongo, the co-ordinator of the Drug Access Initiative under the UNAIDS, says that the so called "anti-AIDS" drugs are protein inhibitors; otherwise called anti-retrovirals (ARV)s. When the ARVs are taken indefinitely in prescribed combinations, they slow down or even stop the multiplication of the HIV in the blood. Dr.Ochola explained that the inhibitors are not a cure for AIDS.
She regrets the prohibitive cost of these drugs and hastens to add that though the triple drug therapy costs $750 per month in Uganda, the cost is several times higher in other countries. "Despite the prohibitive cost, these drugs are subsidised by donor countries and agencies to make them affordable to Ugandans," she says.
"With or without the drugs," reasons Mrs.Beatrice Were, "Ugandans ought to learn how to combat HIV/AIDS using the available resources." According to her, prerequisites for a proper living with HIV/AIDS are a balanced diet with plenty of water, a rigorous self-discipline devoid of unprotected sex, alcohol and drugs.
She says that recreational activities which do not tire the body are crucial. She adds that aromatherapy, a controlled application of essential oils through massage, does wonders to maintain and promote the vitality of the spirit, control emotions and rejuvenate the physical body.
As all sections of Ugandan society continue the battle against HIV/AIDS, they must keep a firm grip on the traditional methods of HIV/AIDS prevention, namely: Abstinence, Faithfulness and Safer sex.
And as the title of a newsletter produced by The Philly Lutaya Initiative of People With AIDS (PLI/PWA) reads: "If today it is me, let it be nobody tomorrow".
END
CONTENTS | ANB-BIA HOMEPAGE | WEEKLY NEWS
PeaceLink 1999 - Reproduction authorised, with usual acknowledgement