Category Archives: Uganda

Draconian Law setback for Uganda’s HIV response

Kampala, 23 December 2013 (IRIN) –
The draconian Anti-Homosexuality Bill passed by Uganda’s parliament on 20 December would deliver a major blow to the response to HIV/AIDS if it was enacted by President Yoweri Museveni, activists have warned.
Those found guilty of homosexual acts can be jailed for up to 14 years under the new law, a sentence that increases to life in “aggravated” cases, such as those committed by an HIV positive person, or those involving minors, the disabled and serious offenders.

Civil society activists fear that high-risk groups such as men who have sex with men (MSM) and sex workers – whose HIV prevalence is 13.7 and 33 percent respectively – will see their already limited access to prevention and treatment further eroded.

Amnesty International called the law “a grave assault on human rights [which] makes a mockery of the Ugandan constitution.

“President Museveni should avoid the trap of scapegoating a vulnerable minority in the interests of short-term political gain,” said Daniel Bekele, Africa director at Human Rights Watch.

“He should recognize that this repugnant bill is of no benefit to Ugandans – that it only serves to jeopardize basic rights – and reject it.”

The United States government has also called for the bill not to be enacted.

Here is a selection of reactions from those working on the front-line of the response to HIV/AIDS:

Pepe Julian Onziema, programme director, Sexual Minorities Uganda (SMUG), a local rights group

“It’s with deep disappointment that I receive the news of the Anti-Homosexuality Bill passing in our Parliament.”

“If the bill is assented to, the Act would spell a major setback for Uganda’s gains against HIV/AIDS as it will compromise doctor-patient confidentiality, which will push affected LGBTI (lesbian, gay, bisexual, transgender and intersex) persons further underground for fear of prosecution.”

Asia Russell, Director of International Policy, Health GAP

“This harmful and blatantly unconstitutional bill will deal a devastating blow to evidence-based efforts to end the AIDS epidemic in Uganda – a country that is almost unique among aast and southern African countries in that it has rising rates of new HIV infections. Why? Because existing criminalization provisions have meant prevention and treatment services aren’t reaching populations like MSM, who have much higher HIV prevalence.”

“Under this new bill, providing those services would now be illegal – we will see new infections continue to rise as populations get excluded further and further from life-saving treatment, prevention, information and support.”

Milly Katana, veteran activist and board members of the Global Fund to Fight HIV, Tuberculosis and Malaria

“Totally disheartening! It is one of those moments where as a country we move one step forward in realizing civil liberties and public health common sense, [then] we take 10 steps back.”

“The little achievements of the Ministry of Health starting to think of making services available to people who are most at risk of contracting HIV are put in total jeopardy. I hope the president, who has announced himself as a champion for HIV prevention by encouraging Ugandans to test for HIV and knowing their status, will see the non-wisdom in this Act and not assent to it.”

Alice Kayongo, Regional Policy and Advocacy Manager, AIDS Healthcare Foundation – Uganda Cares

“The effects of this (bill) will be felt in almost all sectors but most especially in the health sector and particularly for HIV/AIDS where over 80 percent of the AIDS response is funded externally.”

“Even with amendments, the proposed law will have an impact on the quality of healthcare and health education to be provided to gay people living with HIV for the fact that treating someone or providing them with HIV related information will be seen as a promotion act, yielding to imprisonment. While there have been indications of forward movement in this country’s AIDS response, we are at risk of losing so much of what we have gained in the recent past.”

“Evidently, with such developments in the political and legal environments, Uganda is miles away from attaining [the UN-backed target of] zero new HIV infections, zero AIDS-related deaths and zero discrimination. It will not be a surprise if Uganda’s prevalence rate stagnates around 7.3 percent in 2017. However, we still have some hope, His Excellency President Yoweri Kaguta Museveni should reject the passing of this bill into law and everything else will fall into place.”

Flavia Kyomukama, director of the Global Coalition on Women and HIV/AIDS in Uganda

“At a time when the country is trying to implement the national HIV prevention strategy that has underscored the sex workers and MSM as key in the reduction of the epidemic, the legislature thinks it’s a waste of time to have these people access services.”

“A mother, a teacher, a health worker, an employer is by obligation expected to report any LGBT within 72 hours of notice and confirmation that someone is LGBT.”

“How do I report my son? As a teacher how do I report my student who comes to me in confidence? And as a health aide how do I abuse the confidence of the patient? All of us are going to be imprisoned.”
“If the proponents of the bill claim homosexuality is a mental disorder, is it logical to [give] life imprisonment? The [logical] approach would be counseling and treatment.”

And here are some reactions from champions of the new legislation:

Simon Lokodo, Uganda’s state minister for ethics and integrity

“This bill is going to cater for the lacuna which has been existing in the current law and legal frameworks in Uganda concerning this unnatural act. Having passed this bill, a lot has been done to protect our children and innocent victims who would be lured into these western cultures and behaviours, which are totally unacceptable to us.”

“The law is going to condemn any recruitment, promotion and financing of the activities related to these malpractices.”

“On the threats from donors and development to withdraw their financial assistance over this bill, we don’t care and are not bothered at all. We prefer to lose that money than our culture and people.”

“We have an obligation as a sovereign state to protect our people against this unnatural act.

Michael Lulume Bayiga, shadow health minister

“I am happy and excited this bill was passed. We are waiting for the president to assent to it in order for it to become a law. I am particularly happy with the provision that bans the promotion of this cult (homosexuality). This provision will ensure this act will doesn’t take root in our country.”

“No health worker asks patients whenever they seek treatment from a health facility about their sexual orientation, unless he/her chooses to do so. For all the years I practiced medicine, I have never known any sexual orientation of my patients. There is no discrimination in the health service provision.”

[Courtesy of IRIN]


Uganda: Mothers in New HIV Campaign

16 November 2013
Uganda’s first lady, Janet Museveni will join the Kampala Capital City Authority (KCCA) to launch a new campaign to end mother-to-child transmission of HIV/Aids.

The campaign is coordinated by the Uganda Aids Commission. UAC Director General David Kihumuro Apuuli said last week, over 1.5 million people in Uganda were living with HIV/Aids, most of them the result of the mother-to-child transmission.

He told journalists in Kampala the campaign was critical to inform HIV-positive women that they could give birth to HIV-negative children. According to 2012 national HIV/Aids indicator survey, at least 16,000 babies were born with HIV in 2011 alone.

Kihumuro hopes that with the campaign, this number will reduce, in the next year. According to the commission, 140,000 people were infected with HIV between 2011 and 2012, down from 160,000 in 2010/2011, a 13 per cent reduction.

Dr Sarah Zalwango, the HIV/Aids focal person at KCCA, said a number of activities such as male circumcision, cancer screening and counselling would take place on that day and urged people to come in huge numbers.
[Courtesy of AllAfrica News]]

Uganda:HIV Study Reveal Rampant Stigma

061511 Health Aids News

Last year, a primary school teacher in Masaka, Florence Najjumba, lost her job after she declared that she was HIV-positive.

Had the media and Uganda Human Rights Commission not intervened, Najjumba would have lost her livelihood. Yet she is only one of the luckier ones. According to the People Living with HIV Stigma Index, 2013, most HIV-positive people are still discriminated against at work.

The study, released last week by the National Forum of People Living with HIV Networks in Uganda (Nafophanu), surveyed 1,110 people living with HIV.

“[Some] 255 of the people living with HIV reported losing jobs or incomes within the past year preceding the survey and 27 per cent of these attributed it to [their] HIV status,” reads the study report.

Among those that reported losing their jobs, more than half were men. Some 288 reported that their job descriptions had changed due to a combination of factors, including poor health.

Some were discriminated against at work by either co-workers or employers. Eight percent of the respondents reported that they had been barred from work in the previous 12 months.

Supported by UNAIDS and Uganda Aids Commission, Nafophanu conducted the survey in 18 districts.

“This stigma prevents people from getting tested for HIV, seeking medical care and adherence to treatment and follow-up. A biased attitude towards people living with HIV must be stopped,” said Stella Kentusi, Nafophanu executive director.

Consequently, the study states that income levels among people living with HIV are relatively low, with 60 per cent of those surveyed earning less than Shs 250,000 every month.

Home, work

Gossiping, according to the survey, was the most prevalent form of stigma, with 60 per cent (666) of people living with HIV, convinced that they had been gossiped about at least once within the previous year. Also, nearly one in five of the surveyed people said they had been subjected to psychological pressure or manipulation by their husband or wife at least once.

Some 21 percent said they had experienced sexual rejection at least once in the last 12 months before the survey. About 10 per cent had been excluded from family activities such as eating together or sharing rooms.

The study suggests fear of stigma and discrimination are major reasons why people are unlikely to declare their status in public, let alone taking an HIV test.

“This means that disclosure is done selectively or not done at all. People are not free to seek and take up treatment,” Kentusi says, adding that victims of stigma soon develop internal stigma – negative feelings about oneself.

UNAIDS Country Director Musa Bungudu says to reduce such stigma and discrimination, people living with HIV should enjoy economic empowerment and receive updated education about HIV.

Bungudu proposes “a cascade of training of trainers workshops” not only to address attitudes and practices but also to meet information needs and HIV-related supplies.

On his part, the acting programme manager, Aids Control Programme, Dr Joshua Musinguzi, wants more resources dedicated towards access to anti-retroviral drugs for all HIV-positive people.

Today, 566,000 people have access to ARVs out of the 745,000 expected to be put on treatment by the end of this year.

“We need to disseminate the findings to the lowest level so that the health ministry and stakeholders may roll out programmes, reducing new infections and fighting for the rights of people living with HIV effectively, efficiently and transparently,” Musinguzi says.

Uganda: Paediatric Vaccine Crisis

KAMPALA, 20 May 2013  – Ugandan children are going unimmunized as the country grapples with persistent and widespread vaccine shortages, the result of insufficient funds and inefficient procurement and supply systems, officials say.

“We are getting reports and calls from all the districts about the stock-outs of all types of anti-immunization vaccines. They don’t have anti-TB [tuberculosis] vaccines, anti-tetanus, polio [vaccines]. The ministry is faced with inadequate funding for most of our programmes,” Asuman Lukwago, permanent secretary in the Ministry of Health, told IRIN.

“The current major problem on the vaccines is the distribution issue. We are working around the clock to have the problem solved and sorted out immediately.”

Most of the health centres across the country are facing critical shortages of vaccines to protect against tuberculosis, polio, tetanus, diphtheria, rotavirus and pneumonia, putting children at risk of largely preventable diseases.

Health officials now fear these frequent shortages could prevent mothers from bringing their children in for immunizations.

“You can’t [ask] mothers to move to health facilities three to four times and they don’t find vaccines. This practice discourages some of them to go back to the hospitals,” said Huda Oleru Abason, chairperson of the Parliamentary Forum on Immunization.

Procurement woes

In 2011, the government of Uganda shifted the procurement of vaccines and drugs from the Uganda National Expanded Programme on Immunization (UNEPI), under the Ministry of Health, to the National Medical Stores (NMS), an autonomous government corporation. The move was intended to inject efficiency into the country’s drug procurement system, but the drug shortages have continued.

Yet officials at NMS are blaming the shortages on late requisitions for vaccines by UNEPI. The procurement of drugs is the responsibility of NMS.

“Placing of orders is not the responsibility of NMS, it’s [the job of] UNEPI,” Dan Kimosho, a spokesperson at the NMS, told IRIN. “So if they don’t put request in time or under-quantified for the supplies, it’s not our problem. Our responsibility is to procure, store and deliver the requested vaccines. We can’t begin delivering vaccines to districts and health [facilities] if the orders have not been placed to us. We have the competency to deliver the requested drugs and vaccines.”

An estimated 48 percent of children under age five in Uganda are either unimmunized or under-immunized, meaning they do not complete their immunization schedules, according to the 2011 Uganda Demographic and Health Survey.

Uganda has recently experienced a decline in immunization levels, in part due to inadequate funding, health staff shortages and  [parents’]poor adherence to vaccination schedules.

In April 2013, the government launched a countrywide rotavirus and pneumococcal vaccination program targeting over 1.7 million children.

In an interview with IRIN, Director General of Health Services Ruth Achieng noted that, “Uganda is not doing very well in [its] immunization programme… We don’t want our children to die from preventable diseases. We need to act now. Otherwise, we shall get an outbreak of polio and tetanus.”

Uganda’s budget support for the Expanded Programme on Immunization, EPI, – which had been hailed for increased vaccination coverage between 2000-2007 – decreased by more than half in recent years, falling from 7.7 percent in the 2006-2007 financial year to 3.6 percent in 2009-2010.

Officials say the government has plans to revitalize the country’s immunization programs.
“We have worked out the revitalization plan, and if implemented well, we shall be able to change the low status of immunization in Uganda. The government has mobilized some funds and, with support from GAVI, everything is revisable. We are going to embark on [an] aggressive campaign to ensure there are no vaccine stock-outs in the country and ensure all the children are immunized,” the Ministry of Health’s Lukwago said.

There is also a legal push to improve immunization. An immunisation bill currently pending in parliament will make it illegal for parents and guardians to fail to have their children immunized. It also seeks to punish health officials who fail to offer immunization services to children.

[Courtesy of IRIN)

Uganda’s midwives struggle to meet demands


8 April 2013  – Despite the significant role midwives play in Uganda’s maternal health programmes, they face numerous challenges, including lack of training, inadequate facilities and poor pay.

According to the Africa Medical Research Foundation (AMREF) just 38 percent of Uganda’s estimated 11,759 midwives are either registered or have a college education. Yet they attend to 80 percent of all births in the country’s urban areas and 37 percent of all births nationally.

Esther Madudu, a midwife in Uganda’s rural Soroti District, explained to IRIN that many go to great lengths to help women deliver.

“Health centres lack electricity, water and other essential medical commodities to assist in delivery. In the past, I used to [hold] my cell phone in my mouth [and use its] torch to [assist delivering] mothers at the health centre,” she said.

A 2009 analysis by the UN Population Fund (UNFPA) found Uganda’s health system “unsupportive to midwives, as characterized by poor remuneration, poor health service infrastructure, lack of essential equipment and supplies, eg, gloves, drugs – especially in public health facilities – inadequate protection from infections, high workload owing to few qualified staff” and lack of supervision or training opportunities.

Maternal deaths

Uganda grapples with high rates of pregnancy-related complications and maternal deaths, consequences of poor healthcare investment by the government, low education levels and an unmet need for reproductive health services.

Uganda’s 2011 Demographic and Health Survey showed the maternal mortality rate at between 310 and 480 deaths per every 100,000 live births.

According to the Ministry of Health, 24 percent of these deaths are the result of severe bleeding, and many are due to infection, unsafe abortion, hypertensive disorders and obstructed labour.

Experts say much more must be done if Uganda is to meet Millennium Development Goals 4 and 5 – the goals on reducing child and maternal mortality and achieving universal access to reproductive healthcare – by the 2015 deadline.

“Death resulting from pregnancy-related [complications] is a big issue in Uganda that requires urgent attention,” health commissioner Anthony Mbonye said, noting that these deaths are preventable “with improved access to [quality] healthcare to the population and… positive attitudes towards… health workers.”

Too few health workers

Midwives say their small number has them struggling to meet demand. They have called on the government to recruit more midwives.

“We are only three midwives working day and night with [the] assistance of two nursing assistants,” said Lydia Tino, a health supervisor and midwife working at a centre with 20 maternity beds in the rural Gulu District.

In 2006, the government stopped midwifery trainings, arguing that nurses could be given additional skills to take up the roles played by midwives. This has not happened.

And the few who have midwifery skills often leave the country.

“Uganda has trained many midwives, but [the] majority opt to work in places outside the country where facilities and remuneration are better,” Mary Gorettie Musoke, senior midwife and trainer, told IRIN.

n a progress report by Uganda’s Ministry of Health, tabled before a parliamentary committee in February, the government indicated that it had employed an additional 5,707 health workers to help plug the gap.

But many rural health facilities are still unable to perform either basic or comprehensive emergency obstetric and newborn care.

Government obligation

Government officials told IRIN it plans to carry out a countrywide maternal health audit as part of its efforts to deal with the problem.

“We are under obligation to perform our duties, so the government doing everything possible to address problem,” said Sarah Kataike, the health minister.

While government health facilities in Uganda are supposed to provide free services, they are understaffed and lack essential medical supplies. At times, patients are forced to pay extra fees before they can receive services.

Florence Akio, 34, had to be transported to a private facility some 45km away after failing to receive any assistance at a nearby government facility.

“My labour started in the middle of the night, but I couldn’t make to Atiak Health Center III. I waited until morning, when my husband borrowed a bicycle and carried me to the health centre. But, reaching the health centre, there was no sight of any staff to attend to me,” she told IRIN.

In a landmark 2011 case, civil society organizations sued the government over the high maternal mortality rate, but the case was dismissed. The organizations had argued the government had failed to provide essential medical commodities and services to pregnant women.

[Courtesy of IRIN]

Tied to a rope because she is disabled

Tied to a rope because she is disabled

Although she is 14 years of age, *Lisa cannot eat by herself or talk. She does not play with other children either, and needs help with basic activities. Therefore, her parents tie her to a tree because they feel it is the only way to keep her safe.

Lisa, 14, spends her day tied to a tree near her parents’ home in Nateete, Uganda with a rope. The rope is fastened onto her right leg. When she is not tied there, the rope remains. The tree is now known as Lisa’s tree.

This is not another case of the nodding disease. Lisa is deaf and mute. Her parents think tying her to the tree is the best way to manage her. While there, she keeps on moving around it. From time to time, she picks anything on the ground and puts it in her mouth. Her sisters keep on removing leaves and sticks so she has nothing to put in her mouth. But that doesn’t deter her from searching for something else. She tries to go as far as her rope allows her and when she finds nothing, she continues moving around the tree and sits down when tired.

All this she does while making sounds similar to that of a goat bleating.

Perhaps the saddest part in this story is that this slender and tall teenager was not born with any abnormality.

“She was born normal and could talk and hear. But when she was two years old, she got malaria and got a seizure. Since then she lost her sense of hearing, talking and she sees only partially,” her mother *May Nakato, says.

She says that even when Lisa was older, she couldn’t sit like other children of her age. Someone advised them to take her to a traditional doctor who advised that a hole is dug and Lisa sit in it for a couple of hours a day with a blanket wrapped around her to keep her straight so as to strengthen her back. After three months, she could sit and even started walking. However, she still couldn’t see well, and when she walked, she kept on bumping and knocking whatever was in her way. That is when her parents started tying her onto a rope.

Nakato says, “I don’t know how the idea came to me. I was helpless when it occurred to me. It was a better solution because we couldn’t afford to take her to a school for the deaf and dumb which is the ideal and best solution.”

An attempt at getting medical help
The seizure 12 years ago was the start of the family’s trips to hospital. Lisa has since been in and out of the hospital. Sometimes she is put on drip. One time she needed a blood transfusion and once, had to be put on oxygen. Usually, she is discharged after staying in hospital for about a week.

The doctors recommended that she is taken to hospital every month for medication saying it would stop her from eating dirty things which the mother says was done for six months. But the parents say there was no change so the teenager continued to spend the day tied on to the tree which is dangerously near an electric pole.

One day a lady saw the child and told Nakato that what she was doing could get her arrested. Nakato acknowledged that and asked her to help them because they had run out of affordable options.

The lady advised her to take the child to Butabika Mental Health Hospital where other children like Lisa stay.

“When we reached there, I found that the children there are not in the same state as my daughter. Though deaf and dumb, they can play with balls, go for short and long calls without help. They also feed themselves and walk with a sense of direction,” says Nakato.

Unlike them, when Lisa is left to walk, she wanders around like a zombie, moving aimlessly and she usually gets lost. Even when she sees other children playing with objects like a ball, she doesn’t seem to have any interest. She doesn’t join in when urged to or even kick or touch the ball when it is given to her.

She urinates and passes stool on herself. When she is given food, she ends up throwing it all over the place because to feed, she scratches it like chicken wasting the food. So she has to be physically fed. But she drinks by herself without taking the cup off her mouth till it is empty and then she throws the cup.

Lisa was taken to Butabika for three days and was given medication. But she got a seizure one day so her father, decided to take her to Mulago Hospital where they were told to take her whenever she got a seizure.

Necessary evil
Though strange at first, the sight of a child tied on the rope is something the neighbours have gotten used to. Her parents have also made their peace with it. It is like a necessary evil. Nakato, a mother of four explains that she has to work to help her husband with financing the home so she can’t stay at home looking after Lisa.

In fact, when her siblings are at school, her mother locks her up inside the house because there is no one to watch over her. “Thankfully, I work nearby so when I leave in the morning, I go back at 10am to give her breakfast and bathe her. I return at 2pm to feed her and at 4pm Lisa is taken to her tree because then, her siblings are around to watch her.”

Though the family says they don’t have relatives with the disability and the rest of the children are normal, before Lisa, they had a child who was in the same state as their daughter. But unlike Lisa he could play, recognised things and when he walked he seemed to know where he was going. He too was tied to a tree during the day because, according to them, it was an easier way to manage him. Unfortunately, he got a seizure and passed on. When Nakato talks about him, it is with a pain in her voice. It explains the emptiness and helplessness with which she talks about Lisa’s state. “I wish we could afford to take her to a school for the deaf and dumb. I am sure it would help.”

Irene Nenduta, a neighbour tried to get help from African Network for Prevention and Protection of Children against Child Neglect and Abuse (ANPPCAN) but wasn’t able to go far. The officials say they think Lisa needs to be taken to a home for children like her but unfortunately ANPPCAN doesn’t know one such. The established ones require that some money is paid, so they are trying to find sponsorship for her.

Courtesy Saturday Monitor

Uganda: HIV- Aids Increase in Karamoja


MOROTO, 30 April 2012 (PlusNews) – The nomadic Karimojong ethnic group, once regarded as a low-risk HIV population because regional instability in northeastern Uganda and strong adherence to their culture kept them relatively isolated, have not been a priority on the country’s HIV agenda, but recent statistics show prevalence among this community is now 5.8 percent, up from 3.5 percent five years ago.

Over the past decade large numbers of Karimojong have settled in urban centres, where business is flourishing and many NGOs have set up shop; there has also been heavy military deployment in the area as part of a disarmament exercise. These and other changes in a strongly traditionalist society have combined to push prevalence closer to the national average of 6.7 percent.

“The drivers of the pandemic that exist elsewhere are now occurring here. There is also a lot of alcoholism and [domestic] abuse here, which is one of the drivers of HIV/AIDS infection,” Dr Michael Omeke, health officer for the Karamoja region’s Moroto District, told IRIN/PlusNews.

Limited Health Services
Just five hospitals serve seven districts and a population of 1.2 million scattered over some 28,000 square kilometres. “In general, HIV treatment and care services are still low in the region,” said David Wakoko, Karamoja area manager for the Mulago-Mbarara Teaching Hospitals’ Joint AIDS Programme (MJAP).

Most health centres in the region do not have clinical officers trained to provide life-prolonging antiretroviral (ARV) drugs or offer HIV care and treatment. Kaabong District for example, has five health facilities, but only the district hospital has a medical officer authorised to treat HIV-positive patients, and the hospital does not have a CD4 machine to test blood samples and measure immune strength.

Few health workers are keen to live in the remote and underdeveloped region. “Human resources are a big challenge. You need someone who is qualified to help these people, but we are not attracting… personnel,” said Dr John Anguzu, District Health Officer in Nakapiripirit. “Even the local people we try to train here to help, they leave.”

The region has also not been spared the drug shortages that have occurred in other parts of the country. “We do experience ARVs stock-outs… We are trying to work with the Ministry of Health and National Medical Stores to see that these stock-outs are reduced,” said Omeke.

A lack of food in the arid region and the long distances to health centres are major problems for people living with HIV. “These are weak people and can’t move long distances to go for treatment and drugs. The health centres are too far,” said Gabriel Lokubal, who lives in Moroto. “ARVs are very strong drugs, which require a lot of eating. However, most of us don’t have food, so some people have stopped going for drugs.”

Knowledge about HIV is also very low. A recently released preliminary report on the AIDS Indicator Survey shows that just 30 percent of women and 45 percent of men in the northeast are well-informed about HIV/AIDS.

A complex region

Spreading the word about HIV is not easy in Karamoja, where open discussions about sex are extremely unusual and the population is largely uneducated. According to MJAP statistics only 35 percent of Karimojong men have accessed HIV/AIDS services, compared to 65 percent of women.

“Because of the nature of the society and tradition, the men remain in the kraals [communal cattle pens] and are on the move in search of pasture and water for their cattle. They have little interest in seeking HIV services,” said MJAP’s Wakoko. “Most of those who access HIV/AIDS services are women, especially the pregnant ones, who visit health facilities for ante-natal services.”

“The HIV patients also tie HIV services to food. If you don’t have food, people don’t come,” Anguzu said in Nakapiripirit.

Stigma is highly problematic for health services trying to reach people living with HIV. “When you test a person and… [the result] is HIV-positive, he or she will never come back again for further… [treatment],” said a nurse at the ARV clinic at Moroto Regional Referral Hospital. “We are trying to sensitize the community to accept their status and learn to live positively.”

In an effort to bring the services closer to the people, Uganda’s Ministry of Health and MJAP are running a home-based HIV counselling and testing programme, but low staffing and occasional insecurity in the region are affecting the door-to-door campaign.

“The security situation remains fluid, as it changes any time despite general improvement in the sub-region, thereby affecting the implementation of programme in most of the catchment areas,” said MJAP’s Wakoko.

Health workers in the region say the nature of the causes and effects of HIV mean it cannot be tackled in isolation, and a holistic approach should be used.

“The interventions need to be shared among sectors – health is concept which is determined by social, economic and cultural aspects,” said Samuel Enginyu, a health educator with the Ministry of Health. “We are working on an integrated and collaborative approach with the Minister of Gender and Culture and other stakeholders.”

[Courtesy of IRIN News]