Africa, Development & Aid, Headlines, Health

HEALTH-UGANDA: Success Story, Fighting HIV/AIDS

Evelyn Kiapi Matsamura

MASAKA, Uganda, Dec 20 2002 (IPS) - About six years ago Rosemary Kityo, 31, discovered that she was HIV-positive. Her husband, Yowasi Kityo, had already succumbed to the disease, after a long illness.

‘’At first I didn’t know that it was ‘slim’ (AIDS). But my neighbours talked about it. Even then, I did not believe it. My husband was a faithful man,” she says.

Soon, Kityo began falling ill, too. Her last-born child, Joseph, who was two years old, died. Kityo – bed-ridden as she was – had to look after the remaining three children, surviving, sometimes, on a meal a day. In 1999, a relative introduced her to The Aids Support Organisation (TASO).

‘’At first I was hesitant. I did not want anybody to know I had AIDS. I thought it was embarrassing. People would despise me,” she recalls. But after falling ill more than often, Kityo swallowed her ‘pride’. Today, she is a member of TASO, a non-governmental organisation, founded in 1987 by a group of 16 volunteers to support people living with HIV/AIDS.

TASO, with 67,000 members, contributes to a process of restoring hope and improving the quality of life of persons and communities affected by the disease. It has centres in major cities like Kampala, Entebbe, Jinja, Tororo, Mbale, Masaka, Mbarara and Arua. Kityo is at the Masaka branch, 120 kilometres south of the capital Kampala.

‘’I am happy that I declared my HIV status early. I have received counselling and I think I can be useful to my family and community for a long time,” she says.

Kityo is not alone. While an estimated 2.2 million people have the virus, the disease continues to chew through society, affecting all sectors and communities across Uganda.

Around 1.4 million people are currently estimated to be living with HIV/AIDS and over 1.7 million children orphaned by the disease, says a 2002 report by the Ministry of Health.

The first HIV/AIDS cases were identified along the shores of Lake Victoria in Rakai district, Southern Uganda, in 1982.

By then, the mysterious disease, was dubbed ‘slim’ because of the effect it had on the victim. As many succumbed to the virus, others blamed witchcraft and sought the treatment of traditional herbalists and witchdoctors.

The disease found the Ugandan society off guard with inadequate health infrastructure and facilities, lack of regular check-ups, and very low doctor-to-patient ratio.

In 1986, Uganda’s Minister of Health announced the existence of HIV/AIDS in the East African country at the World Health Organisation (WHO) meeting in Geneva.

President Yoweri Museveni came out and openly declared war on AIDS, leading to the establishment of Uganda AIDS Commission (UAC), set up under an act of parliament, with the President himself being the first chairperson. Today, it is the body that co-ordinates all other stakeholders in the fight against HIV/AIDS.

UAC spokesperson, James Kigozi, says more than 700 NGOs, including religious groups, schools and traditional healers, work with the commission.

These groups are financed through the Uganda HIV/AIDS Control Project, with a 450-million-U.S.-dollar loan from the World Bank.

Every player at national, district, community level, as well as 19 government ministries like health, education, finance and agriculture also benefit from the loan.

In Uganda, HIV/AIDS has created a lot of challenges. The capital Kampala, for example, has problems of sex workers, beggars and street children – all offshoot of the HIV/AIDS pandemic.

As a result, Uganda has discovered that the fight against HIV/AIDS cannot be fought single-handedly.

‘’One thing about the fights against HIV is that nobody can do it single-handedly and claim they have done so well. What we have learnt through our experiences is that the struggle against HIV/AIDS is a partnership. You put in your part, so does someone else and then the government does the same,” says Kigozi.

There is no single HIV/AIDS problem, which has been solved, or one particular benefit, which has been achieved by only one organisation, says Kigozi.

‘’Also, we have been able to harness and exploit the goodwill of the government who are really committed to the struggle,” he says.

‘’Uganda has been lucky in that we have been open and able to control (the spread of HIV/AIDS) and we have been able to provide resources,” says Kigozi.

The first lady, Janet Museveni established in the Uganda Women’s Effort to Save Orphans (UWESO) an organisation that cares for HIV/AIDS orphans.

‘’When our government came on the scene, we decided to resort to the loudest method of spreading an alarm to the people. We gathered all the possible information there was on AIDS virus. We worked with doctors and other experts from other parts of the world to get a general picture of what we were dealing with both medically and scientifically,” President Museveni said during a recent speech about the on-going struggle against AIDS in Uganda.

‘’We also realised that in the absence of either a cure or a vaccine, it was our duty to protect those who were free of the disease by scaring them about the disease and its consequencesà Although the initial response was largely resistance, many of our people have come to appreciate it today,” he said.

Museveni has won two international awards in recognition for his fight against the disease.

‘’We have repeatedly advised our people on the importance of behavioural change, abstinence from sex, use of condoms and fidelity in marriage,” said Museveni.

UAC director, Dr. David Kihumuro Apuuli, says the government pursues a policy of openness and non-discrimination against people living with HIV/AIDS. As a result, the latest records show that the rate of prevalence has gradually fallen from a national average of 30 percent in the 1992 to about six percent today, the lowest in the sub-Saharan region.

‘’Government is committed to reducing these figures even further. This will be achieved through scaling HIV/AIDS programmes and greater involvement of people living with HIV/AIDS,” he says.

The openness about HIV/AIDS started in 1989 when a Ugandan artist based in Sweden, Philly Lutaaya, came up and openly proclaimed his HIV status. Because it was taboo for people to talk about sex, and declare, their HIV status, many thought Lutaaya was just seeking popularity and trying to make some capital out of it.

However, his was one of the moves that brought up the concept of fighting HIV/AIDS with openness.

Now several local artists, HIV-positive or not, have joined the campaign, using music to send the message across. Concerts are staged with the support of NGOs like African Youth Alliance (AYA) as well as the Ministry of Health.

The social and economic costs of the disease have been high for a developing country like Uganda.

The disease has had a negative impact on the young people who are now recognised as a high priority in Uganda’s HIV/AIDS National Strategic Fund (NSF) and the draft National Youth Policy. Since it was realised that their vulnerability to HIV/AIDS is particularly aggravated by lack of sex education and thus not morally equipped, a national strategic plan was called for at the beginning of 2002 by President Museveni to improve communication about HIV/AIDS. The aim was that teachers addressed the problem in school right from primary level.

Now Uganda’s near success story has led the country to international recognition and benefit from the falling prices of the Anti-retroviral drugs, that three years ago cost close to 700 U.S. dollars per month. Today it has fallen to between 41 U.S. dollars and 36 U.S. dollars per month. The cost of testing for HIV/AIDS fell from an estimated 150 U.S. dollars to just 10 U.S. dollars.

Condom use has also increased, as they are easily accessible and affordable. HIV prevalence in pregnant women in urban areas has fallen for eight years in a row from a high of 29.5 percent in 1992 to 11.5 in 2000, a UNAIDS/WHO report says. This is due to the heavy focus on the Information, Education and Communication (IEC) approach, as well as the decentralisation programmes that reach down to the villages.

In Masindi, western Uganda, and Palisa, eastern Uganda, for instance, common use of condoms with casual partners in 1997-2000 rose from 42 percent and 31 percent to 51 percent and 53 percent, respectively.

In the capital Kampala, it was reported that almost 98 percent of the sex workers surveyed in 2000 said they had used a condom the last time they had sex.

‘’Our commitment to fight AIDS is total and irrevocable. We are convinced that the war against AIDS is winnable, given the will to do so. Therefore, we in Uganda are determined to win it,” said President Museveni.

But, while Uganda may have won a few battles, the war against the disease continues.

That war includes a plan by the Ministry of Health to provide free AIDS drugs (Niverapine) to all expectant mothers to reduce the risks of infection at birth.

Recalling the difficult days, Kityo, who is now involved in enlightenment campaigns, says ‘’it had been tough.”

 
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Africa, Development & Aid, Headlines, Health

HEALTH-UGANDA: Success Story, Fighting HIV/AIDS

Evelyn Kiapi Matsamura

MASAKA, Uganda, Dec 20 2002 (IPS) - About six years ago Rosemary Kityo, 31, discovered that she was HIV-positive. Her husband, Yowasi Kityo, had already succumbed to the disease, after a long illness.
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