Health

Mothers Deserve Better: m-Health And e-Health Must Feature In This AU Summit.

maureen — Fri, 02 Jul 2010 13:50:16 +0200

Prior to the summit, an African Youth forum with the theme “Maternal Infant and Child health: African Youth call for Action” will be held at the Imperial botanical beach hotel in Entebbe from 17th to 19th July 2010. This is a very good initiative by the African governments to involve young people in matters that will affect their future.

Uganda, like many African nations has limited resources in terms of man power and health facilities to enable her provide quality health services for mothers, infants and children. According to the report by Population Action International which based its figures from the Uganda National Health Policy, “supplies and medicines may either be unavailable where they are affordable or unaffordable where they are available”. This prevents low-income women from accessing basic medicines due to the high cost of purchasing drugs from private pharmacies. Worldwide over 350,000 women die due to preventable causes during pregnancy and childbirth.

The main causes are bleeding, infections, abortions and obstructed labour among others. The majority of women who die during or as a result of child birth are low-income earners from marginalized groups. Despite advancement and availability of technology interventions to save mothers and babies, maternal deaths have continued with 99% of deaths in developing countries of Africa and Asia.

As the African heads of state and leaders meet in this 15th AU summit, it is important for them to focus on issues of violence, human rights, education and poverty which are some of the key underlying causes of maternal and infant mortality. They must also not forget to intensively discuss the role Information and communication technologies (ICTs) play in preventing mortality and come up with feasible solutions on how different governments can tap into this potential of ICTs. With an increasing range of devices for communicating and disseminating information, Mobile and electronic health applications are very powerful tools in solving a number of health related problems. These include; sharing information on health related issues, monitoring treatment of patients as well as monitoring health workers. Given the fact that mobile phones cut across literacy levels and have been adopted by many women in rural areas all over Africa, it is important for the African governments to invest in mobile technology and e-health Applications.

The Ugandan ministry of health should partner with Organisations/ institutions like Text-to-change, Mobile Monday Kampala, Faculty of CIT at MUK, SMS media, UNICEF and Women of Uganda Network(WOUGNET) through her SMS campaigns to tap into the potential of mobile and electronic application as a starting point in solving the problem of high maternal deaths.

If the Millenium development Goal of reducing deaths for newborns and children is to be achieved within the remaining five years, our leaders have to “WALK THE TALK” in the upcoming government leaders meetings like the African Union (AU)- July in Kampala and the G8 summit-September in Canada.

The writer is a trained Citizen journalist and an Information Officer with Women of Uganda Network (WOUGNET)

Foot And Mouth Disease

mercy — Fri, 25 Jun 2010 10:48:05 +0200

Locally known as Omolomol in luo language, the disease is rampant in many parts of the world, including Uganda.It affects cattle, goats, sheep and other hoofed animals. It is highly contagious, but rarely affects human beings.

Symptoms include high fever, blisters inside an animal’s mouth, excessive saliva secretion and ruptures and blisters on the hooves. The animal also drools instead of eating.

The incubation period is two to three days and can be fatal. Many times, the affected animals are culled or slaughtered.

African trypanosomosis
It is referred to as nagana in cattle and sleeping sickness in human beings. It is caused by the trypanosomes parasite, transmitted by tsetse flies which thrive in savannah grasslands in low lying areas. In Uganda, the most affected areas are Busoga, Teso and West Nile.

The affected animal suffers from fever and general body weakness and stops feeding. This results in weight loss and anaemia. If the animal is producing milk, the amounts reduce and finally disappear. If not treated, the disease is fatal.

Anthrax
It is an acute bacterial disease that commonly infects wild and domesticated herbivorous (plant-eating) mammals. It is more acute in cattle, sheep and goats. By the time an animal displays the symptoms, the disease is in an advanced stage.

It kills within three to five days. It has been known to kill animals in large numbers. It does not spread directly from one infected animal or person to another. It spreads through spores.

Domestic herbivores contract it from water, pasture, or from the carcass of animals that died of the disease. An infected animal is identified by staggering, trembling, convulsions, bleeding from the body openings, confusion and fever.

Dead animals must be quickly disposed of by burning or burying inside a deep grave to prevent resurfacing of spores or soaked in formaldehyde to kill the spores.

Vaccination is the best weapon against anthrax. It can be acquired from veterinary offices all over. However, it should only be carried out in affected areas. If a farmer identifies the symptoms, he must report to a veterinary officer.

By: Mercy L. Apio

Team Leader

Kubere Information Centre – Apac

Email:mlapio@wougnet.org/kicinfo@wougnet.org

Second test of HIV vaccine in pipeline.

pmlay — Mon, 10 May 2010 13:20:27 +0200

Tanzania will soon embark on the second phase of a pilot project of HIV vaccine conducted by the Mbeya Medical Research Programme (MMRP).

The programme’s director Dr Leonard Maboko said on Friday that the project, which is being funded by the government of Sweden, would be implemented in Mbeya and Dar es Salaam regions involving 120 people.

“The vaccine known as ‘TaMoVac-1’ will be tested on 120 people, including 60 from Mbeya and 60 from Dar es Salaam,” he said, adding that results of the trial vaccination exercise would be announced after six months.

He informed that drugs for the vaccine were prepared in the United States and Sweden and had passed through all safety measures and legal procedures before they were endorsed for testing on human beings.

Dr Maboko noted that the tests would be conducted on people who volunteer themselves, adding eligibility for those wishing to undergo the test include living in a particular region for 24 months and being of between 18 and 40 years of age.

Other criteria are; proven sound health, being HIV negative and living in an environment likely to get him or her infected with the virus.

According to Dr Maboko, volunteers to the project must be ready to take thumbprints on special forms filled in by participants, indicate where they live and must be ready to assist researchers; including letting them pay home visits any time.

He further said that the volunteers would be informed about all important matters concerning the vaccine and given ample time to answer questions to be aware of all facts surrounding the exercise before being vaccinated, adding that the volunteers have the right to withdraw from the exercise any time without conditions.

He stressed that the volunteer would be required to attend clinic 19 times over a period of two years at the MMRP centre.

Dr Maboko said volunteers to the vaccination would be given an allowance of 15,000/- for those residing in Mbeya and 20,000/- for Dar es Salaam residents.

Giving details on how the vaccination would be administered, he said the drug would be injected on the shoulder by using special tools.

However, he said the vaccine was not expected to cause any harm to the volunteers, but if they experience any complication, they should report immediately at the center for check up.

Regarding Mozambique, which is implementing a similar project along with Tanzania, Dr Maboko said that there would be no volunteers on this phase, noting that there would be a series of capacity building workshops as part of the project.

Mef clinic to get drug boost

mwiinga — Wed, 24 Feb 2010 18:28:35 +0200

Mindolo Ecumenical Foundation (MEF) director, Rev Reuben Daka, has revealed that the clinic will this year experience fewer drug shortages, compared to last year. Rev Daka said this on Friday 22nd January, during a two-hour orientation talk with first year students.

“Last year we experienced a lot of medicine shortages at the clinic because we had miscalculated the required number of drugs against the student populace. When we enrolled the first Zambian-based students last year, we overlooked the need to accurately calculate how much medical fees they could have paid,” he said.

Rev Daka affirmed that this year the MEF clinic would experience fewer drug shortages because it had signed an agreement with the Churches Health Association of Zambia (CHAZ) to assist the clinic with medical supplies.

Meanwhile, project assistant officer, Mr Jonathan Mwape, has revealed that CHAZ wants to build the capacity of the MEF clinic by opening up a Voluntary Counselling and Testing centre (VCT), putting up computers, stocking test kits and training peer educators to inform the community about HIV/AIDS. He said it would be easy for people within MEF and surrounding areas to access VCT services, anti-retroviral therapy and treatment for sexual transmitted infections.

Mr Mwape added that MEF, under the Global Aids Fund, had successfully implemented behavioural change communication to 12,800 people in various project sites. “MEF has successfully managed to reach target populations as prescribed to us by CHAZ and Global Aids Fund round one and two,” he said.

CHAZ is an organisation which funds faith-based organisations. MEF has been in partnership with CHAZ for eight years now.

By Agness Lubinda Mulonga and staff members

OUT Launches "Know Your Status Day"

nthateng — Thu, 18 Feb 2010 15:25:40 +0200

While South Africa remains one of the countries with highest HIV prevalence rates, gay rights organisations are doing their bit to curb the spread of the syndrome and to ensure that people know their statuses.

OUT LGBT Well-being, a gay health rights organisation in Pretoria, has initiated a campaign called “Know Your Status Day”, which it hopes will effectively respond to the HIV/AIDS pandemic.

The aim of “Know Your Status Day” is to increase the need for people to go for regular HIV testing, says OUT. “Although we are targeting lesbians, gays, bisexuals, and transgender (LGBT) people, the day is aimed at promoting HIV/AIDS testing across identities, so we will not turn heterosexual clients away”, said Elmie Munday, Prism HIV and STI nurse at OUT LGBT Well-being.

“Know Your Status Day” is a monthly event.

Statistics show that currently, South Africa has the largest population living with the disease, with more than 5 million people infected. According to UNAIDS, people fail to get tested for HIV because of various reasons such as fear of stigma and discrimination, and Munday thinks educating mainstream service-providers will go a long way.

“The LGBTI community still experiences stigma issues regarding their sexual preferences. If you were to be HIV positive and gay or lesbian, you would experience double the stigma. The way forward is be to make service-providers LGBTI sensitive by means of giving sensitisation workshops and marketing services as LGBTI friendly”, she concluded.

For more information about the “Know Your Status Day”, visit www.out.org.za

Article by: Mongezi Mhlongo (Behind The Mask Senior Reporter)

Provide condoms to inmates, says top Zambian prison officer

Mumba — Thu, 18 Feb 2010 11:02:55 +0200

The director of the newly-established prison medical directorate in Zambia, Deputy Prison Commissioner, Dr Chisela Chileshe, has urged the prison command in Zambia to start providing condoms to inmates in Zambian prisons to avert the escalating prevalence of HIV infections.

Speaking during a consultative workshop held between senior prison officers and human rights advocates from the Human Rights Watch at the prison headquarters in Kabwe last weekend, Dr Chileshe disclosed that the HIV prevalence rate amongst inmates in Zambian prisons is almost twice that of the outside community.

He said that HIV prevalence rates for the vulnerable and marginalised prison inmates now accounts for 27 percent as compared to 14 percent for the outside community. He attributed the rising prevalence of HIV infections to sodomy that he said had become very prevalent in most correctional facilities in the country.

"I really shed tears when am attending to sickly prison inmates, most of whom are in the advanced stage of their HIV infection with very low CD4 counts, yet they have been unable to access antiretroviral treatment despite opportunistic infections seriously manifesting themselves," explained Dr Chileshe.

He said that most of the juvenile delinquents who are awaiting trial were sharing the same cell with adult convicts, a situation that exposed them to high risks of exposure to sodomy.

The consultative meeting was chaired by the prisons commissioner for the Zambia Prisons Service, Gibby Nawa, and the entire top hierarchy of the prisons command in Zambia.

Human rights advocates from the US-based Human Rights Watch are in the country on a three-week research trip, to investigate the welfare and human rights issues facing prison inmates in the country. The research team includes a human rights advocate from the AIDS and Rights Alliance for Southern Africa (ARASA),who also are the sponsors of the research.

The team also includes representatives from the Prisons Care and Counselling Association (PRISCCA), a prisons based civil society organisation working to improve the well-being of inmates in Zambia and the author, who is a human rights activist under ARASA. Among the six prisons to be visited is Mukobeko Maximum Security Prison, that holds 320 inmates on death row and 471 serving life imprisonment.

Zambia to increase funding to AIDS programmes

Mumba — Wed, 17 Feb 2010 17:19:30 +0200

A Cabinet Committee of Ministers on HIV and AIDS has made a declaration of commitment to increase internal funding to HIV and AIDS programmes in Zambia.

In a communiqué issued in Lusaka recently, the Cabinet Committee of Zambian Ministers on HIV and AIDS stressed that the Zambian Government has realized the need for home grown solutions to the threat of the epidemic on the productive lives of its citizenry. This includes internal finances to support national AIDS programmes in order to increase the sustainability of interventions which are currently dominated by external doctors.

Among the commitments suggested include the need to scale up prevention measures, further interrogation of research findings, financing the response, and implementation of the Decentralisation Policy.

In the first commitment the Ministers noted that whilst appreciating the policy for universal access to antiretroviral treatment (ART), the cost of providing free antiretroviral drugs to those in need has become costly due to the global economic meltdown which has affected contributions coming from cooperating partners.

“Therefore the Cabinet Committee of Ministers on HIV and AIDS commit themselves to scaling up on prevention measures which are less costly and which would contribute greatly to the response, such as scaling up male circumcision and reducing multiple and concurrent sexual partnerships.”

While considerable effort has been made in research on the response, there is need for further interrogation of research on the relationship between poverty and HIV and AIDS.

It was also agreed that the current situation of relying heavily on donor funding is unsustainable. In the light of this, the Ministers agreed to work on ways to broaden the funding base, including greater funding from government coffers, as well as looking at creative ways to develop a sustainable funding mechanism.

The Cabinet Ministers also agreed on the need to rapidly implement the Decentralisation Policy as a means to rapidly scale up the multi-sectoral response to HIV and AIDS. They said they felt compelled to fully engage themselves and their Ministries to address the current needs in the national response to HIV and AIDS.

MoH bans microbicide clinical trials

Esnart — Wed, 17 Feb 2010 16:57:24 +0200

The Ministry of Health has banned all microbicide clinical trials in Zambia. This is according to a letter dated December 29, 2009, addressed to a Dr J. Stringer -- an official at the Centre for Disease Research, written and signed by health permanent secretary, Dr Velepi Mtonga.

Dr Mtonga stated that the ministry would not approve any clinical trials until such a time that safer and more efficacious methods were available. This means the embattled Microbicide Development Programme (MDP) in Mazabuka has suffered a major setback following the ban. Dr Mtonga cited the findings of the HPTN 035 where the gels were found to be about 70 per cent ineffective in reducing the risk of HIV infections.

Dr Mtonga further stated that the recent findings from the PRO 2000 whose results were released in December last year, had also proved to be very risky to trial participants. The ban by the Ministry of Health follows a request by Dr Stringer to conduct a study for MTN 003 phase 2 B safety and effectiveness of Tenofovir 1 per cent gel which is an ARV-based microbicide.

Mazabuka MDP Project coordinator, Rose Kasonde, refused to comment particularly on the disapproval by government to give authority to her organisation to conduct a test of the ARV-based microbicide in Lubombo area in chief Naluama’s area.

Dr Kasonde told ZANIS in Mazabuka yesterday, she was not aware of the disapproval because her office had not yet received a letter from the Ministry of Health. But Mazabuka district medical officer, Keith Mweebo confirmed receipt of a letter from the health permanent secretary, disapproving and banning all microbicide clinical trials in the country.

Dr Mweebo said MDP management should be honest enough and tell the truth because they were written to, through the Centre for Disease Research in Zambia. The letter is also copied to UNZA Research Ethics Committee and the director Pharmaceutical Regulatory Authority.

Zambia risks extinction of adult population to AIDS

Mumba — Wed, 03 Feb 2010 15:54:45 +0200

ZAMBIA has become one of the seven countries worldwide, most seriously affected countries by HIV. This is according to the recently released Zambia Demographic and Health Survey statistics.
According to the final report released by the Zambia National HIV/AIDS/STI/TB Council, approximately 82,681 of the entire adult population in the age group of 15 to 49 years became newly infected with HIV in the year 2009 alone, despite the availability of information and free distribution of condoms in public health centers countrywide.
The report was released through the Zambian Ministry of Health and the statistics have been confirmed by UNAIDS and the Global HIV/AIDS Program (GHAP) on funding from the World Bank.
Entitled “Zambia HIV Prevention Response and Modes of Transmission Analysis,” the report further revealed that in the country of 12.5 million inhabitants whose overall adult prevalence rate stands at 14 percent, almost 1.6 percent of the adult population becomes newly infected each year. Furthermore of the next 100 new infections, 71 are estimated to arise through sex with non-regular partners.
The increasing HIV prevalence rate amongst adults has proven to be tenacious despite significant decreases in some populations and in some geographic areas that have so far led Zambia’s HIV epidemic to stabilize at high levels. However, HIV continues to infect many Zambians and most of those who are infected do not even know their status. Fewer than 20 percent have so far undergone an HIV test -- a large number of them being expecting mothers through ante-natal clinics.
Twenty-one percent of new infections are estimated to occur in people who report that they have only one sexual partner. This signals significant HIV risk even for those who are faithful, given the large number of couples in which one person is HIV positive. Low levels of male circumcision in most of the country, still inadequate condom use (female condoms in particular), and a range of social norms increase risk and help drive Zambia’s varied epidemic.
Significantly higher prevalence was also found in women often spending the night away from home compared to women staying at home; men and women with higher education compared to those with no or little school education; urban couples compared to rural couples; and couples with large age gaps compared to couples with partners of similar ages.
On other sources of new infections contributing to transmission other than heterosexual, are is probably not a main contributor to annual HIV incidence. The analysis noted that unprotected anal sex is also practiced by Zambian male and female adolescents.
The Treatment Advocacy and Literacy Campaign (TALC) in collaboration with partners such as the Prisons Care and Counselling Association (PRISCCA) are seriously advocating to ensure that men who have sex with men have equal and affordable access to Antiretroviral Therapy (ART) services without any prejudices or stigma from the community, breach of confidentiality from health care workers or restrictions and violation of their human rights from law enforcement agents.
Despite such threatening statistics however, Zambia is seeing the benefits of rapid scaling-up of Prevention of Mother-to-Child transmission of HIV (PMTCT) and ART, safe blood supply, and Behaviour Change Communication (BCC) that appears to be showing results in some groups (notably more educated men and women in urban areas, and young women attending antenatal care).
But much more effective efforts are needed with regards to multiple and concurrent partners, transactional and inter-generational sex, and discordant couples in order to reduce incidence. Zambia’s very rapid scale-up of ARV treatment is also an opportunity for concerted “prevention with positives”. Rapid rolling-out of male circumcision (with careful counseling and information) to act on Zambia’s stated commitment has also become a priority, with long queues of adults being seen waiting to register outside male circumcision clinics. In some, there's a three-month waiting list!
To improve the prevention response in Zambia, the country needs to prioritize and target evidence-based programmes for specific populations that will avert the highest number of new infections over the shortest period of time; implement programmes sustainably to excellent quality and equity; and measure rigorously to determine programme effectiveness and efficiency.

Safer sex for soccer fans and sex workers

lufeyo — Wed, 09 Dec 2009 08:10:28 +0200

With only six months until South Africa hosts the 2010 FIFA World Cup, the nettlesome question of how to deal with sex workers looms. "There are actually almost no sex work programmes in place at the moment," said Marlise Richter, a sex work researcher and member of the South African National AIDS Council (SANAC). She was speaking at a recent consultation in Cape Town on HIV, sex work and the World Cup.

"If we look at healthcare-specific programmes [for sex workers], there's very little, and this is what we should be doing in terms of the National Strategic Plan [on AIDS], ” Richter said.

Public health and human rights experts fear a potential disaster in the combination of a criminalised sex trade, one of the world's highest HIV infection rates, and the arrival of an expected 450,000 soccer fans.

The consultation, co-sponsored by the Sex Workers Education and Advocacy Taskforce (SWEAT) and SANAC, brought together civil society, government, and other key players to discuss the potential impact of the World Cup on the local population, with a particular focus on developing strategies to address HIV risk in the context of sex work.

Among the draft recommendations that emerged from the two-day meeting were the need for human rights training, public health messages specific to sex work, a government directive to end police harassment of sex workers, and a moratorium on arrests of sex workers during the event.

The point was also made that safer sex campaigns should target not only sex workers, but also their clients, non-paying partners, and the general public. The German "Fair Play" campaign, which ran during the 2006 World Cup, was cited as a good example because it increased condom distribution and started targeting sex workers and their clients with messages about safe sex more than a year before the kick-off.

According to the recommendations, the South African campaign should include the distribution of male and female condoms packaged with a soccer logo and lubricant. Coasters printed with the message: "Don't leave this bar without picking up a condom", could also be placed in bars and pubs where soccer will be watched.

The Young Face of HIV/AIDS

loycek — Wed, 02 Dec 2009 11:26:28 +0200

Nora Nabanoba (not her real names) walked into my office, greeted me in a local language, and asked me how we help women. She narrated the story of how she came to Kampala. “I finished primary seven and because my parents were poor, I could not afford to join secondary school. Our neighbour had a daughter who was working in Kampala and she decided to take me to look for work in Kampala,” Nora said.

When she reached Kampala, things were different. The person who brought her to Kampala never assisted her as she had promised, and instead took her to her home to become her maid without paying her. Nora said that after working for along time without pay, she decided to escape and look for work somewhere else. She found a job and started working as a house maid, earning a small wage.

Two years later, a friend brought her a man whom she agreed to marry. Norah reveals to me she decided to marry the man because he had sofa set in his one-roomed house, which they did not have in her home. They stayed together for a few years and had a baby. Eve became suspicious when the baby and her husband begun falling sick so often. Later on the baby died, and after the death of her baby she decided to take a bold step and go for an HIV test. The results came out positive. “I felt like my life was ending there and then,” Nora said.

Finally, she had to come to terms with the reality of her situation. When she told her husband about her HIV status, the husband started abusing her, beating her and accusing her of infecting him. Little did Nora know that her husband had many other sexual partners. The husband became critically ill and was admitted to hospital, and then recovered.

Nora got pregnant again and had another baby. Since she knew her HIV status, she never breast fed baby and the baby is HIV negative. When her baby was three months old, her husband abandoned her. She was not working, and yet she had to feed her baby with milk since she was not breast feeding. “I reached a time when I was giving my baby water only because I did not have any money to buy milk -- not even food for myself,” Nora said.

Nora is now on ARVs and is temporarily staying with her friend. Given the costs of living here in Kampala she feels she is a burden to her friend. She is not working.

Nora’s story is no different from that of many women and young girls who come to Kampala to look for jobs in the city, only to end up in terrible circumstances. People come to them promising a good life and they have ended up in such situations or even worse.

General

Take Responsibility Against AIDS- SANAC On World AIDS Day

nthateng — Tue, 01 Dec 2009 16:33:56 +0200

SOUTH AFRICA: As the nation gathers at the Pretoria show grounds today for President Jacob Zuma’s World AIDS Day address, LGBTI organisations country-wide are doing their bit to commemorate this day, raising awareness about the pandemic that has claimed an estimated 25 million lives worldwide.

Themed, “I am responsible. We are responsible. South Africa is taking responsibility,” today will be marked by various activities and gatherings throughout the world.

OUT-LGBT Wellbeing will commemorate World AIDS Day by providing free HIV testing at its VCT clinic in Pretoria. “The tests will be confidential and free, performed by our warm and friendly professional staff from 10:00 until 19:00,” Elmie Munday, a Clinic nurse for OUT LGTB Well-Being said.

OUT will also set up a testing area at Club Legends on 5 December 2009, where all participants that test for HIV before 9 pm will get free entry, and those that test after 9 pm will receive a voucher that can buy them a free drink.

“HIV/AIDS is not a death sentence, therefore each one of us has to take up the responsibility to get tested and eliminate the transmission of HIV,” said Munday. Talking specifically about today, Munday said “the significance of World AIDS Day is to acknowledge the fight against HIV. We also acknowledge those who lost the fight against HIV, as well as the loss their families have experienced.”

Junaid Seedat, Communication, Advocacy and Campaigns Manager of the South African National Aids Council said individuals should take responsibility for their own health, life and the people in their lives. “In so doing you are protecting yourself,” Seedat said.

According to UNAIDS there are more than 33.4 million people living with HIV in the world.
Furthermore in 2008, 2.7 million people became infected with the virus and an estimated 2 million people died from AIDS. And around half of these people became infected with HIV before the age of 25 and died from of AIDS before the age of 35.

Meanwhile the national Minister of Health in South Africa, Aaron Motsoaledi ,recently revealed the shocking numbers of HIV/AIDS deaths in the country, vowing to implement measures to respond to the pandemic.

On the other hand, the Congress of South African Trade Unions (COSATU) has called on former president Thabo Mbeki to apologise for his failure to respond to HIV and AIDS effectively during his term of office. This after COSATU called for the former president to be charged with genocide, for the alleged failure.

Article by: Mongezi Mhlongo (Behind The Mask Senior Reporter)

My first time to hear about HIV / AIDS in Kagera region

Kamala — Tue, 01 Dec 2009 12:48:19 +0200

It's clearly known and believed that, in Tanzania, the first person with HIV/ AIDS was found in Kagera region in 1983. Being a Tanzanian young man, born and brought up in Kagera, I believe I was among the first few young boys to hear, read, know and be threatened by this new and frightening disease. As a young boy, I started to be aware of the disease in the 1988, when I was about 7 years old, when I started at my nursery school in our local church in Bugandika ward in Misenyi district -- formerly called Bukoba Vijijini district.

My Christian nursery school teacher, the late evangelist William Bakobi, started to feed his class with information about the occurrence of the disease. He warned that once one is infected, it cannot be cured and no vaccination for it. He told us it spreads through sexual intercourse, surgery and wounded bodies.

That was my first day to officially hear about the pandemic, at that young age. It was a time when preachers in many churches talked a lot about it, with bigger voices, which proved to frighten the congregation.

Kagera region’s community, mainly the Wahaya people, received the new disease by giving it several names. At first it was named Juliana. Juliana, was a name for what at that time was a fashionable piece of women’s clothing (ling blinking gown). The name meant that it looks smart like the gown but inside, it’s a killer. Later the name changed to the Haya word, “bakuntumile” which meant, “I am sent to take you and you have no objection, we have to go”. This name was chosen, after the Hava community had experienced many, many deaths caused by HIV/AIDS.

Strange with names especially when naming new troubles, Kagera residents continually adopted new names to fit the disease. It was now called, “silimu”. Silimu is the Haya pronunciation for the English word, “slim”, which means thin, slight and an opposite of the word fat. This was after realising that every AIDS patient became slim before dying.

In 1993, when I was a Standard Four student, our science teacher taught my class about HIV and AIDS. It was my first time to learn that HIV stands for Human Immunodeficiency Virus and AIDS stands for Acquired Immune Deficiency Syndrome. These were difficult long words for a Swahili student from the village to memorise, and even to mention.

But the Swahili word that was easy for village student to use to refer to HIV was now introduced to us. It was UKIMWI which abbreviates “Upungufu/ukosefu wa kinga mwilini”. Education was given and to us on how the disease infects and affects, how to avoid it. and that it’s not easy to identify anyone infected by HIV since many of us thought that every thin person, is infected and a fat person is not. This was of course, incorrect.

We read a booklet, on HIV/AIDS, but it did not state clearly the source and where the pandemic originated. That booklet stated that Tanzanians said that, it came from Uganda while some Ugandans claimed that it came from Tanzania. Moreover, the booklet stated that some Europeans claimed that HIV came from Africa while some Africans claimed that it came from Europe.

At many gatherings in our village, local people discussed about the pandemic and believed that its source was Europe where people were having sex with animals. Religious leaders didn’t refrain from blaming human beings for sinning against almighty God who, they said, was now angry and had decided to show his hate to human beings. They said that the only way was to turn back and re-obey Gods laws, even though later some of these religious leaders were lost through the same pandemic.

It was at this time that funerals became the song of the day. Witch doctors and traditional healers did not escape, either. Some of them were infected through blood contamination due to their healing practices, in which some used razor blades and other sharp equipment which exposed them to the infection.

The situation was terrible: people were dying like they had come into the world wrongly. Everyone had to share the consequences of HIV. It was at this time when various phrases and sayings arose among the Haya community. One artist sang that people are dying like grasses. My grandmother used to say that AIDS is like a punishment for giving birth, given that it mostly killed young people.

I remember a story from Mr Nyonyi, from Kanyigo ward – a ward which had many deaths and victims compared to other parts of a region – who gave a testimony about a family which had 10 children. Seven of them were already dead, while between the remaining three, one was sick and the other 2 seemed to keep on getting weaker.

The grandmother and grand father had to take care of the family. The new grandchildren remaining behind had to be taken care of. Some of these grandchildren were born infected or acquired the virus through breast feeding. There was also danger of new infections for these kids who had to share sharp equipment like razor blades.

It was at this time when a ship had to sail with various dead bodies from up-country for burials in the deceased’s local villages. It was this time when many people came from up-country to their homes direct to bed – until the time of entering the four squared hole. In my simple understanding, it was as if in every five families at least one had a victim who would pass away at any time.

Plastic water basins became new link between the toilet and victim’s beds.

In 1991, we heard good news concerning the coming of a new saviour. This was not the return of Jesus Christ, not him at all, but a man similar to him. It was a man called Philip, a French man, coming under the umbrella of an NGO called “Partage Tanzanie” – a French name meaning, “let’s share what we have”. He came to redeem the orphaned families. This man came at the right time in right place; his work for the orphan was recognisable. He paid school fees for orphans, bought them new shoes, clothes and assured them of at least three meals a day.

Many orphans changed. They looked great with happy faces, even if they were coming from homes surrounded by graves, still they looked overwhelmingly happier.

Partage was forced to offer meals, clothing and other things to all children in schools since those non-orphaned, expressed their jealousy towards the orphans who looked better than they did. There was fear that they might poison their parents, as some were heard saying, what if my dad died, couldn’t I be like these orphans under Partage?

In 1998, when I was a secondary school student, the pandemic proved its cruelty to me by taking away my beloved Daddy. I had no way to deal with it, other than crying and mourning.

Many Tanzanians where lost because of the mistaken idea that HIV/AIDS was a special disease for the Haya tribe and forgot to take precautions.

It is only now that infection has decreased a bit in Kagera region, while shifting to some of the northern and southern parts of the country. It’s not easy for me to prove that infection has decreased in Kagera region or that it is now higher in other parts of the country than in Kagera region. But I remember hearing one person from the USA saying that at least people are more available in Bukoba town than in the past few years – lamenting that, if infection hadn’t decreased, Bukoba town would have been totally empty.

HIV, the very same disease, has brought a memorable date to our calendars, to have us mark every 1st December to be an important day. All ways and means of fighting it seem to be useless, since it seems to win the battle against us through the raising of new infections. Nothing seems to bully it.

Kamala Lutatinisibwa jlkamala@yahoo.com

This piece is a personal reflection by Kamala Lutatinisibwa, expressing his own memories, reflections and feelings about HIV/Aids. Please remember that condoms ARE effective in preventing infection, and treatment with ARVs can keep HIV-positive people alive for many, many years. The situation is not at all hopeless, but we do all need to keep practising safe sex and abandoning risky behaviour.

Community News

Global Recession Results in ART Interruptions

Mumba — Sun, 29 Nov 2009 12:45:39 +0200

The lives of close to two million people living with HIV infection worldwide could be under threat because of interruptions in their anti-retroviral treatment resulting from the current economic crisis, a World Bank report has revealed.

Africa will be the worst affected out of 22 countries which will face hurdles in providing antiretroviral drugs this year. The report also found that eight countries currently face antiretroviral drug shortages or other treatment disruptions.

Only one third of HIV-positive people in need of antiretroviral therapy (ART) have access to treatment in Africa. The report examined the effect of the economic crisis on 69 of the most impoverished countries worldwide, and found that 15 believed they were “highly exposed" to the risk of antiretroviral treatment interruption because of decreases in domestic and foreign funding.

According to the report, because governments are hesitant to stop treatment for HIV-positive people already receiving antiretroviral drugs (ARVs), prevention programmes could be cut even more. The report found that 34 countries, which represent three-quarters of HIV-positive people worldwide, said they anticipate prevention programs aimed at high-risk groups to be negatively affected.

Joy Phumaphi, the World Bank's vice president for human development, said, "This new report shows that people with AIDS could be in danger of losing their place in the lifeboat. The global economic downturn has taken a wrecking ball to growth and development in the developing world."

The World Bank has said that requests for funding from developing countries for its current fiscal year have more than tripled, compared with one year before. Up until the end of the current fiscal year on June 30th, the World Bank expects to authorize $3.1 billion for health, compared with $1 billion during the same period last year. Jon Liden of the Global Fund to Fight AIDS, Tuberculosis and Malaria said, "Everybody knew that once started, a continuous supply of commodities was a lifelong pledge. We are talking about a set of global commitments that the world cannot run away from."

According to Liden, the Global Fund has commitments from government donors at least until 2011 to 2012, although he added that there could be a possible crunch for the latest ninth round of requests. Liden said that although the Global Fund might be willing to consider more rapid additional funding to help countries in filling short-term budget gaps, no such requests have been made. In addition, the Global Fund is not able to provide extra support if the funding provided allows countries to divert domestic spending to activities not related to health.

Dr Bactrin Killingo of the HIV Collaborative Fund warned that if the current cost constraints faced by HIV treatment programmes are not addressed, while the demand for expensive second-line treatment increases, we will find ourselves in a situation similar to the 90s, where millions of lives were lost unnecessarily because people could not afford the treatment they needed to stay alive.

When US President Barack Obama released his US$3.6 trillion budget on May 7th, he broke two campaign promises and created a total shortfall of US$3.3 billion in U.S. support for Global AIDS funding through U.S bilateral AIDS programs, including PEPFAR, and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

“President Obama also sent a message to world governments that it is acceptable to underfund global health, in particular the Global Fund,” sad Dr Zeitz, the executive director for the Global AIDS Alliance (GAA). “The Global Fund is already facing a financial gap, and this will only make it worse by setting the wrong example,” he added.

James Kamau, of the Kenya Treatment Action Movement said the people of Africa must speak out and tell President Obama, a son of Kenya, that he must meet his promises to those who are living infected and directly affected by HIV and AIDS. The Zambia based Treatment Advocacy and Literacy Campaign (TALC), through Felix Mwanza, the Programs Manager emphasised, “It is not morally right for the US President to cut down on the U.S. global health contribution, especially on AIDS, because cutting the budget for global AIDS funding is tantamount to genocide, and President Obama shall be held accountable for deaths that will ensue.”

The Global AIDS Alliance estimates as a consequence of President Obama’s broken promises on U.S. bilateral AIDS programmes, one million people around the world won’t receive treatment for AIDS, while 2.9 million women also won’t receive services to prevent mother-to-child transmission of HIV. A total of 27 million people won’t be able to access sexual disease transmission prevention programmes, and 1.9 million orphans and other children affected by, or vulnerable to HIV/AIDS, won’t receive care and support services.

Sub-Saharan Africa bears the greatest burden of disease, and has 68 percent of the world’s HIV-positive people, but only one percent of the global expenditure on health, and two percent of the global health workforce. A recent African Union report states that sub-Saharan Africa faces a grim scenario with respect to the health of its people, estimating that only seven percent of total government expenditure in the region goes to health despite the 2001 Abuja Declaration commitment to commit 15 percent of government expenditure to health.

These shortcomings were highlighted at the Conference of African Ministers of Health (CAMH) summit recently held in Addis Ababa, where the Africa Public Health Alliance submitted a petition to African Heads of State and Ministers of Health and Finance to close the US$10.7 billion funding gap for regional implementation of the Global Plan to Stop TB. The Global Fund reports that it has saved an estimated 2.5 million lives worldwide, and has disbursed 57 percent of international donor aid raised for TB, 50 percent of malaria, and 23 percent of funds for HIV/AIDS.

However, the increasingly steep trajectory of demand for Global fund grants, coupled with dwindling donor input and the global economic crisis, have resulted in the Global Fund announcing that it is at least $4 billion short of the money that it will need to continue funding essential HIV, TB and malaria services in 2010.

General