Kakaire A. Kirunda
6 September 2008
Kampala — In this last instalment of a three-part series about Uganda's efforts to control the spread of HIV/Aids We explore Uganda's ability to provide not only care and treatment to HIV/Aids patients and victims, but also social support services.
When people fall sick, especially with a condition like HIV/Aids, they obviously need care and treatment. But care and treatment are not enough in a situation where someone has to spend the rest of their lives on medication.
For instance, what happens when they get stigmatised? Who encourages them to take their medication when they no longer want to take them? Who helps them when they need financial support?
That is why a 2006 UN member states special session on how best to respond to the Aids pandemic made social support as a part and integral aspect of health services that should be extended to all those infected and affected by HIV/Aids at least by 2010.
As we wind up this three part analytical series on Uganda's road map to universal access to HIV/Aids prevention, care, treatment and social support by 2010, we examine the country's prospect of beating the 2010 international deadline of offering social support services to all HIV/Aids patients.
Government through the National HIV/Aids Strategic Plan (NSP) plans to increase provision of quality psychosocial support to orphans and other vulnerable children (OVCs), Persons Living with HIV (PLWH), Persons with Disabilities (PWD) and other disadvantaged groups.
According to World Health Organisation (WHO), psychosocial support addresses the ongoing emotional and social problems of persons living with HIV, their partners, families and caregivers.
Psychosocial support is important because HIV infection can seldom result in stigma and fear for those living with the infection, as well as those caring for them, and may affect the entire family. An estimated one million persons are living with HIV/Aids. And to date, Aids has claimed the lives of over one million Ugandans.
This has contributed to the orphan crisis in the country. As at the close of 2007 there was an estimated 1.2 million children orphaned due to Aids.
So, can Uganda be able to offer psychosocial support services to the over two million patients and their families?
Several Ugandan HIV/Aids experts believe this is another target that might not be met by 2010.
"There are no sufficient funds to implement most of the activities and programmes of this group of people," said Dr Chris Baryomunsi, vice chairperson of the Social Services Committee of Parliament.
Similarly, the manager of the Aids Control Programme, Dr Elizabeth Madra, said it was unfortunate that while government knew what needs to be done, the limited resources make it hard for the country to sufficiently run psychosocial support services.
Jennifer K's situation makes sense of Dr Madra's argument. "I have HIV; I lost my husband and almost all my children. This remaining child is also going to die, yet I have to share whatever I get. In fact I have even abandoned medicine because there is no food to go with the medicines," said Jennifer (not real name).
It is people like Jennifer, and there are many like her, that Aids activist Dr Lydia Mungherera says need "very urgent help."
"Women affected and infected by HIV need a lot of emotional support. They can easily break down due to the challenges that they face," said Dr Mungherera.
She is the founder of Mama's Club, which offers psychosocial support to young mother who are HIV positive. And while the NSP targets a couple of groups under the social support response, in the actual sense, most of the focus is on orphans and other vulnerable children (OVCs).
But the long term strategy is to prioritise prevention that is anticipated to lead to a reduction in the incidence of OVCs and other associated socio-economic effects since far fewer people would be getting infected with HIV, thereby reducing the numbers of persons getting sick and dying from Aids.
The Ministry of Gender Labour and Social Development is charged with overseeing the OVCs. But while the ministry has helped districts set up technical teams at their levels, meager or no funding at all has rendered them inactive.
"I have been upcountry as a peer mother to talk to fellow women looking after children but the situation is very bad. Here in Kampala things are okay. But in the countryside you find children living with HIV who want to go to school but poverty has taken over their households," said an HIV positive peer mother who preferred anonymity.
As the Gender Ministry continues with its current development of an information system for capturing and storing OVC indicators, what happens here will have a lot of bearing on the success or failure of the response to the psychosocial needs of those infected and affected by HIV/Aids.
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