24 November 2012

Uganda: The First Ugandan to Die of Aids


If there is a family in Uganda that has been shattered by AIDS, it is that of the late Gideon Kivumbi, a resident of Kebe sub-county in Rakai district.

Kivumbi is believed to have been the first Ugandan, and most probably African, to succumb to AIDS in November 1982. Subsequently, three of his wives and 11 children also died of the dreaded disease.

Today, signs of doom are quite detectable in Kivumbi's home in Kinyigi village, Gwanda parish, Rakai.

Going to Kivumbi's home

After travelling a distance of 90kms from Kyotera town through Pinto Road, which was named after Emmanuel Pinto, the former Kakuuto MP, I arrived at Kinyigi village.

Kivumbi's fairly old house, built with unburnt bricks, is isolated and some residents still dread going near it, thinking it is a ghostly house. The house was quarantined and it is now used as a centre for attraction to tourists.

Moulencia Nasonko, Kivumbi's only surviving daughter, was there to receive me as she probably receives many other visitors seeking to learn about her family's unfortunate story.

Nasonko, however, was composed and relaxed, like someone who has narrated the sad story over and over again. Flanked by her five children, she reminisces about her father's death.

Nasonko narrates ordeal

"I was nine years old, but I knew what was going on," she says.

"He died in a very pathetic way. People said he had been bewitched. It is only now that I realise he died of AIDS. People did not know the disease then. In 1982, everyone talked about a mysterious disease," Nasonko adds.

She says her father kept on wasting away, until his death. He had all the symptoms of HIV; sporadic fever, diarrhoea, weight and hair loss, ugly and irritating skin, a rash and dry cough.

"He became abnormally weak and he could not sit without support. Before he died, he was so thin, pale and helpless!" she recalls.

As Nasonko narrated the experience, I was spellbound, listening very attentively. She shed a few tears, but later she composed herself.

Kivumbi's friends comment

Then, Anatoli Kafeero, Nasonko's village mate, interjected, saying he knew Kivumbi well since they grew up together.

Kafeero says he was 30 years old when he saw his colleague painfully waste away in one year. But nobody knew what Kivumbi was suffering from.

"We used to drink together and Kivumbi was very popular with the women. He had money and he would brag about it," Kafeero explains.

"He was a prominent tailor and a tax collector at Lukunyi landing site, which was, at that time, a centre of smuggling between Uganda and Tanzania. He was exceptionally social and generous."

Kafeero remembers Kivumbi as a generous person

Deaths blamed on Witchcraft

In the 1980s, when Uganda was in political turmoil, Kafeero said there were no taxis and all the boats from Kisumu and Mwanza used to ferry goods to Lukunyi and Kasensero landing sites on Lake Victoria.

When Kivumbi fell sick, residents alleged that he had stolen goods from Tanzanians, which had prompted them to bewitch him. After Kivumbi's death, several other people in the area wasted away and died in the same slow and painful manner.

Later, the disease that was decimating the community was given a name, 'slim'.Retrospectively, people then discovered that even Kivumbi had died of 'slim'.

The following year, Kivumbi's first wife developed the same symptoms that Kivumbi had and she, too, died. Later, Kivumbi's two other wives and 11 children also died.

"Residents accused my father of bringing evil spirits (mayembe) to the area, saying the spirits had turned against him and killed him before attacking other residents.

Slim, as the disease was called then, fuelled separations between couples, hatred among relatives and accusations of witchcraft. Traditional healers had a field day exorcising what they called mayembe," says Nasonko.

Kivumbi's home shunned

What hurts Nasonko most is the fact that all her father's relatives and the village mates abandoned her father at the time he earnestly needed them.

"Our home was abandoned, even our relatives dreaded coming near our house. They thought our father had brought evil spirits, which were still at our home and were tormenting the village."

After the death of her mother, Nasonko lived with her step-mother.

Soon, Nasonko's step-mother also succumbed to AIDS. Nasonko recalls suffering a lot after the death of her step-mother. Her elder brother took her on, but he also died, later.

"Then, I was 11 years old. I went to my uncle, who chased me away from his home, fearing that I would transfer the evil spirits to his home."

When all the relatives shunned her, she grew up entirely on her own, heading her father's family at 15. She dropped out of school in Primary Six.

According to Nasonko, residents later realised that the strange disease that had hit the area was AIDS.

Today, Nasonko, 38, is married to a peasant farmer. She is knowledgeable about HIV/AIDS. She takes part in village sensitisation seminars and trainings.

She, however, regrets that 40 years since AIDS struck her village, some people, especially the youth, are still reckless with their lives.

Nasonko says they have a slogan that slim tatta kasitoma, loosely translated as; AIDS does not kill a person who has sex with prostitutes.

HIV fight through the times

1981: The US Centre for Disease Control publishes the first mention of what later became HIV. The report mentions five cases of pneumocystis carinii pneumonia in young men.

1982: A new disease pattern, locally known as "Slim" is tracked down in Rakai district and it claims Gideon Kivumbi, the first known victim in Uganda.

Later, doctors from Makerere University clinically identify it as the Acquired Immuno Deficiency Syndrome (AIDS) to describe the sudden loss of immunity in previously healthy people. But there is still little understanding of what AIDS is.

1983: The US Congress passes the first Bill to fund AIDS research and treatment

1984: Scientists identify the virus that causes AIDS first named after the T-cells affected by the strain. Its name is later changed to HIV, or human immuno deficiency virus.

1985: The US approves the first licensed test for HIV.

1986: The Ministry of Health establishes the AIDS Control Programme. Uganda announces to the world that it has citizens with HIV, at a time when other countries were trying to hide due to economic reasons.

1987: A total of 16 volunteers who were personally affected by AIDS come together to found TASO. The AIDS control programme is also set up. In US, AZT is approved as the first ARV.

1988: WHO declares December 1 the World AIDS Day.

1991: In Uganda, HIV prevalence among pregnant women,15-24, peaks at 21%. UNAIDS estimates the national prevalence rate at 15%.

1992: The Joint Clinical Research Centre starts to conduct clinical research on HIV/AIDS, care and treatment.

Uganda is the first country in Africa to open a Voluntary Counselling and Testing (VCT) clinic called the AIDS Information Centre, and pioneers the concept of voluntary HIV testing centres in Sub-Saharan Africa. The Uganda AIDS Commission starts to co-ordinate the multi-sectoral approach to AIDS control

1996: The Joint United Nations Programme on AIDS (UNAIDS) is established by the UN.

2000: Nevirapine, a new single dose drug, whose trial was carried out in Uganda, is approved for use to prevent mother-to-child transmission of HIV.

2001: Uganda's HIV prevalence falls to about 5%, the World Bank agrees to spend $47.5m over the next five years on AIDS prevention and treatment programmes in Uganda. This money eventually became a subject of embarrassment when officials mismanaged it and the World Bank suspended the grant.

2004: Former US president George Bush launches PEPFAR, the US president's emergency plan to combat AIDS worldwide. Free ARVs start in Uganda. Uganda becomes the world's success story in reducing its HIV prevalence by 70% since the early 1990s.

2005: The national sero-survey shows that HIV transmission is highest among the married (42%), followed by commercial sex workers (21%) and casual sex (14%).

2009: Large studies of male circumcision reveal firm evidence that the procedure reduces the risk of HIV infection. US president Barack Obama removes a travel ban preventing HIV+ positive people from entering US.

2010: A microbicide gel trial, known as CAPRISA 004, shows that the gel reduces the risk of a woman becoming infected with HIV during sex by 39%. Trial reveals that ARVs may also be effective in preventing infection.

2011: The National Institute of Health publishes the results of a study that showed taking ARVs at the onset of HIV leads to a dramatic reduction in HIV transmission to an uninflected heterosexual partner.

2012: Ministry of Health statistics put the new HIV prevalence among adults at 7.3%. Health experts blame it on general complacence, corruption, waning political will, poor prioritisation and inadequate funding.

Compiled by Hilary Bainemigisha

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