Dr. Stephen Watiti is one person you can call the face of HIV/AIDS in Uganda, going by the passion with which he has, over the years, disseminated information and created awareness about the disease. Watuwa Timbiti spoke to him about his personal life and career:
Watiti, who is living positively, confirmed in 1993 that he was HIV-positive, although he suspects to have contracted the disease much earlier, around 1985.
"In January 1994, I lost my wife. In 1999, I got sick, characterised by tuberculosis, meningitis and Kaposi's sarcoma, a cancer that comes with terminal HIV," he explains.
Subsequently, he started taking ARVs between 1999 and 2000. "I improved a bit, but the adherence was still poor until 2003. But I still felt my life was not good, contemplating leaving Joy Medical Centre in Ndeeba, where I was working, for something else, or move to Botswana," he recalls.
However in 2004, he applied to join Mildmay Uganda, where he is currently working, following an advert on a job vacancy.
"Upon starting my work here, I found a group of stigmatised people, some of whom I knew - they did not want to talk to me," Watiti says.
One morning, he says, when giving the patients a health talk, they cared not to listen - they were busy reading newspapers and did not want to open up.
To get their attention, he had to tell them his own experience. "They stopped whatever they were doing, they shifted their eyes onto me and listened in unbelievable silence," he says.
Living positively and healthy:
Watiti says he has lived positively and healthy because he takes his drugs on time. "I also know my limits, for instance, I am close to 60. So I do not strain myself so much," he says, adding: "I eat healthy and have not tasted alcohol for the last 40 years."
"Getting married again helped me. I have someone I am accountable to. Those who can remarry should do it. It helps; it is part of positive living," he advises.
Building trust with patients:
According to Watiti, the best way to win the patients' trust is to show that you listen and empathise with them.
"He or she will eventually trust you and tell you all that they cannot tell other people. Yes, there are challenges, for instance, sometimes I so much get involved that I am misunderstood," he observes.
There are cases, he says, when people treat him with mistrust, fearing he would talk about them before other people.
HIV among medical workers:
HIV prevalence among medical workers, Watiti observes, is still high. "Those who are HIV-positive have refused to open up. Others get infections through exposure, for instance, those working in laboratories and handle open TB cases and extensive surgeries - serious precaution must be taken," he counsels.
Due to failure to open up, Watiti says most medical workers are on self-medication. "But even if you are a qualified doctor, it is advisable to surrender yourself to another person because you may not be objective," he advises.
The fact that an HIV-positive person, according to Watiti, looks healthy, is a big challenge. HIV is no longer taken seriously. This, he says, is too dangerous and has accounted for many new infections.
Stigma is still a big problem. People, Watiti observes, cannot openly say they are sick. "Let us move to that level where people happily say they have high blood pressure or diabetes. Actually others say my pressure or my diabetes," he advises.
Towards zero tolerance:
To avert any increased effect of HIV/AIDS, Watiti says the zero tolerance strategy is the way to go.
"Our target is zero new infections, zero HIV/AIDS related-deaths and zero discrimination of HIV-positive people," he explains, adding: "In Uganda, there are 100,000 new infections annually, 20,000 of which are children.
We can, for instance, secure zero new infections by treating all HIV-positive mothers, then about 90% will certainly produce HIV-negative children. Subsequently, the number of infected people will be low and so easy to treat and care for."
With zero infections, he explains, people infected will not die of AIDS because there will be enough money to care for them.
With zero infections and access to treatment, discrimination, which is enacted stigma, will move towards zero.
Lastly, about 1.5 million people in Uganda are HIV-positive and between 300,000 and 340,000 are on ARVs.
More people, Watiti argues, can get treatment, if we all tested and knew which people to focus on and make their life better through a trusted fund.
"To sustain that fund, we can decide as a country to double every donor dollar with a dollar so as to get more people on treatment," he suggests.