PartnersGF - 2004-04-15
Member viewpoint: Uganda
Rosemary K. Kezaabu
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Allow me to share and give my personal experience and contribution on the Global Fund on HIV/AIDS programmes as the only strategy to development and disease control sector especially in developing countries. HIV/AIDS is spreading like a bush fire in rural areas in some developing countries where there has been little or no awareness.
Women, the girl-child and to a smaller extent the boys are prone to this pandemic because of cultural practices, such as initiation rites which lead to genital mutilation of girls and circumcision of boys; wife inheritance and sharing, polygamous marriages, rape and defilement. All these limit the ability of marginalized groups of people to control their sexual and reproductive health.
It is thus important to note that a bottom-up approach policy can be applied to understand and learn the problems from the grassroots of vulnerable populations which will enable researchers, governments and stakeholders to tackle the problem of HIV/AIDS from the grassroots by using a rural participatory learning approach.
In some developing countries, HIV/AIDS awareness is more prevalent in urban than in rural areas; yet majority of the people stay in rural areas. Some people living with HIV/AIDS (PLHAs) migrate to rural areas spreading the same to people who cannot detect a person suffering from HIV/AIDS.
Prevention is better than cure and thus, lack of knowledge on HIV/AIDS, and access to quality health care contributes to the spread of HIV/AIDS. Worse still the rigidity of cultural change and practices have continued to engineer the spread of HIV/AIDS in our societies.
Global fund on especially HIV/AIDS education programmes needs to be enhanced in primary schools up to institutions of higher learning. For example, in Uganda there is Universal Primary Education such that at least every household has children in school, hence, awareness of HIV/AIDS prevention will be imparted early enough to the youth for future prevention. Against this, Global funding is looked at as a mechanism to curb the pandemic through grants related to HIV/AIDS programmes.
More so, seminars and workshops at the grassroots will help to create awareness on the HIV/AIDS and preventive measures. For example, in rural areas of Uganda, some people do not know how condoms look like while others do not know how to use them despite the governments efforts to open up and talk about the pandemic. Besides, they cannot afford buying them even if there were available at a very low cost.
My concern is, unless this pandemic is tackled from the grassroots, there is little to achieve. It is also important to note that many projects and programmes stop or operate near the main roads, in urban and peri-urban areas, yet the majority of the people are in remote areas. Therefore, funded programmes may not benefit the truly infected and affected communities in remote areas hence, community-based organisation, community health centres and clinics should not be overlooked for they zero down their services to the grassroots.
Communication is vital to promote HIV/AIDS awareness through the print and mass media. Through these channels, causes, symptoms and prevention of HIV/AIDS are disseminated to many people especially women. This has been done in Uganda using all radio stations, Straight Talk for the youth in the government newspaper and posters in community centres, hospitals and clinics and use of condoms as preventive measures, have been crucial in spreading the gospel about the disease in Uganda. These measures have the potential to reach many people in other countries, particularly in developing countries.
However, the majority of rural population in developing countries are either illiterate or semi-literate. So, reading and language barriers are limitations to the dissemination of HIV/AIDS prevention. Besides, in rural areas, some people are poor, they cannot afford to buy radio cells to listen to the radio and newspapers to read. Meanwhile, women and the girl child can never get time to either read or listen to radio programmes because of their domestic chores.
Against this background, Global Fund in its operations should consider rural-based organisations that address the needs of the rural people. Bearing in mind that these grants are strictly monitored to ensure that the needs of the vulnerable people in rural areas especially women and the girl-child are addressed.
Voluntary counselling and testing services at grassroots and in institutions are of paramount importance which need a lot of funding and attention.
Hardly any counseling is done in formal and informal sectors. PLHAs are still looked on as parasites on organisations because their weak and deteriorating health, impacts on organisations productivity, labour turnover, labour costs as far as replacement and recruitments are concerned coupled with training and development of new employees and succession planning.
While in rural areas time which should have been spent on tilling the land, is taken up by looking after and attending to the sick. Hence this affects food supply, food security and household income.
All people should be sensitized that HIV/AIDS is like any other disease. This is because PLHAs have suffered indignation and stigmatization.
Palliative care and social support to HIV/AIDS patients has a therapeutic effect, and home based kits containing testing equipment and brochures can be distributed to patients homes. Anti-retroviral drugs are expensive; therefore governments and WHO should avail these drugs freely or at subsidized price.
In general the HIV/AIDS pandemic needs a holistic approach from the local and international communities.
It is my strong belief that Global Fund will improve the lives of the vulnerable populations. Please note that all the above is from my own opinion subject to be revised.
Rosemary K. Kezaabu
Crested Towers, 5th Floor
Uganda Revenue Authority
P. O. Box 7268
KAMPALA
Email: rosezaab@hotmail.com