HIV/AIDS
The cloud of gloom has yet transcended upon
Uganda as global experts fear that the country is losing its gains in the fight
against HIV/AIDS. Over the years, experts like Festus Mogae and Stephen Lewis
have shown pessimism that Ugandans have become complicit to the advent of
anti-retroviral medication that provides hope for a prolonged onset of AIDS.
Further, the political will that previously elevation and sustained a high
profile of HIV/AIDS among the population has been usurped by corruption and
ideological disunity that threatens human rights.
This article intends to bring a critical
perspective in the HIV/AIDS discourses and it intends to point out the critical
gaps where current health service orientations have been unable to cover. There
are fundamentally three areas that requires urgent attention if Uganda is to
gain its stead to return to its glory path of curbing HIV. These areas are an
investment in an integrated behavioural change approaches; adhering to strict
and accurate data collection and management and; expanding existing healthcare
systems to care for communities, rather than individuals.
Behaviour change
The Daily Monitor newspaper on May 18th,
2013 quoted Mr. Musa Bungudu, UNAIDS country coordinator as casting fear on the
rising prevalence rate of HIV in Uganda.
New cases of HIV infection show an increasing trend, from 124,000 in
2009 to 145,000 by 2011. On the average 353 Ugandans are infected daily and over 60,000 Ugandans die annually from HIV/Aids related ailments. Prevalence rates continue to vary from place to place, peaking at fish landing sites, conflict studded areas and urban centers. These are not small numbers, but they also don’t tell
the entire truth due to many factors, but mostly that many Ugandans are still
not testing their status.
Further, complacency to anti-retroviral
medication treatment, sustained beliefs in mysticism and witchcraft as well as
partaking in risky sexual expeditions are key domains of Uganda’s regular
lifestyles. And yet it is empirically known fact that the most common route of
HIV infection is through the sexual route and blood transfusion. Somehow,
irrespective of unintended accidents, HIV can majorly gain entrance in the
human body through the body fluid – blood.
In the early 90s, it was excusable for anyone
to conduct themselves dangerously as to have unprotected sex with an excuse
that they didn't know how to access and use condoms. Many did not have explicit
access to HIV screening or testing services. These arguments should be stale in
the current epoch because condoms have been with us for the last 30 years and
with the advances in media coverage and telecommunication system in Uganda, not
using condoms or testing for HIV and other preventable diseases is no longer
justifiable.
Therefore, a behaviour change effort must be
made through a combination of policies and a deliberate reflexivity from
cultural standpoints if we are to tackle the HIV scourge.
Further, Ugandan society is still largely
patriarchal along its social and cultural landscapes. What this means is that
age and gender remains major factors of subordination. Males are still
repressive of the females and older individuals are still suppressive of the
younger ones. In essence, women and young people – both boys and girls-
continue to internalize their position in society as that of being submissive
to the older and more so when they are men, making them easy prey. This fact
also corresponds to high prevalence rates among this group (15-19 at 7.3% and
women at 8.3%). Further, the people on retroviral treatment appear to be
healthy and yet, their health also becomes the resource for their silence that
leads to the spread of the virus – most especially when they are “loaded” or
acting as sugar-mommies.
Research have found that it is the men who are
more reluctant to seek HIV testing and even when they know that they are
infected, they still blame it on their sexual victims who happen to be women or
younger individuals than them.
This brings me to the issue of HIV prevalence
and incident rates. These are epidemiological terms meaning “new” and “existing”
cases of HIV among a population of 1000 people. In Uganda, the estimated
national prevalence rate is about 7% and the total estimated number of people
considered to be HIV carriers are 2.2 millions as of 2012.
These figures are contestable irrespective of
whether they are World Health Organization's estimates or from Ministry of
Health in Uganda. My contentions are as follows; most of Ugandans who seek HIV
screening are Urbanites and often they chance on the results upon seeking
treatment for other symptoms.
In as
long as Ugandans are asymptomatic, they would endure all sorts of silent killer
diseases, like hypertension, diabetes and HIV infection, without seeking care.
It is during this time that they will also distribute the virus
indiscriminately. Therefore, most HIV statistics are taken at focal points when
it is too late and yet it is very difficult to draw inferences for deaths
outside the hospital where rural autopsy would consign it as witchcraft,
poisoning or suicide. Therefore, a conservative estimate would say that the
national prevalence rate is about 13% and the total number of incidences of HIV
at about 5 million people!
Healthcare system’s deficit
Further, the failures of our healthcare system
to succinctly capture, record and follow children who are born with the virus
adds weight to the numbers dilemma. In the early 90s when Rakai was symbolic of
the HIV/AIDS debacle, we were shown so many orphans whose parents had died due
to HIV/AIDS. Most of these children were born with the infection. Today, they
have become of age and some of them are pretty humbled by their modest
upbringing under churches and orphanages. Many of them are virgins while a host
o f them are the ones jumping helter skelter on the street with mind blowing
minis and stilettos.
Unfortunately, the state cannot account for
these and yet they are occasionally adding to the increasing number of HIV
prevalence in Uganda.
The fight against HIV/AIDS is failing, not
because of a single factor, but a multiplicity. This also means that the
solution to the HIV problem should be an integrated approach that focuses on
behavioural change at all levels of society. Ugandans must become bold to
reclaim their moral aptitude and begin to conduct themselves with some sense of
purpose beyond hedonism.
The Uganda of today is as tense as and worse
off than Biblical Soddom and Gomorrah with promiscuity. Literally every married
couple is a cheat and every person in authority is corrupt. In essence, Uganda
is a country where both the cat and the mouse fight to swallow each other, such
that each has become fearful of the other. The elders who should reinforce
morals are themselves so devoid of such authority and yet the young people, in
whose hands our futures should behold, are running amok with a life so
precariously!
Integrated systems
Finally, the healthcare system requires
restructuring to ensure that it is expanded outwardly to treat the community
more than the individual. A combination of community based medical model which
integrates social behavioural and biomedical sciences can help mediate between
individuals and their precarious cultures. This model offers a formidable
fruitful venture in healthcare investment, at public and private sector levels.
This will also imply that we stop treating symptoms, but we treat the disease,
the people and community all at once and it comes at a lower cost to the public
purse.
END
No comments:
Post a Comment