UGANDA: Poor working conditions slow ARV rollout in war-ruined north
Photo: Stuart Price/IRIN
Working conditions are tough at this internally displaced people's camp in northern Uganda
Kampala, 28 August 2006 (PlusNews) - Health workers in northern Ugandan have warned that treatment of HIV-positive people will be jeopardised unless working conditions for medical staff improve.
Qualified and committed staff are crucial to ensuring that patients understand and adhere to complicated antiretroviral drug regimens, but few like the idea of working in war-torn northern Uganda's refugee camps.
"There are skilled, knowledgeable staff in this country but they aren't willing to work in the camps," said Christine Schmitt, Head of Mission at international relief charity Medecins Sans Frontieres (MSF)-Holland.
The nationwide problem of poor, irregular remuneration, coupled with devastated health facilities, has meant that only eight of 15 subcounty-level health centres in the northern district of Gulu have clinical officers, making antiretroviral (ARV) treatment nearly impossible.
"The proportion of HIV-positive patients being treated with ARVs is much lower in the north than in other areas. The demand is very high, but the drugs and the staff for follow-up are just not there," said Dr Jackson Ojera, Gulu coordinator for the United Nations Children's Fund (Unicef).
Patients need to take ARVs regularly and consistently to avoid developing drug-resistance and more frequent opportunistic infections.
Prevalence in the Gulu and Kitgum districts is nine percent, according to the government's 2004/05 National Sero Survey - three percent higher than the national average.
ARVs are free at government and NGO clinics, and at a charge from private clinics. Catholic Relief Services (CRS) provide anti-AIDS drugs from hospitals such as St Mary's Lacor in Gulu, St Joseph's in Kitgum and some of the larger camps.
NGOs plan to expand free care, but Schmitt admitted that MSF was struggling to find staff to man its new ARV programme in the northern Lira district.
According to Ojera, Unicef was extending ARV provision from towns and large camps to outlying areas, and "we planned to do that by the end of 2006 but I don't see that as being forthcoming - we just don't have the clinical officers."
Theme (s): Care/Treatment - PlusNews,
[This report does not necessarily reflect the views of the United Nations]