UGANDA: HIV/AIDS rising amid extreme poverty of north's IDP camps

kampala, 21 November 2006 (PlusNews) - Rebel attacks in northern Uganda over the last 20 years have shattered basic healthcare services, hitting HIV-positive people in need of life-prolonging antiretroviral (ARV) drugs particularly hard.

"The proportion of HIV-positive patients being treated with ARVs is much lower in the north than in other areas," said Dr Jackson Ojera, coordinator for the United Nations Children's Fund (UNICEF) in the northern town of Gulu. "The demand is very high but the drugs and the staff for follow-up are just not there."

No one is prevented from accessing medication at gunpoint, but conditions complicate the provision of ARVs in more subtle ways: roads - if they exist at all - are poor, there is almost no public transport and distances are great.

Attacks by the rebel Lord's Resistance Army have decreased this year, and talks that could bring an end to the war are ongoing in Juba, southern Sudan, but crippling poverty continues for the region's two million displaced people.

In the five districts of northern Uganda - Gulu, Pader, Kitgum, Lira and Apac - the population is pinned into protected camps, rife with disease and without access to the farmland necessary to provide a balanced diet, so opportunistic diseases flourish and malnutrition is widespread.

The camps sprang up within a matter of weeks in 1996, when civilians were told to leave their homesteads and settle near army garrisons. Camps like Pabbo in Gulu District - with a population of more than 60,000 - were never planned; instead, people built huts wherever they could, just inches from their neighbours, with sewage seeping down rutted paths.

Such conditions are ideal for cholera and malaria, and the north has the highest rate of diarrhoeal diseases in Uganda, while opportunistic infections like tuberculosis take a heavy toll among people weakened by HIV infection.

"These [ARV] drugs are toxic and people have to eat well but ... people in the camps are short of food," said Ojera. "They rely on the WFP [World Food Programme] and sometimes there are delays and shortages. This can be very unpleasant and affect compliance [with the ARV drug regimen]."

Michael Tewolde, of Catholic Relief Services (CRS), commented: "In most places, even when there is poverty, there is some kinship support, but in northern Uganda nobody is going to help you because they are all at the same level."

Distribution of ARVs tends to be concentrated in the main towns and a handful of outlying camps. CRS dispenses free drugs for 670 people at St Joseph's Hospital, the largest provider of treatment in Kitgum District, but just 24 percent of the hospital's HIV-positive patients receive ARV medication.

The government and its partners are aiming to expand ARV provision across the north. The international medical charity, Medecins Sans Frontieres, for example, is set to provide ARVs to camps and towns in Lira District.

The suffering in the region is so acute that Dr Jackson Kansime at St Mary's Lacor Hospital in Gulu District, the main CRS distribution point for ARVs, believes more than just drugs are needed.

"Sometimes I feel people have put the cart before the horse. We have been giving people very expensive drugs when they don't have any food or shelter; some see ARV treatment as the panacea for everything, but it isn't," Kansime said, calling for more investment in improving the overall living conditions of the region's internally displaced people.

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Theme (s): Care/Treatment - PlusNews,

[This report does not necessarily reflect the views of the United Nations]