AIDS orphans in Uganda
By Jacqueline Lampe, Director AMREF Flying Doctors

 Therefore these AIDS orphans seldom attend school and often become ill because of lack of (healthy) food and medical care. Fortunately there are projects that help to support these children. One of these projects is the Nakasongola AIDS Orphans and Vulnerable Children Project in Uganda.

AIDS in Uganda

Uganda is one of the countries that have been greatly impacted by the devastation of HIV/AIDS. The disease had a long lasting effect on Uganda’s population and has caused over 2 million Ugandan children to have been orphaned, losing one or both parents to AIDS.

In 1982 the country was the first in the region to declare HIV cases, followed by Kenya in 1984 and Tanzania in 1985. Although Uganda is highly affected by HIV/AIDS, it has a success story in the fight against the disease. This thanks to the effective Aids Control Program (ACP) established by President Yoweri Museveni. Shortly after he came into office in 1986 he initiated an education campaign promoting a three-pronged AIDS prevention message: abstinence from sexual activity until marriage; monogamy within marriage; and condoms as a last resort. The message became known as ABC: Abstinence, be faithful, use a condom if A and B fail.

The government used a multi-layer approach to spread its AIDS prevention message: it developed strong relationships with government, community and religious leaders who worked with the grassroots to teach ABC. Schools incorporated the ABC message into their education programs, while religious communities trained leaders and community workers in ABC. The government also launched a media campaign using print, billboards, radio, and television to promote abstinence, monogamy and condom use.

In 1990 Uganda was the first country in Africa to open a Voluntary Counselling and Testing (VCT) clinic called AIDS Information Centre and pioneered the concept of voluntary HIV testing centres in Sub-Saharan Africa. Uganda realized that HIV/AIDS was more than a ‘health’ issue and created a “Multi-sectoral AIDS Control Approach”.  In addition, the Uganda AIDS Commission founded in the same year (1992), has been developing a national HIV/AIDS policy, including the development of various approaches to AIDS education.

As a result of these campaigns the number of HIV patients began to decline in the late 1980s and continued throughout the 1990s; between 1991 and 2007 HIV prevalence rates declined dramatically.

A variety of problems

During the beginning of the eighties Uganda was afflicted by a civil war. This Ugandan Bush War, also known as the Luwero War, the Ugandan Civil War or Resistance War, had as result that between 100,000 and 200,000 civilians were killed and thousands of others were detained, tortured and assaulted. The war mainly took place in the Luwero triangle, an area of Uganda to the north of the capital Kampala.

Many health workers were killed or fled the region, and health centers were destroyed or ruined by neglect during the conflict. Family units broke down and thousands of people were displaced. All of these factors had a devastating effect on HIV, TB and malaria rates, which are higher in this district than the national average. As a consequence the Luwero district is home to a high concentration of orphans who lost one or both their parents to HIV/AIDS. These orphans are cared for by surviving widows or grandparents and the majority of them live in poor households, and are unable to afford education or expensive medical services.

The Nakasongola region is part of the Luwero district and home to over 120,000 people. Health indicators are amongst the lowest in the country. For example 36% of the children have not grown properly due to malnutrition and poor health. The majority of children orphaned by AIDS are poor and have inherited very little or nothing from their parents. They also are faced with a variety of problems, including losing their parents, social stigma, severe poverty, manipulation and exploitation.

To help these children and their care takers, one of the major NGO’s started a project, called the “Luwero Orphans and Vulnerable Children Project” in 1991 in the Luwero/Nakasongola [1]area, now known as the ”Nakasongola AIDS Orphans and Vulnerable Children Project”.

The goal of this project is to assist orphans and other vulnerable children and help them realize their full potential. Needs for these children include food (there is a lack of adequate food or balanced diet), shelter, clothing, medical care, sources of income, psycho-social support, access to education, vocational training and protection against abuse and exploitation. The project provides assistance in all of these matters and helps guardians to become more financially independent by for example giving them training and loans for income generating activities (IGA).

In general the project aims to strengthen community-based support for orphans by training village orphan representatives, formation of parish orphan committees and parent teacher’s associations.

Advocate and lobby for the rights of children orphaned as a result of HIV/AIDS and raising awareness of HIV/AIDS and its transmission in order to reduce HIV/AIDS prevalence and stigma are also keypoints. And last but not least: providing vocational training to orphans and vulnerable children to give them employable skills and help them become active members of their communities.

Namande Toppy & Gorret Nasolo

One of the persons supported by this project is the 60 year old widow Namande Toppy. She lost her husband during the civil war and has buried all four of her own children, some of their spouses and several grandchildren. All of her children and their spouses died from AIDS. She now takes care for 12 orphans ranging in age from 2 to 16, of which several probably are HIV positive. Toppy also cares for a 30 year old mentally handicapped step-daughter from her late husband. Being identified by the community as most in need for support she was provided with an income generating activity of pig breeding, which she chose herself. The income from this small business enables her to provide basic necessities for her family such as food, medicines, shelter and clothing. Several of the children are also being supported by the project and attend primary school, with support for their uniforms and school materials.

Also 37 year old Gorret Nasolo is a widow and supported by the project. Her husband died of an AIDS related illness, as did nearly all of her adult relatives. She lives with 16 children (including four of her own) in a small house with a leaky roof. Half of these children have succumbed to HIV/AIDS. “It’s a big challenge for me looking after so many children. But thankfully AMREF is supporting me. They have paid primary and secondary school fees and are paying for uniforms and school equipment. Before, the children weren’t able to go to school.” Gorret Nasolo was also helped to run her shop, where she sells soap, sugar and flour. With profits from her shop she is able to buy food, drugs and other essential items for her family.

Wamalas’s story

Wamala Godfrey, a 16 year old orphan who lost both his parents to AIDS related diseases, now takes care of his younger brothers and sister. When his parents died, he and his brothers and sister went to live with their grandmother, together with the other children who already lived with her. “Although she was loving, there were too many of us for her to feed and care for. She couldn’t cope”, he explains. “I felt responsible for my family. I decided to move back home with my brothers and sisters. I now plant cassava, maize, potatoes and keep some pigs on our little land. The rain varies so we can’t depend only on farming. I have to make money to feed my family so I bake chapatti bread and sell it at the market two kilometres away. I make a little money so I can buy kerosene for the lantern and items for the house like bowls or soap.”

Wamala is helped by the project that educates orphans to realize their full potential and encourages community members, like “village orphan representatives” (VORs) to support them. This way, the before mentioned NGO is helping the community to better cope with the impact of HIV/AIDS. The VORs routinely visit families like Wamala’s to offer counselling and psychosocial support.

Although primary education is free in Uganda, lunch and activity fees are still mandatory; these are all provided by the project along with books and learning materials for Wamala’s siblings. Wamala himself is in his first year of secondary school, and the project supports him and encourages him to continue his studies. He wants to expand his business, but also dreams of taking up a formal career in the future. “When I finish school, I would like to become a policeman, or maybe a teacher. Anything that will help me put some food on the table and provides a better future for my family.”

Fortunately there are many stories of persons like Toppy, Gorret and Wamala, who take care of AIDS orphans and can have a more “normal” life now (working or going to school) thanks to the support of AMREF. Other achievements and positive results are that there is less HIV occurrence is this region and an increase in the awareness of HIV/AIDS, which resulted into more requests for tests.