Friday 26 November 2010

Uganda Wishes – HIV Free Generation?

They put on brave faces.
“Why do you think you need to test for HIV?” says Mengo Hospital’s, Tahya, Coordinator for Prevention of Mother To Child Transmission.
The women are pregnant. There is 30 of them sitting in plastic chairs in what’d we’d call an alcove between two buildings. It’s their education room in the open air. Rows of chairs meet the rainwater drains. To walk to the front is to duck the open windows.
“It’s important to test when they are pregnant. There are two lives,” says the only man in the room. He sits at the back.
Know your HIV status. Should be mandatory here in Uganda. According to the latest news reports, up to 7% of the population are positive.
But the problem is disclosure. While a woman may learn her status is positive, she likely won’t tell her husband or sexual partner. For fear of abandonment. In most cases, they have no way other then their husband to support themselves.
Many of the women are also ‘side dishes’ I hear. Unmarried but in a sexual relationship with a man who is.
If a woman is working here in Uganda they receive one month’s maternity leave for the birth of their child. That’s it.
“The reason is to protect her baby. So she can live longer and see her baby grow up,” Tahya adds.
“How can you tell if someone has HIV?” she then asks.
Tahya stands proudly in front of the women and the one man. She sparks laughter amongst them. One by one she drills them on what they know. Then she tells them what they should know.
Adding awareness of the prevention of Malaria during pregnancy. Noting that a bout of Malaria can weaken the placenta and affect the baby. Prevention is possible, through drugs taken twice. Which they have to pay for. 
Should a women test positive today, medication is available and can be taken to prevent the child from being born HIV.
Still, to stop the spread the problem is disclosure.
Income generating education once formed part of the Antenatal ward’s mandate. But the funding was cut a year ago.
When a woman is self-sustaining she may not fear telling her husband her status. And not be afraid he will leave.
Later I ask Tahya for her wish for Uganda.
“To have a HIV free generation. So people can lead the best of their lives,” she answers.
"For the world?" I ask. "How about for the world?"
“Unity,” she replies. “For people to be together. So everyone feels for one another. Everyone has sympathy. Everyone needs equal opportunity.”
I sit with Tahya when she reveals the test results. One woman slinks into the room in shame. In fear. Scared. I feel her anxiety. Turns out she is negative, today. She bursts into tears. But is reminded, she needs to come back in three months and be tested again. Along with her husband or partner.
Abortions are illegal in Uganda, except on medical grounds. Tahya emphasizes how some women can make blind decisions. Part of her job is to try to wake them up.
“The women they really need us,” she says. “We give them the courage to go on.”
But she tells me, sometimes it’s interesting and sometimes it can be painful.
“Our role is to give them the right information,” Tahya states.
And hope that they come.
“The HIV free generation begins with me,” Tahya concludes with a smile.

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