AIDS Plagues the North

Government attempts to combat spread of HIV virus, one of the lingering effects of 20 years of war with LRA.

Thirteen-year-old Leo Bua remembers the day five years ago when Lord’s Resistance Army, LRA, fighters raped his two sisters in the village of Omoro, near Lira in north central Uganda.

The teenage girls had lived most of their lives in the Omoro internal refugee camp and were sexually assaulted in front of their mother during an early morning attack on the camp.

“The eldest sister, 15 at the time, subsequently tested negative for the HIV,” Leo told IWPR. “But the youngest sister tested positive. She was 13 and later died.”

Leo, now a seventh grade student at the Angetta Primary School not far from the former camp, hates and fears the rebels and their leader Joseph Kony in equal measure.

“Kony must be executed,” Leo said angrily. “I hear that he has failed to sign a final peace accord, and I fear that he will come back.”

Leo’s sisters were not the only victims that day. Several teachers and other children were abducted by the LRA and forced to become fighters and sex slaves for rebel commanders.

Some of these abducted children returned and were infected with HIV, say health officials. And, as a result, the disease spread throughout the north’s refugee camps.

Today, HIV/AIDS plagues northern Uganda, one of the lingering effects of 20 years of war with the LRA.

Official statistics show the overall infection rate in Uganda is 6.2 per cent of the population, with the figure in northern Uganda standing at nine per cent.

While war and rape may have contributed to the problem, health experts in northern Uganda told IWPR that the spread of the virus has been due largely to the crowded conditions in the 200 refugee camps in the region, many of which have dismantled or abandoned.

When villagers were forced into camps over the past dozen years, there was widespread social breakdown. Traditional lifestyles and values were lost as families and clans were dislocated and often destroyed.

“There was massive cross-generational sex, where younger girls [had relations with] older men in exchange for money to make ends meet,” said Dr Vincent Owiny, the Oyam District health officer.

Older men preferred to have unprotected sex, explained Owiny, and thereby spread HIV/AIDS among the camp residents.

Additionally, unborn children were infected by their pregnant mothers, said Owiny.

While rebels have been blamed for raping women in camps, they were not the only ones accused of sexual assaults and spreading the virus.

Some children were infected after being raped by the Ugandan army, according to some residents. But Lira resident district commissioner, Joan Pacoto, disagrees.

He said that the extreme poverty of camp life and dependency on international food aid resulted in parents selling their children into prostitution.

“Many parents started sending their children to the streets to bring them money for survival,” said Pacoto. “This makes it very [difficult] to believe that they were raped by the army.”

Omoro assistant community development officer, Betty Ajalo, said that some villages have been hit hard by the disease. In Oculukori, a dozen youngsters and 18 adults have been tested positive for HIV, she said.

“Women are more vulnerable and they are at a risk of contracting the disease,” continued Ajalo, because “many have turned to [the] sex trade to make ends meet. Their husbands cannot provide [for them]”.

Despite efforts to educate people in the north about how HIV/AIDS is spread, she said many women remain ignorant, “Women lag behind when it comes to understanding the epidemic. They [do] not take care of themselves. We want the community to be educated on the danger of HIV.”

Owiny told IWPR that the infection rate among children in his district appears to have overtaken that of adults among those who voluntarily come to his clinic for testing and counselling.

“Children account for ten per cent [of the cases] compared to seven per cent of adults who go for voluntary counselling and testing for HIV annually,” said the doctor.

Of the pregnant women who agree to be tested and counselled, seven per cent have been found to be HIV positive, he said.

But some 90 per cent of these pregnant women who tested positive will transmit the disease to their babies, continued Owiny.

Also contributing to the high rate of the disease among children, he added, is that the vast majority of pregnant women do not get tested, “The rate of infection in children is high because expectant mothers run away from the test. We intend to begin testing every pregnant mother who comes for health services to reduce the risk of infecting their unborn babies.”

Lira medical superintendent Dr Jane Aceng Ocero said many who are HIV positive are dying in remote villages because they don’t have access to trained carers.

In the Lira area, medical practitioners are working to attract HIV positive children to clinics.

“We are going to paint [clinics] that will be used to provide HIV services to children to make them child-friendly,” said Ocero. This she hopes will “attract many infected children to come for treatment”.

These efforts may be late in coming, said Charles Angiru Gutomoi, a member of parliament from northern Uganda.

He estimates that at least five people die each day from AIDS or other diseases.

Many are children or elderly people who have left the former refugee camps and now live in their old villages.

“There is high death rate [among] children and elderly people,” said Gutomoi. “I’m burying people almost five times a day. It’s a serious matter.”

While HIV/AIDS is a problem, so is typhoid, cholera, hepatitis, and malaria, which some people mistakenly attribute to the HIV virus, he said.

The MP said he has asked the government to move quickly to improve health in the north, but worries help is slow in coming.

“We want the government to construct health centres,” he added. “We need referral hospitals in every sub-county for easily accessibility to AIDS drugs.”

To address the HIV/AIDS problem, Uganda has channeled 25 million US dollars to treat and educate HIV positive Ugandan children via the Baylor College of Medicine Children’s Foundation-Uganda. The organisation will coordinate HIV/AIDS treatment of children in all government hospitals and health centres.

“BCMC-U will use the funds to expand HIV services for 140,000 children living with the virus,” said Dr Wilfred Ochan Lokol.

“The programme will cover 32 districts in the first phase of the project implementation.

“Out of 140,000 infected children in the country, 50,000 are in need of HIV treatment, but cannot access [it] because of the few sites that provide AIDS services to children.”

Bill Oketch is an IWPR-trained reporter.