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Providing Health Care Services For Northern Uganda

“Some of our members and their households used to fear to go for HIV and AIDS tests. Now we no longer fear to go and test for HIV and AIDS. We now know our HIV status and some of us who are positive are open about our status, other than keeping silent. Those of us who are HIV positive now go to the health centre to get ARV treatment for prolonging our lives. Stigma between those who test positive and those who test negative has reduced. Group members support one another in the group and at homes.  Increased appreciation of the fact that HIV and AIDS  do not kill immediately and one can live positively has enabled us to live positively by taking good care of ourselves, eating nutritive foods, visiting health centres for services and not to isolate ourselves, but to continue to actively engage in productive activities.  For those amongst our members who tested negative,  have changed their behaviour, such as not sharing sharp objects and not engaging in extra marital sexual relationships which increase the risk of  being exposed to getting HIV. They make every effort to stay negative.”

This testimony was shared on 13th March 2014 by members of Lobo Dongo Ki Dano Farmer Field School (FFS) while they discussed with an independent consultant, Mr. Godfrey Kayobyo of Nkoola Institutional Development Associates Ltd. Their discussions were focused on most significant change stories in relation to the Farmers First (FF) Programme which CPAR Uganda implemented in Lango, in Northern Uganda, from 2009 to 2014. Lobo Dongo Ki Dano FFS is located in Dok Ayira Village, Alal Parish, Aloi Sub-County, Alebtong District. FF was funded by the Canadian Government through Canadian Physicians for Aid and Relief.

The testimony of Lobo Dongo Ki Dano FFS was confirmed by health staff in Alebtong who during discussions with the external consultant on the subject matter revealed that the HIV and AIDS prevalence rates in Alebtong District had reduced from 9.2 percent in 2010 to 5.5 percent in 2013. Of note is that the HIV and AIDS prevalence rates for Alebtong District were much lower than 8.3 percent – the rate for mid northern Uganda; and were lower than 7.3 percent – the national prevalence rate for Uganda as a whole at the time.  It is highly likely that FF contributed to this achievement as indicated by the story of Lobo Dongo Ki Dano.  A high proportion, 94 percent, of the hundreds of participants in outreach days that were supported by FF got tested; pointing to an increase in the knowledge levels on HIV and AIDS in the FF target communities as indicated by Lobo Dongo Ki Dano.

FF participating farmers indeed rated their knowledge and sensitivity levels as high with regards to HIV and AIDs. They attributed their improved knowledge and sensitivity levels to the trainings on special topics, and health outreach undertaken under FF in collaboration with the relevant local government organs.  Their increased knowledge and sensitivity was measured by the enhanced willingness to test for HIV and use of VCT services; increase in the number of mothers opting to give birth at health centres and moreover accompanied by their husbands and especially mothers living positively with HIV; desisting from sharing cutting/sharp items like razor blades, and needles; not touching open wounds with bare hands; reduced conflicts in the homes due to drinking; less quarrels and fighting among community members, notably men; abandoning practice of extracting pseudo teeth from children; expectant mothers going for antenatal check-ups and postnatal check-ups; child spacing by couples; and women going for cancer screening. This is as exemplified by the story of Lobo Dongo Ki Dano.

Whereas in the recent past CPAR Uganda has majorly focused on providing health training and awareness creation services, during the height of the insurgency in Northern Uganda – 1992 to 2008 – CPAR Uganda, as a Country office of the Canadian Physicians for AID and Relief at the time, greatly contributed to health services in Northern Uganda through construction of and equipping of health facilities.  With funding support from its partners, including UNICEF, CPAR Uganda constructed 14 Maternal Health Centres at Bobi and Kalali in Gulu District; Aromo in Lira District; Purongo and Todora in Nwoya District; Mucwini in Kitgum District; Agulurude, Otwal, Adigo and Acokara in Oyam District; and Ayer in Kole District. All the 14 health centers it donated to the respective district local governments to own and to manage in accessing services to the people of Northern Uganda.