UGANDA: Fishing communities missing out on HIV treatment
Fishing communities in Uganda receive little attention from the government’s HIV programs
KAMPALA, 26 November 2012 (IRIN) - Fishing communities in in Uganda do not have adequate access to life-prolonging antiretroviral drugs (ARVs), posing a possible setback to the country’s fight against HIV, new statistics reveal.
As of June 2012, just 15 percent of 6,225 fisher folk - considered one of the country’s most at-risk populations - in need of ARVs were receiving it, according to the Uganda AIDS Commission (UAC) in its annual review of the Uganda National AIDS Strategic Plan.
Officials blamed low literacy among this segment of the population as well as the remoteness and inaccessibility of the islands where many of them are found.
“Our HIV intervention among the fishing community in Uganda remains low and a big challenge. Most of these people stay in islands, which are hard-to-reach areas. Most of the islands lack health facilities,” Peter Kyambade, most-at-risk populations coordinator at the Ministry of Health, told IRIN/PlusNews.
“These people keep moving from one island to another. If we are to access them, we need motorized boats and fuel, which is so expensive. The fight requires a comprehensive approach. We can’t put health facilities on every island.”
Lack of information, stigma, side effects, weak linkages between health facilities and programmes, stock-outs of ARVs, understaffing at health facilities, limited health centre accreditation to offer ARV therapy [ART], and the migratory nature of the fishing communities were all cited as possible barriers to treatment.
A 2011 study among fishing communities in the Lake Victoria Basin of Uganda found an HIV prevalence of 22 percent, more than three times the national average of 7.3 percent.
Although the Ministry of Health reported that over 700 health facilities were providing ART in government-owned and private health facilities, only 532 facilities were doing so by March 2012, according to the report.
Civil society organizations have petitioned the government to scale-up the provision of ARVs and prevention programmes for the most at-risk populations (MARPs).
“There is an urgent need for the definition of MARPs. UAC should commit on how to involve MARPs and on accelerating treatment and prevention programming for MARPs,” the organizations said in a 16 October ten-point plan.
At Katosi-Ntenjeru, a health clinic in Mukono that serves people from the country’s 52 islands, just 400 of some 1,500 HIV-positive people are currently receiving treatment.
“We have over 1,500 clients eligible for ART. However, as you can see in our shelves, we have over 1,100 dormant files. These people are eligible for treatment, but we can’t trace them,” Susan Kirabira, a counselor at the centre, told IRIN/PlusNews.
Lack of focus on fishing communities could jeopardize efforts to curb Uganda’s new HIV infections.
“If the fishing community continues to be neglected, it will be a source of infection to the rest of other people. These people come and socialize with the people on the mainland,” Reuben Kagwa Mubiru, programme manager at the Kyetume Community-Based Health Care Programme, an organization fighting HIV in the fishing community in Mukono.
In some districts like Kalangala, the US Mission in Uganda, through the US President's Emergency Plan for AIDS Relief (PEPFAR), has launched a combination of clinic-based interventions, outreach programmes at locations such as boat landing sites, and home-based care to reach fishing communities.