to. The CPO told me about a case in which a thirteen-year-old girl was abandoned by her father after she developed epilepsy. He locked her out of the house and refused to give her any food, making her sleep outside, alone, in the rainy season, for three months. With Plan’s support the father was arrested and successfully prosecuted, and the girl now lives with her mother. There are an overwhelming number of cases, the CPO said, and not enough resources to help them all. But she does her best, with the help of volunteers from the community.
Later I asked one of these community volunteers what has improved since Plan came to the area. ‘Child protection,’ he said without hesitation. What else, I asked. This time he had to think for a bit. ‘Nothing,’ he said.
I found out more about the ‘negative impact’ of HIV and AIDS the next day in a visit to a local hospital. The hospital comprises several buildings scattered around a compound, but only has one full-time doctor, plus a volunteer doctor and a number of midwives. This isn’t too bad, considering that country-wide there is only one doctor for every 23,000 Ugandans. I kept having to remind myself, looking at the patients sitting or lying on the dirty concrete floor, with no food or water, waiting for hours to be seen, that these people are lucky. There was one old woman lying on the ground, immobile, with only a thin cotton wrap between her and the hard floor. Right at that moment, as it happened, my own grandmother was in a hospital in France. A few days later, in fact, she would die, but to the last she would be in a comfortable bed, with clean sheets and blankets, and 24-hour medical care. I imagined her lying in front of me, on that floor. I am still imagining that.
The hospital workers I met were determined and positive about recent improvements in HIV and AIDS care. All pregnant women who come to the hospital are counselled about HIV/AIDS, and those who consent are tested. People are now also coming forward for voluntary testing, I was told – this is new, and reflects the decreasing stigma of the disease, and the growing understanding that treatment can help extend life expectancy. There has also been an increase in the number of people seeking treatment, and staying in treatment programmes. I was told that if a pregnant woman follows the whole of the PMCT (Prevention of Mother to Child Transmission) programme, it will successfully prevent transmission of HIV to their baby in all cases. Unfortunately, it is rare that any of the women here can successfully complete the programme, as one of the key preventative factors is not to breastfeed your baby, but the cost of formula is $9 a week, and the average Ugandan income is less than a dollar a day.
When I asked the hospital administrator where the funding comes for the hospital, he laughed and reeled off a seemingly endless stream of NGOs, as well as the local health authority. It’s hard to imagine just how much time is taken up administering and coordinating all of these separate income sources. And with so many different organisations with different priorities funding different services in the same place, key areas of provision fall through the cracks. So, for example, Plan’s most notable contribution to the hospital is a machine which counts CD4 cells for HIV/AIDS patients – an invaluable piece of equipment, without which it is impossible to decide which ARV drug to prescribe, and at what dose. People travel from miles around just to have their blood tested by the machine. We are taken to visit the machine. I basically have no idea what I am looking at. It looks like a machine. But everyone is clearly very proud of it. Unfortunately, the machine needs specific reagents to make it work, and Plan don’t provide these, and neither does anybody else. Supplies of the reagent can come from local government, but are as often as not stolen, both before and after they reach the hospital – drug theft is a
Later I asked one of these community volunteers what has improved since Plan came to the area. ‘Child protection,’ he said without hesitation. What else, I asked. This time he had to think for a bit. ‘Nothing,’ he said.
I found out more about the ‘negative impact’ of HIV and AIDS the next day in a visit to a local hospital. The hospital comprises several buildings scattered around a compound, but only has one full-time doctor, plus a volunteer doctor and a number of midwives. This isn’t too bad, considering that country-wide there is only one doctor for every 23,000 Ugandans. I kept having to remind myself, looking at the patients sitting or lying on the dirty concrete floor, with no food or water, waiting for hours to be seen, that these people are lucky. There was one old woman lying on the ground, immobile, with only a thin cotton wrap between her and the hard floor. Right at that moment, as it happened, my own grandmother was in a hospital in France. A few days later, in fact, she would die, but to the last she would be in a comfortable bed, with clean sheets and blankets, and 24-hour medical care. I imagined her lying in front of me, on that floor. I am still imagining that.
The hospital workers I met were determined and positive about recent improvements in HIV and AIDS care. All pregnant women who come to the hospital are counselled about HIV/AIDS, and those who consent are tested. People are now also coming forward for voluntary testing, I was told – this is new, and reflects the decreasing stigma of the disease, and the growing understanding that treatment can help extend life expectancy. There has also been an increase in the number of people seeking treatment, and staying in treatment programmes. I was told that if a pregnant woman follows the whole of the PMCT (Prevention of Mother to Child Transmission) programme, it will successfully prevent transmission of HIV to their baby in all cases. Unfortunately, it is rare that any of the women here can successfully complete the programme, as one of the key preventative factors is not to breastfeed your baby, but the cost of formula is $9 a week, and the average Ugandan income is less than a dollar a day.
When I asked the hospital administrator where the funding comes for the hospital, he laughed and reeled off a seemingly endless stream of NGOs, as well as the local health authority. It’s hard to imagine just how much time is taken up administering and coordinating all of these separate income sources. And with so many different organisations with different priorities funding different services in the same place, key areas of provision fall through the cracks. So, for example, Plan’s most notable contribution to the hospital is a machine which counts CD4 cells for HIV/AIDS patients – an invaluable piece of equipment, without which it is impossible to decide which ARV drug to prescribe, and at what dose. People travel from miles around just to have their blood tested by the machine. We are taken to visit the machine. I basically have no idea what I am looking at. It looks like a machine. But everyone is clearly very proud of it. Unfortunately, the machine needs specific reagents to make it work, and Plan don’t provide these, and neither does anybody else. Supplies of the reagent can come from local government, but are as often as not stolen, both before and after they reach the hospital – drug theft is a
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