Keep fighting the good fight: A report from an ARV clinic in Uganda

Sam Sanden, a congressional district leader for ONE and a pastor in Washington state, makes an eye-opening pit stop at a district hospital in Uganda. The hospital receives US foreign aid, which is put to good use, but still faces many challenges…

Last month, I had the privilege of traveling to Uganda. I was leading a team from my church in partnership with some schools in the northern part of Uganda, more specifically Arua and Yumbe.

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Being a ONE member and a congressional district leader, I decided to use the opportunity to track down an antiretroviral (ARV) drug distribution center during my time there. I just couldn’t pass up the chance to see with my own eyes the impact of smart and efficient programs we fight for, like PEPFAR and the Global Fund.

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After doing some research online, I found that ARVs are distributed to more than 300 locations in Uganda, and our friends on the ground found that the hospital in Yumbe was one of those locations.

Yumbe is a small town located in the northwest corner of Uganda, bordering South Sudan and the Democratic Republic of Congo — and the hospital we visited is the only hospital in the whole of the Yumbe district. The northern part of Uganda has seen decades of violence and civil war, (Joseph Kony and the LRA, etc.), impacting the economy and making development difficult and dangerous. Now this region is trying to catch up with the rest of Uganda, but it is a long process.

The Yumbe Hospital, with only about 100 beds, is only meant to serve the half a million people in Yumbe District. But because it borders the DRC and South Sudan, clients from the whole war-torn region walk through their doors, serving over 1 million people.

As a result, funding and resources are scarce, and while there are many needs and wants, the hospital staff can only do what they can. As an American, it’s hard to fathom how only one hospital (and 22 smaller clinics scattered in the district) can even scratch the surface in caring for a population larger than a city of the size of Seattle, but that’s what they have to deal with. Another huge challenge is the lack of clean water, as the hospital itself does not have running water, something we take for granted on a daily basis.

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I had the privilege of speaking to the head doctor, Dr. Mubarak Nasur. He talked about about the hospital’s HIV/AIDS work and the difference they have made with what they have.

Currently, the hospital treats more than 500 people with ARVs, provided with the help of The Global Fund, and another 1,200 people are in care receiving counseling. The hospital has put in place some great procedures in regards to HIV/AIDS testing.

A big focus is put on preventing mother-to-child transmission and therefore every pregnant mother is tested before delivering her baby. Since July of last year, the hospital has delivered 1,576 babies, and of the mothers tested, only 25 were found to be HIV-positive. If found positive, counseling and treatment are initiated right away, and upon going home, the mother is then referred to the nearest clinic.

Testing is also done when a child is admitted to the pediatrics ward. And children admitted to the malnutrition ward are tested for TB in addition to HIV/AIDS. So far this year, four children have been diagnosed with HIV/AIDS and, of those, one child has since passed away. Unfortunately, many times parents wait too long before seeking help, so early testing is key.

Dr. Nasur shared that there are many challenges in the fight against HIV/AIDS. For example, in the Yumbe district, there are currently only three locations that are dispersing ARVs, which means people might have to travel far to get their monthly regimen. This causes extra challenges in the rainy season when roads might wash out and rivers become impassable, making people unable to make even the monthly trip to receive their ARVs or care.

Another challenge is lack of trained staff. Out of the 14 doctor positions at the hospital, ten are currently vacant; two are administrative, leaving only two doctors to actually provide for patients. This hurts the distribution of ARVs as currently only doctors are allowed to administer ARVs, but Dr. Nasur was encouraged as PEPFAR is working to change that policy on a national level so that nurses would be able to do it as well. This would enable more people to be treated.

However, one of the highlights the doctor shared with me was that, due to the encouragement, support and availability of ARV’s from The Global Fund, Dr. Nasur has requested the Ministry of Health of Uganda to open an additional three ARV distribution clinics in the Yumbe district. This would be an incredible enhancement to the HIV/AIDS fight in Yumbe, enabling more people to be closer to the life-saving medicines and the care and counseling needed.

Several people I spoke with also shared how food security is a vital component in the fight against HIV/AIDS. With poor access to food, people are more vulnerable and less able to fight side effects of HIV/AIDS; they don’t have the energy to walk to the clinics, or time to take off work to get to the clinics, etc. Therefore, programs like Feed the Future make a great complement in the fight against HIV/AIDS.

While the road is still long, seeing men like Dr. Nasur fighting the good fight against HIV/AIDS through the partnership of organizations like PEPFAR and the Global Fund, it gives me hope that we can achieve the “Beginning to the end of AIDS by 2015”. This is not the time to let our guard down, but to stay the course and change the tide of AIDS!