HIV Screening: Lack of Supplies are Critically Effecting Beneficiaries in Northern Uganda

Last week the GROW Team had the opportunity to observe two separate HIV screening sessions. Along with maternal health and livelihood, our GlobeMed project also focuses on HIV/AIDS prevention. These screenings help us reach communities in ways that a sensitization session cannot. Many people in Northern Uganda would not have the opportunity to be tested multiple times a year due to the extreme distance between their homes and the health center, which is equipped with the supplies necessary to conduct proper HIV testing. Before the screening session starts, we pick up the clinical workers from a health center and the supplies for the kit and from there we drive out to the specific parish.

On June 10th the GROW Team headed out to Palema Parish to conduct the first HIV screening. The process of HIV screening is simple. The patient writes down his or her information: name, gender, parish, and signature. David and Isaac, a driver for GWED-G, assisted those that did not know how to write and had them stamp their fingerprint as a signature.

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David and Isaac working together to record the names of community members receiving HIV testing.

Afterward, the patient waited for their name to be called and then received a a number before their screening started. The clinician numbered the HIV testing strip and the patient received a corresponding number to the strip that will contain their blood. Blood was captured in one of two ways, either through a vein in the arm or through a finger prick. At Palema Parish we were lucky enough to have 20 vials to capture blood in, and Rosemary, the clinician, explained that these vials of blood can be used for testing later in the day if there are any discrepancies. Unlike in the United States, where blood can be easily stored in a cool refrigerator and referenced days later, blood samples cannot be used longer than three hours later due to both a lack of refrigeration unit as well as frequent power outages.

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Rosemary, a lab technician at Kaladima Health Center, draws blood to be tested for HIV.

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HIV testing strip. One bar on a strip represents a negative test, while two represents either a positive or false negative. Any strip with two bars is tested again to ensure that accurate HIV status results are found.

After the results have been verified, the patients receive counseling. On June 10th, Beatrice, an HIV positive VHT, accompanied us to the field. We are so lucky to have people like Beatrice working with GWED-G and our HIV prevention project. Beatrice and Franny counseled 35 community members, and only 3 out of 35 tested positive. Surprisingly, a few couples requested to be counseled together. While this may not seem out of the norm, it’s pretty unexpected when men in the community want anything to do with knowing their HIV status or agreed to learn about their status with their wife.

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Franny counseling a community member after her HIV testing results have been confirmed.

On June 12th, the GROW Team, Franny, and a team of clinicians crammed into the GWED-G vehicle to conduct another HIV screening at GiraGira Parish, and also to provide vaccinations to children of the community. The process for the screening was the same as last time, although this time a few children were screened. Franny explained to us that children 18 months and younger must be tested five times with special kits that we are not allowed by the government to handle. The main problem that community members face with this law is that the results are not immediate. The blood samples are sent off to Kampala, but are not returned promptly. We learned from the new mothers at GiraGira that they do not know the HIV status of their recently born children, and some of these children were born in January. Until the government in Uganda addresses this problem we cannot expect mothers to efficiently know the status of their children, and this poses extreme problems for both the mother and child due to not knowing whether or not the child should be taking ARV medication.

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A lab technician from Labongogali Health Center tests both a father and his two children for HIV.

Along with HIV screening, clinicians also provided vaccinations to children and antenatal care to the community. 44 mothers that knew the HIV status of their babies received vaccinations for measles and mumps while 27 children received the vaccination for tetanus.

 

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Tetnus shots are distributed to youth.

While the vaccinations were taking place, Emma, Helen, and I accompanied Franny to visit pregnant mothers that were due to deliver. During one visit we learned that a mother’s water had broke the night before and desperately needed to be transported to a hospital. This was the mother’s first child and luckily we were able to utilize the GWED-G van and take her to Kaladima Health Center. Later we found out that she gave birth to a healthy baby boy with help from the mama kit she had received when joining the program.

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Listening to the baby’s heart beat during a pregnancy check up with Franny.

While success stories such as this one do take place, the critical lack of supplies here in Northern Uganda is preventing many births from having such positive outcomes. Uganda is currently facing an extreme shortage of HIV testing kits as well as for mama kits. According to Pam, NGO presence and support in Uganda that had helped with procurement has decreased since Museveni’s passing of the anti-homosexuality bill. The government is also to blame in its allocation of funds to these health centers. Because the government has made private hospitals and health center IV’s a priority over health center I-III’s, the latter are enduring the brute of the hardship. Most of our beneficiaries only have access to the health center I-III. We can’t expect the HIV rate to decrease in the upcoming years if this problem is not addressed. The question that remains is, how do we solve this problem? While I can’t provide a specific answer, I can offer my thoughts. By staying here in Gulu I’ve learned that three quarters of Uganda is illiterate and does not even know what bills have been passed or what they entail. Because of this, I think that the US NGOs that have cut these critically needed health funds should reconsider their position. I believe it is imperative that these supplies are funded if the Ugandan government is not properly allocating funds for them. There is no way the HIV rate in Uganda will decrease in years to come if the supplies are not provided to ensure 1.) a healthy birth and 2.) the ability to know the HIV status of the mother and child.

GROW Team Out.

-Sarah

 

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