Why are we there?
- Armed conflict
- Endemic/Epidemic disease
- Healthcare exclusion
- Uganda: MSF concludes emergency Ebola response
- Uganda: controlling the Ebola epidemic
- Uganda: interview with Ebola survivor, Kiiza Isaac
In Uganda. Médecins Sans Frontières/Doctors Without Borders (MSF) operates HIV and tuberculosis (TB) programmes and assists people recovering from years of conflict in the north of the country.
MSF supports hospitals and health centres in the districts of Kitgum and Lamwo and the subregion of Karamoja in northern Uganda. In 2011, staff conducted close to 17,000 outpatient consultations and 3,365 antenatal consultations, and admitted 506 people to hospital.
Since the conflict ended, the general health situation has improved, and this has prompted MSF to switch the focus of its activities in Kitgum and Lamwo to supporting victims of sexual violence: there are now 18 centres in the two districts that can care for survivors of sexual violence.
In Karamoja, fighting persists, and a number of patients needed treatment for wounds.
When yellow fever and hepatitis E broke out in the region, MSF assisted the health authorities, and also supported the response to an outbreak of Ebola in Luwero, central Uganda.
MSF continued to run its TB programme, and more than 500 new patients started treatment in 2011. In December, the first patient to start treatment for multidrug-resistant TB (MDR-TB) in the programme was declared cured. MSF has been lobbying for other organisations to provide treatment for MDR-TB.
HIV care in Arua
The Ugandan Ministry of Health decided that it would start implementing nationwide MSF’s treatment protocol for preventing mother-to-child transmission (PMTCT) of HIV in 2012.
MSF continued to provide treatment at Arua regional referral hospital, in the northwest of the country.
Each month, an average of 25 women gave birth through the PMTCT programme. Nearly 2,000 new patients were registered at MSF’s HIV programme and more than 6,400 received antiretroviral (ARV) treatment.
Being close to the border with the Democratic Republic of the Congo (DRC), where access to ARV treatment is very limited, a significant proportion of the people living with HIV in the Arua area come from the DRC.
MSF has been supporting an HIV clinic at a health centre in Oli, on the outskirts of Arua. At the end of 2011, more than 780 patients were receiving care in Oli. This programme will be handed over to the Ministry of Health in 2012.
The Oli and Arua programmes both offer integrated care for HIV patients suffering from other conditions associated with the infection, including TB and malnutrition. More than 700 patients co-infected with TB and over 550 children suffering from severe malnutrition received treatment in 2011.
Sleeping sickness (human African trypanosomiasis) is endemic in Uganda. MSF had been supporting Ministry of Health programmes, but in the middle of the year, after an assessment revealed prevalence to be less significant than suspected, the team decided to focus instead on lobbying for the opening of treatment centres and on providing training to national and regional programmes.
A number of research projects were carried out in Uganda in 2011. With the London School of Hygiene and Tropical Medicine, MSF undertook operational field research into TB and drug-resistant TB patients’ acceptance of home-based care through village health teams.
In Karamoja, researchers embarked on a study of how children’s recovery from malaria, diarrhoea or respiratory infections is affected by their nutrient intake. MSF also started a study on rapid diagnostic testing methods for HIV.
At the end of 2011, MSF had 613 staff in Uganda. MSF has been working in the country since 1986.
Opira, 34 years old, has MDR-TB
“For quite some time now, I have been taking 18 tablets a day … Sometimes when I take the drugs, I feel weak because the drug starts working on me immediately and I cannot go anywhere; I have to take some time.
"Sometimes, I can take the drugs and, when I have eaten well, I may not feel like vomiting. Sometimes, I might feel like vomiting but I can still walk around. But most of the time when I take the drug, I feel like I should first have a rest in bed because I cannot walk.
“In the end I will go back to Gulu. That is my plan. I lived there during the conflict and didn’t leave until last year, 16 May. That is the day I came to Kitgum, because of my illness.”
Opira writes a blog as part of MSF’s TB&ME project.