Uganda

Security has improved in northern Uganda since peace talks began between the government and rebel group the Lord’s Resistance Army in 2006. An estimated 95 per cent of the 1.6 million people who had been displaced by fighting have returned home. The healthcare system is gradually being rebuilt, but there is a shortage of trained health staff, an irregular supply of medication, and a lack of care available to people suffering from HIV/AIDS, tuberculosis and malaria.

HIV care

The Arua Hospital Aids Program in Arua, northwestern Uganda, offers integrated treatment for people co-infected with tuberculosis (TB) and HIV. Staff also provide ready-to-use food for malnourished adults and children living with HIV. Of the more than 8,000 patients currently registered at the hospital, almost 5,500 are receiving antiretroviral (ARV) treatment.

MSF has been providing HIV treatment to patients living in the West Nile region since 2002. In 2010, an average of 158 patients were enrolled in the programme every month.

In the towns of Madi Opei and Kitgum Matidi, in the north, more than 1,120 HIV-positive patients were registered on MSF’s treatment programme by the end of the year, and 520 of them were receiving ARV treatment.

Tuberculosis care

For TB treatment to be successful, patients must follow a long course of regular drug administration. Inadequate TB services, coupled with recurrent displacement due to conflict in northern Uganda, have disrupted treatment for many patients. This increases both their resistance to the drugs, and the prevalence of drug-resistant tuberculosis (DR-TB), for which treatment is even more complex and can take up to two years.

In 2010, MSF increased the number of TB screening sites in the northern districts of Kitgum and Lamwo from 7 to 13. More than 310 new TB patients started medication, and DR-TB care was introduced.

Malaria care

Malaria is the main cause of death among young children in Uganda, and the most effective treatment is artemisinin-based combination therapy (ACT), which has low toxicity, few side effects and acts rapidly against the parasite. In 2010, MSF treated close to 26,000 patients for malaria, using ACT where applicable.

Sleeping sickness

Sleeping sickness (human African trypanosomiasis) is endemic in Uganda, the only country where two forms of the disease are present: an acute form known as "Rhodesian", and a slower-developing chronic form, known as “Gambian”. Both forms of sleeping sickness attack the central nervous system and cause death. MSF supports the Ministry of Health’s sleeping sickness programme in the West Nile region by offering screening and giving technical support and training to community health workers and other staff.

Maternal healthcare

Karamoja region, in northeastern Uganda, is an underresourced area where health services are scarce. MSF teams carried out more than 26,000 paediatric consultations at Kaabong hospital, in health centres and at mobile clinics across the region. MSF also opened a maternity waiting house in Kaabong in partnership with local non-governmental organisation AWARE. Here, women at risk of a complicated delivery can spend their last few weeks of pregnancy in a safe space close to medical care.

Patient story

Christina

Christina is the mother of three-month-old Nancy. When she discovered she was pregnant Christina was in despair because of her HIV-positive status. She went to the Madi Opei clinic where she received counselling and was enrolled in the prevention of mother-to-child transmission programme. Now Christina is waiting to see whether her daughter has the HIV virus. “I was really worried about passing on the disease to my child. The last two tests for my baby have been HIV negative. It is a struggle and a long wait for that final day when I will know for certain.”

At the end of 2010, MSF had 572 staff in Uganda