Dr. Jill Biden, the vice-president's wife, visits women and children at the Dadaab Refuge Camp in Kenya. Official White House Photo by David Lienemann.

“Thousands of Somalis are fleeing the famine and seeking refuge in Kenya and Ethiopia, which are also affected by the drought,” said Jay Carney, the White House press secretary, in a press brief yesterday afternoon.  You can click here to watch the video.

The U.S. State Department recently announced new guidelines to give foreign aid workers more flexibility in providing aid to others controlled by al-Shabaab.

-You may be familiar with social coupon sites like Living Social and Groupon.  Recently, Africa.com launched its own social coupon website for Africans living abroad at deals.africa.com.

After signing up for free with the website, members are offered a weekly, deeply-discounted deal.  If enough members sign up for it, they receive a voucher for it.  For instance, the first deal were deeply discounted tickets between New York and Lagos.

Other deals include discounted airfare to Ghana, South Africa, and other destinations on the continent, as well as social coupons for international phone cards, money transfers, hair styling, and cell phone services.  Vendors who sign up can access the market power of Africans living abroad, who remitted an estimated $40 billion last year collectively, according to the African Development Bank, the Sacramento Bee reported.

-There are more Ethiopian doctors in Washington D.C. than all of Ethiopia, and 60 percent of medical doctors trained in Ghana since the 1980s have gone abroad, according to this New York Times editorial by Josh Ruxin, a Columbia University expert on public health, and founder of Rwanda Works.  Only 3 percent of the world’s health care workers serve the African continent.  However, two Rwandan doctors are teaming up with a New York obstetrician to start a second Rwandan medical school (there is only one medical school right now, housed at the University of Rwanda) to increase the country’s capacity for training.

Graduates of the Kigali Medical University, funded by the Rwanda Development Bank, may still end up working abroad, but the school plans to emphasize education and the need to stay home and serve the country’s medical needs.  Its first class of students will begin this year.

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By Daniel Alinda

KAMPALA (Ugandans Abroad)— The number of people seeking medical assistance for diabetes is rising in Africa at a time when health experts say the continent’s overburdened health care systems are ill-equipped to diagnose and treat the disease.

A diabetes screening camp in Kenya. World Diabetes Foundation.

According to the World Health Organisation, an estimated seven million Africans suffer from this disease, which is now ranked as the fourth main cause of death in most developing countries.

The International Federation of Diabetics (FID) projects that the prevalence rate will shoot up by 95 percent by 2010 from the current 0.5 to 3 percent range across the continent.

National surveys in most parts of Africa indicate that diabetes cases are on the rise due to rapid urbanisation and fast changing diets which are marginalising traditional ones in favour of the western diets.

In Uganda in 1972, only 254 African diabetic subjects were registered in Mulago Hospital’s diabetic clinic. But this national referral hospital alone handles over 300 diabetics weekly now, according to their statistics.

In Uganda, it is hard to get accurate data on the number of people suffering from the disease today. But outside of Mulago Hospital, data from the Arua Regional Referral Hospital indicate that in 2004-2005, a total of 1,201 diabetic visits were made in the health facilities.  In 2005-2006, they had 2,056 patients.  The Uganda Diabetes Association notes that there about 10,000 diabetes cases reported nationally.

Insulin is used to treat diabetes. World Diabetes Foundation.

The cost of insulin is far beyond the capacity of ordinary people. A packet of 50 vials of insulin costs about sh450,000.  One patient can use as much as 50 vials in six days, yet a patient is supposed to be on medication for the rest of her life.

Studies carried out recently in Zambia, Mali and Mozambique highlight a stark reality.  A person requiring insulin for survival in Zambia will live an average of 11 years; a person in Mali can expect to live for 30 months; in Mozambique, a person requiring insulin will be dead within 12 months.

Diabetes is responsible for over one million amputations each year, a large percentage of cataracts, and at least five percent of worldwide blindness is due to diabetic retinal disease.

In 2003, Zimbabwe recorded more than 90, 000 cases of diabetes, an increase of 3,000 from 1997.  The prevalence of diabetes in the adult population was estimated to be 10 percent in 1995, a figure that health experts say is particularly high.  During this time, 50 to 80 percent of all the people in the developing world were unaware of the condition.

The Diabetic Association of Zimbabwe estimates that around 400,000 people in the country have the disease.   Health experts think the number could be as high as 800,000.  The disease is also reaching worrying levels in most countries in Southern Africa.

Insulin syringes. Wikimedia Commons.

Last September, global health partners and policy makers on the continent met in South Africa to lay strategies on averting the rise of diabetes and other non-communicable diseases at the Diabetes Leadership Forum.

The forum was part of an ongoing campaign to support the implementation of the UN Resolution on Diabetes.  It reviewed current trends and initiatives on non-communicable diseases (NCDs), diabetes and related-health system challenges. The form focused on strategies to move the agenda forward, while looking ahead to UN Heads of State Summit on NCDs in September 2011.

Analysts say that more than one-third of African women and a quarter of men are estimated to be overweight, and the World Health Organization says this will rise to 41 percent and 30 percent respectively in the coming 10 years.  Being overweight can put one at risk of a variety of diseases, included diabetes.  We can eat ourselves literally into a diabetes epidemic.

Outside of South and East Africa, the World Health Organization also reports a growing number of people seeking medical assistance in West Africa.  It estimates that more than 3,3 million people in West Africa suffer from this disease.

In Senegal, the National Centre Against Diabetes initially reported an average of 200 new cases each year in the 1980s. However, this figure has increased more than 10 times, with 2,411 new cases reported in 2005.

Worldwide, analysts say, an estimated one billion people are overweight.  Paradoxically, 800 million are undernourished.  Health experts say the poor are the most vulnerable to poor nutrition.

The prevalence rate of this chronic disease was estimated to be 194 million in 2003, and health experts estimate that this figure will hit 333 million diabetic people by 2025.

Most African countries, including South Africa, still face a number of problems related to the management and treatment of the disease.

Critical shortages of diabetic medicine, the rising cost of drugs and treatment, competition of resources by other diseases which often get priority, and the general lack of equipment to diagnose the diabetes has hampered efforts to manage and control the disease.

In Zimbabwe, pharmacies and all major hospitals, at times go without essential diabetic medicines.  This is largely due to a lack of foreign currency to import some of these drugs.

In Mali, insulin can take about 20 percent of monthly household income for diabetics.  In Burkina Faso, a monthly minimum treatment for diabetics costs between $16-24, excluding examinations and follow-up health care.

The average cost for primary healthcare treatment in the US after amputation is estimated between $7,000 and US$10,000. In Africa, the costs are actuallymuch higher, given the prohibitive cost to import drugs and equipment, as well as the shortage of specialists.  Health experts also say that families without electricity or refrigerators face the added problem of how to safely store insulin.

Diabetes is a chronic life-long condition which requires careful monitoring and control.  It occurs when the body’s cells cannot take glucose from the blood.  As the cells are starved of glucose, they begin to use their own proteins, which quickly becomes very dangerous.  Common symptoms of diabetes include excessive thirst, frequent urination, sudden weight loss, extreme tiredness and blurred vision.

Without proper management and control, health experts say it can lead to hyperglycemia or raised blood sugar, which can damage the body and lead to failure of various organs, nerves and blood vessels, as well as amputations in adult.

Health experts warn that the high cost of medicines means that the majority of the poor often go untreated, or only access treatment sporadically.

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By Arao Ameny

UGANDANS ABROAD (New York)—

It is a sanctuary for those affected by strife, poverty, disease and persecution.  Tucked away between high rise apartments, it is known as the haven in Harlem for African immigrants in New York City.

African Services Committee.

The African Services Committee, a non-profit organization started in 1981 by Ethiopian refugees, is a multi-service agency that provides health, legal, housing and social services to 10,000 Africans each year, mainly immigrants, asylees and refugees.

The Ugandan Diaspora in New York can be greeted in Luganda, Rukiga, and English.

In its infancy, ASC was largely created to help immigrants with legal issues, particularly to stop unethical lawyers from preying on unknowing immigrants.  ”A lot of lawyers say they work or do immigration law, and don’t do it correctly,” said Kaplan.  ”People get into major issues when they don’t go through the correct channels.”

ASC branched out from immigration services for the Ethiopian population to serving the larger African immigrant population with both immigration and HIV-related services.  This is largely because in the late 1980s and 1990s, a wave of West African immigrants started coming to the U.S.  Today, the largest percentage of ASC’s clients are from West Africa.

East Africans In New York

Stephanie Kaplan, the communications director for the African Services Committee, when she served in the Peace Corps in Burkina Faso.

ASC still makes an effort, though, to reach out to the East African community in the metropolitan New York area.  However, they have served less than 5 percent of the East African diaspora community here as a whole.  On an annual basis, they provide services to about 100 East Africans, out of the  10,000 people they work with every year.  Kaplan says this is because the East African community in New York is small, and that most East Africans speak English, enabling them to avoid many of the language barriers that other African immigrants face when maneuvering New York’s healthcare system.

“The fact that Ugandans speak their native languages alongside English helps them, and also cuts down the numbers that come here into ASC,” Kaplan said.  “Mainly the Africans that come here is because of the language barrier.”  ASC works with with East Africans mainly on issues related to HIV/AIDS and other STD testing, as well as housing.  However, Kaplan said that ASC would also like to work with individuals on prevention and awareness of HIV.

ASC tends to help more male than female immigrants, at a ratio of 60 to 40.  For East Africans, they usually work with immigrants between the ages of 20 to 39 who have lived in the U.S. for less than 5 years.  Pregnant mothers from all African countries typically seek ASC’s services, since mothers have to be tested for HIV and AIDS by law before giving birth.  ASC often helps individuals navigate the healthcare system, as well as find housing.  They also offer English learning classes to individuals who do not speak English in their home countries, or need to improve their skills.

The English language classes largely cater to West Africans, many of which are from Francophone countries.  ASC primarily relies on clients passing on information about them through word of mouth to advertise their services, though they do have street teams in New York City that hand out stickers, key chains, and other materials about their free testing services.

Accessing Healthcare in New York

Newer immigrants from Uganda can still utilize ASC when seeking healthcare in New York City, particularly individuals who may not have legal documentation and need to understand both their rights and responsibilities.  “If someone is an illegal immigrant or not, you have access to HIV medication,” said Kaplan.  “Some people don’t even know that, and they are scared of immigration issues, especially now [with] the current immigration climate.”  She added that Ugandans and other African immigrants need to understand their rights.

One success that ASC is known for is their cultural focus on tackling issues that their clients face.  Unlike other nonprofits that may tackle an issue from a dominantly American perspective, ASC tries to recognize the cultural nuances that affect major health issues.  For instance, the taboos surrounding the topic of HIV/AIDS in African countries is reflected in New York African’s communities.  Understanding these nuances, male and female gender roles, and other important cultural dynamics are essential to ASC’s success and growth.

HIV-Related Stigma In New York’s African Communities

The African Services Committee at City Hall in New York City.

HIV-related stigma is the biggest challenge to get individuals to come through the nonprofit’s doors.  As a result, they offer a wide range of services, from glucose testing to diabetes testing to general health services. “We offer a range of services for people who feel uncomfortable walking into an agency that does [strictly] HIV testing,” she said.

“People will walk past the door ten times to make sure no one sees them, to make sure that no one they know is coming in here, they fear that someone will consider them HIV-positive.”  The diverse array of services helps people to feel more comfortable about coming to the office.  Many African immigrants are concerned about being isolated from their respective cultural and linguistic communities, so confidentiality and cultural understanding is very important.

When asked if there was a single message that she wanted to send out to the Ugandan community in New York and the metropolitan area, Kaplan said that she hopes the Ugandan diaspora will open up a dialogue about HIV in their community.  ”Get tested and start talking about HIV and AIDS,” she said.  ”Talking is the only way to start.  We would love for people to talk about it, and be willing to talk to people who are HIV-positive.”  Even if you are HIV-negative, knowing your status is powerful and will encourage others to get tested.  That is an opportunity to possibly save someone’s life.

Kaplan told Ugandans Abroad about a Kenyan woman who was elated to see a group of Africans at an ASC meeting talking about how they would treat a relative or friend who is HIV- positive. The woman was encouraged to learn that the group was very accepting of HIV-positive individuals and would not reject or ostracize the person. Kaplan said that dialogue is productive not only for individuals with HIV or AIDS, but for the community as a whole to be educated about prevention, treatment and care methods.

ASC's Why Stand campaign-- this image shows a message from Miss Senegal USA.

Kaplan said that the dialogue, whether it is in the Ugandan community or other respective African communities in New York, has to come from the top. “Leaders in the communities that you know and can relate to, an imam or president of the African organization need to start the dialogue,” she said.  “It has to become a normal thing within the community [to] dispel the fear of rejection.”

Unfortunately, some people are still kicked out of their houses after revealing their HIV-positive status, and the African community as a whole in New York needs to tackle this issue head-on through cultural and religious leaders at churches, mosques, and community meeting.

Currently, ASC tests over 4,000 people per year and plans to open weekend hours to accommodate their clients’ work schedules, even offering incentives for individuals to get tested for HIV/ AIDS. “We are going to move forward with Saturday opening. We are at full capacity. If you come out for testing you get a metro card,” she said.  ”We offer different incentives to get people to come out for the free testing.”

Interestingly, some Latino and Asian immigrants are also using the African Service Committee’s HIV-related services to avoid their own communities during testing.  “They come here so they don’t run into members of their own communities so we have two Spanish speaking people on our staff,” she said. To battle this on-going stigma that crosses cultural and racial barriers, ASC launched the Stigma Initiative program.

The program worked with the New York City Department of Health and Public Health Solutions, a New York-based nonprofit, to create an inclusive, mainstream campaign to target all groups called the Why Stand Campaign.  For instance, in the poster featured in the image on the right, a message about HIV stigma comes from Miss Senegal USA.

“We recruited local respected leaders and put it in local African, Caribbean, and African websites like allafrica.com,” she said.  ”The whole campaign is about acceptance of people who live with HIV.  The goal of the campaign is to get people talking about why they should accept and stand with people with HIV.”

Get Involved Now: Every Little Bit Counts

Ugandans in New York can get tested, post on their social networks that they will be doing this at ASC, and encourage their community members to do this as well.  Ugandans can also join ASC’s street teams to let Africans in the diaspora know about the nonprofit’s free services, and speak on why prevention and early treatment is so important.

“Ugandans in New York can get involved by sharing in the campaign and recommend leaders in the Ugandan community to be spokespeople for the Why Stand campaign to support and encourage people living with HIV,” she said.

For World AIDS Day this year, an HIV women’s support group met a ASC, and held a candlelight vigil.  The group wrote the names of deceased friends and family on a big prayer cloth.  The community supports and encourages each others, while reiterating prevention methods in these activities.

“ASC is proud of its diverse African staff, which includes six members from Kenya and Ethiopia.  “I am so proud to be a part of an organization like this, because our organization staff mostly African-born members, and because of that connection we have a really organic reach to the African community here in New York City,” she said.  ”So we are not trying to forge connections that don’t exist.  We have connections with community leaders, imams, churches, church leaders, and through friendships with people who have moved here and integrated themselves in the African community.”

Outside of ASC’s work in Ethiopia, some clients have developed HIV programs in Mali and Cameroon, using the ASC’s model of services.  Some of the clients moved back to Africa for either immigration reasons or to be closer to their families.  They still maintain a close relationship with ASC.

Moving forward, the nonprofit hopes to do mobile testing on New York City’s streets, and get involved with more community organizations, such as East African diaspora organizations.  “We would love to make better connections with the East African community,” Kaplan said.  “We want to get to know the organizations more so that we can of be assistance to all Africans.”

For More Information:

-Check out the African Service Committe’s anti-stigma initiative, Why Stand, here

-Visit the African Services Committee’s website here.  Their office is based at 429 West 127th Street, and you can give them a call at 212.222.3882.

-Become a fan of the African Services Committee on Facebook.

-Want to support the African Services Committee this holiday? Send donations securely online here.

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NEW YORK – A new campaign aims to beat stigma and discrimination against HIV-positive Africans in New York by urging the wider population to show solidarity with them.

“For those living outside their home turf, the vulnerability that comes with being HIV-positive really exacerbates HIV stigma,” explained Kim Nichols, co-executive director of the African Service Committee (ASC), an NGO that provides HIV and other health services to African immigrants in New York.

“There’s a fear of deportation, a fear of being rejected by family and friends if they find out about their status that is just as real, if not more, because of the small community they are living in,” she added.

According to the ASC, while effective treatment has dramatically changed the fight against AIDS, stigma and discrimination against HIV-positive people remain as strong as ever.

HIV-positive African immigrants face interpersonal and institutional stigma. Photo: Marionzetta/Flickr

The “Choose to Stand Up” campaign calls on people to break the silence surrounding HIV stigma; share information by talking about experiences and concerns about HIV with friends and family; and to treat those with HIV with respect and compassion.

According to a 2008 study published by the US National Library of Medicine and conducted in several US states, up to 41 percent of diagnoses in women occurred among African-born individuals. Another study, published by Sociological Research Online in August 2010, found that Africans living with HIV in the US experienced “interpersonal, internalized and institutional” stigma.

Two countries, one stigma

When Ana* learned she was HIV-positive after moving to New York City, she wanted to return to her native Guinea, which she had left just four months before.

“I didn’t want to stay here and die alone,” the 29-year-old said. “But it was explained to me that if I stayed, I would get treatment, I could have children and I would have a better life.”

The ASC helped Ana secure free HIV treatment. While her health has improved since she received her diagnosis in January, she still does not feel comfortable to “tell most people my secret”.

“It’s two countries but it’s the same thing,” she said. “People here talk to people there and then everybody knows.”

The ASC, which works with approximately 4,500 HIV-positive clients, has tried to reduce stigma by integrating its HIV services into other health programmes.

According to ASC communications officer Stephanie Kaplan, taking a blood test that could be for HIV, or could just be for high blood sugar in a general testing facility, curbs client speculation about who is visiting the offices for what purpose.

The NGO tries to raise awareness of the availability of services to test and treat HIV. African immigrants often do not realize they are entitled to free HIV-related healthcare, regardless of their immigrant status.

“It’s probably a barrier to learning one’s HIV status, because if you don’t know that there will be future coverage for your treatment, you are not likely to get tested,” Nichols said.

Fear

It can take time to persuade some of the ASC’s HIV-positive clients, of whom 80-90 percent are undocumented, to visit a health clinic or emergency room.

“People don’t want to go to the hospital because there are fears of immigration [authorities catching them], yes, but it is also about fears of a disease that you don’t want to share,” said Rebekah*, 42, an HIV-positive Cameroonian ASC hospital escort, who helps immigrants navigate the health system.

Rebekah, who describes herself as “the luckiest person in the world” because of her immediate family’s support, has another factor working in her favour – permanent residency.

In January, the Obama administration lifted a 22-year-old travel ban against people living with HIV/AIDS. According to Jim Alexander, a Washington DC-based immigration lawyer, the repeal signifies a more positive attitude towards HIV-positive individuals by the US government, but is unlikely to create new opportunities for HIV-positive illegal immigrants.

Alexander has represented African clients who gained asylum because of their fear of persecution resulting from their HIV status, homosexuality or transgender status.

“The number of people who actually go forward with cases is fairly small,” he said. “We see people who are HIV-positive and decide not to pursue a case because the risk of coming forward for them is just too great.”

The simplest option for many is to retreat and get on with a quiet life, as Ana has done, trying to send money home when she can and plan a future with her fiancé in Tunisia.

“I pray I can get my papers so I can travel so Tunisia to marry my fiancé,” she said. “If somebody loves you even after you’re sick, that’s love.”

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KAMPALA, Uganda (Ugandans Abroad)— Millions of taxpayers dollars are most likely squandered every year in public-private healthcare units in Uganda.

Have you ever gotten free medicine from a private clinic back home, or have your family and friends? Most likely, you have never had the opportunity.  But for over a decade, the government has been sending cash and essential drugs to private clinics, under the mission of reaching people far away from government healthcare units.

Last financial year, the government spent sh222 billion, or $100.9 million, of taxpayer’s resources on nonprofit but private hospitals, primary healthcare centers, and lower-level health units.  But very few of these entities actually provide free medication.

In Uganda, sick children have to look to sources as unlikely as the U.S. army to receive free medicine. Photograph by Edward Echwalu.

The money for free, essential drugs comes from the national shared programme, as well as the health sector support programme II project.  The essential drugs supplement other drugs that are procured with money for districts and referral hospitals.

The nonprofit health units also get money from the Joint Medical Stores for immunisation, and receive free ARVs and anti-malarial drugs.

An additional 119 nonprofit doctors are given financial support in 25 districts, paid according to the government scales and levels, including an allowance for lunch.

For example, in the rural distract of Kibaale in Western Uganda, government-supported healthworkers form 48 percent of major professional staff in private, not-for-profit health services.

Despite this, you might never know that the government subsidizes these clinics at all.  At the Nagawa Memorial Nursing Home, a nonprofit clinic in the city suburb of Namugongo, patients still have to buy essential drugs like Coartem.

Despite government support for such nonprofit clinics, the clinic is headed by Willy Bukenya, a senior four drop-out.  Bukenya prescribes drugs, a job better handled by licensed pharmacists.  This is not a problem for the district health officer, whose job it is to ensure high-quality service delivery.  After all, Bukenya is his brother.

The clinic does not have the proper authority to admit patients, but it still admits several, who a midwife takes care of.  Its laboratory is appaling– not only is it congested and filthy, but some of its drug containers are weaved in cobwebs.

Despite government funding for free and subsidized essential services throughout Uganda, many back home find it difficult to access basic drugs. Photograph by Edward Echwalu.

Nagawa Memorial Clinic is not alone.  In fact, it is largely a mirror image of hundreds of nonprofit health clinics throughout Uganda, all receiving government funds on an annual basis.

One employee of Jinja district’s health services, speaking on conditions of anonymity, told Ugandans Abroad that “some of the NGO clinics were dens of criminals, as many of them are owned by local, influential people.”

Ugandans Abroad spoke to Diana Atwine, who heads the government’s recently-created Drugs Inspection Unit.  She says the greatest challenge surrounding governmental support of these private clinics is that “most people are not aware that they can get free or subsidized treatment in such health clinics.”  And the clinics are in no rush to inform their patients.

Government support alone raises a number of managerial and human resource challenges.  Private, nonprofit managers must supervise workers they do not have full authority and control over.  The government-supported workers report to both the Ministry of Health and the nonprofit healthcare unit managers.

These issues pale when you compare such clinics to phantom clinics, which you don’t even exist at all.  Several local government officials are in the lucrative business of creating ‘ghost clinics,’ which might not exist but are funded by Ugandan taxpayers.

How does the government select which private, nonprofit clinics to support? Some formal factors are population, accessibility of health services in communities, and the history of the clinic seeking support, among others.  The district’s local government and the private units’ have to form an agreement on the clinics’ activities.

Despite public support, these private clinics are largely the preserve of the few.  The majority of poor Ugandans cannot afford to pay for these clinics’ services, and the situation has exacerbated impoverished households in rural communities.

Government support of private, nonprofit clinics is supposed to help people in remote communities access healthcare. Edward Echwalu.

Ugandans Abroad reported that urban and rural-area patients do everything possible to access these services, which are supposed to be free or subsidized.  They even sell major assets like their land to receive treatment.

Paying for services at private, nonprofit clinics was even found to be a potential source of further impoverishment of households around Uganda.

Dr. Atwine’s team has begun to tackle the situation through random checks on various nonprofit clinics supported by the government.  These investigations have been alarmingly complicated by distinguishing which drugs are provided by the government, and which have been stolen.

“The doctors and other health personnel steal the drugs, and sell it in their private clinics,” she said.  ”It is hard to tell what are government drugs, because they are not labeled.”  The government is now working to carefully label its drugs to deter outright theft.

Director General of Health Services, Dr. Sam Zaramba, says that all government-supported clinics that don’t follow health service delivery guidelines are gradually being scrapped off the list for support.

“These are public funds,” he told Ugandans Abroad.  ”We cannot allow this mess to go on.  We shall scrap off all such clinics that are not up to the standard.”

Some in the diaspora go home regularly, others may not have been home in years.  But the Ugandan health system is a pluralistic system, combining many different agents.  There are public government-owned and managed health services, faith-based facilities, private nonprofit services, and private for-profit health providers.  There are also traditional medicine practitioners, whom many Ugandans consult.

Some of these categories overlap.  Faith-based nonprofits represent 78 percent of the 490 private, nonprofit health units in Uganda, while the rest are run by humanitarian and community-based healthcare organizations.

Efforts to reconstruct the government healthcare system started in the late 1980s, after the change of regimes back home.

In 1996, the private, nonprofit health facilities asked the government to partner with them so they could survive, and the government began to seriously negotiate with them in 1997.  The official Public-Private Partnership for Health (PPPH) began in July 2000.

D.A. is a reporter based in Kampala, Uganda.  He is committed to helping the Ugandan diaspora follow critical issues back home.

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KAMPALA, Uganda— Panic has spread in a Gulu sub-county in Northern Uganda, due to four recent HIV/AIDS-related deaths and an acute shortage of anti-retroviral and septrine drugs for adults.  The four that died were patients attached to the Lalogi Health Center, and passed away during the center’s drug shortage.

There have also been press reports of patients being told to buy medicine in privately clinics, some at far distances, as well as shortages of malaria drugs.

“Four HIV/AIDS clients have died over the period from different places within the sub-county following the acute shortage of the ARVs,” said Richard Nyeko, who runs the Lalogi Health Center, based in the Lalogi sub-county.  ”Even the Septrine tablets for the adults have run out of stock.  Only the infant ARVs and Septrine are in stock.”

Over 561 registered clients taking ARVs and 1,600 clients of septrine tablets are asking the center to urgently resupply the medicine so they can survive, according to Nyeko.  The only sliver of hope is that the Baylor Foundation, a Texas-based Christian ministry that runs a privately-owned medical center in Kampala, has promised to restock the hospital early this week through Gulu’s district health office.

However, it is too late for the four adults that recently passed away.

Dr. Paul Onek, Gulu’s district health officer, spoke to Ugandans Abroad.   “It is unfortunate that the ARVs and the drugs have run aout. But we are  trying to do all things that are possible through the Baylor Foundation Medical Centre to restock the health cente,” said Dr. Onek.  ’We are trying to sort the problem administratively to have them in place.”

Onek says the shortage is related to overall shortages nationwide throughout Uganda, but affirmed that the Baylor Foundation was making arrangements to release drug stocks soon.

The Ugandan government recently said that plans were underway to acquire and restock  the districts in need with enough ARVs and Septrine tablets.

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By Ian Kavuma and Rebecca Harshbarger–

Doctor Sarah Matovu is a long way from home.  She was born and raised in Kampala, Uganda, where she lived in Bakulu-Namirembe, and she studied medicine at Makerere.  However, the doctor  now runs her practice in Macon, Georgia.  Although she has been married for twenty-nine years to the man she met in medical school in Uganda, Dr. Frank Matovu, she has raised three Ugandan-American kids in the U.S.

Dr. Sarah Matovu, second from left, on a trip to Uganda. Str8Talk Chronicle.

Her heart is still thousands of miles away- and she hopes to take her practice there too.  The health challenges Ugandans face everyday have inspired her to go back in two years, after her last child leaves home.

What’s on Dr. Matovu’s mind? Although some progress has been made in Uganda’s health sector, there is still much to do.  The average Ugandan man lives to only 49 years, and women are expected to live on average to 51.  Uganda has the third-highest deaths from malaria on the African continent, with an estimated 320 people dying every day, according to the Ministry of Health.

Because of these issues, Dr. Matovu hopes that more Ugandan doctors in the diaspora will consider going home– if not permanently, on short-term trips that can still have a large impact.  Those interested can get in touch with the society here.

“We are very concerned about the brain drain,” Dr. Matovu told Ugandans Abroad.  ”We are losing our doctors by not paying them well.  If you a pay doctor sh600,00 a month, that’s $300.  It’s not enough for them to sustain their families.  They’ve got to address the salaries of healthcare workers to keep citizens healthy.”

Dr. Matovu, who is based in the U.S. herself, has tried to address the  brain drain with her work for the Uganda North America Medical Society, a nonprofit that works to unify doctors, surgeons, and dentists that have an interest in Uganda.

The society conducts an annual medical mission every summer, a tradition they began in 2007.  This year’s trip took place in Kasese, near the border of Uganda and the DR Congo at Bwera General Hospital.  ”We did forty surgeries in one week,” Dr. Matovu said proudly.

The organization also plans to sponsor a resident in Uganda to become an oncologist, due to rising cancer rates back home.  They are currently working to have large institutions donate equipment and services to Uganda’s health sector, with a focus on Ugandans suffering from cancer.

“Right now, cancer patients are expected to buy their own chemotherapy and take it to the Uganda Cancer Institute,” she said.  ”We are trying to train Ugandan doctors to be cancer specialists, [and] we need a blood bank specifically for cancer.”

Until salaries improve for healthcare workers, the shortage of healthcare workers and their emigration to other countries looks likely to continue.  Despite this, the doctor hopes that other medical professionals abroad will do more to help Uganda, even if they can’t go home.  ”Collectively, we can do more to help Ugandans,” she said.

In Ugandan communities in the U.S. and other countries, Dr. Matovu is also worried about the health of diaspora.  Diabetes, hypertension, HIV/AIDS, and heart disease are all health issues facing Ugandan immigrants.  Dr. Matovu hopes that Ugandans living abroad will take greater responsibility for their lifestyle changes, and change their attitudes towards doctors, particularly preventative medicine, as well as their lifestyle and exercise habits.

Some progress, she says, has been made.  ”In the diaspora, it’s no longer cool to be obese,” she said.  ”They are doing something about it.  It’s not a compliment to be told you’re fat.”

Tips  Dr. Matovu Suggested For Ugandans Living Abroad:

• Change your attitude toward preventative medicine.  Even if you’re feeling healthy, you should still get an annual checkup from your doctor.  Pap smears, mammograms, and prostate exams should all be discussed and planned for one with one’s doctor.
• Be aware of changes in your lifestyle since leaving Uganda to go abroad, particularly diet and exercise.  Be more proactive! It’s your health.
• Watch out for the health of the larger African immigrant community abroad.  HIV/AIDS, domestic violence, child neglect, and female genital mutilation are major health challenges for the African diaspora.

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Ugandan taxpayers will pay over sh150million for Bebe Cool's trip to Boston for medical treatment next week. The artist will travel with wife Zuena Kirema and their two children.

Worried about the health of Bebe Cool, after he was shot in the legs by a police officer last January?

Don’t worry, President Museveni is too.  Which is why he will use taxpayer dollars to pay for the singer’s treatment and travel in the U.S., as well as that of his wife Zuena and two kids– over $75,000, according to reporting by New Vision.

Cool spent three weeks in Nsambya Hospital after being shot, and currently has to move using a wheelchair or crutches.

Ugandans in Boston may want to wish the star good health in person– Cool will fly out their next week for medical treatment.

The State House’s decision to fund Cool and his family’s trip to the U.S. comes at a time when there have been press reports that hundreds of children have died at the Uganda Cancer Institute due to an ongoing drug shortage.

The government announced this Thursday that these were rumors, and health state minister James Kakooza said the Institute would have drugs again in two weeks, according to reporting by New Vision reporter Conan Businge. A public dose of treatment for cancer costs sh93,000, while a private dose is about sh450,000.

The artist was lucky to survive the bombings in Kampala last month, after attending the Kyadondo Rugby Club on July 11th.

According to reporting by the Daily Monitor, the impact of the blast threw Cool to the grass from his chair, where his wife and others picked him up.

In response to the bombings, Cool called off his October launch date for his latest album, saying security in Uganda would need to regroup before people could be entertained again.  Ragga Dee changed the launch date of his album from July to December, and Gen. Mega Dee shifted his to September.

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Uganda continues to hold the dubious honor of leading the entire African continent in alcohol consumption.

The Daily Monitor reports that the average Ugandan drinks nearly five times more alcohol than citizens of other African nations. Researchers at Makerere University have found that Uganda consumes 19 liters of alcohol per capita, while other African countries drink an average of only four liters per person.

In 2005, the World Health Organization named Uganda as the leading consumer of alcohol in the world, followed by Luxembourg and the Czech Republic.

“What amuses us most is that Uganda has fewer people taking alcohol than other nations but those who drink consume a lot,” said Makerere University senior researcher Nazarius Mbona during a press conference. He also noted that 80 percent of the alcohol consumed in the country is produced informally.

Photo by Flickr user xjara69

The researchers also warned that Uganda was suffering from an alcohol-related public health crisis. “In developed world, people drink alcohol for socialisation, but here in Uganda, people drink for toxication,” said Dr. Sheila Ndyanabangi.

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Mental health patients receive treatment at Butabika Hospital in Kampala, Uganda.

By Rebecca Harshbarger

After a mentally-disturbed resident of Wakiso district turned himself into the Ugandan police, claiming responsibility for the destruction of Kasubi Tombs, the Ugandan press has run stories on the disturbing state of mental health in Uganda.  Last  summer, I attended a mental health conference in Lira with journalists Chris Conte (who organized it through the Health Communication Alliance), Lydia Namubiru, and Igor Kossov, among others, where reporters were trained in covering mental health issues.

Uganda may very well be ground zero for mental illness internationally– despite that it is a country of 33 million people, many of who have lived through several wars, there are only 28 psychiatrists (much less than Kenya’s still-anemic 80).  Most Ugandans, perhaps as many as 80 percent, visit traditional healers for madness, dementia, and other problems.  Egan Taboro reported on self-injury for the Daily Monitor last March, and  Chris Kiwawulo took on the mental health beat in New Vision recently– check out his reporting here.

Kiwawulo says that David Basangwa, a leader on mental health in Uganda, and the senior consultant psychiatrist at Butabika Hospital, estimates that as many as 35 percent of Uganda suffer from mental illness.  A study that came out in 2006 in a publication called BMC Psychiatry estimated that half of adults assessed in two districts in northern Uganda, Gulu and Amuru, suffered from post-traumatic stress disorder (PTSD).

A mentally-ill man claimed credit for the Kasubi Tombs' fire, but police doubt his credibility.

To address the state of Uganda’s mental health, the government includes mental health services in the country’s national health budget, and added mental health units to 13 regional referral hospitals nationally.  Kampala’s Butabika (a psychiatric hospital) currently serves thousands of patients a year in its 900-bed facility.  Health officials hope the addition of the mental health units will decongest Butabika.  Joseph Musoke, the resident of Wakiso that said he burnt down the tombs, was recently referred to Butabika for a mental checkup, but he is still a suspect in the tragic Kasubi fire.

Related Resources:

Butabika Hospital’s homepage

Mental Health Uganda, a community NGO

Ugandan Ministry of Health

Thank you for supporting Ugandans Abroad.  For more information, visit the Healthy East Africa blog here.  You can follow Rebecca on twitter at www.twitter.com/rebeccaugust.

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