Ignorance crippling HIV fight in Kalangala

Ms Bridget Namuwanga, a health worker, demonstrates to fishermen at Miyana Landing Site in Kalangala District how a female condom is used. PHOTO BY HENRY LUBULWA

The fight against HIV in Kalangala District has stalled in the previous two years due to ignorance about preventive measures that can be used to avoid acquiring the virus, a report by the Kalangala District NGO Forum has indicated.

The report titled; “The good and bad in the fight against HIV Aids in Kalangala District,” showed that although there is still a lot of effort towards the fight against the virus, HIV is still among the leading diseases in the area.
“Almost all non-government organisations are involved in fighting HIV, but there is an increase in the number of people who acquire the virus. This is an illustration that there is a lot of wasted energy, which could only be saved if partners in the fight discuss other measures that have led to the increase,” the report recommended.

Kalangala has the highest HIV prevalence in Uganda. The rate is put at 26 per cent out of a population of 53,000 people. The district also has 12 partners supporting the HIV fight.
According to the report, some landing sites in distant islands still lack sensitisation.

For instance, despite the increased distribution of condoms, some people on the landing sites, including Miyana in Mazinga Sub-county and Nkese in Bubeke Sub-county still do not know the use of condoms.

“Although many people know and have knowledge about the virus, people have still failed to know more about the preventive measures like the use of condoms,” the report noted.

Polythene bags used
According to the report, some residents use polythene bags as preventive measures against acquiring any sexually transmitted diseases.

Mr Joseph Ogwal, a fisherman at Nkese, says people use polythene bags due to lack of condoms. He adds that condoms can only be ferried from Kalangala’s main Island of Bugala or from Entebbe.

“This is the biggest challenge since we rarely have people coming to this island. We have no means to attain condoms,” he says.

Nkese is near Bukoba Island in Tanzania. Transport from the island to the main land is by use of a cargo boat. The boats go to the area once in two weeks.

According to Ms Annet Namisango, a health worker in the district, people no longer use preventive measures against HIV, especially when engaging in sexual intercourse since they care less about disease than dying while fishing.

“Most fishermen come out of the lake feeling happy. What they want most is to sleep with commercial sex workers. In fact, many of them fear drowning more than HIV,” Ms Namisango says.
Dr Edward Muwanga, the district HIV/Aids focal person, while delivering a report on the state of HIV in the area recently, said currently, the area is facing challenges of implementing the “test and treat” policy of fighting HIV due to the acute drug shortage.

“This new policy was adopted in January this year with a directive from the Ministry of Health. We are, however, failing to implement it since many people we test are not given HIV drugs due to the shortage,” Dr Muwanga said.

According to Dr Muwanga, the test and treat policy is where all patients tested and found to be HIV positive are immediately put on Anti-Retroviral (ARV) drugs to support their CD4 count.
He asked government to restock HIV drugs in the district to avoid any deaths caused due to lack of drugs.

Treatment

Challenges: Kalangala has nine health centres that administer HIV treatment. Many patients have to travel by boat from one island to another if they are to get HIV treatment.
Transport fare: One needs a minimum of Shs100,000 on water using a motorised boat, a fare many can hardly afford.
Prevention: The district health officer, Dr Hillary Bitakaramire, says there needs to be a combination of preventive measures to reduce the HIV prevalence in the area. These include family planning, emphasizing behaviour change and being faithful to a single partner. “Such methods are an enhancement to the message we usually tell our people. Through the treatment preventive measures such as ARV treatment, Kalangala can easily achieve its objective of zero HIV infections,” Dr Bitakaramire says.