Initiative restores hope for HIV positive refugees

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INNOVATION

Uganda is one of the largest refugee-hosting nations in the world, with 1,660,524 refugees as of March 2024.

The influx of refugees is due to several factors in Uganda’s neighbouring countries, especially war and violence in South Sudan and the DR Congo, and associated economic crises and political instability in the region.

However, refugees continue to have several difficulties in accessing social services, even with efforts made by the Government and development partners to guarantee their comfort.

The refugee influx in Uganda did not only cause an increased population in the areas of settlement, but also put pressure on the available resources.  

Hope Mafaranga and Rogers Sunday examine how refugees living with HIV are coping.

Farazia Uwimana, 37, is among the hundreds of Congolese nationals who were resettled at the Rwamwanja Refugee Settlement in Kamwenge district.

Her life was a blend of simplicity and struggle, joy and sorrow, but she carried a secret that had transformed her world in ways she could never have imagined.

Uwimana is living with HIV. Uwimana discovered her status eight years ago when a routine health check revealed the virus in her blood. At first, the news shattered her.

The stigma attached to HIV in her community was immense and she feared the judgment and isolation that would follow. But she was a fighter, and she decided that this diagnosis would not define her.

With the support of the United States Agency for International Development funded Keeping Children Healthy and Safe project led by Trans-cultural Psychosocial Organisation (TPO) and implemented by AVSI Foundation in Kamwenge district, Uwimana began antiretroviral therapy (ART) at Rwamwanja Health Centre IV. 

The health facility is located within the refugee settlement. The medication was a lifeline, and it gave her the strength to continue doing her daily tasks. She kept her status private, sharing it only with health workers, who became her pillar of support. Uwimana’s days are filled with hard work.

When she arrived at the refugee settlement, the Office of the Prime Minister gave her a plot of land, where she grows food and vegetables to feed her two children.

One day, health partners in the refugee settlement organised a health awareness event with a focus on HIV education, and the goal was to reduce stigma and promote testing and treatment.

“People testified about how they had lived with HIV and how it was okay to speak about it. At first, I was hesitant. I feared the reaction of my neighbours,” Uwimana said.

Innocent Cwinyai

Standing before the gathered crowd, she took a deep breath and began to speak. She shared her story with honesty and courage, describing her journey and the importance of seeking treatment. Uwimana spoke of hope and the possibility of living a full life with HIV.

“From that day on, I became a beacon of hope in my village and an ambassador of change in fighting HIV stigma among the refugee community,” she said.

Fate of her son  

Unfortunately, Uwimana’s son is also HIV positive, having contracted the virus at birth. While other children of his age played outside, her son was often bedridden and weak.

Despite his condition, it never occurred to her to conduct a rapid HIV test at the nearest health facility.

“As a parent, my son’s condition was a great concern and I felt helpless,” Uwimana said. She explained that most of her efforts were focused on finding and providing food, even though her son seldom had an appetite.

Dorothy Kemigabo

Hope for her son

While Uwimana was out trying to find food for her family, para-social workers from the AVSI Foundation, a non-governmental organisation dedicated to sustainable development and addressing real human needs, visited her home.

“They took my son to the hospital for treatment. The results indicated that he was also HIV positive,” she said. Upon receiving the positive diagnosis, her son was promptly enrolled on HIV treatment, which he has successfully continued to this day. Like any other parent, Uwimana’s joy and confidence were restored upon seeing her son respond positively to the treatment.

“Today, my son even rides a bicycle and goes to school by himself. I am happy because I see him progressing well,” she said.

Uwimana explained that her son is equally optimistic about his future. “My son is pursuing vocational training and specifically wants to become an excellent mechanic,” she said.

However, they said one of the biggest challenges they face is transportation to go for their medical appointments and drug refills.  

“Sometimes my drugs get finished when I don’t have transport money to pick a refill, but because I know the importance of drug adherence, I have to walk to ensure I don’t miss them,” Uwimana said.

Farazia Uwimana

Good nutrition  

To maintain a healthy body while undergoing HIV treatment, all group members were trained and encouraged to establish kitchen gardens. “Lately, I no longer spend any money on buying vegetables because I already have them in my kitchen garden,” Dorothy Kemigabo said.

She said both her health and her son’s have improved due to consistently taking their medication in a timely manner, along with maintaining a healthy diet at every meal.

“Green vegetables are beneficial for everyone, but they are especially important for people living with HIV. I was also taught the importance of taking my medication on time, so I usually set an alarm clock to remind me,” Kemigabo said.

She happily noted that both she and her son have been positively responding to the medication.

Kemigabo said she had started to lose hope in her son after realising that he was HIV positive.

“It is through the TPO project that I managed to return my son to school because before, I had lost all hope, thinking that he would never compete favourably as he would constantly fall sick and miss class,” Kemigabo said.

A health worker writing down prescriptions for a person living with HIV at Rwamwanja Health Centre IV. (Credit: Ivan Kabuye)

Today, Kemigabo is confident that acquiring HIV is not the end of one’s life on earth.

“Although there is still a lot of stigma among people living with HIV, what we all ought to know is that acquiring HIV is not a death sentence,” she said, adding that more focus and interest should be put on minors living with HIV.

Innocent Cwinyai, the team leader for AVSI Foundation in Kamwenge, said they are actively engaged in numerous initiatives within the Rwamwanja Refugee Settlement, aimed at enhancing the health and livelihoods of both refugees and the host communities.

Speaking to New Vision, Cwinyai emphasised that their primary focus is on HIV prevention among children and households.

He elaborated on their collaboration with health facilities to test, treat and suppress the viral load among people living with HIV.

“We have a target of 3,784 ART patients, including minors who have been sexually abused and those born with HIV,” Cwinyai said.

Additionally, he said they run the Game Connect project in the Rwamwanja settlement, which uses sports to improve the mental health and psychosocial wellbeing of young refugees and host community members.

“This project aims to build social support networks and promote unity among the youth through safe sports activities. Although children’s health is the primary focus of the project, it also supports the children’s caregivers, empowering them to provide effective care,’’ Cwinyai said.

A woman receiving ARVs at Rwamwanja Health Centre. (Credit: Ivan Kabuye)

“Once we identify a household, we continuously monitor their medication restocking by providing transport to and from the health facility. To ensure adherence to medication, our para-social workers, who are based within the community, perform regular and timely monitoring of all ART clients,” he added.

Cwinyai further said when necessary, they arrange ART appointments with relevant health workers for people living with HIV.

The Rwamwanja Refugee Settlement has six health facilities, with Rwamwanja Health Centre IV serving as the primary referral point.

Cwinyai also said they support backyard gardening demonstrations, nutrition screening and education for parents.

“Households receive guidance and support in creating development plans, improving nutrition, parenting, health and hygiene,” he said.

Cwinyai said under the Game Connect, they have reached 3,390 youth, of which 2,169 were refugees.

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Livelihood and HIV

Dorothy Kemigabo, a Ugandan national residing in Bisozi, Rwamwanja, is an active member of a lives and livelihoods association that supports people living with HIV from Uganda and Congo.  

The association, consisting of 30 members, is an initiative of the AVSI Foundation. It empowers people living with HIV by teaching them how to cultivate a savings culture and maintain a healthy lifestyle while on medication.

“It was late last year when Jorum Timbigamba, a para-social worker, introduced me to the AVSI organisation, which aimed to help us people living with HIV,” Kemigabo told New Vision.

Despite being on medication for a long time, Kemigabo was not responding well. 

“Doctors always told me that I was not responding well to the medication, primarily because I was not taking it on time and was not eating a balanced diet,” she explained.

Through para-social workers, the association members learned how to establish and maintain stable income-generating activities for their families. 

“I chose to open a bakery, and today, I  am able to sustain myself and my family through the daily sales from baking,” Kemigabo said. Thanks to her daily savings from the bakery, Kemigabo has started a piggery project. “The piggery project I have today is worth sh170,000, which I funded from the savings of the bakery project,” she said.

This story project was done with support from WAN-IFRA Women in News Social Impact Reporting Initiatives grant. However, the views expressed are not those of the sponsor.