Stigma: HIV positive boy abandons school

By Tom Gwebayanga and Conan Businge                                                                                             
 
AT Nabwigulu Primary School, hundreds of kilometers away the capital Kampala in the western district of Kamuli, the 13-year-old Charles Okurut is crashing under HIV and segregation, and has opted to dropping out of school to avoid being a subject of mockery amongst his peers.

He has become  talk of every child at school and no one wants to play, eat or sit next to him in class.

"I am frustrated. My friends  run away from me. They even abandon the desks where I'm seated," Okurut says. "I always have to scratch myself to en extent of the skin peeling off, to be able to get relief. My skin is always irritating me. It itches badly." He laments

Okurut is just one of the 1.2m AIDS orphans in Uganda, according to Ugandan National Bureau of Standards estimates.

An estimated 150,600 children are living with HIV in Uganda today. More 27,000 children are estimated to be will be born with HIV; of which 50% of them will die before their second birthday. Reports also show that 75% will most likely die before their fifth year of life.

Okurut's ordeal started in April when he developed a skin rash, as a drug reaction from the ARV's he got from the Anti-Retroviral Therapy clinic in Kamuli Main hospital.

 Besides that, he is malnourished and often goes misses the school porridge meal because his guardians are poor cannot afford the six kilograms of maize and sh3,000 for its milling; as demanded by the school authorities of every pupil every term.

His elder sister, Tapenensi Nansubuga says Okurut  has abandoned school and spends roaming the village  and climbing trees as his growing hobby out of desperation.

It is believed Okurut contracted the virus from his deceased parents; who died in the early 2000s of HIV/AIDS. Nansubuga admits  she is financially struggling.

Okurut tested positive last year and was put on Septrin tablets, before he started ARV's, following the fall of his CD-4 count. "He may improve but the rash is at a high magnitude and there's need for serious consultations," Salamuka, the District Chairman for the Forum for the People Living with HIV/AIDS says, adding that, "the boy needs counseling and better feeding."

Okurut enjoys rice, matooke, meat and milk, which his guardians cannot readily afford. He gets colds in the morning and evenings, has general body weakness, coupled by excessive throwing up.

Okurut, wants to study and become a teacher so that he can help pupils with the similar plight. " I pray that some one helps me out even if it means being taken a TASO home, like Jjaja's Home in Entebbe," he says with a stern face.

Ruth Mutoya, a child counselor and psychologist says ,"Okurut is suffering with identity issues and is now stigmatised. He needs love and affection self-disclosure to be who can understand him well."

The Counselor says that changing schools is not enough if the other issues of his treatment, counseling and good feeding are not quickly sorted.  "He needs counseling to restore his self-esteem and identity," Mutoya, who works with Healing Talk Counseling Services, adds. 

Anti-Retroviral Therapy for Children:

Only three of every 10 HIV-positive children in Uganda receive treatment they need, according to the latest official reports. There are about 76,000 children who urgently need ARVs in the country, but cannot readily obtain them, according to the statistics.

 It is only 28% of eligible HIV-positive children who are on antiretroviral therapy, and there is little emphasis made to ensure the infected children survive.

Even the few who join, later drop off the medication; meaning that some of them die. A review has showed that only 60% of all children enrolled on antiretroviral therapy, before July 2009; are alive and active in care.

The ministry of health with support from Clinton Health Access Initiative (CHAI), in a comprehensive review of pediatric HIV services in some facilities in Uganda, found that only 60% of HIV positive children were retained on treatment.

The review shows that, "Less than 80% of active HIV positive children were assessed for adherence, screened for TB, or even clinically staged." 

About 90% of the HIV infections to children below 14 years of age are from mother-to-child. The other infections to children are caused by blood transfusions, unsterile injections, accidents, and sexual abuses.