Two decades ago, Karamoja was lying low with an HIV prevalence of only 1.7% in 2000 (UAIS, 2,000). As HIV prevalence in Uganda dropped from 36% to the current 7.3%, that for Karamoja tripled from 1.7% to 3.5% in 2006 and to 5.3% in 2011 (UAIS, 2011). It may even higher than that by now
By Dr. Daraus Bukenya
As we continue to commemorate World AIDS Day that is celebrated on December 1, with more focus on reducing transmission of HIV to zero levels and prolonging healthy living for people living with HIV and AIDS, Karamoja has a different story, heading in the opposite direction.
Two decades ago, Karamoja was lying low with an HIV prevalence of only 1.7% in 2000 (UAIS, 2,000). As HIV prevalence in Uganda dropped from 36% to the current 7.3%, that for Karamoja tripled from 1.7% to 3.5% in 2006 and to 5.3% in 2011 (UAIS, 2011). It may even higher than that by now. This, as one councillor said in Moroto, is because ‘we had been forgotten' in HIV and AIDS programmes.
Improved relative peace, infrastructure in paved roads, electricity and economic activity in trade and mining has also been accompanied with an escalation of the HIV incidence. An evening walk around the KamSwahili slum of Moroto town will bring you face to face with teenage girls transacting with mining truck drivers and business people. These are scenes that were considered taboo in the Karamoja culture and unseen decades ago.
The end of the conflict in Acholi region also saw a huge migration of NGOs and UN Agencies to Karamoja. These came with new entrants, a beehive of development activities and more socio-economic interactions. The increased economic activity in Karamoja has seen not only an escalation of the cottage industries in major towns but also increased travel in and out of Karamoja by locals as traders, workers, students and housemaids.
Due to their vulnerabilities, these teenagers and young people from Karamoja have become exposed to sexual exploitation and some return to Karamoja after they are already been infected with HIV. Some then become the index cases from which HIV spreads further. In spite of the economic growth of the region, poverty levels remain high at 74.5% (UBOS, 2014). These rates are even higher among young women and girls making them even more vulnerable to HIV.
So, as we cheer Karamoja for the rapid economic transformation, HIV infection is also taking its toll and could risk a reversal of this growth. As such, the government, NGOs, UN agencies and Irish Aid have responded with a joint stakeholder Karamoja AIDS Programme 2016-2020, worth Ushs 74 bn. Its coordinated by UNAIDS. Action Africa Help-Uganda (AAH) is a partner to this programme.
AAH has partnered with UN Women and Irish Aid to implement the Karamoja Economic Empowerment Project (KEEP). The project supports young women and adolescent girls living with HIV and AIDS as well as those at risk of infection, to carry out viable economic activities and improve their health and wellbeing.
The extreme levels of stigma and discrimination in Karamoja together with gender-based violence, sexual abuse, early marriage, unequal power relations, coupled with poor access to basic education, health services, social protection, sustainable incomes and information makes the young women and girls in Karamoja exceedingly vulnerable to HIV. More so, when the main economic activity; livestock and land which is owned and controlled by men.
The KEEP project started this year, is currently in Moroto and Kaabong districts and trains the women and girls in groups of 10 people in business and social skills. Then supports them with business start-up capital of 4-7 million on a revolving fund basis. By March 2017, 250 young women and girls will belong to such economic empowerment groups in both districts and more will be supported.
Some of the observed results among participating women and girls include improved self-esteem and social standing, reduced stigma and discrimination, adherence to drugs due to affordability meals, improved overall household welfare and reduced vulnerability to gender based violence as a result of increased knowledge and income options. As one Lopuka said:
‘In Karamoja, the source of life is the cows which are controlled by men. But for us now, this business has become our cows'.
Figure 1 Lopuka in her group grains store/shop with project officials
One other beneficiary, Carol said,
‘This project has come to support people who have never been supported by any organisation. I don't know where this God has come from'.
The success of these groups will see an expansion of the programme to cover more groups and all the districts of Karamoja over the next five years (2016-2020). So as not to roll back the recent peace and development gains, as the Irish Ambassador Donald Cronin, committed himself recently at the launch of the Karamoja AIDS programme, by saying,
"Unless we are able to stem the growth of the HIV/Aids prevalence in the region, then perhaps at some stage in the future, the figures will overtake the national average and that is not something we want,"
The writer is the Country Director for Action Africa Help-Uganda (AAH-Uganda)