[procaare] Hunger Kills you Faster say HIV-positive Northerners in Uganda

["IRIN PlusNews" <procaare@healthnet.org>]

UGANDA: Hunger kills you faster, say HIV-positive northerners
IRIN PlusNews 25 Oct 2006
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KITGUM, 25 October (PLUSNEWS) - Life-prolonging antiretroviral (ARV) 
medication is rare enough in war-damaged northern Uganda, but the lucky few 
able to access treatment have the additional problem of finding enough food 
to go with the powerful drugs.

With the support of Catholic Relief Services and the European Union, 670 
people receive ARVs from St Joseph's Hospital in the northern district of 
Kitgum, the largest provider of drugs in the district, but this represents 
just 24 percent of the hospital's HIV-positive patients who need treatment.

"For the rest, we just have to treat their opportunistic infections as they 
get them," said Robert Ochola, coordinator of HIV/AIDS programmes at the 
hospital. "For children, we are only able to treat 30 percent of those who 
need the ARVs, and even then we do not have [paediatric] ARVs for them - 
they take the same drugs as the adults in different doses."

Kitgum is one of the districts most affected by two decades of war between 
the rebel Lord's Resistance Army and the government. About 90 percent of 
Kitgum's people live in camps for the internally displaced and are almost 
entirely dependent on relief aid, as insecurity has prevented them from 
farming.

It is even worse for the region's HIV-positive people, who need a healthy 
diet to maintain their immune systems to fight off the HI virus.

Some of the hospital's ARV patients receive nutritional support from the 
United Nation's World Food Programme and the Comboni Roman Catholic Mission, 
but qualification is not automatic: patients complete application forms and 
the organisations then decide who is eligible for the limited food aid.

The rations are enough to feed a family for a month. They make a real 
difference to the overall health of the patients, and increase the 
likelihood that they will adhere to the daily ritual of taking their ARVs, 
which can have unpleasant side effects even on a full stomach.

Sylvia Ocan and Christine Oyela have both been on treatment for two years, 
but only Oyela has qualified for nutritional support. Oyela looks healthy 
but Ocan is visibly undernourished and suffers from a condition that has 
left unsightly, dry patches on her face.

"I don't know why I did not qualify for the food, but I have no money to buy 
food and I get sick quite often," said Ocan, whose husband died from 
AIDS-related complications three years ago. "I make tablecloths and mats to 
sell, but my two children and I sometimes can spend the whole day without 
eating anything - I feel dizzy and weak if I do not eat when I take the 
drugs, and then I can't even work."

Despite these difficulties, Ocan has persevered with her medication, aware 
that if she does not she risks developing resistance to ARVs.

"The main reason for non-adherence among our patients is the lack of food. 
Of our 2,000 patients, just 819 are receiving food support," said Charles 
Odong, coordinator of Meeting Point, a local NGO helping HIV-positive people 
in Kitgum.

People who default on treatment often turn to traditional healers for 
remedies, which can make them even sicker, he said. With the support of 
relief agencies like the Italian NGO, Associazione Volontari per il Servizio 
Internazionale, Meeting Point provides home-care kits of soap and sugar to 
its members, and grants of school fees for their children.

"People are so desperate for food that many are willing to sell sex and risk 
contracting HIV because they say the disease will take some time to kill 
you, while the hunger will kill you immediately," said Odong. "Finding food 
for people in the region should be a priority for the government and aid 
agencies, because it helps those who are already sick and could also help 
prevent new infections."

This is part of a series of stories in a new PlusNews Web Special: 'ART on 
the frontline'
http://www.plusnews.org/webspecials/ART/default.asp

Kr/oa/he

IRIN-SA
Email: IRIN-SA@irin.org.za