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Taboo is broken, now we need drugs

Selina Akello sits in a clearing between the mud huts in her village. "I will tell you anything," she says. An older man passes within earshot ear·shot  
The range within which sound can be heard by the unaided ear; hearing distance: listened until the parade was out of earshot.
 but she does not falter. This conversation would have been impossible a few years ago; Akello has the disease that used to be called "slim" because people wasted away. Now it is called HIV/Aids.

"Once in a while I get scared for the future," she says. "Then I pray I beg; I request; I entreat you; - used in asking a question, making a request, introducing a petition, etc.; as, Pray, allow me to go s>.

See also: Pray
 to the Lord to help me to live longer and I always make sure I take my tablets."

A few years ago HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States.  was cutting through a generation of health workers, farmers, teachers and parents. Few would speak about it, let alone be tested. But Uganda, where Akello lives, has been at the forefront of a roll-out of low-cost Aids drugs, subsidised Adj. 1. subsidised - having partial financial support from public funds; "lived in subsidized public housing"

supported - sustained or maintained by aid (as distinct from physical support); "a club entirely supported by membership dues";
 by the Global Fund, the US government and other donors. Figures released this week by UNAids show that 22.5 million people in sub-Saharan Africa have the virus in their bloodstream blood·stream
The flow of blood through the circulatory system of an organism.


the blood flowing through the circulatory system in the living body.
, of whom 1.34 million are receiving treatment - 28% of those who need it immediately. Those who look after themselves may not need the drugs for 10 years after infection.

The improved care has turned HIV from a taboo subject to something people can discuss and try to prevent.

Akello is not yet on antiretroviral antiretroviral /an·ti·ret·ro·vi·ral/ (-ret´ro-vi?ral) effective against retroviruses, or an agent with this quality.

abbr. Bible
American Revised Version

ARV n abbr (= American Revised Version) → traducción americana de la Biblia

ARV n abbr (=
) drugs to suppress the virus but is taking Septrin, or co-trimoxazole - an antibiotic that wards off infections deadly to those with damaged immune systems immune system

Cells, cell products, organs, and structures of the body involved in the detection and destruction of foreign invaders, such as bacteria, viruses, and cancer cells. Immunity is based on the system's ability to launch a defense against such invaders.
. She is only receiving care after travelling 20 miles to Soroti town, where the Ugandan charity Taso, The Aids Support Organisation, recently opened.

But support and treatment are slow to reach rural areas such as Katine, where Akello lives. Nobody knows how many people have HIV there. The health centre at Tiriri often runs out of test kits, which means staff cannot even save babies from infection. A dose of drugs to the woman before birth and the baby afterwards af·ter·ward   also af·ter·wards
At a later time; subsequently.

afterwards or afterward

later [Old English æfterweard]

Adv. 1.
 cuts the risk of transmission, but in Katine health workers do not know which pregnant women have HIV.

Once you are on ARVs you must take them for life and the virus in your bloodstream may become resistant to them. Akello knows she will not live a full span and people rely on her. Her baby died but she is bringing up her sister's children, aged eight, 10 and 16, because she has a small business, making the local hooch hooch Substance abuse 1 A street term for marijuana See Marijuana 2 Moonshine, see there , and her sister has nothing. She worries about the children. "I try to plan for them," she says. "They help me when I am a bit weak with the business, but sometimes it is so hectic that I get pains in my chest and my back."

She was tested after realising during a meeting held by Taso in Katine that she had put herself at risk. After her husband left her she had relationships with more than one man. She tries to warn people in Katine, chatting with the women at the well. Some listen, she says, but many do not believe she has HIV because she does not look ill.

Angela Alelo, 30, found out in May that she and her three-year-old daughter Sarah Muyama were HIV positive. Her partner had been tested first because he was clearly ill and losing weight.

Alelo has three children, aged 16, 10 and six, from her first marriage. She left that because she was beaten. Her family paid back the dowry dowry (dou`rē), the property that a woman brings to her husband at the time of the marriage. The dowry apparently originated in the giving of a marriage gift by the family of the bridegroom to the bride and the bestowal of money upon the bride by  and at 27 she set up house with a respected police officer called Edward Wamboka. Sarah was born soon after. She is not angry with her husband who she thinks was HIV positive when they met. "There is no way I can blame him," she says. "Many people now fall sick. It has happened."

Both were put on ARVs and Wamboka, 45, is back at work. The child does not yet need ARVs and is being given Septrin. But they know the drugs only prolong life for a while in Africa. "We are worried because of the children. There will be nobody to care for them," she says.

Part of this tragedy was preventable. Alelo should have been tested during her antenatal an·te·na·tal
See prenatal.


before parturition. Called also prenatal, antepartal.
 care. Tiriri health centre participates in the Prevention of Mother to Child Transmission Programmes that are supposed to be sweeping across Africa with the drugs - but not when the HIV test HIV test Various tests have been used to detect HIV and production of antibodies thereto; some HTs shown below are no longer actively used, but are listed for completeness and context. See HIV, Immunoblot.  kits have run out, and it has never had antiretrovirals to dispense.

But it is not only about drugs, says Dr Godfrey Egwau, acting medical superintendent at Soroti hospital. "It is about the way you look after yourself. If somebody is involved in farming and is less and less able to work, gradually it erodes your economic style. You may not be able to feed yourself properly or transport yourself from A to B."

Taso thinks many people in Katine need help, beyond its 217 registered clients who have journeyed to Soroti town. Most people can only get to Soroti if they walk or get hold of a bike.

Government policy is for every level-4 health centre such as Tiriri to offer ARVs. Dr Simon Oluka, the only doctor in the 25,000-strong Katine sub-county area, would like to begin an ARV programme at Tiriri but says: "If we are not able to sustain mere test kits, how are we to sustain ARVs?"

Against the odds, the HIV death sentence is being commuted in much of Uganda. But not in Katine. It is one of the areas in which the African Medical and Research Foundation, with the Guardian's support, plans to bring about change.

What we want to achieve

Provide diagnostic kits for HIV/Aids

Train or retrain re·train  
tr. & intr.v. re·trained, re·train·ing, re·trains
To train or undergo training again.

 village health teams in the latest treatments and therapies

Train lab personnel in improved diagnostic methods

Distribute insecticide insecticide

Any of a large group of substances used to kill insects. Such substances are mainly used to control pests that infest cultivated plants and crops or to eliminate disease-carrying insects in specific areas.
 nets to all those with HIV/Aids

Provide bicycles and kits for health workers to reach people in remote areas of Katine county

Distribute condoms throughout the county

£50 could pay for kits for 20 people

£16 a month, given over three years, could provide eight health workers with regular training on the latest methods of prevention, diagnosis and care of those with HIV/Aids

· The Katine project is run in partnership with Amref and Barclays
Copyright 2007
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright (c) Mochila, Inc.

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Date:Nov 24, 2007
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