Testing Times in Uganda

testingI have recently returned from CWB’s Autumn 2015 Project in Northern Uganda, and area where both people and infrastructure have been devastated by recent wars, in particular by the atrocities committed by the Lord’s Resistance Army.

The LRA infamously abducted thousands of children in this region and trained boys as merciless killers and took girls as sex slaves. The area is now returning to relative normality, but the scars remain all too apparent. We encountered 16 yr old school children, often returnees from S. Sudan, whose eyes were expressionless: deep voids, lacking the ability to engage, cold. Emotionally eviscerated by what they had experienced. And obviously at risk in terms of HIV/AIDs.

testing2In 2012 CWB undertook a pioneering project in schools across the war torn area; establishing links where cricket was largely unknown, and in a context where schools and local infrastructure, including healthcare were struggling against the odds to be re-built. But the effects of this early intervention by CWB were apparent when we went to Arua, Gulu and Lira this Autumn. Teachers, often proudly wearing old CWB tee-shirts, gave us a warm welcome back. Cricket equipment left by CWB was still in evidence, and there was reasonable familiarity with the ABCT mantra. We were able to build on these foundations, and over the two weeks coached almost 4,000 children and trained 80 teachers. We also tested 380 children for presence of the HIV virus at ‘Testing Days’ across the three locations.

Ensuring adequate testing resources at every location we regarded as a critical priority in order to be able us to give full, practical, expression to our HIV/AIDS awareness messaging. In past projects it had not always proved possible to engage local organizations in the provision of comprehensive testing. We had endeavored in advance to make email contact with agencies potentially able to provide testing, but we got either no, or unsatisfactory, replies. Fortunately, our contact at the Uganda Cricket Association, Grace, who has responsibility for the Northern Districts, was able to come up with some possible contacts at two of the three locations. On arrival at Arua we immediately went to the local hospital and made contact with the HIV/AIDS Unit, which principally offers palliative care, but which also had some limited outreach/testing capacity. The Head of the Unit engaged with our objectives, and together we sought out the hospital’s Principal Administrator who had the sole authority to commit resources to outreach testing. He was, in principle, supportive, but it took some detailed negotiations, and rigorous adherence to management protocols and conventions, before he agreed to a team of five (two nurses, 2 counselors and one technician) attending our Testing Day. In the event the team tested 150 children, with compassion and breath-taking efficiency. Long queues of boys and girls, together, were rapidly processed. Three tested positive; they were given immediate counseling and commitment to long term psychological support following treatment with ARV’s at the hospital clinic, which commenced the following day.

testing3On interviewing the nurses and counselors at the end of the day we learnt, to our surprise, that an 11 year old boy who had tested positive, had proclaimed himself ‘happy’ at his diagnosis. For him, it explained his worrying symptoms of nasal bleeding, fever and convulsions; the promise of immediate treatment had given him hope. A returnee from S.Sudan, with his S. Sudanese parents now off the scene, the boy was cared for by his grandmother. The active involvement of his schoolteacher in conjunction with a counsellor and hospital treatment are not just life changing for him, but potentially life saving. The team left Arua with a spring in their step.

In Gulu, we worked with TASO, a national NGO, in the of testing. Amongst those tested was a group of street children who we actively involved in the Testing Day, together with masses of children from local schools, as a result of a chance connection made with a charity operating in Gulu, called ‘Surface Uganda’. We managed to enlist the help of a volunteer at Surface Uganda in supporting one of the street children who tested positive. She agreed to act in in loco parentis to the 14 year old (who was sexually active) and ensure that he attended the local clinic to receive ARV’s and appropriate counseling.

testing4Finally in Lira we worked with the local Regional Hospital which provided a five strong testing team, following making immediate contact on arrival in the town and, as in Arua, protracted negotiations with the hospital’s administrators and instant production of required paperwork. The team managed to test a further 170 children. The two children testing positive were followed up, again with the active participation of their teachers who were on the spot at the Testing Day.

Having a highly visible testing post, used by throngs of children, puts the T in ABCT. It is part of one big event that children will remember. By getting tested children not only learn their status, they are proud of having done it: together, boys and girls, as a team. Having been tested once they are more likely to seek repeat testing; and in between be aware of how to protect themselves, via ABC, and stay negative. And CWB now has established a strong partnership with agencies that can provide testing in the future.

Steve Wells
HIV Lead, Uganda
November 2015.

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