Kampala Erupts

Rhona - 25th March
Life in Kampala has been a bit tense since a week ago last Monday when there were riots at Makerere University following the death of two students. There was a strike on Monday and then there was trouble at a student hostel, which a security guard tried to resolve by shooting three people with one bullet, killing two.
The following day there were student riots, and then on Tuesday night the Kasubi Tombs, a World Heritage site, was razed to the ground by fire with more rioters stopping the fire service from entering.



 

 We were at the Tombs three weeks ago with Donald and David. It was a nice antidote to the bustle of the centre of the city but it is off our Kampala tour for our future guests. 


 
Fortunately we are on the southern outskirts and the troubles were all on the north. We were pretty safe and unaffected but some VSOers live on the north and had to stay at home until the situation died down. There are elections due in May 2011 so there may be more trouble to come.Today's news is of a further 2 student deaths.
However, we had a very nice evening on Friday with other VSoers in a boutique hotel on the north of the city and all was calm, apart from the sky which was lit up by lightning all night though there was no thunder or rain. The Emin Pasha was built by a safari company whose clients were not greatly enamoured by the big international hotels in the centre of Kampala and they certainly got this one right. It is very elegant with terraces to sit on and very nice music, very sophisticated and a great end to a busy week.
I have been spending time with the nurses and learning a bit more about the treatment of HIV/AIDS. I attended a group education session for clients who are starting antiretroviral therapy (ART). 

Clients who are HIV +ve but well are prescribed Septrin, an antibiotic which they take routinely once a day to reduce their chance of picking up opportunistic infections, to which they are susceptible. When the disease progresses to a certain level, they start on ART (for life) which involves taking heavy-duty tablets twice a day and they have to take them at exactly twelve-hour intervals to be effective. The medication makes people feel unwell, especially in the first few  months and particularly if they do not take food beforehand. Many people can only afford one meal a day and not always that. They have to come to the group education sessions along with their treatment supporter, a family member or friend who has agreed to help them to stick to their regime. The community health workers also visit them at home at least weekly to give them support. The session was very well done by one of the staff of the Adherence and Support Department who monitor and support people on ART and also those on TB treatment as well. In addition they look after pregnant women and their children up to the age of two years, who are enrolled into the PMTCT (Prevention of Mother To Child Transmission) programme.
I also attended the weekly meeting of the community health workers. They are all HIV+ve and clients of Reach Out  and each looks after a small number of families in their own community. They have a community leader who supervises them and they discuss clients and refer upwards if necessary. There is a strong religious element as well and they will often go and pray with clients who are very ill. It was interesting hearing about the problems they encounter in a country where there is absolutely no welfare state to provide a safety net for people in extremis. Clients of Reach Out are very fortunate that they are so well cared for and can be given food, although the World Food Agency have stopped their programme at Reach Out and food aid is decreasing generally. They also have community supporters who will look after clients who are very ill and have no family to care for. However, while our clients enjoy a Rolls Royce service, others in the same community who are not HIV +ve and those in other areas do not have access to even basic care, which does raise questions about equity of access to health care.