From: ACET Newsletter, October 1999

Meeting the Need in Uganda

Bruce Townsend describes how ACET in Uganda is facilitating care and prevention for those most in need.

One of the first volunteers was Rachel Guttabingi, who is now the full-time co-ordinator. The project grew from small beginnings and overcame initial suspicion to become accepted by the local community. Initially people feared loss of confidentiality and stigma, and Rachel walked the village seeking out the most seriously ill. In the first year almost all of her 60 clients died. Today most clients come on their own initiative, and are numbered in the hundreds.

One of the first jobs was to provide training for the community. With no idea how to care for relatives with AIDS, or even how to prepare food which they could take, local people required teaching from the ground up. Today the project is more broadly-based. Community seminars raise awareness and provide people with the skills they need to protect themselves from infection. Most affected families receive counselling in their own homes. A large prevention programme particularly targets the youth. Activities such as sport, drama and skills training create an environment in which preventive education can take place.

Over-dependence is a constant challenge. Because volunteers live in the same community, clients tend to come to their homes seeking all kinds of help and support. On one occasion staff arrived at the COBAP office to find an eight year-old girl waiting for them with the dead body of her father, another victim of the AIDS epidemic. Her mother had died four years earlier, and her two brothers had run away. Evelyne Rurabuhemba, one of the volunteers, cared for her until the girl herself died just a month later.

Despite the pressures and the pain, the project's success stories are all around. One lady with HIV who received care, rehabilitation and treatment for secondary infections is now living a normal and healthy life, earning a little money to support herself by making charcoal. Another client received a loan to buy fibre to make mats, and is now also self- supporting.

In one tiny timber-framed hut I was introduced to Sarah. A widow with four children and three other dependants, and HIV+, she has received help and support from the project. She scrapes a living by using her home as a cafe, selling food and drink to people in the village. Another AIDS widow, Judith, has a market stall nearby. Also a beneficiary of the project's loan scheme, I met her when business was slow. "People are buying less because it's the dry season and food is expensive", she said, "and because the school term has just started and they have to pay the fees."

Around the corner in a small mud-brick house we found David - a young man of 32 with full-blown AIDS. Listless and gaunt, David had been suffering diarrhoea, headaches and fever. Living today with his grandmother, his future is bleak, and there is emptiness in his face. Back on the street I heard David's story. David's mother, a single parent, refused to tell him who his father was. After a lengthy search David eventually identified his father, only to discover that he had died shortly beforehand. David is not well treated by his family and the project is his only source of care and compassion.

Another house we visit is smarter and much larger. A woman opens the door and invites us inside. On a mattress on the living-room floor a girl lies, vomiting into a bowl. She looks up at us with a hopeless stare. The girl has AIDS and suspected meningitis. It quickly becomes obvious that it's not appropriate for us to remain, so we say a short prayer and leave. I feel a complete intruder, and on the verge of tears. Just one morning spent amidst such suffering has left me totally devastated and emotionally drained. To my shame, it comes as a relief to find that my visit is nearly over.

I left with the feeling that Nakulabye represents something of the best and the worst of the human experience. The suffering of the poorest of its people cries out for justice. Yet the compassion and care of the COBAP volunteers, together with the commitment and professionalism of Rachel and the ACET support team, is a remarkable demonstration of love for those most in need.