Community outreach is of particular importance in the Gulu region. The considerable transience of Gulu's population due to conflict has led to the highest HIV prevalence rate in Uganda. Some residents in the Gulu area are so poor, they are willing at times to accept rice in return for sex.
Both a client and a program volunteer, Alice Bongomin holds a record of her hospital visits and antiretroviral medications received through the PEPFAR-funded AIDSRelief consortium.
To help stem the disease's spread and fight misinformation, Comboni Samaritans of Gulu and St. Mary's Lacor Hospital have undertaken significant community education. Staff even had to convince residents that antiretroviral therapy actually worked. Before the lifesaving medications were widely available in the region, people were buying the expensive drugs, taking them for a month or two, and then going off of them a few months later when they could no longer afford them. This led to drug resistance and, for many people, death.
"At first people thought the drugs killed people," Opiyo notes. "Now they are seeing teachers back to teaching and soldiers back in the army." Even so, few men are seeking treatment, driving the need for additional education.
Ironically, the sustained peace in northern Uganda is bringing a new set of challenges to St. Mary's Lacor Hospital and Comboni Samaritans of Gulu.
"When people were congested in camps, it was easy to [serve] them. But now with peace coming, people are being scattered as they go back to their homes far away," Opiyo explains. "It's making our catchment area so much bigger, but we need to go and give them services." The PEPFAR-funded AIDSRelief programs in Gulu are reaching out through monthly mobile clinics that bring community- and client-support activities to more remote communities, and by opening satellite clinics in surrounding areas.
"When I see someone looking miserable, sometimes I read from their face that this one might be sick. Then I just go and console them," Betty adds. She hasn't fallen sick again since starting antiretroviral therapy. "I give him or her courage, because [HIV] is not the end of somebody."