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Healthcare provision and infrastructure in Uganda are chronically underfunded and highly variable in quality. A system of "cost sharing," whereby hospitals must charge for treatments, means that most Ugandans have to pay for health care when they get sick. The high cost of care leads many Ugandans to turn to cheaper, traditional medicines rather than attend a hospital. As a result, people with illnesses such as malaria will often delay care for as long as possible before seeking treatment. These periods of waiting can result in increased hospital expenses, serious illness, or even death for some patients.
Uganda's infant mortality rate and life expectancy age are among the worst in the world. More than 50 percent of Ugandans have no access to clean water, making them vulnerable to cholera and diarrhea. Malaria and respiratory illnesses are widespread and are frequent causes of death. Economic liberalization has created a healthcare system that places the poor at a stark disadvantage. Other major healthcare issues are basic hygiene; nutrition; women's and children's health; and sexual/reproductive health (especially for young people and women).
A new health issue developed in the mid 1980s when HIV/AIDS became an epidemic. Scientists now believe Uganda's Lake Victoria region was one of the areas where HIV first began infecting humans. Ugandan president Yoweri Museveni was not aware of the virus until a group Ugandan soldiers were sent for training in Cuba. In September 1986, Fidel Castro informed Museveni that 18 of the 60 soldiers had the HIV virus, and this may indicate a high prevalence of HIV in Uganda.
AIDS has claimed millions of households throughout Uganda and has reduced the life expectancy of Ugandans from 48 years in 1980 to 43 years in 1995. Unlike in the United States, the Ugandan government's initial response was based on the recognition that AIDS affects all strata of the population and poses a major threat to the development of the country and welfare of its people. President Museveni established the AIDS Control Program (ACP) within the Ministry of Health (MOH) to create policy guidelines for Uganda's fight against HIV/AIDS. Uganda quickly realized that the virus was more than a health issue and, in 1992, created a "Multi-Sectoral AIDS Control Approach." In addition, the Uganda AIDS Commission (founded in 1992) has been instrumental in developing a national HIV/AIDS policy. A variety of approaches to AIDS education have been employed, ranging from the promotion of condom use to "abstinence only" programs. Uganda was the first country to open a voluntary counseling and testing (VCT) clinic in Africa and pioneered the concept of voluntary HIV testing centers in sub-Saharan Africa. These top-down efforts gave the impression that Uganda was the African leader in the fight against HIV/AIDS.
The scope of Uganda's success, however, has come under increased scrutiny. The government repeatedly misused international funds directed toward AIDS relief efforts, and in 2002, a medical journal The Lancet published research that questioned the accuracy of previous reports in Uganda that indicated a dramatic decline in HIV infections. It is claimed that statistics have been distorted through the inaccurate extrapolation of data from small urban clinics to the entire population—90 percent of whom live in rural areas. Also, recent trials of the HIV drug Nevaripine came under intense scrutiny and criticism. U.S.-sponsored abstinence promotions received recent criticism from observers for denying young people of information about any method of HIV prevention other than sexual abstinence until marriage.
HIV/AIDS is prevalent in Jinja and Masaka, and there is much work to be done to stem the spread of HIV as well as to care for people living with HIV/AIDS and their families. FSD works to support bottom-up strategies in addressing the virus and its many complex issues and social structures. Interns and volunteers assist a vast network of HIV/AIDS programs that serve communities who have been drastically affected by the virus. Basic medical treatment and health education are also provided by FSD to productively support a growing population.
Read more about Child and Maternal Health programs and opportunities initiated by our Community Partners in Uganda.
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