Uganda & Ghana- Kuchus and HIV in Africa (2); The Failure of Africa’s Medics & Health Care Workers (3)

  

Continued from the previous post: Kuchus and HIV in Africa (2); The Failure of Africa’s Medics & Health Care Workers (2)

Uganda has actually had some great results with HIV prevention and care. It is deservedly praised…, as was lavishly commented on by the UNAIDS/PEPFAR/Global Fund joint statement.
Although the statement was taken quite negatively in Uganda, I think it was quite a ‘sucking up’ in many ways. The flattery, even evidence based, is quite a lot. Maybe Winnie Byanyima, knowing the Ugandan psyche thought it better to upload with lots of diplomatic nice talk to cushion the bite in the message…

If it was that, well, it was a dud.
Ugandans are quite consistent, and human. We embrace our prejudices with fervour and our prejudice to ‘homosexuality’  is the mother of all prejudices.Our doctors as detailed are also prejudiced. They are Ugandans!

But, we still expect better of them. A laughing stork Uganda demands people to blame. The medics are very convenient here…!
The Director General of Uganda AIDS Commission did explain the issue, though the article in the Daily Monitor relegated him to an after-thought. I guess it was more profitable for the paper to fan the flames of ‘Uganda is being bullied’!

Explains Dr Nelson Musoba, DG of UAC;

 

““they are just taking precautions and saying for communities that may be discriminated, ‘What steps do we want to put in place to ensure that they continue accessing treatment to ensure that they continue to access treatment?’”

 

Egg on our collective face as Ugandans. The conveniently reviled Americans were trying to protect our prize HIV/AIDS programme? The statement said so. It is our bad faith that read nefarious ‘colonialism’, ‘blackmail’, in their words. Prejudice twists clear thinking. Uganda collectively was a great example there.

But this begs the question, with Dr Nelson Musoba, Director General of Uganda AIDS Commission (UAC) knowing these probable effects of the Anti-Homosexuality Act 2023 on HIV programming, why wasn’t the Parliament of Uganda and the President of Uganda in the know? This is established science, this day and age of the HIV pandemic surely? It wasn’t ‘the Americans’ duty to inform our in-country experts.
Rumour was, Speaker of Parliament was so rushed to pass the bill UAC was not invited to the party. But, a lot of organisations came out detailing the probable effects of the proposed law. All that fell ‘on deaf ears’ in Uganda. No appeal to sanity could have stopped us passing the Anti-Homosexuality Bill, 2023.

Why did it fall to the US ambassador in Uganda to actually secure a promise from the President that the health services would not be subject to the Reporting mandate in the Anti-Homosexuality Act, 2023?
It is ridiculous when the conveniently reviled Americans seem to care more about our people than we do. It is shameful, and that shame tracks back to Uganda’s medics and health care workers, the Ministry of Health and the Uganda AIDS Commission.

The American envoy to Uganda actually commented this about Dr Jane Aceng, which makes me wonder what Uganda’s Minister of Health, a medical doctor, has been saying behind closed doors.

 

“She reportedly took issue with Health Minister Jane Aceng, who was not in the meeting, saying her disposition on the matter of homosexuality was likely to reverse years of gains in healthcare and particularly HIV/Aids treatment, largely supported by development partners.”

 

That is a loaded statement, particularly coming from a diplomat.

The same challenges are happening in Ghana. But, in their case, though there are medics and health workers who don’t understand, it seems the Ghana AIDS Commission has come out against the anti-homosexuality bill in Ghana.
And, for that temerity, Members of Parliament in Ghana are condemning the Ghana AIDS Commission.
I think that that is better than in Uganda where the Ministry of Health seem both ignorant and unwilling to state facts. The doctors responsibility is to state the facts, part of that responsibility for the power we hand to our medics and health workers.

In Ghana, the anti-homosexuality bill in parliament aims to stop or reduce HIV/AIDS programming to Ghanaian Kuchus. Why? Because HIV programming is actually ‘promotion of homosexuality’.
The bills in our parliaments, plural, aim to stop the heinous ‘promotion of homosexuality’.

If true, and Ghanaian MPs are refusing to listen to the Ghana AIDS Commission…, well, please don’t blame ‘the Americans’ for our own ignorance, and failure to be educated because of prejudice. We are sovereign in that.

It is the member of the clan who should point out that the elder didn’t wash face in the morning. Not to wait for a guest or visitor.
Yeah, and as an African, I am pointing out to my dear leaders and elders-, your are walking around naked, with unwashed faces. You are embarrassing us, please!

 

gug

From the Director General of Uganda AIDS Commission

‘Gay activities rife in schools’

Thursday, 21st August, 2008

SCHOOLS have become breeding grounds for homosexuality, according to Dr. Kihumuro Apuuli.

Anne Mugisa reports that the Aids Commission chief urged the education ministry to stamp out the vice. He, however, noted that parents and guardians had an even bigger responsibility to inculcate African values in their children.

‘The practice is common among young people between 15 and 24 years.’

He was answering questions about attacks against Uganda during the recent HIV/AIDS conference in Mexico. Many participants, he said, claimed that gay people were being harassed in the country.

‘We had quite adverse publicity in Mexico. Many speakers condemned our country but I believe we have strong values in terms of behaviour and what we think is right,’ said Apuuli,

It was difficult, he added for someone to depart from the values they are taught right from the time they were toddlers.

Over 30,000 people were at the conference. They included people living with HIV, scientists and policy makers and other stakeholders. Over 500 Ugandans from here and the Diaspora also participated.

---

Well, bang goes the thought that because he is a scientist, he is an ally. Was only my wishful thinking.

Sunday Vision Editorial

I felt so insulted by this editorial that I would like to burn the writer at the stake. But I have an inkling it is someone very high up in the Govt!!!!!

Just a thought! Though I respect the New Vision enough to know when someone is forcing their prejudice onto them. Well, it is the government mouthpiece.

But I bet David-Nicholas Kimbowa loves it! Hi Kimbowa, small question, ever had the joys of sex? Only a proffessional abstainer would give this kind of advice. Sex is too lovely a joy to punish myself with 'abstinence'!!! But that is me!

A tip for gays

ON Wednesday, gay activists were arrested over bursting into an HIV/AIDS meeting at Imperial Hotel Royale in Kampala.

Carrying placards pleading to participants to consider gays in the planning and prevention of the HIV/AIDS, it is reassuring that they too are aware of the pandemic.

Earlier Dr. Kihumuro Apuuli, the Director of Uganda Aids Commission, had called for the inclusion of gays in designing anti-HIV/AIDS strategies during the same forum.

The right of expression is guaranteed but it’s not absolute. It does not provide for legally proscribed groups and activities.

Whatever the arguments and concern, including human rights considerations, homosexuality is illegal. This curtails any programme for those with orientations against the course of nature.

Besides it’s not only in the law books, but the Uganda cultures abhor it too. It might be argued as sad, but the stark reality is there is no room for gays at the moment in Uganda. It will require a change of laws, cultures and customs for space to be created for them, which is impossible.

But it is not the end of the world for the gays. They have one, and very effective protection against catching HIV/AIDS and stress of the unnatural activities. Abstinence is the answer. They should try it out. It is free, cheap and about personal life.

It is healthy too. The heterosexuals may have three options ‘abstinence, being faithful and using condoms’ the ABC strategy. But it may not be a good thing to have many options. One, like abstinence, works better for the gays.

Published on: Saturday, 7th June, 2008

Press Release

Press Release

On 2^nd June, 2008 the Director General of Uganda AIDS Commission (UAC), was widely quoted by international media saying "Gays are one of the drivers of HIV in Uganda, but because of meagre resources we cannot direct our programmes at them at this time,"[1]

We would like to point out:

· 26 years since the epidemic of HIV started there has not been a single government led prevention programme amongst gay Ugandans.

· That from the very beginning of the world wide epidemic it was known that gay men are a vulnerable group.

The statement by the Director General is particularly sad, following statements of other Ugandan leaders that gay people should be marooned on an island to die[2], and from an advisor to the UAC that “Our previous experience showed us that bringing homosexuals into campaigns against HIV only gives them a chance to propagate their illegal and unnatural acts.”[3]

We are Ugandans. We are gay Ugandans.

We have a right to life.

We have a right to health.

We have a right to be free of HIV.

We have a right to knowledge about HIV prevention and treatment. We have a right to protect our selves, our lovers, our families and our communities.

26 years since the HIV epidemic started, Gay Ugandans believe myths and lies about HIV.

We are gay Ugandans, fellow human beings. We are your brothers and sisters, fathers, mothers, cousins and clans mates.

Please stop discriminating and stigmatizing Gay Ugandans in the fight against HIV. Gay Ugandans need an HIV prevention programme.

---

[1] http://africa.reuters.com/top/news/usnBAN240719.html

[2] http://allafrica.com/stories/200710151334.html

[3] http://www.monitor.co.ug/artman/publish/news/Include_gays_in_Aids_fight_reports_say.shtml

Gays excluded from HIV work in Uganda

The head of Uganda's AIDS commission has claimed that gay people are driving up the number of infections in the country, but said they would not be targeted with prevention work.

Kihumuro Apuuli claimed a lack of money prevents him from giving any attention or treatment to gay people.

Instead soldiers, prostitutes and the transient workforce will be targeted. More than a million of Uganda's 27 million people are already HIV+.

"Gays are one of the drivers of HIV in Uganda, but because of meagre resources we cannot direct our programmes at them at this time," Mr Apuuli, chairman of the Uganda AIDS Commission, said today.

Government officials have regularly threatened and harassed lesbian, gay, bisexual and transgender Ugandans.

And then follows a litany of how Ugandans, government and society, have been (mis)treating gay Ugandas. Even I get tired of repeating those!

I am amazed, and actually amused. My salute to the Director General of Uganda AIDS Commission, the learned Prof. Kihumuro Apuuli

In the same breath, we are condemned and stigmatized for spreading HIV, and then of course we are told there is not enough money to protect us. Poor gay Ugandans! We are really the devils. Have to brush up my tail and polish my horns. They need to hit someone!

GayUganda

HIV and Gay men

Its always a wonder to me. The fact that I can and do affirm that I am gay. That I am a gay Ugandan. And that I can actually be proud of the fact.

Yeah, pride is an important thing to have in oneself. Because of the fact that we can and easily believe that what the world believes of us is correct.

I got to this article, called an ‘abstract’, a summary of a scientific research paper. It was done in Kenya, and the statistics that I see here are frightening to me.

In Kenya, our neighbours to the east, they have managed to start doing HIV prevention amongst gay Kenyans. Kudos to them.

In Uganda, it is the opposite. The Ministry of Health does not comment. The Uganda AIDS Commission, re-known all over the world, does not apparently cater for gay men.

And the Churches (and Government) believe firmly that this should be so.

I do not understand all that is written in this paper. But I understand one statistic. Amongst the gay men who were tested in Kenya, the HIV infection was at least 43%.

What is the rate amongst gay Ugandans? We are supposed (in Uganda) to have a higher HIV infection rate. But even I know that it has never been 43% of the population. Indeed we (gay Ugandans) are at risk.

Yeah. I have to learn to be safe. But it galls me that homophobia in Uganda is so blatant in its capacity to prevent something as basic as HIV prevention amongst a vulnerable population. And they call themselves a ‘very religious….’

Here is the article.

HIV-1 infection in high risk men who have sex with men in Mombasa, Kenya.

22 Dec

AIDS. 21(18):2513-2520, November 30, 2007.

Sanders, Eduard J a,b; Graham, Susan M c; Okuku, Haile S a; van der Elst, Elise M a; Muhaari, Allan a; Davies, Alun a; Peshu, Norbert a; Price, Matthew d; McClelland, R Scott c; Smith, Adrian D e

Abstract:

Background: The role of homosexuality and anal sex practices in the African HIV -1 epidemic is not well described. We aimed to assess the risk factors for prevalent HIV-1 infection among men who have sex with men (MSM) to guide HIV-1 prevention efforts.

Methods: Socio-behavioural characteristics, signs and symptoms of sexually transmitted diseases (STD), and serological evidence of HIV-1 were determined for 285 MSM at enrolment into a vaccine preparedness cohort study. We used multivariate logistic regression to assess risk factors for prevalent HIV-1 infection.

Results: HIV-1 prevalence was 43.0% [49/114, 95% confidence interval (CI), 34-52%] for men who reported sex with men exclusively (MSME), and 12.3% (21/171, 95% CI, 7-17%) for men who reported sex with both men and women (MSMW). Eighty-six (75%) MSME and 69 (40%) MSMW reported recent receptive anal sex. Among 174 MSM sexually active in the last week, 44% reported no use of condoms with casual partners. In the previous 3 months, 210 MSM (74%) reported payment for sex, and most clients (93%) were local residents. Prevalent HIV-1 infection was associated with recent receptive anal sex [odds ratio (OR), 6.1; 95% CI, 2.4-16], exclusive sex with men (OR, 6.3; 95% CI, 2.3-17), and increasing age (OR, 1.1 per year; 95% CI, 1.04-1.12). Only four MSM reported injecting drug use.

Conclusions: The high prevalence of HIV-1 in Kenyan MSM is probably attributable to unprotected receptive anal sex. There is an urgent need for HIV-1 prevention programmes to deliver targeted risk-reduction interventions and STD services to MSM in Kenya.

(C) 2007 Lippincott Williams & Wilkins, Inc.

Sunday Evening

I think I owe you an update. Now that I can give it.

About a couple of weeks ago, I told you of an interview that I had with a reporter. And the fact that I was very apprehensive. I said then that I had rolled the dice, and did not have any control on how they landed.

Well, the interview was aired. On WBS-TV Sunday evening.

My debut on national television. Guess what, I was not anywhere near a television set!

It is hilarious. I was informed that the program was on the air, when I was on my way to a ‘joint’, a bar. We had left home when there was a power cut (they are becoming really common these days. Uncommonly common!), so we could not return. We continued to the bar.

Now, Sunday evening was special. Kampala, Uganda holds its collective breath when there is a major Premier League match being played. Forgive me, not the Ugandan Premier League- the English Premier League. What with the advent of satellite TV, and the fact that our local league had gained a terrible reputation, those who love the beautiful game (all Ugandans apparently) are usually tuned in.

I was informed that my debut on TV was imminent. I was impatient. How telegenic am I? That is a question any normal human being wants to know. Beamed miraculously into the homes of many Ugandans. I would have loved to see how suave I was. How collected and impressive!

Sadly, it was not to be. Most people on the streets were glued on the premiership match. Arsenal against Liverpool. Crowds in the bars where televisions sets were turned to the street to attract clientele. They stood on the sidewalks, and looked into the bars. I am not sure whether they bought anything. It was a tense match.

I don’t know when Liverpool scored the first goal. I know it was in the first half. Walking the street to my bar, there was this air of gloom. Little conversation, the tvs blaring, radio commentaries. The gloom of the evening was not in the low light. It was the atmosphere generated by so many people ‘feeling’ for Arsenal. I didn’t know that plucky club had such a following!

That was a detour.

About my telegenic self. I knew it was a risk to appear on tv. Too many uncontrolled variables. But I figured that it was worth it. Now with Pastor Ssempa arguing that we gay Ugandans were using HIV as entrée to gain acceptance. Of course we are. It is our lives on line. If we don’t wake up to the fact that we are dying slowly but surely, we will die. We must destroy those myths.

I know I have outed myself. One more time, that is, if you watched the WBS programme. If you didn’t, well, I don’t know how much you missed. I did not also!

When I got to the bar that I wanted to use, I found that there were two competing programmes. There was Arsenal vs Liverpool, the second half, and of course Maureen being ‘evicted’ from the Big Brother Africa 2 house. When I demanded that the channel be changed to see my self, I was woefully booed down. You know football fans. Anything about changing the channel at that moment is a capital crime offence. The punishment swiftly meted out.

I was in the bar when Arsenal equalised. The roar was deafening.

Thereafter, it was the match’s post-mortem. A verbal dissection of every move and counter move. Needless to say, my pleas for silence were not heard. Who wanted to hear about the risks of gay men and HIV?

I know I said my piece. And Ssempa said his piece, and the Uganda AIDS Commission said theirs. Yeah, you may have recognised me, or not, but then, that is a small price that I will pay. A progressively controlled outing to the whole of my Ugandan country mates.

To those who know my identity, please don’t use it as yet on this blog!!!! Let me retain that last bit of my anonymity!

GayUganda

PS. For the next week or so I may not post that regularly. Something has cropped up which needs my attention for the near future.

No, it is not the police at the door. The beauty of media is that once the broadcast is done, then one has to use legal means to check the discussion. Of course I am vulnerable in other ways, but those risks are bearable.

gug