December 1 is World AIDS Day…..

A few weeks ago, in late November, Rakai District sent all clinics a notice that they were a little short of funds for the events plan for World AIDS Day. After much discussion with various people, we decided to help support the event….. as I was handing over the shillings to one of the coordinator, I was graciously invited to come and see what was happening…. I had not thought about going until that moment.

The theme for this year is “Re-awakening leadership against AIDS”. Rakai District was going to have there celebration at Kasensero (Ca-sense-ee-row). Now, I have never been to this village but was told it was a very small fishing village on Lake Victoria near the Tanzanian boarder and the trip from Kibaale to Kasensero would take anything from 2 to 4 hours… This would all depend on the road and security. I understood that most of the trip would be on a single lane dirt road… what I mean is that only one vehicle can travel on the road at a time. The first vehicle has to move over and hang off the side of the road to let a second vehicle pass. What I did not understand was security….. everyone believed that the President of Uganda was coming to this event. I could understand why anyone was going to travel to the far end of Uganda to this place in the middle of nowhere. Nevertheless, I was interested in finding out what was happening with AIDS in Uganda. The clinic has the ability to test for AIDS and we counsel every patient who has been tested…. but we do not have or prescribe antiviral medications this is done at a government clinic.

The clinic was closed and seven of us left Dec 1 at 8:30 for Kasensero. We got as far as Ssanje (sand-gee) which is on the main road leading to Tanzania. We stopped for a few minutes which turned out to be many as one large white vehicle with black lettering stating UN passed us by. After the UN convoy passed by, I moved in behind the last truck and headed off down the road…. but by the time we reached the turn off… they were long gone. I was surprised at the speed they were traveling down this rugged, narrow dirt road.

Less than 30 minutes later, a dark blue police jeep pulled up behind me with sirens on… I pulled over to let at least 20 large, black, shiny impressive cars passed by….. Once again I moved into behind the last one and tried to follow them down the road but I was uncomfortable traveling at those speeds….. I may have gone a 3 or 5 miles when another dark blue police jeep pulled up beside me this time and told me to move over…. and another long convoy of big, black shiny cars passed me by. By now, the clinic staff were positive the President was coming to this AIDS Day events but I had my doubts.

Finally, at 11 o’clock we arrived and found parking in an off the road field; went through security where I was told I could not bring in my camera…..and was directed to seats under one of the six or seven large tents set up for various dignitaries. The next 2 1/2 hours was one set of amateur entertainment after another…. I made me think we were waiting for some… It was truly local talent from numerous school music and dance groups to a high school marching band to two young boys doing acrobatics…… Finally, the activities changed and became more like the start of the program… it was because the President of Uganda had arrived…. He walked into the small circle of tents and passed by the many booths promoting various items, programs or agencies for the fight against or supporting those with AIDS.

Once the national anthem of Uganda and AIDS had been played the speeches started…. I asked the staff what was being said but no one was willing to translate…. after numerous speeches, a little girl come up to the mike and just by her actions I guess that she was telling the President about her life with AIDS…. The clinic staff finally translated her story… she was an orphan, both parents and grandparents had died of AIDS…….. she asked the President for the necessary medications to kept her healthy, a new house and a new school since both were falling down….. It was just then that I understood the everyone’s speech as really a request for money.

There were two English speeches…. the first one was by an UN representative, Janet Jackson, presented the following information…. today, Uganda’s is one of two countries in Africa where the rate of AIDS has increased. In the beginning, Uganda was the example to all countries and governments how to educate about the ABCs for the prevention of AIDS, (A = abstinence; B = Be faithful during marriage; C = use condom); how to ensure that those affected receive the necessary antiviral medications; and how to support those living with the infection. But over the past few years things have changed….now 50% of those tested are positive and only 50% of those infected will receive antiviral medications. Unprotected sex and mother to baby transmission accounts for 99% of all cases…..

The second speech was from a gentleman who represented the international partners…. he expressed the deep concerns the foreign partners had as to why things had deteriorated over the past few years to cause a significant increase in Uganda’s rate of the infection.

By 3:30, I was hungry and the speeches were continuing… I had obtained the information I want… so we walked down the narrow vehicle filled street to see Lake Victoria and find some lunch which was fresh fish…. I would not call this village picturesque in any way…there was no motels, no hotels, no gas stations, no restaurants overlooking the lake with patios where you could enjoy a cup of coffee or tea… the village was made of old broken down wooden huts which look like they would fall down with the next wind storm…. it was foul smelling and dirty. I could not understand why a large event like this would take place in this village…. I later learned that the first case of AIDS in Uganda was from this village of Kasensero.

My plans were to leave at 4:30 so I could be home before dark… I do not like traveling on these road after sunset which is around 7 pm, but at 4:30, I quickly learned the President had just left…. Now, I had to wait for all the police vehicles and all the other support vehicles to depart before I could even think about moving my land cruiser.

I was expecting the trip home to be faster and easier but I was truly wrong…. first of all, many of those who had attend the event were impatient and wanted to get home immediately and therefore demanded that I pull over and let them pass… So it was stop and start most of the trip into Ssanje. We had to stopped to check and see if everyone was O.K. for two accident where the vehicle had rolled over but each time we were told everyone was alright.

I was less than a half mile from the turn off to Kibaale in Ssanje when I saw a very large military helicopter surrounded by the same vehicles who had just passed me minutes ago….. just then one of the staff informed me that the President had two appointments that afternoon. They did not say where the second one was…. I thought it must be in Ssanje… and I was wrong.

I was half way to Kibaale when I came face to face with a dark blue police jeep coming straight at me… I quickly pulled over and learned that the President had gone to the small village of Mannya to open the school and new health clinic. Now…. the various police and military vehicles were not coming from behind me but were coming towards me…. and once again I had to pull over and wait for them all to pass….. I saw the President a second time.

Once I got to Mannya….. the narrow dirt road was filled with crowds of people and I was not able to pass for sometime….. the trip back to Kibaale was extremely challenging…. I did not want to hit anyone and everyone was in very good spirits celebrating the fact the President of Uganda and come to their village….

Yesterday, I spoke to all members of the clinic staff about the events of December 1, World AIDS Day and I expected the discussion to be about the fact the President had come to this remote village but the staff talked for sometime about what we as a clinic can do to educate the community about the AIDS epidemic and the ABCs (abstinence, be faithful and the correct use of condoms); the importance of testing and receiving counselling of the results and making sure the person who is infected receives the antiviral medications….