RSCJ | Home Based Care for HIV/AIDS Clients in Karamoja

Home Based Care for HIV/AIDS Clients in Karamoja

Home Based Care is a program which the Religious of the Sacred Heart in Naoi, Karamoja, run for people who are struggling to cope with being HIV + or who are actually sick with AIDS. They work with a group of volunteers; most of them HIV positive themselves.

Location of the Programme

Moroto is situated in Karamoja region, North-Eastern Uganda. The District consists of flat plains interrupted mainly by a number of isolated volcanic peaks. The climactic conditions make human settlement difficult. The unpredictable seasonal variations make agriculture very risky, hence the pastoral life-style of the Karimojong. Livestock becomes central to life, culture and economy. The relatively harsh climate, that is, high temperatures even during the rainy season, results in a long, dry season for the rest of the year. Geographical and social isolation, the people's life-style and insecurity, make this region the least developed in Uganda. There is insecurity due to cattle raiding and road ambushes which interfere with health programmes and development activities.

The Home Based Care Programme in Moroto is an effort by generous people including some who are HIV positive themselves who volunteer to care for clients who are badly off. The volunteers receive a very small allowance twice a month. They really work for love, since they have all been near death themselves and understand how important a disciplined life is for those living with AIDS.

Meeting of some of the volunteers of the Home Based Care program

Sister Maria Eugenia (Itae) instructing villagers on HIV/AIDS preventionSister Maria Eugenia Herrera, a Religious of the Sacred Heart, a Nurse, is leading this effort, helped by the members of her Community. At the moment they cannot afford more full time members or staff for the program although they really need a social worker and another counsellor. The program focuses on prevention and awareness.

In total they reach 350 clients with the respective children and families; the majority are women as the stigma is strong and men do not yet feel free to come out.

Most of the clients in our program have no job, no income generating activities, so house rent, food, school fees are a big challenge for them and for us. Alcoholism is a big problem for them and is in relation with the lack of food.

When a client is sick, the volunteer encourages him/her to go quickly to Moroto Hospital for treatment, even accompanying them when necessary. The volunteer (and the Sisters) visit the patient in the hospital when they are admitted and ensure that he/she is being looked after medically and is being kept clean and fed properly by a member of the family. If the patient wants the Sacraments we can call upon the Regina Mundi parish and a priest will come.

When a patient dies, as happens frequently, the volunteers gather with the bereaved family to comfort them and see how the orphaned children can be helped to go to or remain at school. The burial sheet and the digging of the grave are paid for if the family is poor.

We work together with Moroto Hospital, and are close to the nurses who provide the treatment. Together with the nurses we try to follow up adherence to the treatment. When there are new clients the nurses refer them to us and when we visit clients at home we send them to the Hospital when the adherence is not good or if there are medical problems. We feel that the care of our clients is improving. The nurses are much more caring and committed than they formerly were. Four members of the Hospital Staff are Volunteers, valued members of the team.

We work with the Army Barracks. Three soldiers, active members of the clinic in the Barracks, are members of our volunteer group, as in this area where many soldiers are suffering from HIV it helps us to be in touch and follow up their wives and families.

Choose Life Tailoring Group. With some funding received from ISP (Insiem Si Puo Limited) we recently managed to send 14 people to Gulu for tailoring training with the objective of making them self-reliant… ISP also donated five sewing machines and a place where the group could begin to work. Trento group from Italy gave us three sewing machines and several sacks of materials.

The Care of Orphans, especially those who are HIV+. We try to see that these children are with relatives who will look after them and not exploit them, that they go to school (which involves fees and uniforms), that they have enough to eat, that they are not scattered so that they lose contact with their siblings.

Children Activities

The majority of the children´s activities are supported by C & D, (Cooperation and Development). We work together in the planning, implementation and funding.

"School of Life" is an activity for the group of children whose parents are HIV Positive or whose parents died of AIDS. Some of the children are HIV Positive. We have activities with these children twice a month; we cover topics with them which we feel are good for their lives and daily living. For example: Children's Rights, Sanitation and Hygiene, Family Issues, and Education. These topics help the children change their ways of living and their behaviour, they have tried to understand their responsibilities as children, and are sharing freely what is taking place in their localities. We also do sports with them and we are now trying to teach them how to make beads out of papers. They are learning the skill very well and they seem to be happy. We have evaluated the children's activities with the children and with the parents and all found the activities are helping the children.

School Fees. We have 75 children whom we sponsor-for primary-education. We visit them at their schools to hear from them and to know how they are doing and encourage them. The challenge we have is that some of them are not cooperating and they are not supported by their families. As a result the attendance at school is very poor, but we are trying to follow them more closely both at home and at school and with this follow up they are improving.

After School Program. We realise that it is not enough to pay school fees; the children need motivation and close follow up. So with the help of C & D we are offering on Mondays to Thursdays, two hours of coaching for these children to help motivate them and improve their reports.

Holiday Program. We have activities in the mornings three days a week for the children combining time to relax time with educational activities: drawing, drama, dances etc. The objective is to keep these children busy in a healthy way and at the same time to improve their school reports.

Holiday program for children with HIV/AIDS or of Parents with HIV/AIDS

Parents Meeting. We try to keep the parents motivated by trying to involve them in the education of their children. We have meetings with the parents once every term together with their children.

World AIDS Day 2012. With the support of Save the Children, the group of children and the adults presented a very good educative drama and song. It was a good experience for all in facing and working against the stigma of HIV/AIDS.

Building Project and objective of same

  1. To be able to have a referral place (Centre) for our HIV/AIDS people where they will know somebody is there to listen (counselling) or help, a place where they can spend their free time doing something positive (gardening, making beads, tailoring, cooking, sharing experiences, group discussion, Alcoholic Group Support, awareness, learning new things like literacy, self-esteem, etc.) instead of remaining at home drinking alcohol or being inactive.
  2. To have an appropriate space for all our activities: children's activities (“School of Life”), tailoring project and workshops. Awareness program, AA, Education for Life, Meetings with the volunteers. Counselling.
  3. To be able to rent the hall to other organizations if the hall is free, in order to get some income for the project.

Realization Of The Building Project

  1. In January 2012 we managed to buy a piece of land 400 square meters in Katanga.
  2. In May, Insiem Si Puo Limited (ISP ) finished constructing a borehole on the plot.
  3. We have a man who is helping us to plant some vegetables on the plot.

Our dream is to put up a simple building. We would like to have:

  1. A Hall for all our meetings (awareness program, Alcoholic Anonymous, on-going formation, workshops, children's activities on Saturdays);
  2. Room that can be used for the tailoring group in case the sponsor of that small project stops, or it can be used as a dormitory when we have workshops;
  3. A kitchen and a store, that we can use to assure that the food we are preparing is consumed in our presence, and to make sure that the clients are taking the medicine, because simply handing out of food can mean it is being sold down the road or given to someone other than the intended recipient;
  4. A small Office with space to keep files of the clients to help us to follow them up;
  5. A counselling room;
  6. A latrine;
  7. Small garden to cultivate vegetables and to give the chance to some clients to be busy.

Misereor has granted us the funds for the construction of the centre.

Sustainability

Home Based Care is a wide field and until now we are running the program of Home Based Care (HBC) for HIV/AIDS in Moroto as a Faith organization duly registered, and authorized to carry out charitable activities in Moroto district. All the expenses are covered with the help of some particulars private donors. In the future we hope to get ways to sustain the project with the income generating activities like tailoring.