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MSF in Uganda, 2008
Field Staff: 719
Reason for Intervention:
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HIV/AIDs affects an estimated eight percent of Uganda's population. According to the World Health Organization (WHO) there are more than one million people living with HIV or AIDS in Uganda, including 312,000 who need antiretroviral (ARV) therapy. It is estimated that 42 percent of patients are on ARV nationally, but the percentage is much lower in northern Uganda.
In Arua, MSF’s HIV/AIDS clinic includes integrated treatment for HIV/tuberculosis (TB) co-infection, nutritional support for malnourished adults and children living with HIV/AIDS, and a program providing antenatal care and prevention of mother-to-child transmission of HIV/AIDS. More than 4,700 patients are undergoing ARV therapy in Arua regional hospital. In parallel, MSF supports three decentralized HIV/AIDS clinics in the West Nile region, to ensure that people can access local health care.
Only 10 percent of HIV-positive patients have access to care in Madi Opei, Kitgum district. MSF made HIV/AIDS and TB care available, and provided treatment in the outpatient, inpatient, and maternity departments. Every month, around 2,000 outpatients were seen and 100 patients were admitted to the clinic.
In Gulu district, MSF teams continued their intervention in the health center in Lalogi, about 21 miles southeast of Gulu town. To build up a system that can be taken over by the Ministry of Health, the teams are making the comprehensive secondary healthcare in Lalogi—which includes maternity, inpatient care, mobile services, and HIV/TB care—as sustainable as possible. In 2008, they treated more than 53,000 patients.
In November 2007, hepatitis E appeared in Kitgum as a consequence of the deplorable sanitation in the camps. Hepatitis E is a virus spread through contaminated water or food. There is no cure or vaccine, and therefore MSF teams focused on case management of infected patients and prevention of the spread. Pregnant women and children, who are at greatest risk, were specifically targeted. By the end of 2008, MSF had treated more than 1,500 patients in Kitgum. MSF also implemented prevention and referral activities to prevent the spread locally and to other districts.
At the end of 2007 and into the beginning of 2008, MSF responded to an outbreak of Ebola hemorrhagic fever in western Uganda in the two key areas of Bundibugyo and Kikyo.
At the height of a cholera outbreak between January and April in Arua district, up to 40 patients per day were being admitted to an MSF cholera treatment center. At the end of 2008, MSF assisted refugees fleeing fighting in the Democratic Republic of Congo in Ishasha/Matanda and in Nakivale, providing a health clinic and improving the water and sanitation facilities in the camps.
Malnutrition in Kaabong and Karamoja
In Karamoja, in northeastern Uganda, several factors, including a poor harvest in 2006, little rain in 2007, and late rains in 2008, made food scarce, leading to increased prices and depleted livestock. MSF started a nutritional intervention in June 2007 in Kaabong district. This intervention lasted throughout 2008, ending in a handover to Action Contre la Faim in December.
In 2008, in Kaabong, MSF treated almost 900 cases of severe malnutrition and 2,500 cases of moderate malnutrition. Malnutrition was treated in the stabilization center in Kaabong hospital between January and July. In July 2008, MSF started to expand its project in Kaabong into pediatrics and all areas of reproductive healthcare. The project will grow in 2009 to include victims of violence resulting from government disarmament activities.
Following reports of increased rates of malnutrition in Karamoja, MSF initiated a second nutritional intervention in the districts of Moroto and Nakapiripirit, treating almost 4,000 malnourished children.
MSF has worked in Uganda since 1980.