Wednesday, June 18, 2014

TASO


In present day Uganda, there are many clinics and hospitals designated specifically to HIV/AIDS care and treatment. But this was not the case 30 years ago. When Yoweri Museveni came to power in 1986, HIV/AIDS was looked down upon and discriminated against by many; there was nowhere to go that provided care and treatment without belittlement and the negative stigmatization that was almost as prevalent as the disease. TASO’s founders desired to create an institution that removed the general ignorance surrounding the disease, and were dedicated to educating and treating anyone with regards to HIV/AIDS. In 1987, TASO was founded, Uganda’s largest and oldest NGO. Their official mission is to, “contribute to a process of preventing HIV infection, restoring hope, and improving the quality of life of those affected by HIV” in the ultimate hope of living in a “world without HIV.”
There is no doubt TASO has made a major impact on the community and stigma surrounding HIV. The prevalence of HIV has greatly diminished from what it once was in the 1980s due to an explosion of clinics, which assist patients all over the country. TASO educates its patients with the fundamental ABC’s: abstinence, being faithful to one’s partner, and condom use. Additionally, TASO expects patients to both obey the acronym and educate others around them, with the objective of eliminating misconceptions about the disease.
Since I have no definitive research or assignment to finish, I’m free to move around the various departments to see how TASO functions as a whole. The various departments I’ll work in include medical labs, clinics, field work, and counseling for adolescents and adults (the distribution of my time in these departments may not be equal, as the work load varies on a day-to-day basis). My time so far has been spent in the medical lab. I have already conducted medical experiments that I would be forbidden to do in the states, simply because of where I am in my education. I’ve drawn blood for malaria tests, performed urinalysis and pregnancy tests, and have used flow cytometry for CD4 and CD8 screens on actual blood samples. That has actually been the most nerve-wracking assay, as it is important to handle each sample professionally. In school, it is easy to blame faulty flow cytometry results on the machine or reagents or some other obscure detail. But circumstances change when those results dictate whether a patient is healthy or needs to be put on anti-retroviral therapy asap.
On a different note, I have some preliminary observations that may support reasons for the why HIV is so prevalent. Today, I tagged along with a small team from TASO, as we traveled up to O & M Energy, a hydropower plant in Bujagali, just 15 minutes from TASO. The objective of the trip was to educate workers at the plant about HPV and cervical cancer and safe male circumcision (SME). TASO even offered to hold a clinic at the end of the week, specifically for any worker who wished to be screened for cervical cancer or to be circumcised. There were about 20 workers, three-quarters male, all in their late 20s to 30s who attended the presentation, and while they were engaged by the HPV presentation, they became especially rowdy during the SME presentation. Most of them, who were uncircumcised, asked elementary questions about circumcision, ranging from the actual process to the safety measures ensured by circumcision. The discussion then turned towards condom use, which provoked even more questions regarding proper and efficient use. I instantly became rather annoyed that we had to go over the very basics; the workers were asking questions like, “can I reuse condoms?”, “how does being circumcised reduce the prevalence of HIV?”, “should I change condoms after using them for an hour?” It was not until after the discussion that I realized that these workers most likely never received education about this in their schooling. I was fortunate to have had sex education classes in middle and high school, which covered the basics and safety measures of condoms and circumcision. I had been informed by TASO that most primary and secondary schools preach the ABC’s to their students, but it seems like their sex ed curriculum ends there. When talking to Dr. Susan, the head medical coordinator and leader of the TASO contingent, about this naivety, she said that sex ed is a rather embarrassing topic for most people to talk about and is avoided by some cultures in Uganda. If this is the case, than there needs to be an initiative for schools to thoroughly cover a complete sex ed curriculum and mature so that they can hold conversations about these topics. It is very possible that a large percentage of the workers in that lecture today have come across STI’s or are HIV positive, due to a lack of education. If students are not being educated about this, I believe that the cases of HIV will never decrease, since all the initiatives and treatments fail to teach and educate the youth to prevent acquisition of the disease in the first place. While I do not have a specific sex ed curriculum schools use, I am under the impression it is very skimpy, if at all real.  Schools, and even NGOs like TASO, should make an effort to improve sex ed curriculums. The consequences may be more significant than just simply treating HIV patients.

2 comments:

  1. Do you think abstinence is a realistic strategy for young single men in their early 20s?

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    1. That's an interesting question you ask. No, it would be foolish to think that. Young men will do what young men want to do. The 'A' in the ABC is standard "sex education" that all Ugandans receive. They are reminded of that in school, at hospitals, even on TV. I believe it is impossible for young adults to simply be told to practice abstinence. The next best solution is to try to explain why abstinence is a good choice by listing the consequences of unprotected sex, but then you enter a gray area, in which some cultures deem it unacceptable to talk about such matters. Sex ed is between a rock and a hard place in Uganda.

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