Update at TASO

Hello, hope all you guys had an enjoyable 4^th. Most Ugandans had no idea it was America’s Independence Day last week, so I had to report to work. There were three conversations I had throughout the week that I found to be pertinent to HIV prevalence.

Last week was a fairly quiet week at TASO. Monday consisted of lab work and some filing. Tuesday was more adventurous as the day was spent in the field. We went to two sites, both of which were relatively small, only 12 patients at each site. Since there wasn’t an overload of patients, I assisted in documentation and preparation of supplies for the nurses to draw blood. The car-ride back to TASO was filled with discussion about why HIV is so prevalent. While SMC and safe sex practices were listed as ways of reducing the prevalence, they don’t target the root of the problem, which a lot of TASO’s staff believes to be behavior and the will to better one’s self in all aspects of life. This conversation carried over into Friday’s workday. I was stationed with Lawrence, a counselor who is congenial enough to talk to even the most rugged of patients. In between counseling sessions, after Lawrence explained to me what had been said, we began discussing what might affect behavioral issues. Lawrence informed me that the conception of a family in Eastern Africa is very different, almost deranged from the point-of-view of a Westerner. A man may have multiple ‘wives’ whom he will have children with all of them. From what I gathered, having children is like a badge of honor; the more children a man has, the more respect he commands from his peers. Children are the currency for popularity. This is pre-empted by the Busoga culture, which covers the domains of Jinja and some of the surrounding area. More importantly, there is no family planning involved when having children (in most cases). Darwinian tendencies come into play, as those clever enough to fend for themselves survive, while the weak fail to adapt and perish. While this method of child rearing may yield stronger and robust future generations, it allows HIV and reckless behavior to endure.

Friday also provided me the opportunity to talk to/counsel a mother who could speak English! She was the mother of four children, with the three eldest in boarding school. The youngest accompanied her mother, and was a year away from entering primary school. Her husband had ‘separated’ from her, but they were still technically married; no one else knew about their split up, primarily out of fear that her peers would chastise the mother for not being a better wife/mother. Her financial burdens are many; as a seamstress, she spends her time making clothing, and is always traveling in order to sell her creations. She has to make sure there is enough food for both her and her daughter, and that she has enough money to pay for her daughter’s upcoming schooling. Her husband provides no financial support, as he refuses to pay for his daughter’s education. I learned from her that life as a single parent with multiple children can be very tough, but also that uneducated Ugandan men will do as they please. I am still baffled that the father will not pay for his daughter’s education. He knows he can get away without paying, as his wife is too timid to speak up against him or consult additional help. This behavior sickens me, as it is irresponsible and cowardly. Unfortunately, it is typical of a lot of uneducated Ugandan husbands to act this way, and to leave their wives to fend for themselves and their families. Maybe this stems from Busoga culture, but I’d have to conduct more research before making that claim.

Following my time with this client, I resumed my conversation with Lawrence as we began discussing President Museveni and the anti-gay laws. The consensus we arrived at is that Museveni has shot himself in the foot. Museveni toured the country when the bill was still in discussion in Parliament, championing the bill. After it was signed into law, he publicly celebrated it’s passing. The law could be viewed as the foundation for his platform in the upcoming 2016 presidential election, as it confirms that Museveni has been an active in trying to ‘improve social issues’ amongst Ugandans. Unfortunately for him, he did not expect the US and other nations to boycott the law by cutting funding. HIV/AIDS organizations everywhere are beginning to hurt. TASO, for example, is already planning to make cuts to their faculty. Originally, there were 18 counselors for all the patients TASO receives, but now there are only 11. TASO needs to reduce that number to six in the coming months, meaning the workload for one counselor will triple on average. This is due to a lack of funding; the CDC is TASO’s biggest donor and without them, TASO can’t afford to keep as many workers around to attend to a growing clientele. This downward spiral, coupled with increasing HIV positive patients is a script for disaster. Museveni most likely will not raze the anti-gay laws, as doing so would be hypocritical, severely harming his chances at re-election. Simultaneously, HIV prevalence is going to become much worse in the next couple of years without funding, a consequence that could harm his popularity. Museveni is in a jam.

These conversations concluded what was otherwise a hushed week. This week, I will be a part of more counseling sessions in addition to some excursions to nearby clinics, to assist them. I also plan to learn more about Busoga culture. If patriarchal arrogance is a notion instilled by the culture, then is it possible that getting rid of the culture, or amending it, will reduce HIV prevalence? Is that even an ethical thing to say? Is it even ethical for a Westerner to try to impart his own culture on a society that has followed a certain model of life, even if he believes his ways will improve gender equality and reduce HIV prevalence?