After reading in the media about your philanthropy and generosity, we have decided to contact you with an humble request for a donation of any amount which you may offer, to our charity orgainsation for our project on HIV/AIDS Advocacy, Care and Empowerment Programme (HAACEP).

We are begging you to kindly put smiles also on the faces of some impoverished and needy people in the proverty stricken Uganda, in Africa.

Please find here below, our project proposal for your attention.

Thank you very much.

Yours sincerely

Joseph Ocwet
Chairman
Africa Relief Trust
88 Cranberry Lane
London
E16 4PE
United Kingdom

Email: ocwet@aol.com
Mobile: + 44 7958 222 142
Telephone: + 44 207 511 0000

AFRICA RELIEF TRUST (ART)
(Registered charity in England and Wales number: 1077946)

HIV/AIDS ADVOCACY, CARE AND EMPOWERMENT PROGRAMME (HAACEP)
In Conflict Affected Areas of Uganda

Proposal to Mr Charlie Crystle

February 2010

Background

Africa Relief Trust (ART) was set up in 1998 and then it was registered with the Charity Commission of England and Wales in 1999, to assist people in social distress in Africa, but more specifically to support the most poor and disadvantaged children in the conflict areas of Northern Uganda, by raising funds for good causes relevant to relieving poverty, advancement of education and training for employment or skills, and relief of sickness as well as preservation and protection of health. However, from 2002 up to 2007, with funding from Comic Relief, ART and a local partner called Equality Foundation (EF) based in Oyam District in Northern Uganda, specialised in supporting Children Living With HIV/AIDS (CLWHA), most of them children who are less than 16 years old, and those other children affected by the scourge, in the rural communities which suffered from conflicts for more than twenty years. We worked together in the provision of care, advocacy, economic empowerment and other services.

Comic Relief awarded ART a grant over three years in 2002 and extended it by one year in February 2006, to allow ART and its local partner organisation, EF, provide services for HIV/AIDS Advocacy, Care and Empowerment Programme (HAACEP) in Oyam District, an area seriously affected by the conflict in Northern Uganda. The project ended in February 2007, with the prospects of HAACEP being self-sustainable after four years of funding from Comic Relief. However, the realities on the ground seriously affected the self-sustainability of HAACEP, much as only four years were not enough. Through local fundraisings and well-wishers, it continued for a year at a much smaller scale. But many hundreds of the beneficiary children are slowly relocating to Kampala City as destitute street children, who are homeless and they survive by begging and sleeping rough.

Achievements of Aims and Objectives

During the four years’ funding from Comic Relief, the grant continued to strengthen the capacity of both ART and EF, while supporting thousands of beneficiary children within the project area. However, more thousands of children from neighbouring conflict areas, outside our project area, persistently came to the project area over the years to try and benefit from our services, but most of them were unfortunately left out of our services because the funding from Comic Relief was very limited, therefore our budget and resources were equally limited. Throughout the four years, HAACEP included many children affected by HIV/AIDS in delivering services and managing the work, while providing all beneficiaries with different services. The project supported many children who are affected by conflicts, the majority of whom are also affected by HIV/AIDS. The beneficiaries are victims of all categories, irrespective of cultural beliefs, religious affiliations, tribes, ages, political opinions, genders (but girls, orphans, and children with disabilities had affirmative priorities), in line with ART’s policy of impartiality.

With funding from Comic Relief, we achieved this after establishing one rented HAACEP Resource Centre in Achaba sub-county, Oyam District in Northern Uganda. Apart from that we also rented smaller premises, for Day Care Centres at strategic places within our project area. The Resource and Day Care centres provided facilities and resources for the beneficiaries, giving them access to some of the resources and opportunities enjoyed by many children who are not socially excluded.

During the funding from Comic Relief, HAACEP employed six staff and recruited thirty nine volunteers, then trained and facilitated all of them. Previously, within the project area, Children Living With HIV/AIDS (CLWHA) or suspected to be in that target group, were routinely treated as development, economic or social rejects, so we campaigned aggressively against this segregation through intensive advocacy and awareness programmes. We carried out teenage vocational training programmes which are suitable for CLWHA, to empower those who are fit enough and set examples as demonstrations for their inclusions as normal children in society. While relying on 3 motorcycles, 30 bicycles, and walking, the project staff and volunteers provided community outreach services, through home visits, hospital or health centre visits, school visits, seminars, workshops, etc. Most, if not all, of the staff and volunteers were people affected by HIV/AIDS, including many CLWHA. They delivered voluntary services for the rest of the beneficiaries, e.g. advocacy, awareness, counselling, advice, domestic care, hospital care, social amenities, and providing basic literacy, numeracy and vocational skills. HAACEP served the basic needs of the most disadvantaged children in society, whose entitlements were denied by poverty, conflicts, diseases, nature, ignorance, stigma or social injustice.

1. With the grant from Comic relief, ART and EF recruited more volunteers; continued to strengthen internal structures; and reviewed working methods.

2. Meanwhile as weeks, months and years progressed, we continued to carry out the following activities in parallel:

• Continued to publicise the availability of the project, in order to invite more potential beneficiaries and other participants from within the project area, while advertising extensively to ensure that all the people are informed about the project.

• Continued to provide up-to-date/translated information and facts about the HIV/AIDS pandemic, from agencies such as UAC, TASO, UWESO, NACWOLA, and UK sources.

• Continued to provide/translate the information in the Luo vernacular.

• Continued to promote mechanisms of peer and others’ exchange of information and experiences.

3. Community Capacity Building:

• Supported community groups of CLWHA, and other children who are affected by HIV/AIDS in conflict areas.

• Carried out refresher training for staff and volunteers in counselling and caring skills.

• Carried out refresher training for staff and volunteers, and CLWHA in organisational management, establishing internal controls, constitutions, policy codes, fundraising, etc.

• Trained and supported staff and volunteers in preventative education.
• Trained many drama groups on themes related to HIV/AIDS, to sensitise the public.

• Ran drama competitions with school children on HIV/AIDS themes.

• Trained many peer educators in communities, schools, etc.

• Provided refresher training for staff and volunteers working with community groups.

• Provided support to mutual support groups.

4. Supported the critically ill and self-declared CLWHA, and other children affected by HIV/AIDS as well as being affected by conflicts:

• Identified and registered critically/chronically ill service users and identified CLWHA and their families. Facilitated the formation of support groups among the ill and their attendants.

• Recorded deaths and supported bereaved families, relatives and friends.

• Trained groups on their rights, legal and constitutional aspects of their situations, and supported them to support their membership.

• With support from NACWOLA, we promoted the adoption of Memory books for posterity and off-springs, but also as a basis to protect off-springs’ rights and property.

5. Community Home Based Care (CHBC):

• Provided free, acceptable and accessible care to children with symptomatic HIV infection, including preventative health education to the critically ill and self-declared CLWHA and their families.

• Trained volunteers and staff of EF in CHBC and peer-support techniques. This also entailed provision of support to workers dealing with children in extreme difficulty. Volunteers who are themselves HIV sero-positive were additionally supported in the range of needs their families might have.

• Particular attention was given to encourage the involvement of boys in the provision of home-based care, because it was recognised that culturally, the burden of home-based care in Uganda is usually left on girls and women alone. Therefore, we made efforts to include boys with the hope that over time, there may be a possibility of cultural transformation that shares this burden more equitably between girls and boys.

6. Undertook regular monitoring, bi-annual monitoring, annual evaluation and appraisal performance of the project. Monitoring visits from the United Kingdom were regularly conducted by ART trustees and volunteers.

7. Raised awareness and advocated around HIV/AIDS issues with:

• Communities in terms of attitudes and cultural practices which hinder curbing of the pandemic.

• Service providers, schools, government structures and other development agencies operating in the area for affirmative action in favour of CLWHA and not to discriminate them; health service providers to avail affordable and free medication to HIV/AIDS victims as well as preventative services to the communities.

8. Provided social viability:

• Trained volunteer vocational skills counsellors, to provide training and support in various areas such as business management training and market research.

• Trained groups of CLWHA in basic education, including literacy, numeracy, different skills, market research and record keeping.

• Trained beneficiaries in formulating formal agreements of engagement in business activities.

9. Supported traditional birth attendants and EF’s maternity home at Achaba to safely handle HIV positive mothers’ deliveries – provided kits and training, especially around HIV/AIDS issues. Supported the structures of EF to run the programmes, evaluate them and plan the future. This entailed a closer look at their accounting and personnel systems, administrative systems, office procedures, equal opportunities policies, strategic planning, report writing, proposal writing to enable them fundraise locally, etc.

10. Supported CLWHA to organise the legal issues for the beneficiary children; supported orphans and families of children who have died from AIDS in defending their rights of ownership of property, land, etc. Technical assistance was sought from agencies such as TASO, UWESO, UAC, NACWOLA, Uganda Mildmay Hospital and Federation of Women Lawyers Association (FIDA).

11. Performed networking and research: with other organisations especially those in better positions to keep abreast of the happenings in the field, e.g. TASO, UAC, UWESO, NACWOLA, Uganda Mildmay Hospital, Atapara Hospital, etc.

• Supported exchange visits between group members to share lessons learnt.

IMPACT

The project definitely reduced HIV infection rates, and improved the quality of life of children infected with and/or affected by HIV/AIDS in conflict areas of Northern Uganda, by addressing their social care, psychological, physical and material needs. It supported children who are affected by HIV/AIDS to live a more dignified life and exerting their rights and those of their families, parents, guardians, relatives or dependants. It strove to equip the community structures to take care of children incapacitated by HIV/AIDS, while ensuring that the rights of their parents and guardians are upheld. It tackled fear, ignorance and discrimination surrounding HIV/AIDS such that children affected by it are now supported by their communities, while it increased children’s understanding of how to prevent it spreading. This was done through dissemination of information about the pandemic in a culturally sensitive fashion and building of strong community groups to support children of all categories, irrespective of cultural beliefs, religious affiliations, age, tribes, political opinions, genders (but girls, orphans and children with disabilities received affirmative priority).

• The project geographical area was increasingly sensitised about HIV/AIDS.
• Awareness campaigns greatly reduced the stigma associated with HIV/AIDS, while it promoted positive attitudes from the community towards CLWHA.
• Discrimination and social exclusion of CLWHA was much reduced within the project area.
• More and more CLWHA and those affected by HIV/AIDS in the conflict areas, were made aware of their rights and are now more confident of seeking help.
• We had an increased knowledge of the scale of the problem through a baseline survey conducted with over 2500 children affected by HIV/AIDS.
• Collection and analysis of data improved.
• Our publications raised awareness further afield.
• We networked with other stakeholders and represented the project at local and national seminars, workshops and conferences.

THE RESOURCE AND DAY CARE CENTRES

The centres’ services were recognised and respected by the sub-county authorities, local health authority, the Local Councils (LCs), and the community. It became very common for the sub-county officials to collaborate with our project centre workers when dealing with HIV/AIDS issues. This was especially so when there was a need for counselling, supporting or caring for the bereaved or CLWHA, and to encourage them to live positively. On the same note, the LCs recognised the services of HAACEP centres and were first referring local HIV/AIDS cases to the centres. This was because they knew that the CLWHA would get more adequate help at health centres or hospitals with a referral from the HAACEP centres. There were also many calls by the community to have more Resource and Day Care Centres (if possible at least one Resource Centre and three Day Care Centres in each parish) because the community saw the centres as the best and most convenient avenues through which they could access our project services. However, after struggling for one year without proper funding, while relying only on local well-wishers in Uganda and local fundraising, the end of funding from Comic Relief unfortunately led to the closure of all HAACEP centres in 2008.

OUR PARTNERSHIP WITH EQUALITY FOUNDATION (EF)

On an ongoing basis, HAACEP developed and strengthened the capacity of EF as a result of the funding from Comic Relief. This led to an improved publicity, knowledge, supervisions and regular training, through which a lot of new and useful experiences as well as new contacts were gained. EF acquired many additional skills, during the implementation and accountability of the project. HAACEP developed the capacity of EF in a number of ways, e.g. through capacity building, it registered increases in the number of beneficiary children and trained volunteers and there were a lot of improvements in the quantity and quality of its services. EF was strengthened, it became better organised and more effective, in our efforts for it be in a position to eventually become self-reliant. In the long run, as a direct result of the project, EF would attract more professional volunteers, e.g. doctors, teachers, nurses, psychiatrists, physiotherapists, etc.

PROVISION

• Within the four years of funding from Comic Relief, at the Resource and Day Care Centres and at their homes, we provided services to 2482 CLWHA and thousands of other children affected by HIV and AIDS, much as we gave referrals to 993 CLWHA to other service providers.
• A bereavement counselling unit was established by the project, and this counselled and supported bereaved families, relatives and friends of 257 beneficiaries who sadly died, mostly from AIDS related illnesses within the four years.
• We trained and supported 31 community groups of CLWHA to provide HIV/AIDS advocacy, care and empowerment services.
• We conducted several community outreach services at local schools, cultural festivals, churches, etc. We selected 50 pupils each from 12 primary schools in Oyam District, producing a total of 600 pupils who were trained as peer educators in schools.
• We established a feel-free network with other community groups providing other community services, e.g. domestic violence prevention services.
• Some of our volunteers were taken for HIV/AIDS local and national conferences, workshops and seminars that took place in those years at various venues in Uganda.
• Due to poor transport means in the rural area, we designed “Bicycle Ambulances” to transport seriously ill beneficiaries to and from hospitals or health centres as well as transporting dead bodies. Anybody in need was allowed to borrow and use the “Bicycle Ambulance” free of charge.

After the end of funding from Comic Relief, HAACEP depended for one year only on local well-wishers in Uganda and local fundraising by EF. As a result, lack of funds and resources eventually brought HAACEP to a complete standstill, much as ART would like to revive it with support from Mr Charlie Crystle, if possible.

THE COMMUNITY’S PARTICIPATION

The community is now accepting that HIV/AIDS is a community problem, not family or individual issues. They are now taking action, particularly against discrimination and social exclusion of CLWHA or those suspected to be infected with HIV. The local people and EF were involved in developing and managing the work through the following ways: first, we always involved all of them in decision making and their opinions were given direct recognition. The entitlements of local children were allowed to prevail in all planning and implementation processes. Where there was difficulty in meeting any of the local groups, HAACEP devised means of reaching them, especially children with disabilities who had difficulties in reaching the centres. We used simple questionnaires and other methods that encouraged the beneficiaries to give their opinions in the development and management of decisions. We encouraged beneficiaries and other local children to develop and manage their own services and activities, while we provided guidance to them. Meanwhile we promoted training and learning for the beneficiaries and EF so as to enhance their management knowledge and skills. These were regular ongoing processes and we expected in the long run, that they would be self-sustainable.

COLLABORATING WITH OTHERS

We implemented HIV/AIDS advocacy, care and empowerment in our project area in Uganda by complementing the little advocacy and care which was being done by a few NGOs, local groups, local authorities and the Government. Whereas those original little advocacy and care are covering mainly the urban areas, we were reaching out to the rural people of one very remote District, and supplementing the intervention with empowerment for our beneficiaries. The original service providers have on their agendas advocacy and care programmes, but they lack adequate funding for implementation, therefore HAACEP provided them with raw inputs for their advocacy and care strategies. We were therefore complementing them by expanding and providing practical ways to enhance HIV/AIDS advocacy, care and empowerment, while referring some of our beneficiaries to them or other agencies for the services that we do not provide. Our target group were included on first come first served basis and we sought further help for them from other relevant sources and agencies, especially for technical back-up.

CHALLENGES

Reasons for the continued HIV/AIDS prevalence

While existing literature purports an increasing level of sensitization and a decline in the rate of infection in Uganda, the reasons for the incidence of and causative factors cited, have been largely explained as follows:

• The majority of our beneficiaries argued that since most of the children in the project area are poor rural children whose livelihoods are based on agriculture, and yet the prices of farm produce are depressed, the young girls when approached for sex in return for money by rich older men or by the many army men in the war zone, easily give in thus making them have a higher risk of HIV/AIDS infections. Furthermore, due to widespread unemployment among the youth, lack of financial independence makes them more vulnerable, (mainly the females).
• Several reasons were given for the continued incidence of HIV/AIDS despite the current widespread knowledge of the risks and dangers involved. Hopelessness and helplessness of the children to fight against HIV/AIDS, make them to prioritise addressing short-term needs against HIV/AIDS, whose impact is still further way. Some children seem not to pay heed. The most vulnerable group includes boys and girls who dropped out of schools, and children with disabilities. Curiosity in the children who are adventurous despite sensitization also causes them to go in for sex. Idleness brought about by the conflict situation, led to over drinking of alcohol in the local areas making even children promiscuous. Yet they always do have unprotected sex because condoms are neither easily available nor affordable, and culturally the local children do not believe in condoms anyway, much as HAACEP worked hard to educate the community on the need of always using condoms for protection against HIV infection and other sexually transmitted diseases, and preventing pregnancies.
• The population is traumatized, (first from the effects of war and then HIV/AIDS), hence most of them are withdrawn, so children take things at large (lightly), and therefore seem not to be serious on matters related to HIV/AIDS. There have been many cases of intentional unprotected sexual intercourse by CLWHA, who feel they should not die alone, as the victims are less sensitized.
• Cultural practices like inheritance of teenage widows as a result of early child marriages. Funeral rites and other cultural ceremonies where there are tendencies of general freedom, promotes sexual promiscuity. These practices put children at great risk of HIV/AIDS infections.
• Indecent assaults by older people on young boys and girls are rampant within the rural communities, hence they are also responsible for HIV/AIDS infections.

Problems and needs of children affected by conflicts and HIV/AIDS

• The beneficiaries tend to suffer from common ailments like diarrhoea, skin diseases, chronic coughs, TB, etc, which need treatment and are recurrent due to reduced immunity, such that it becomes too expensive to treat. There is also a general lack of essential drugs for treatment of these opportunistic infections. This situation is aggravated by lack of access to health facilities within an average radius of about 40 kilometres, and usually the distance to the nearest health facility is too far away for many children.
• AIDS treatments, i.e. antiretroviral drugs are not available in Oyam District because the cost of getting them is too high. Yet these drugs increase the survival rate by reducing the viral load in the blood and increasing the immunity of CLWHA. Therefore HAACEP advocated for the drugs to be brought nearer to them and at a very low and affordable cost. The hopelessness of the situation was captured by Betty Akwir, a 41 year old widow who said, “I sold all our land and our only permanent house in Lira town to buy medicines for my two children who were suffering from AIDS. In the end, I had to borrow money to transfer them between hospitals before they both died. Now I am left a destitute, yet I am very sick and dying from starvation.”
• Many children in child marriages are dying leaving their parents and grandparents the burden of caring for their orphans. Almost always all these old people have very limited means of supporting themselves, let alone the additional burden of their grandchildren. Mzee Obongonyinge, an old man in his late 70s, from Abanya parish said, “They are my flesh and blood, I can not chase them away. I am the only surviving adult, so there is no one else to care for them if I don’t. I have to learn the trick of child care afresh, in order to fend and fettle for them. It is not easy. But why, God why us?”
• Because HAACEP was operating on a very small budget, we provided very limited opportunity for counselling services and psychological support for positive living, making effective decisions, and being able to write a will. Some beneficiaries still suffer isolation because a small section of the community and relatives still do not know the realities of HIV/AIDS and fear to be infected. Thus such beneficiaries are usually very irritated and at times very aggressive due to constant fear of death.
• Basic necessities like food, a balanced diet, clothing and beddings are very inadequate and relatives or friends are unable to take proper care of the beneficiaries and their families. Sometimes they are left in in-hygienic conditions, for example with beddings lacking plastic sheeting to take care of fluids like infectious diarrhoea.
• Protective wear and devices like plastic aprons, and gloves for personal protection and for those caring for the patient are absent.
• Financial burden is high because of the high treatment cost for opportunistic infections and yet the treatment is necessary. Coping mechanism with the sickness is lacking. As they are weakened by sickness, they are unable to carryout meaningful economic activities.
• Because of the limited resources of HAACEP, lack of enough carers and means of transport to reach hospital made most of the beneficiaries end up dying prematurely at home. There is poor maintenance and upkeep of the family members, especially the children. This includes lack of money to sustain the family, pay school fees and provide other essential items to the children affected by HIV/AIDS.
• There is still shortage of knowledgeable and trained people who can influence the community to completely change their attitudes towards CLWHA and make them comfortable enough to lead a positive lifestyle. Moreover, because of bad traditional beliefs, some people in the community still do not believe in HIV/AIDS scourge. They believe that their patients were charmed (bewitched), and hence they end up taking the patients to the witch-doctors instead of taking the patients to health centres or hospitals. Mary Odongo, a 58 year old woman who recently lost her only son said, “When my son was returned home from Kampala because he was terminally ill, we all believed it was a witch who did not wish him well. We consulted seven witchdoctors, to no avail. ART and EF pleaded with us to take him to hospital, and eventually I borrowed money and took him 35 miles away to Atapara Hospital, where we were told he was suffering from slim (AIDS). We sold nearly all our possessions in order to buy medicines, yet even with that money, the doctors said we could not afford the drugs that could help him. What we paid for his partial treatment was so expensive that our family had to starve afterwards because we were left with no money for food. My son is now dead, I don’t have him and I don’t have any possession anymore – I am a complete destitute.”

Feelings and Attitudes of the CLWHA towards themselves

Most beneficiaries, both the community and project workers, summarize the attitude and feelings of HIV/AIDS patients as being desperate, frustrated and with a high irritability. This is because many CLWHA are psychologically traumatized and usually feel like isolating themselves from other community members, since they feel out of place. However, as a direct result of HAACEP, a significant proportion of CLWHA in Oyam District became very optimistic about recovering and they begged to be taken to hospitals which unfortunately are all very far away. There is also a category of CLWHA who feels that God is a key solution and most of them turn towards religious salvation.

Unfortunately there are a relatively large number of CLWHA who still feel they should not die alone, but go ahead and spread HIV/AIDS as a revenge. This group feels that they should die earlier, since after all they are moving corpses. Some of these children say they should die because they cannot tolerate the experience of suffering without food, fees and proper care (no more hope for their families). Others have suicidal feelings while some blame themselves at all times. Such are CLWHA who do not share out feelings but remain secret with trauma and other psychosocial effects. Such children often become very aggressive and sometimes they have the tendencies of recklessly wasting away their little resources. Nevertheless, HAACEP made every effort to reach out to this category of CLWHA in the project area, and slowly by slowly we registered a remarkable success in changing the attitudes of such children and many of them are now living positively with HIV/AIDS like the rest of the beneficiaries.

A 25 year old mother of two children said: “I lost my eldest daughter just a year ago, when she was only four years old. One of my remaining two younger children is terminally ill. Their father died recently and yet I am also bed ridden. I have no money or food to look after them and myself, leave alone affording treatment for my cursed children. How I wish death could come and relieve my children and I of these agonies. Life has no meaning for any of us.”

Among many reports which always appear in the various Ugandan media daily, the following is one of the most touching articles on HIV/AIDS which was published in the Monitor Newspaper:

Headlines

O’Neill’s team weep at TASO
By Carolyne Nakazibwe & Badru D. Mulumba
There was hardly a pair of dry eyes at The AIDS Support Organisation (TASO) yesterday, as children living with HIV sang and testified about personal harrowing experiences with the disease. The Rush Hour film star Chris Tucker, Mrs O’Neill, U2 singer Bono and several officials from the American Embassy could not hold back the tears when Agnes Nyamayarwo gave a moving testimony about how she is living with HIV.

The teenage girl said she had lost both parents, her husband and a two-year-old daughter to the scourge, while her younger brother disappeared and has never returned after he was teased at school about his parents and sister living with the HIV virus.

“I cried because I couldn’t imagine people planning to die, doing the photo books for their children for the time after they are dead,” Tucker said in an interview later.
When the TASO drama group presented a song Bono recognised, he jumped and grabbed a microphone, and gave an impromptu ‘show’ with the group at their offices in Mulago Hospital.

Tucker and Bono are accompanying US Treasury Secretary Paul H. O’Neill on an official tour that started in Ghana, through South Africa, to Uganda and ends in Ethiopia.

O’Neill heard from the Director General of Health Services, Prof. Francis Omaswa, how the health sector is under funded due to fears expressed by the IMF that accepting too many grants would cause undue appreciation of the shilling.
“That is baloney! I could use a worse word but I cannot use it here,” O’Neill said, and promised to discuss the issue with President Yoweri Museveni.

After the meeting with President Museveni at State House the same day, O’Neill, who is also an economist, told journalists he still found it a “bogus idea” to put a limitation on assistance to Uganda.

Museveni and the Secretary discussed the issue of trust from donors as well as the difference between advice and imposing.

Museveni praised the improved relations between his Government and donors, saying it had moved from being parasitic to being symbiotic.

O’Neill said the George Bush administration was pushing for replacing loans with grants, since most poor countries could not afford to pay back loans, but the move was yet to be approved by other donors.

Museveni explained to the Secretary that the Uganda government believes in prioritising the problems it is trying to solve with the US Government’s help, and could not handle all of them at a go.

The delegation left later in the evening for Ethiopia.

However, the people affected by HIV/AIDS referred to above are from Kampala City in Central Uganda where several NGOs and the Government have concentrated in implementing HIV/AIDS projects. The situation is extremely bad in the conflict affected Northern Uganda, and even much worse in the remote rural area of the HAACEP project.

Community feelings and attitudes towards CLWHA

As a result of HAACEP, most of the people in the community of the project area have started to accept and accommodate the HIV/AIDS pandemic as a real challenge. They are now beginning to accept CLWHA and treat them equally and others feel that since God created this disease, God should provide the solutions through their faith in prayers. This community now feel like helping CLWHA but they lack the adequate means, much as the resources of HAACEP were very limited. The majority of the members now feel that families affected by HIV/AIDS should be given assistance in the form of foodstuffs and that Government or other agencies should provide for them affordable treatment.

There are however still some negative tendencies existing among a few members of the community: some of them continue to isolate and marginalize CLWHA or those suspected to be infected with HIV, thereby stigmatizing them and isolating them, while labelling them as social misfits. A few of such people think that CLWHA should all be put in one isolation place so that they do not mix with those who are believed to be HIV/AIDS free. As part of the resentment such people feel that they should not share drinks, food and other goods from containers touched by CLWHA and that their orphans should be neglected since their child parents looked for HIV/AIDS. Worse still, they feel the patients should die very fast to relieve their community of unnecessary burdens. But HAACEP did everything possible, within the means of the project resources, to reverse those negative tendencies.

The gender and legal dimensions arising from the HIV/AIDS scourge

GENDER CONSIDERATIONS

The project acknowledged that females are more infected than male. It is much easier to identify infected girls than boys due to their procreation responsibilities which tend to deteriorate their health faster than in boys.

On the basis of age, a majority of teenage children get infected compared to the older youth. Meanwhile more girls get infected compared to boys. This is attributed to the concept that girls are more psychologically exposed than boys. They tend to have sex earlier than the boys and their anatomy is delicate hence injuries during sex tends to put them at a greater risk. Indeed, older men who are financially empowered tend to go for the young girls.

Many girls think that they are infected more because they are usually left behind when men move to work or to other places and get other women outside, thus importing the infections into their relationships. Some community leaders infect girls, because the girls fear them and respect them, and therefore can not turn down their sexual advances. Yet infants are infected because they are born positive through contact with the HIV virus from their mothers who may be positive. The youth are infected because they are very active sexually and many have more than one partner. Indeed, some youth are infected because they want money from older men or women to improve their financial positions.

Girls are particularly vulnerable as a result of several reasons. They have to maintain certain social requirements, and for family girls this includes providing for the families. It is acknowledged that prostitution is rampant, but communities are casting an understanding attitude towards prostitutes, due to the prevailing poverty. It is little wonder that girls are unanimous in pleading for access to health facilities, especially with sexual reproductive health facilities. (This finding sparked an interest in ART to undertake a study on prostitution and the needs of the prostitutes in these communities).

Infection factors
In statistical terms, the following aggregated information was recorded:
• The younger age group between 12-16 are infected, mainly females. This is because in this age group they are very active sexually, and in most cases they are shouldering the burden of caring for their families.
• Those above 20, males are more infected.
• Between 14-18, young girls are infected mainly because they want material gains from men who end up infecting them. Such girls lack self-esteem, and the rich men tend to lure them with money or gifts. But this age group are also affected because of early/child marriages.
• Among the mature (married) couples, most wives are faithful and stable, but their husbands infect them since they usually have many partners outside marriage.
• Most infected age group are those less than 30 years.
• The infection rate among males is under-reported, because they do not seek medical attention according to the statistics available, with only women mainly attending health services.
• Males are a more sexually active group, and one male can infect up to 10 females.
• Infection rate is higher among the polygamous families – monogamous families are not so much infected as seen from those who report (those who have more than one wife).
• Females’ infection is mainly motivated by wanting to improve their economic status as they are mainly peasant families.
• The women and girls, displaced due to insecurity in the area, are impoverished and have to find means of income to survive.
• Young boys are victims of rampant indecent assaults during insecurity.

Legal Dimensions
The Government of Uganda and local authorities have no direct law in operation regarding HIV/AIDS scourge. However, the law of Uganda which stipulates that the widow and her children have the right to own the deceased husband’s property in a way tries to solve land and property wrangles which were so rampant in the area.

There is a strong law in Uganda on rape and defilement with severe punishments, but which are not being implemented properly by the judiciary. Some parents have made it a business, by extorting money from the culprits, through out of court settlements. While some people think the punishment on defilement and adultery should be increased, and preferably to the death penalty so that people get more scared and control themselves, several parents forgive defilers, especially if the culprits offer money in order to settle the cases out of court. As a result of the abject poverty, most parents prefer to take fines from the culprits. And yet rape and defilement are ways through which the rate of HIV infection and spread is very high.

The defilement and rape related laws have in a way moderated problems of HIV/AIDS scourge. These laws, which considers both cases as capital offences are strong and have kept men off from young girls. However, the enforcement is not very effective. The law on defilement is reducing the rate of infection because although a few can still dare, the majority are now scared. But that law is not yet well established because it has got a number of controversies, yet it could be very useful in the area of HIV/AIDS scourge. Similarly, the law on rape is also protecting women and girls, while the law on indecent assault is protecting the children and young adults who might be lured into risky situations that expose them to HIV infections.

HAACEP advocated that, child marriages should be prohibited and if caught should be severely punishable. It also advocated that other activities which promote the spread of HIV/AIDS like funeral rites should be held during the day and not overnight, and there should be more restrictions on video shows and discos which expose children to bad acts and eventually make them vulnerable to catching HIV/AIDS.

As a result of HAACEP, there is a new practice with a potential to increase, whereby some clansmen are now prohibiting their relatives from remarrying or inheriting the deceased’s wife or husband as a by-law operating within the clans.

Significance of social/cultural beliefs and practices in the spread and control of HIV/AIDS

SPREAD OF HIV/AIDS
Practices like drinking and merry making, especially during cultural festivities, play significant roles in the spread of HIV/AIDS in the rural areas. Cultural beliefs and practices like funeral rites, widow inheritance, traditional marriages and use of razor blades in traditional treatment or clan markings also play major roles in the spread of HIV/AIDS. The rest of them are listed as follows:
• Traditional culture of widow inheritance which leads to infections of either an HIV negative widow by an infected heir, or an HIV negative heir by an infected widow.
• Certain traditional rituals like funeral rights, treatment of traditional illnesses, rituals on twins, where people often over-drink and fail to control themselves or get sexually over excited, leading to embodiment and easy-go-lucky on sexual encounters.
• Staging of disco dances where many youth are attracted to one another or see indecent acts and strive to imitate them. Traditional gatherings where traditional dances are staged which expose people to one another, and from where they may start new sexual relationships. Funeral rites and traditional marriages where there are tendencies of general freedom on sex.
• Forced marriages where a child is got a partner without his or her consent and forced to marry without testing themselves.
• Traditional healers also at times cause the spread of HIV/AIDS in the course of healing barren women, when they demonstrate through sex on their clients.
• Use of razorblades in traditional treatment.
• Church conventions and fellowships.
• Culture encouraging early marriages, thus in the course of sampling to look for the right partner they stand a high risk of HIV/AIDS infections.
• Polygamous marriages where infidelity is very high.
• Drinking places and act of drinking.
Control of HIV/AIDS
HAACEP seriously controlled the spread of HIV infection by promoting social and cultural beliefs and practices that help in HIV/AIDS control, and the project was able to point out the following:

• Resistance of females towards having a co-wife keeps away the second female who could be infected and checks on the male’s fidelity.
• The cultures of mothers in-law having to look after their daughters in-law after delivery and this keeps the daughter in-law away from the husband for a long time for full recovery of her system – healing. Which otherwise would enhance the rate of infection if she had remained active before healing properly. This method is also a family planning method which controls child spacing.
• Traditional songs which have a bearing on HIV/AIDS control the rate of spread because they always remind people of the dangers of HIV/AIDS.
• Drama groups, dressed with the right messages, help in the control because they present their dramas in many schools, in the communities, churches, etc. There are some dedicated acts which are acted on World AIDS Day and other occasions which have a greater impact on peoples’ lives.
• Strictness in couples.
• Faithfulness among couples.
• Teachings conducted by traditionalist at the fire place to daughters and sons in-law.
• Tradition of monogamy.
• Parents at times choose their children’s future wives and husbands, and advice them to test before marriage.
• Church marriage which leaves a bond between the couple and God.
• Prohibition of night fellowships.
• Monogamous marriages with full fidelity.
• Some clan leaders are trying to discourage traditional inheritance of widows.

MONITORING AND EVALUATION
During our monitoring and evaluation process, we had the following:
- Focus group discussions.
- On spot checks on how the project was working.
- We also regularly visited our groups of children affected by HIV/AIDS.
- Monthly and annual meetings.
- Monthly and annual reports.
- Bi-annual monitoring visits from Africa Relief Trust to the project.

FOCUS GROUP DISCUSSIONS
We had review meetings with focus groups; with our beneficiaries and others were with the entire community, to evaluate the performance of the project. From these answers, we were able to assess how the HAACEP project was performing.
• The respondents unanimously said the HAACEP project gave them a very rare opportunity to benefit from HIV/AIDS advocacy, care and empowerment, much as they appeal for the project to be revived to cater for more beneficiaries.
• The beneficiaries and community asked for more HAACEP centres in each parish so that they may receive services without having to walk long distances. Our future plans were to establish more centres, taking the services closer to users.
• CLWHA through their community groups asked in particular for more counselling services. The issue of changing attitudes and feelings by counselling more and more children affected by HIV/AIDS was requested for unanimously.

ON-SPOT CHECKS
We had on-spot checks with the beneficiaries and the community.
• Checking on the beneficiaries who receive home-based care and support.
• Checking on the community, schools, churches, cultural festivities, etc. during their sensitisation and other HIV/AIDS programmes.
• Our staff and volunteers followed up some cases at random in health centres and hospitals to ensure that care, support and medical attention are provided.
• As a routine, we regularly checked on our service deliveries at our Resource and Day Care centres, as well as the community outreach services, to see how cases were handled and also to make sure the beneficiaries received quality services.

MONTHLY / ANNUAL MEETINGS AND REPORTS
The project team held periodic meetings with the beneficiaries, volunteers, groups of children affected by HIV/AIDS and the community, to see if the project was having progress and impact, and to find out the challenges which the work of the project was facing.
• As a team, we normally held weekly meetings to review our performance and find out the hindrances to our work.
• Simple questionnaires and suggestion boxes.
• The project manager had an obligation to produce monthly reports of the work.
An evaluation form was designed to assess the relevance and impact of the training to our participants and the performance of the project.

PROPOSAL – THE WAY FORWARD
The end of funding from Comic Relief seriously affected HAACEP, yet the demands and needs for HAACEP were growing year by year, and therefore ART has resolved to request a donation from Mr Charlie Crystle. In that respect and in order to strengthen our capacity to raise funds, during our recent research and needs assessment survey in Northern Uganda, the community unanimously decided that Mr Charlie Crystle is currently the most popular, most relevant and could be the most reliable source of funding, and that Charlie may be the best donor to advocate for the plights of our beneficiaries. Therefore ART decided to approach Charlie, with this proposal for funding our charity organisation in promoting HAACEP and other related programmes, including supporting, rehabilitating and repatriating the street children in Kampala City, most of whom relocated from rural areas of Uganda to survive by begging and sleeping rough, yet unfortunately the majority of them become criminals and prostitutes and/or sex workers.

Thank you very much.

Yours sincerely

Joseph Ocwet
Chairman
Africa Relief Trust
88 Cranberry Lane
London
N17 7DQ
United Kingdom

Email: Ocwet@aol.com
Mobile: + 44 7958 222 142
Telephone: +44 20 7511 0000

I figure that a guy who has “done” three companies must love what it entails.

What would you have done as an alternative to the obsessive hours? In hindsight, do you believe that there wasn’t incremental value to the additional attention?

My coworkers and I truly enjoyed reading your post in regards to the things not to do when raising capital. We, like many, are trying to start a small business that will serve many SME’s throughout South Central Pennsylvania with equity funding however it has been very difficult to find foundations and private/public organizations to help. We’d love to get in contact with you and send you our 5-page concept paper and seek your advice and recommendations in order to make this project work.

Thank you for your time and we hope to be hearing from you soon.

Best,
Claire Meyers
(email deleted)