GULU UNIVERSITY MEDICAL JOURNAL

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Gulu University Medical Journal (GUMJ) 2009/2010 Vol 5. whose semester started before the end of the course, and for international students, some of whom had difficulty completing internship interviews in the US before the course began. Students from Gulu University faced accommodation and transportation difficulties because of the course location at Lacor Hospital. The need for many Ugandan students to commute between Lacor and Gulu town made it difficult for Ugandan students to consistently arrive on time in the morning and prevented some of them from staying for evening film showings. Finally, significant challenges were faced in trying to raise enough funding to pay for the course. We met limited success in our efforts to secure funding from NGOs, foundations, and involved universities. The Way Forward Given the great success of this year’s course, the social medicine course will again be offered from January 10 – February 4, 2011 and all Gulu University students will be welcome to apply. In July 2010, SEHC plans to do extensive publicity to encourage applications. This year’s course participants also plan to share the lessons learnt from this course through film screenings and discussions open to all members of the Gulu University Faculty of Medicine. Furthermore, these students will continue to work on advocacy and research projects related to drug stockouts and malnutrition, which have began as a result of the course. In order to enhance next year’s course, efforts will be made to find accommodation for Ugandan students near Lacor Hospital for the full duration of the course. Intensified efforts to find creative sources of funding for the course will be made. These efforts will include asking Gulu University to extend financial support for subsequent years given the great benefit of the course for its students and the surrounding community. Conclusion The social medicine course provided the opportunity for an intensive study of the social determinants of health. Together, students from around the world, developed a map of these determinants of health in northern Uganda. Gender inequality, minimal educational opportunities, poverty, unemployment, food insecurity, political instability, racism, and unequal global trade and exploitation were factors identified as significant contributors to the epidemiology of disease. These themes are intricately linked in both simple and complicated ways to this issue’s theme of maternal and child morbidity and mortality. Tracing these linkages reveals that gender inequality often results in men accessing the best nutrition, opportunities for education, and opportunities to have their voices heard. Meanwhile, too often women and children are left with inadequate nutrition, poor educational opportunities, and a near silencing of their perspectives. Genderbased violence leads to physical abuse of women in an environment that dismisses their concerns. In settings of extreme poverty, women turn to transactional sex for survival, putting themselves at great risk of HIV/AIDS. Inadequate water and sanitation contributes to excess disease amongst children who play in contaminated areas and drink unpurified water. Such social factors clearly worsen the health of women and children. Women and children are not only at greater risk of disease but have difficulty accessing adequate health services. Frail health systems are unable to provide proper prenatal and gynecological care. Mosquito nets, a central tool in malaria prevention, are often too expensive for families. Health centers in rural areas are often understaffed and lack the necessary medicines. Thereby, the common and treatable diseases of children and women, such as helminthiasis, uncomplicated malaria, mild malnutrition, respiratory tract infections, and complications associated with delivery, are not properly addressed in the community at early stages and become serious medical problems. We can likely all agree that some of these social factors identified above have a negative impact upon the health of women and children. But, then, we might ask, why do these factors continue to preferentially contribute to a heavy burden of disease amongst women and children? Analysis through the lens of social medicine reveals that these circumstances are very often shaped by the distribution of money, power and resources at global, national and local levels in ways that disadvantage the health of women and children. Thus, we must remind ourselves to continually ask, “Why treat mothers and children without changing what makes them sick?” Gulu University Medical Students’ Association (GUMSA) Passion for life 28
Gulu University Medical Journal (GUMJ) 2009/2010 Vol 5. Effects Of IDP Resettlement Programme On The Management Of HIV/AIDS In Gulu District, Northern Uganda 1 Hellen Mghoi, 2Mshilla Maghanga, 3Steven Langole 1, .2, 3 Gulu University, P.O. Box 166 Gulu, Northern Uganda Background Due to 20 years of the Lord’s Resistance Army (LRA) insurgence in northern Uganda, most people moved from their homes to IDP camps. At the height of the insurgence in 2004, the number of IDPs stood at 1.7 million (UNAIDS, 2006) in about two hundred IDP camps in Gulu, Amuru, Kitgum, Pader, Lira and Apach districts (UNICEF 2006). However, following positive progress of the Juba Peace Talks in 2006, the Government initiated an IDPs resettlement programme. While this was a very positive development it was envisaged that the access to health care services and specifically the management of HIV/AIDS faced heavy challenges. By 2004, Gulu was second to Kampala in terms of HIV/AIDS prevalence (GoU, 2005). To alleviate this problem, health authorities in both government and Non-Governmental Organizations (NGOs) set up various programmes around IDP centres mostly concentrated within urban centres to attend to the patients and their families. This in a way eased the intensity of problems related to HIV/AIDS care and Management. The management of HIV/AIDS as IDPs moved back to their village homes faced heavy challenges. This was due to both operational changes on the part of health care and support givers, overall economic difficulties, as well as the changes in demand for psychosocial support by patients’ and home based care givers’ that went along with relocation. For example, results of the Uganda Demographic and Health Survey 2006 had revealed that 65% of people in Northern Uganda would not accept a female with HIV/AIDS to teach. This indicated that in the event of returning to their villages, HIV/AIDS patients were likely to face stigma related discrimination. According to TASO as cited in Carter (2008), displaced HIV positive children who start antiretroviral therapy can do as well as children who start ARVs in politically stable settings, though; maintaining good outcomes in such populations is likely to be a challenge particularly because of population movement The general objective of this study was to investigate the challenges faced by HIV/AIDS infected and affected IDPs who have since resettled in their homes in Gulu District, Northern Uganda. Specifically, the study sought to establish the measures being used in HIV/AIDS management of resettled communities, the successfulness of the management, and the challenges experienced. Overview of HIV/ AIDS HIV/AIDS is an incurable disease that is an enormous threat to the society especially in Sub-Saharan Africa (SSA) where Uganda is located. By the year 2004 there were 39.4 million infected people globally, 25.4 million of these from SSA, while an estimated 3.1 million, 2.3 million of these in SSA, had died of the disease that same year (UNAIDS, 2004, as quoted in Bannister et al, 2006). As of 2007, the estimated global figure of people living with HIV/AIDS appeared to have dropped to 33 million (UNAIDS, 2008). However, there were significant increases of new infections in SSA. According to the Uganda AIDS Commission (UAC), (2008) the first incident of HIV/AIDS in the country was reported in Rakai and it is estimated that 5.4% Ugandan adults are HIV positive. According to (GoU, 2008), the number of people living with HIV is higher in urban areas (10.1% prevalence) than rural areas (5.7%); it is also higher among women (7.5%) than men (5.0%). Measures used in HIV/AIDS Management HIV/AIDS management strategies focus on preventing new infections, prolonging the lives of those infected Gulu University Medical Students’ Association (GUMSA) Passion for life 29
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