Amooti Kyasuudi’s sons passed of HIV/AIDS in 2008, 2011, and 2017. After the death of her elder son in 2008, her second son became the husband of his deceased brother’s wife. In addition to the four children his deceased wife gave birth to, he had two more children with his late brother’s wife. After his death in 2011, rumors swirled in the community that Amooti’s family was bewitched as a result of a land conflict. The youngest brother, aged 23 at the time, became the head of the family and had one child with his late brothers’ wife. When he, too, started to get sick, the village named his wife “omukazi wekisirani’’ (a woman of misfortunes). As the situation became more hostile, she escaped from the village on the day that her husband, Amooti’s youngest son, was admitted to Kibaale Health Center, where he died two months later. Amooti was thus left with the care of her three young grandchildren, all of whom had been diagnosed with HIV.
The Intersection of HIV & Nutrition for Ugandan Children
In Uganda, the impact of HIV is widespread and far-reaching, and many families face similar struggles like Amooti’s. According to UNAIDS data for 2020, 1.8 million of the 38 million people living with HIV around the world are children between 0–14 years old. Globally as of 2019, 13.8 million children younger than 18 lost one or both parents due to AIDS-related causes. In Uganda, data indicates that 1.5 million people were living with the illness in 2019, with 50,000 new infections in 2017 and 21,000 deaths in 2018. The Uganda Population-Based HIV Impact Assessment (UPHIA) of 2016-2017 shows the prevalence of HIV among children age 0–14 at approximately 95,000 across the country. UNICEF notes that Mother-to-Child Transmission (MTCT) is a leading cause of HIV infections among children.
Despite the prevalence of HIV among young children, age-appropriate antiretroviral medicines can be hard to find in many rural communities. This is because of a persistent lack of investment in these medicines and in testing for their effectiveness in children. In 2018, UNICEF and Uganda’s Ministry of Health enacted child-tailored HIV treatment reforms and in 2019, 553 facilities across the country provided antiretroviral therapy for children.
Even in places where medication is available, adherence to treatment is often hindered by unstable food access as it is not advisable to take HIV medication on an empty stomach. Proper nutrition also helps people living with HIV to maintain an appropriate body weight. Centers for Disease Control and Prevention indicates that a healthy meal provides energy and nutrients the body needs to fight HIV and other infections. Therefore lack of food reduces HIV drug adherence and affects the body’s ability to absorb the nutrients needed to stay in good health.
Implications of COVID-19 on Children Living with HIV in Uganda
Since Uganda registered its first COVID-19 case in March 2020, the government has established several control measures to prevent spread of the virus, including the National Ministry of Health and WHO guidelines on COVID-19. One notable measure enforced by the government was a nationwide lockdown. While effective in containing the virus’ spread, the lockdown meant that caregivers were suddenly unable to continue their jobs, often in the informal economy, to earn a living to provide food and other basic needs for the children. Meanwhile, accessing treatment for children living with HIV was not possible as means of public transport were no longer operational.
Rural Aid Foundation’s Intervention
In Kibaale District, where the nonprofit Rural Aid Foundation (RAFO) has its head offices, three percent of the children born in 2019 were born to HIV positive mothers. In 2020, RAFO sought to support children living with HIV in remaining in treatment amidst a food shortage throughout lockdown. With support from Catriona Hargreaves Charitable Trust, community churches, and others, RAFO purchased and distributed food items including porridge, maize, cassava, flour, and beans to 106 children living with HIV in 49 different households. RAFO issued a radio announcement of the program targeting 10 villages: Kasonge, Kacu, Bunabo A, Kiguju, Kyakazihire, Kibyasi , Matuntu, Maisuka, Kitanga, and Rweega in Bubango sub-county in Kibaale District.
To promote sustainability, RAFO also provided grandmothers and caregivers with farm inputs including hoes, pangas, and seeds for food cultivation. By October 2020, of the 23 grandmothers and caregivers who received farming inputs, four villages — Bubango A, Matuntu, Kiguju, and Kitanga — had already established their gardens of maize and beans, which are being managed by their small village groups. This effort will continue to strengthen community collaboration in nourishing and protecting the wellbeing of children living with HIV.
Previously a 2018–2019 Global Health Corps fellow, Frank Ategeka is now a Team Leader for Rural Aid Foundation (RAFO). RAFO is committed to advancing and promoting the health and economic rights of vulnerable people in Uganda. If you are interested in connecting with the RAFO team, contact email@example.com.
Global Health Corps (GHC) is a leadership development organization building the next generation of health equity leaders around the world. All GHC fellows, partners, and supporters are united in a common belief: health is a human right. There is a role for everyone in the movement for health equity. To learn more, visit our website and connect with us on Twitter/Instagram/Facebook.