Promoting Gender Equity & HIV Prevention in Uganda

 
$67,607
$12,393
Raised
Remaining
Ox/ox plough that are now being used by Coke youth
Ox/ox plough that are now being used by Coke youth

Hello family, friends, and supporters!

We hope this message finds you happy, healthy, and enjoying the new year. Thank you for your support in 2014. The final quarter was highly successful for GlobeMed at Columbia because we hosted Ms. Pamela Angwech, the director of GWED-G, during which members strengthened personal connections with the inspirational figure who brings GWED-G to life, and the annual global health HillTop conference that drew over a hundred college students and alumni from across the nation; we also held several awareness events and fundraisers, including collaborations with other student groups promoting HIV/AIDS awareness. We have two new co-presidents, Jayati Verma and Mariko Kanai, who will be leading the staff in 2015. We are thrilled to share recent updates from GWED-G below.

To promote maternal and newborn health as well as increased knowledge and awareness on HIV/AIDS, GWED-G staff engaged in follow-up initiatives of HIV-positive mothers and outreach efforts towards adolescent girls of reproductive age. 200 HIV-positive mothers carrying newborns were visited to monitor the progress of drug adherence, offer counseling and referrals when necessary, and to scale-up option B+, which could bring down the mother to child transmission (MTCT) rate from 30% to 2%. Follow-ups also played an important role in locating new HIV-positive mothers to be enrolled on anti-retroviral treatment (ART) immediately, thereby reducing HIV/AIDs-related deaths among women. Furthermore, mobile clinic outreaches helped adolescent girls access family planning services and mothers understand that their 15 and younger HIV-positive children must be put on drugs. With these combined efforts, over 65,000 people living with HIV/AIDS (PLWHA) have been enrolled in treatment.  

Furthermore, 74 new mothers have been enrolled in phase V of the HIV/AIDS mothers’ program. Of the 202 strong women from phase I – IV, several women’s groups have been receiving training in Village Savings and Loan Association (VSLA) and modern agricultural practices that have proved successful; women saw a fourfold increase in their yield. In addition, the mothers’ overall nutrition level has increased due to the proteinous food that their vegetable and sim sim crops allow them to purchase. As part of the workplan drafted in June 2014, phase III and IV mothers are now being supported with bean seeds to support their livelihood and overall nutritional health. Similarly, Village Health Team (VHT) workers are now receiving training for VSLA, along with Gender-Based Violence (GBV).

In regards to the livelihood of the youth beneficiaries, follow-up was conducted on the youth groups supported by the seed and ox distribution projects. Over fifty such groups have been monitored based on their progress in small farming business expansion, youth agricultural work preparedness, and household income generation.  One Coke parish youth group has been benefitting specifically from both the seeds and the oxen and ox plough that the GROW Team distributed in June 2014. With the income generated from the cabbage and tomato crops and the land opened with the oxen and ox plough, the youth bought and planted 2 hectares of rice, respectively. Furthermore, GWED-G strengthened the cycle of self-sustainability by training the groups in technical areas of investment and large-scale quality production for a hopefully stable future income flow.

Not only have the youths been strengthening their households’ livelihoods and nutrition, but they have also been utilizing their youth group structures to disseminate information on HIV/AIDS and sexual reproductive health rights. In another Coke youth group, GWED-G-trained members learned to build trust with their communities and to increase the number of mothers receiving antenatal care (ANC), through community dialogue meetings that stressed the importance of skilled personnel delivery and encouraged youth to bring women to health facilities. Similarly, the newly added initiative in June 2014- the thirty male role models in Coke and Agwayugi parishes- have also been successfully addressing issues of GBV integral to the discussion of HIV/AIDS, while also recruiting their wives into the outreach efforts.

As you can see, both GWED-G and GlobeMed at Columbia finished 2014 strong! We are grateful for your support in 2014 and would like to celebrate the successes we have achieved together. However, we still have a long way to go until the people of northern Uganda fully exercise their right to health. We ask for your contribution to and continued support for GlobeMed at Columbia’s project. Feel free to visit our GlobalGiving page, Wordpress, Tumblr, and Facebook pages or follow us on Twitter.

Happy (belated) New Year!

In solidarity,

GlobeMed at Columbia

HIV+ Mothers conducting their weekly VSLA Session
HIV+ Mothers conducting their weekly VSLA Session
A community woman receives counseling from GWED-G
A community woman receives counseling from GWED-G

Since our last project report in July, GlobeMed at Columbia and GWED-G have begun implementing the new phases of our project aimed at promoting gender equality and HIV prevention in Gulu, Uganda. While our overall objectives do remain the same as before, we are hoping to expand some of our current strategies and would therefore like to take this opportunity to remind our donors of these objectives and how we hope to achieve them. Through our collaboration with GWED-G, we aim to increase the Ugandan community’s knowledge on how to prevent HIV/AIDs transmission; we aim to strengthen community health networks through capacity building and training programs; and we aim to promote maternal and newborn health.  Currently, Uganda suffers from one of the highest HIV infection rates in the world. Moreover, 20.4% of the disease burden is felt by Ugandan women and children. Considering that only 26% of women have access to post-natal delivery, only 11.7% of women deliver in fully functional emergency care facilities, and the physician-to-population ratio is 1:10,000, this statistic is not surprising. Due to the prevalence of HIV infection in Uganda and the disproportionate burden faced by its women and children, powerful advocacy and prevention efforts are required. Our aim is to strengthen our partnership with GWED-G over the next year and work collaboratively and rigorously with them to implement our project strategies within the Ugandan community. Our hopes for the community are ambitious, but we are confident that we can affect change in the right direction with your generosity and support.

A particular strategy to promote maternal health that we would like to expand upon in the coming months is the focus on eliminating gender-based violence. The story of Aida brings to light the reason for this decision. Soon after her first meeting with her husband, Aida asked him to use protection during sexual activity. Upon hearing her request, he engaged in violence, threatened her, and did not agree to use protection. Over the years, each time she became pregnant, he forced her to give birth at home and threatened to kick her out of her home if she tried to go to a healthcare facility. When GWED-G health staff came to Aida’s home and tested her for HIV, she learned that she was HIV-positive. GWED-G was able to convince her to bring two of her children, who were often falling sick, to a community health center to get tested for HIV, as well. Aida learned that both of her children were HIV-positive, and when she returned home and shared this with her husband, he beat her and kicked her out of the house. When GWED-G found Aida after this event, she was hopeless and in despair, planning to commit suicide.  However, while Aida’s story thus far is extremely painful, GWED-G was able to help turn Aida’s life around.

GWED-G offered Aida counseling and assistance from the Village Health Team, and she became apart of regular GWED-G meetings, where she interacted with other women in the community. Aida is now a leader for some of GWED-G’s maternal health groups, such as the group of women who benefited from mama kits and those who benefited from income-generating projects, such as the provision of seeds. Aida’s story teaches us how male violence can traumatize the lives of women in Gulu. Aida, as a target of gender-based violence, not only acquired HIV, but was prevented from seeking any sort of medical care and was emotionally stigmatized throughout the course of her illness. Through GWED-G’s interventions, Aida was able to seek the resources and support she needed to once again live her life. Her story is a testament to the importance and expansion of projects aimed at reducing gender-based violence in Gulu.

GlobeMed at Columbia, in partnership with GWED-G, is therefore hoping to increase the involvement of males in the community in our programs. We have seen the success of Male Role Model groups in other GWED-G projects, whose members frequently stage dramas for their community in order to raise awareness about HIV/AIDS and provide examples for other men on how to properly treat women with the disease. For Phase V of our project, we are looking to implement a similar Male Role Models group within Coke and Agwayugi parishes, to increase male involvement in the promotion of women’s rights and community health. We hope that Aida’s story was as moving for you as it was for us. We appreciate your support as we try to extend the reach of our project to more victims of gender-based violence in Uganda. 

GROW Team members talk with a male role model
GROW Team members talk with a male role model
A community woman receives counseling from GWED-G
A community woman receives counseling from GWED-G

Since our last project report in July, GlobeMed at Columbia and GWED-G have begun implementing the new phases of our project aimed at promoting gender equality and HIV prevention in Gulu, Uganda. While our overall objectives do remain the same as before, we are hoping to expand some of our current strategies and would therefore like to take this opportunity to remind our donors of these objectives and how we hope to achieve them. Through our collaboration with GWED-G, we aim to increase the Ugandan community’s knowledge on how to prevent HIV/AIDs transmission; we aim to strengthen community health networks through capacity building and training programs; and we aim to promote maternal and newborn health.  Currently, Uganda suffers from one of the highest HIV infection rates in the world. Moreover, 20.4% of the disease burden is felt by Ugandan women and children. Considering that only 26% of women have access to post-natal delivery, only 11.7% of women deliver in fully functional emergency care facilities, and the physician-to-population ratio is 1:10,000, this statistic is not surprising. Due to the prevalence of HIV infection in Uganda and the disproportionate burden faced by its women and children, powerful advocacy and prevention efforts are required. Our aim is to strengthen our partnership with GWED-G over the next year and work collaboratively and rigorously with them to implement our project strategies within the Ugandan community. Our hopes for the community are ambitious, but we are confident that we can affect change in the right direction with your generosity and support.

A particular strategy to promote maternal health that we would like to expand upon in the coming months is the focus on eliminating gender-based violence. The story of Aida brings to light the reason for this decision. Soon after her first meeting with her husband, Aida asked him to use protection during sexual activity. Upon hearing her request, he engaged in violence, threatened her, and did not agree to use protection. Over the years, each time she became pregnant, he forced her to give birth at home and threatened to kick her out of her home if she tried to go to a healthcare facility. When GWED-G health staff came to Aida’s home and tested her for HIV, she learned that she was HIV-positive. GWED-G was able to convince her to bring two of her children, who were often falling sick, to a community health center to get tested for HIV, as well. Aida learned that both of her children were HIV-positive, and when she returned home and shared this with her husband, he beat her and kicked her out of the house. When GWED-G found Aida after this event, she was hopeless and in despair, planning to commit suicide.  However, while Aida’s story thus far is extremely painful, GWED-G was able to help turn Aida’s life around.

GWED-G offered Aida counseling and assistance from the Village Health Team, and she became apart of regular GWED-G meetings, where she interacted with other women in the community. Aida is now a leader for some of GWED-G’s maternal health groups, such as the group of women who benefited from mama kits and those who benefited from income-generating projects, such as the provision of seeds. Aida’s story teaches us how male violence can traumatize the lives of women in Gulu. Aida, as a target of gender-based violence, not only acquired HIV, but was prevented from seeking any sort of medical care and was emotionally stigmatized throughout the course of her illness. Through GWED-G’s interventions, Aida was able to seek the resources and support she needed to once again live her life. Her story is a testament to the importance and expansion of projects aimed at reducing gender-based violence in Gulu.

GlobeMed at Columbia, in partnership with GWED-G, is therefore hoping to increase the involvement of males in the community in our programs. We have seen the success of Male Role Model groups in other GWED-G projects, whose members frequently stage dramas for their community in order to raise awareness about HIV/AIDS and provide examples for other men on how to properly treat women with the disease. For Phase V of our project, we are looking to implement a similar Male Role Models group within Coke and Agwayugi parishes, to increase male involvement in the promotion of women’s rights and community health. We hope that Aida’s story was as moving for you as it was for us. We appreciate your support as we try to extend the reach of our project to more victims of gender-based violence in Uganda.

GROW Team members talk with a male role model
GROW Team members talk with a male role model
Mama kits donated by Delivering Hope
Mama kits donated by Delivering Hope

Our project, now in its fourth phase, has made enormous progress since our last update. This year’s Grassroots Onsite Work (GROW) team was fortunate enough to be able to document much of this progress during our five-week internship with GWED-G last month. We delivered 30 mama kits, courtesy of Delivering Hope, to the group of newly enrolled Phase IV HIV positive mothers. Recipients of the kits will now have the resources to have a clean birth at a hospital, where obstetric items cost money, or, in the event that the mother cannot make it to the hospital, at home. We also delivered livelihood support to a number of groups in the community: two oxen and an oxplow to each of two youth groups, and vegetable seeds (cabbage, eggplant, carrot, and okra) to phase II, III, and IV mothers, Coke and Palema youth groups, and VHTs. Items such as these will give members of the community the start that they need to support their families and pay their children’s school fees, as well as expand their agriculture or business and achieve economic independence. We delivered t-shirts for identification to all VHTs, as well as 10 more bicycles in addition to the 12 already delivered during Phase III, allowing all 22 of the VHTs involved with the GlobeMed/GWED-G project to travel deep into the village and reach a greater number of beneficiaries for counseling and support. In addition, GWED-G continues to support maternal health and gender equity by conducting sensitization sessions for community members, in which GWED-G staff hold open discussions about HIV/AIDS; and by conducting blood screenings, at which community members can find out their HIV status within 10 minutes of having blood drawn and receive counseling on that status.

But items delivered are not the end of the story. The GROW Team had the opportunity to converse with beneficiaries of our project, and invariably saw that, despite the benefits our project brought to these women, there still remains much to be done. This fact is well-illustrated by the story of 21-year-old Lakop Lucy. Lucy is one of the Phase IV mothers, and was among the mothers that received one of the 30 mama kits delivered during Phase IV. Eight days later, she gave birth. We met her newborn baby, named Rachel, just six days old, at her home in Coke parish. To our gratification, the baby was healthy, and HIV-negative. But our home visit emphasized more than anything that her HIV-negative baby was not the end of a happy story. In her own words:

“When I gave birth, my husband chased me away … this man chased me away, abandoned me, and has even refused to see the baby. I’m taking care of the baby alone. I’m the one who labored to farm during the rainy season. But after I raised and sold all my crops, he took the money to my co-wives. He kept on dating young girls in the trading center and he sells my things that I’ve troubled to bring home. I came back home and I found that he had sold all the goats I raised, and I’d bought them with the money I raised from digging. … He sold it all. Then he took the money to my co-wives. When I was pregnant and almost giving birth, I was beaten three times by my husband. And even now he might one day kill me. So when my mother came and tried to mediate, he abused both my mother and myself. So my mother decided now to pick me away and take me home. There are two official women but about five others, he keeps moving with them outside like girlfriends. He brings them but can’t manage them also because when he brings them he goes and gets another one so they keep on running away.”

She revealed that the hut she had taken us to, where we were interviewing her, was her former home—the home her husband had chased her out of. She was actually living farther away, with her mother, but had brought us here for convenience. “You should not take long,” she told us regarding our interview, “because such a man, when he comes and finds you here, it might not be safe.” The possibility that her husband might return at any moment and exhibit the same rage and violence she’d told us about was alarming to all of us. To avoid putting Lucy as well as ourselves in further danger, we cut our interview short, drove Lucy to her mother's home, and departed.

Our visit made it clear that the issue of HIV/AIDS is inextricably wound up with issues of gender-based violence and inequity, as well as lack of economic independence. The role of our project extends far beyond providing maternal health services that are not accessible to rural women: it must also combat prevalent views on gender and HIV/AIDS in the community; and equip women with the tools they need to combat stigma and violence, and to financially support themselves and their families.

Further, the need for those basic maternal health services is far beyond our current capacity to provide them. The distribution of mama kits was timely for Lucy, who was fortunate enough to receive a kit just before her delivery. But for many other mothers, the kits arrive too late, or are too few; we budget for 50 new mothers every year, but every year dozens of additional mothers hear about our program and begin attending meetings, and we do not always have the resources to provide mama kits for all of them. The cost and distance of transport to hospitals pose additional obstacles to safe births: many mothers miss out on necessary antenatal and obstetric care, and the coverage of VHTs and health workers is not 100%. The struggles of HIV positive women, vulnerable youth, and the community at large are numerous and deeply woven in the fabric of this war-torn region.

GWED-G and GlobeMed at Columbia are working to combat these obstacles. For Phase V of our project, in addition to continued services, we aim to fundraise for a vehicle that will be dedicated to emergency transport of pregnant mothers to the hospital. We also aim to provide bean seeds for Phase III and IV mothers so that they have enough strength to dig their gardens. We will implement Gender-Based Violence training for VHTs and incorporate GBV training into community sensitizations, so that both community health workers and community members themselves are better equipped to counsel and mediate conflict. We will provide for the maintenance of VHTs’ bicycles so that their outreach will continue to expand in breadth. In order to involve the husbands of HIV-positive women in community sensitization, we will pilot one group of Male Role Models consisting of 30 men from Coke and Agwayugi.

To accomplish all of this, we need your help. With your support, we have accomplished so much; but the need remains so strong in the region, and we have a long, long way to go before the people of northern Uganda can live the way that any human deserves to live. Visit our page at GlobalGiving, our tumblr, or our Wordpress for more information about our project, including photos, videos, and the GROW 2014 blog, and please reach out to us at columbia@globemed.org if you want to know more!

Lucy and her newborn baby
Lucy and her newborn baby
Six-day-old Rachel
Six-day-old Rachel
Phase IV mothers receiving mama kits
Phase IV mothers receiving mama kits
Distribution of vegetable seeds to Palema youth
Distribution of vegetable seeds to Palema youth
South Sudanese refugees in Adjumani refugee camp.
South Sudanese refugees in Adjumani refugee camp.

As our project for this year is underway, we'd like to take a moment to thank all you for your support! Your willingness to contribute to and learn about our project is instrumental to the health and progress of Gulu women and children. Following are a few updates regarding the progress of our project, as well as the ambitions and concerns of GWED-G staff as they strive to improve the health of their community.

Pamela, the executive director of GWED-G, and Juliette, the interim coordinator for GlobeMed's project, recently skyped with a few members of our chapter to provide updates about recent developments in the field and the progress our project has made in the community. The discussion was both educational and entertaining, with Pamela and her nephew Prince expressing their excitement for the GROW team’s visit in May.

The project has seen great success in the past year, with 15 mothers giving birth to HIV negative babies. As the rainy season begins in Uganda, the old mothers and youth groups, who were beneficiaries of our project in previous years, are also beginning to open up their fields, which they plant using the seed grants funded by GlobeMed’s project with GWED-G. Pamela said that the youth groups are hoping to add rice and onions to their crop as well. In addition, the old mothers are now receiving Village Savings and Loan Association (VSLA) training, which will allow them to save money and take loans as a group. Juliette expressed her excitement for the success of the Gender Based Violence awareness component of the project, stating that many of the mothers’ husbands are now accompanying them to their antenatal care appointments and are being more supportive. Both Pamela and Juliette were very proud of how much the project has grown, and are looking forward to the further expansion of GWED-G’s impact in the region.

Despite these successes, Pamela and Juliette also expressed some concerns about the lack of resources in Uganda. Though our project accounts for 50 mothers, GWED-G currently only has 20 mama kits, and will need to receive at least 30 more to fully account for the babies’ safe births. These kits contain items that are often discarded by US hospitals, such as gloves and gauze. They are full of basic, but extremely important supplies needed for healthy births. Pamela is hoping to receive more than that so that GWED-G can donate the kits to the local health centers and by doing so encourage other mothers to receive proper care. The biggest concern, however, is the HIV testing kit shortage in Uganda. There are currently no HIV testing kits in Gulu or Amuru, which are the two main districts where GWED-G’s activities take place. Though GWED-G is trying to make connections to international non-profits to receive kit donations, Pamela is worried that the shortage will hinder GWED-G’s ability to test the newborns in our project. Pamela also hopes that the new GROW team can help establish a relationship with a local auto company and thereby address the transportation concerns that have only increased as people from IDP camps are moving back to their original homes, increasing the distance between villages and health centers: many mothers are not able to get to the health centers in time to have a hospital delivery, or are transported using bicycles or motorcycles, both of which are very dangerous for a mother in labor to travel on. Pamela hopes that GWED-G can come to some sort of agreement with a local auto company, and perhaps commission a vehicle to transport the mothers to the hospitals when needed.

In happier news, GWED-G is greatly expanding their impact in Uganda. Pamela told us about a recent meeting where civil societies in Uganda got together to discuss good government and socioeconomic rights, and was particularly proud of their “Uganda 2020” plan, which entails a strategic vision for growth on a national level. She also talked about GWED-G’s plans to “domesticate human rights tools” by providing literature to local universities such as Gulu University. Pamela hopes that these materials will give background on human rights mechanisms in the context of international law and practice, and make local workers aware of the tools at their disposal and how to use them. Finally, Pamela told the GlobeMedders that GWED-G’s website is being revamped to look more lively and feature more content, and will hopefully have a consistent site manager in the months to come. Clearly 2014 has already been a very productive year for GWED-G, and Pamela shows no signs of slowing down.

When asked if she had a message for GlobeMed at Columbia members, Pamela said, “I want them to know that we are grateful for the strength of the work that the GlobeMed team does. I am happy that you are working together as a team to foster global health, and I hope that you continue that unity. I also want them to know that my door is always open, not just to speak to the leaders of GlobeMed but to anyone who wants to talk or who has questions for me.”

Before she signed off, Pamela brought her nephew Prince onscreen to say hello. He wanted the new GROW team to know that he still likes dragons, and is very excited for them to come (especially now that the team has another boy). He then proceeded to giggle and run off screen into another room.

In other news, the recent conflicts in South Sudan have resulted in an influx of South Sudanese refugees into Uganda. According to UNHCR, as of February 25, over 82,000 refugees had arrived in Uganda from South Sudan. The refugees, 70% of whom are women, largely lack the support that they need to maintain their health and well-being in the refugee camps: the facilities put in place have proven insufficient to provide for the needs specific to women and girls. Refugee women, about 15% of whom have been widowed by the conflict back home, have out of necessity taken on the additional burden of searching for water and firewood for their families, doing household chores, and helping to maintain their households' temporary lots of land. Further, gender-based sexual violence and other forms of human rights violations against women have been reported to occur in refugee camps. The presence of refugees in Northern Uganda has put an inordinate strain upon the resources of host communities, including that of Gulu: in the nearby camp of Nyumanzi, there are over 22,000 refugees in over 5,000 households. As director of an organization devoted to the health of her community, Pamela expressed a few weeks ago her sense of obligation to provide some means of relief for the refugees. Accordingly, she rallied GlobeMed at Columbia University as well as other friends and contacts to help raise money during a month-long campaign to provide emergency health kits for refugee women, including essential items such as soap, salt, rope, a dish towel, a washing basin, sanitary pads, underwear, and educational pamphlets designed for the refugee population on topics such as peace-building, emergency health, and refugee rights. We hope that these simple provisions will help displaced women and children maintain their health and dignity, and that the progress of ongoing peace talks will allow them to return home in the near future.

Although the emergency relief effort for South Sudanese refugees is tangential to our project, we felt a distinct obligation to support GWED-G in its time of strain, and, like Pam, an inability to ignore the suffering of refugees. GWED-G will continue to move forward as planned with our project even while juggling a plethora of other ambitions, concerns, and obstacles, and GlobeMed at Columbia will support them every step of the way.

Thank you again to all of our supporters, and we wish you the best that spring can bring!

 

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Organization

Project Leader

Jayati Verma Mariko Kanai

New York, NY United States

Where is this project located?