Introduction
AIDS stands for acquired immune deficiency syndrome which consists of set of infections and symptoms that result from immune system of human being damaged. It is caused by virus called human immunodeficiency virus and this condition makes immune system not to be effective leaving individuals being susceptible to tumors and opportunistic infections. HIV is transmitted by coming into direct contact with mucous membrane or body fluid that contains HIV virus such as semen, breast milk, vaginal fluid and blood. Transmission of AIDS involves blood transfusions, anal or vaginal sex, contaminated hypodermic needles and having exchange between baby and mother during breast feeding, pregnancy or childbirth.
Uganda is a role model in Africa for fighting against AIDS due to broad-based partnership, strong leadership in the government and campaigns for public education that led to decrease in number of people who were living with AIDS in 1990s. Although a lot is learned from Ugandas campaigns against AIDS in a timely and comprehensive manner, its success is not supposed to detract from devastating effects of AIDS across the country economically, socially and personally. The estimated number of people who are living with AIDS in Uganda currently is 940,000 and children who are orphaned by AIDS are 1.2million. (Cohen, 1997)
Rapid spread of AIDS in Uganda was through sexual networks in urban areas and at major highways after it originated from Lake Victoria. The doctors became aware of it due to severe cases of wasting which were locally known as slim disease and fatal opportunistic infections. The first AIDS case was diagnosed in Uganda in 1982 and there was a link between clinically recognized AIDS and slim disease. When civil war ended in 1986, president Museveni began a major program for HIV prevention because the country had a major epidemic with prevalence rates of 29% in the urban areas.
In 1987, the first program for AIDS control was set up in Uganda for the public to be educated on how to avoid being infected with HIV. The program aimed at promoting abstinence from sex, being faithful to your partner and using condoms as a protective measure. The program also ensured the blood supply is safe and HIV surveillance was started. The main feature of early response in Uganda was strong political leadership and commitment to tackle AIDS epidemic which was rampaging.
There was need to take action against AIDS though prevention work that was began at grass root levels with tiny organizations coming up to educate peers about AIDS. TASO which was organization based in the community was formed. TASO stand for “The AIDS Support Organization” and the sixteen volunteers who run it had personal experience with AIDS because they were infected. Later, TASO became the biggest AIDS service organization that provided AIDS services, providing medical and emotional support to thousand of HIV positive people.
The second phase of HIV epidemic in Uganda was from1992 to 2000 when there was dramatic fall of HIV epidemic from 15% in all adults and 30% in pregnant women in 1991 to 5% in 2001. The decline in prevalence was due government prevention campaign but treatment was not easily available and deaths which were related to AIDS led to decrease in number of people who were living with AIDS. The prevention initiative of Ugandan government continued up to nineties with funding from World Bank and the government.
The third phase of AIDS in Uganda has led to prevalence being stabilized during 2000-2005 and reports indicated a slight increase from 2006. Antiretroviral drugs that are offered free of charge have been used in Uganda since the year 2004. The availability of this drug resulted to complacency because AIDS is not immediate death sentence anymore. Many experts have speculated that shift in Ugandas prevention policy to US-backed programs for abstinence are responsible for risky behavior which is increasing because sex education and promotion of condom are no longer emphasized. (Sayagues, 1999)
In 1990s, there was decline in number of people in Uganda who were living with AIDS. This is due to decrease in new infections and increase in AIDS related deaths. Many people died because there was no treatment to delay onset of AIDS and many people who were infected in 1980s were at the end of survival period. The honest and frank discussions on causes of AIDS infection have contributed to changes in people’s behavior allowing for decline in prevalence levels. Education tours and music by Philly who openly declared his HIV status spread the understanding, respect and compassion for people who were living with AIDS.
The ministry of health in Uganda started offering free prevention of transmission of mother to child in antenatal clinic. This programme was involved in counseling and rapid testing for the women who attend antenatal clinic and treating both child and mother who are HIV positive. The programme had positive results although large disparities were found in transmission from mother to child in different areas which depended on number of staff available. (Narathius, 1997)
Social Construction of the Disease
Uganda is regarded as the most successful in its fight against the spread of AIDS and has challenges in continuing with the progress it made in 1990s. The important lesson during this period is to know how to prevent new AIDS infections due to sexual behavior. When sex is delayed by young people, early HIV exposure is avoided and this results to enormous benefits of postponement to public health and humans. The questions that arises is who is sexually active, the reason why he or she is sexually active and with who. In Uganda, social construction has changed sex contours and HIV epidemic is not easy to deal with. The hope is in universal Secondary education to help Ugandan girls postpone first sex so that they can help in addressing national and global AIDS scourge.
HIV/AIDS is construed as disease that is threatening to life and is supposed to be feared because it results from deviant and promiscuous behavior of other people and high risk groups. Approaches to past communication have been anti-pleasure, fear inducing and anti-sex. Communicators of changing behavior in their frameworks and models do not see love as a social construction which needs trusting, giving and risk taking which is a major contribution to unsafe sex. (Topouzis, 1995)
How the disease and its victims were viewed by general population
Educating the general population and workers in health care about AIDS is very important. Many anxieties and fears need to be addressed about the dreaded illness. Experience shows that the simple information given is of little importance in hospital personnel and general population. Origin of irrational fears and anxieties in AIDS patients need to be addressed and get psychodynamic explanation. Training programs using videotape and group process need to be used in order to have a better address of underlying fears of AIDS patients so that hospital staff can deliver empathic care to the patients. (Hemrich, 2000)
How AIDS victims are viewed by society, families and friends
There was a ministry that was opened in Uganda to support orphans called AROH-UGANDA aiming at restoring hope. This organization is voluntary and non-profit making and helps destitute children and AIDS orphans by supporting them and paying for their welfare, medical care and formal education because there is large number of AIDS orphans who are left without anyone to take care of them. This organization is very important because, there are children whose both parents died and immediate relatives leaving them with their old grandmothers who are not capable of giving them support and providing for their basic needs.
Widows who are HIV/AIDS positive in the society are helped to live long by helping them to engage in activities that generate income because they still have children who need their support but they are not able to work for very long hours because they are weak. The department of AIDS awareness visit schools, churches and community so that the people who are AIDS victims can be advised on how to live positively in the society and have a sense of belonging because there is still hope in life and once they take good care of themselves, they can still survive for a very long period of time.
The families of people who are living with AIDS in Uganda shows a lot of love and care to them and assure them that even if they are positive, they still belong to them. They are provided with basic needs and medical care all the time and are not discriminated in any way by their families. Their friends are advised not to ignore them because; this is the moment when they need great care and whenever they are in difficult situation, they should be encouraged to live positively and enjoy their life. (Stover, 1999)
Using the best scientific knowledge to tell how prevailing attitudes impede effective action
Scientific knowledge is essential link where it create link between research and policy. In order to help in health improvement, priorities must be identified and set, enhance efficiency and quality of health care, develop new interventions and technologies and advance basic knowledge of behavior and human biology. Researchers feel that they should be objective in the work they do and are uncomfortable with having close contacts with the community or decision makers because researchers are regarded as being slow, impractical and too academic as work environment of decision makers try to balance demands of pressure groups. Community members feel intimidated by decision makers and researchers because, if they had the opportunity they would say a lot and apply the new knowledge.
Science and technology can not thrive if the country is in armed conflict or has dictatorial regime. Mediators are important in bringing two parallel processes of policy development and research. The proposal put forward is that complementary and distinctive roles are played by mediators to achieve successful linkages between action and research. Researchers develop communication skills and advocacy to understand the way decision makers allocate resources and how policies are developed, implemented and monitored by policymakers. (Narathius, 1997)
Social causation of the disease
AIDS has impact which is devastating on society and individuals. This condition occurs if the people with HIV have lived long time with it, lost their immunity and are susceptible to opportunistic infections. Most often AIDS results to death and currently there is no vaccine against HIV or cure for AIDS. Apart from causing numerous deaths, there are other problems related to HIV/AIDS; these include increased dependence, reduced income of households, deepening poverty, social discrimination and the depletion of human resources and national resources. These problems have implications and lead to AIDS-related problems. For example, social discrimination in AIDS victims result into stigmatization which make them fail to seek treatment, support and care due to fearing any further discrimination.
The resources of AIDS victims in Uganda are affected due to labor loss and effects of eroding assets and lack of investment. Majority of people of affected cases have negative effects on AIDS which has resulted to vulnerability and impoverishment. Demographic characteristics and socio-economic status of households influence impact of the magnitude of AIDS and the capacity to be able to cope with it. (Topouzis, 1995)
In Uganda, the presidents AIDS initiative have faced challenges. There is lack of health care infrastructure to treat AIDS and deadly diseases. The government is not prepared to deal with AIDS crisis or too corrupt and feels unaccountable to have campaigns for effective treatment. International AIDS activists and organizations have been ignoring Ugandas success and promoted flawed approaches to prevention of disease. Health care workers in Uganda are enthusiastic about condoms but did not consider testimony by health officials of the government about putting emphasis on abstinence from sex and reducing the number of partners.
The Uganda results are unambiguous and startling. The health and demographic survey in 2000-2001 found 93% of Ugandan people changing their sexual behaviors in order to avoid AIDS. The census Bureau in United States estimated HIV prevalence rate in Uganda to be 15% in 1991 and went down to 5% in 2001. The decline in prevalence is unique in the whole world and is subject to intense scrutiny by scientists. Ugandas success is more impressive even after putting into consideration the limited financial resources.
AIDS in Uganda affect economic growth through reducing human capital available. When nutrition is poor and there is no medicine and health care, many people become AIDS victims thereby becoming unable to work and require significant medical care making the economy to collapse in the country because in areas where infection is high, many orphans are left behind to be taken care of by grandparents who are elderly.
In cultural or social action, AIDS stigma is in existence all over the world through rejection, discrimination, ostracism and avoiding the infected people. There has been compulsory testing for HIV without having prior consent or protecting confidentiality of HIV status of victims and also quarantine for infected individuals which make people fear to be tested or secure treatment resulting to death due to chronic illness that could have been managed and this resulted to spreading HIV /AIDS because people are not aware whether they are infected or not. (Stover, 1999)
References
Stover J. (1999): the economic impact of AIDS in Uganda: The Futures Group International.
Cohen D. (1997): The AIDS epidemic and sustainable human development: Fourth International Congress on AIDS.
Narathius A. (1997): An appraisal of the line ministry-AIDS control programs: AIDS reduction program.
Sayagues M. (1999): AIDS hits Ugandas villagers: Africa Recovery.
Topouzis D. (1995): the socio-impact of HIV/AIDS on rural families in Uganda: UNDP discussion paper no. 2.
Hemrich G. (2000): Multi-sectoral responses to HIV/AIDS: Journal of international development.