![]() | AIDS Education Through Imams: A Spiritually Motivated Community Effort in Uganda (UNAIDS, 1998, 35 p.) |
![]() | ![]() | Country profile |
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Following a lengthy period of devastation, Uganda is now rebuilding, with healthy but fluctuating economic growth rates. The cash economy is heavily dependent on coffee, while the population is sustained mainly on subsistence agriculture.
Total population (1997) |
20.344.200 | |
Urban population (1997) |
2.945.254 | |
Annual population growth rate |
2.5% | |
Infant mortality rate |
97(per 1,000 live births) | |
Life expectancy |
male: |
43 |
|
female: |
44 |
Literacy rate |
male: |
65% |
|
female: |
45% |
Per capita GDP (US$) |
283(1995/96) | |
Surface area |
241,038 sq. km |
All figures are from UNAIDS country profile for Uganda, August 1997.
According to the latest population figures, 16% of Ugandas 20 million people are Muslim (compared to Catholic 33%, Protestant 33%, and indigenous beliefs 18%). Muslim leaders feel this number is an underestimate and cite figures between 20% and 30% of the population.
The central organizing body of the Muslim community is the Uganda Muslim Supreme Council, headed by His Eminence the Mufti. Under the Mufti, there are 33 district religious leaders called District Khadis. Under each District Khadi there are approximately six County Sheikhs. Each County Sheikh oversees 30 to 40 Imams, each of whom heads a mosque. Every Imam is the spiritual leader for approximately 75 families.
Addressing the ties between
religiousissues and health issues hasunited Muslim leaders with
theircommunities.
There are certain traditional Muslim practices that have the potential to increase the risk of exposure to the HIV virus. These practices include male circumcision (as sometimes practised in the rural areas with one unsterilized razor being used for several infants), ablution of the dead (if individuals fail to use protective gloves when cleaning bodily orifices) and possibly polygamy (although there is currently no evidence associating polygamy with increased risk of HIV).
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Let there arise out of you a band ofpeople inviting all that
is good, Enjoining what is right, and forbidding what is wrong: |
The AIDS epidemic in Uganda is said to have started in Rakai District, onthe well-travelled truck route from the United Republic of Tanzania to Uganda.
Today it is estimated that 1.5 million Ugandans are living with HIV infection. This means that 1 in every 10 Ugandan adults may be HIV positive. The number of actual AIDS cases is estimated to be 500,000. Mean survival time after progression to AIDS is said to be 1 year to 15months.
The distribution of clinical AIDS cases varies by district, with the greatest concentration found in Kampala, followed by other parts of South/ Central Uganda and the war-torn district of Gulu in the north.
While the picture is bleak, Uganda is known for its innovative approaches to HIV prevention. The Government and the nongovernmental organizational sector have encouraged many pioneering initiatives such as the first multi-sectoral commission coordinating prevention and care efforts and the first voluntary and anonymous HIV testing and counselling centre in sub-Saharan Africa.
Other innovative projects, such as the AIDS in the Workplace project, implemented by the Federation of Uganda Employers, the care and advocacy for persons with HIV/AIDS, provided by The AIDS Support Organization (TASO), and the AIDS prevention project, developed by the National Resistance Army of Uganda, have established Uganda as a fertile environment for creative approaches to AIDS prevention.
The Islamic Medical Association of Ugandas AIDS-prevention programme is yet another pioneering initiative, focused on the countrys growing Muslim community.
Encouraging trends
Ministry of Health surveys show evidence of a significant decline in HIV infection. In some cases, the percentage of mothers testing HIV-positive at urban health clinics in 1997 was almost half of what it was in 1992.
Figure
Most public health workers believe that Ugandas aggressive response to the AIDS epidemic, led by open Government policies and innovative programmes, contributed to a high rate of behaviour change that fuelled this remarkable decline. Surveys of behaviour change in urban areas show that from 1989 to 1995 there were significant delays in age at first sex, less sexual relations with non-regular partners, and increased condom use.
Research carried out by IMAU in their project areas found a similar trend. A follow-up survey in project areas showed that two years after IMAU began their AIDS education effort, community members showed a significant increase in correct knowledge about HIV transmission and methods of preventing HIV infection.
The survey also found changes in high-risk behaviour, showing a significant reduction in sexual partners among respondents under 45 years of age and a significant increase in self-reported condom use.
Our policy in fighting AIDS has been to give it ahuman face and toexpose it as ourtotal enemy. As a result of this openness, we have been able to achieve avery high degree of HIV/AIDS awareness in Uganda.
Prime Minister Kintu Musoke - 1997. Southern Africa Economic Summit
Living positively with AIDS
I let my Muslim brothers
andsisters know the importance ofHIV testing before marriage. Not just with the
first wife, butwith every wife. And the
Sarah Wakabu is HIV positive. She learned this after her husband died of AIDS in 1993.
When he first fell sick, Sarah made the bold suggestion that they both go for HIV testing.
Not surprisingly, her husband refused. Sarah waited until after her husband died to go for testing.
Sarah is now Day Centre Supervisor at The AIDS Support Organization (TASO) in Jinja, one of the organizations where IMAU refers their community members. Sarah is pleased to work for the organization that rescued her with counselling and food assistance when she first received the news that she was HIV positive.
Sarahs job is important because she is responsible for her two sons, as well as several orphans left behind when three of her sisters and one of her brothers died of AIDS.
I have finished building our house and I have started putting something away for my childrens future she says.
For now, Sarah and her sons are healthy and she takes pleasure in sharing her experience of living positively with AIDS with the many HIV positive men and women who come to TASO.
The Joint United Nations Programme on HIV/AIDS (UNAIDS) reports that over 30 million adults and children worldwide are believed to be living with HIV infection - 1 in every 100 sexually active adults. If current transmission rates hold steady, by the year 2000 the number of people living with HIV/AIDS will soar to 40 million.
UNAIDS estimates that 2.3 million people died of AIDS in 1997, a 50% increase over 1996. Nearly half of those deaths were in women and 460,000 were in children under 15. In most parts of the world, the majority of new infections are in children and young people between the ages of 15 and 24.
Since the beginning of the epidemic, 3.8 million children under the age of 15 are estimated to have become infected with HIV and 2.7 million to have died. Over 90% of these children acquired the virus through their HIV-positive mothers, whether before or during birth or through breast feeding. So far, more than 8 million children have lost their mothers to AIDS when they were less than 15 years old - and many of these also lost their fathers. It is estimated that this figure will almost double by the year 2000.
UNAIDS