Uganda food crisis hits fight against HIV

Erratic weather, which has brought floods and drought, and rising food prices are taking a devastating toll on east Africa. Last month, the UN Food and Agriculture Organisation (FAO) said nearly 20 million people were now dependent on food aid in the region.

Uganda is experiencing famine and acute food shortages and the most vulnerable households are those headed by women, children or the elderly.

Antiretroviral drugs used to treat HIV/AIDS/ Photo credit: Krista Kennell/ZUMA/Corbis

But there is another group who could suffer as a result of the food crisis - people living with HIV/AIDS (PLWHA). The situation is beginning to undermine efforts to fight the virus in the north and east of Uganda, the areas most affected by the drought.

The National Community of Women Living with HIV/AIDS (NACWOLA) in Uganda, which promotes positive living for women with the virus, has warned that HIV-positive patients in eastern Uganda are abandoning their antiretroviral (ARV) treatment “in droves” because of a lack of food.

ARVs need to be taken with food, otherwise there could be severe side effects, such as dizziness and vomiting.

In an article written on the NACWOLA blog last month, the organisation said that unless more food becomes available there would be “drug resistance and death”. It called on the government to do more to tackle the food shortages.

“If the government doesn’t address the food crisis, many of us who are on ARVs are going to die,” Stella, a NACWOLA member from Katakwi district, was quoted as saying on the blog.

Rose Amuo, the chairwoman of the PLWHA group in Katine, north east Uganda, says it is now evident that people living with the virus in her sub-county were finding it difficult to follow their treatment cycle.

“Lack of food is threatening our lives because a number of us cannot afford enough, yet you cannot take antiretrovirals without taking in some food,” she says.

More than 200 residents in Katine, where the African Medical and Research Foundation (Amref) is implementing a three-year development project, are HIV-positive.

Katine resident Sarah Arawo/ Photo credit: Joseph Malinga/ Guardian

Sarah Arawo, a 36-year-old resident of Obiol village, is one them. She says the food shortages are making it increasingly difficult for her to manage the condition and she’s stopped taking her ARVs regularly.

Married to Francis Esweu, Arawo has seven children; another child died shortly after birth. Arawo tested HIV-positive in 2006.

“Out of our eight children, one of them [a boy] also tested positive. Both of us are under ARV treatment since October, 2007,” she says.

But it’s challenging adhering to the treatment because of the food shortages, which the family has been experiencing since 2007, but has been exacerbated by the current drought.

“In fact these days I do not take my drugs regularly due to lack of food,” she said. Most families in Katine are now eating just one meal a day. Arawo only takes her medicine when she has food to eat.

“These drugs are too strong, so if you take them without food you get weaker. But there are days when I’m forced to take drugs even without having anything to eat, especially when I get a serious attack. In other words I take my medicine occasionally,” she explains.

The family relies on the small wage Esweu earns repairing bicycles. After taking money to pay for alcohol, which Esweu likes to drink, there is little money to support a big family.

Arawo has been forced to sell the family’s goats to pay for food, but she now has no more left to sell. During days when Arawo does not take the medicine, she feels weak.

“I have even started developing some complications, which I believe are a result of my inconsistency in taking the drugs. The whole of the left side of the body, including the hand, is developing a rash, with too much pain,” she says, as she shows a scar on her left hand.

Despite her HIV-positive status, Arawo says her husband still wanted her to continue having children. Three months ago she gave birth to twins. One of the babies died, the other is a sickly child. While pregnant, Arawo says doctors gave her treatment to protect her from mother to child transmission, but she won’t know until the results are back from the lab whether the baby is free of the virus.

Over the last year, more than 1,800 mothers have attended counselling and testing through the prevention of mother to child transmission of HIV/AIDS programme in Katine.

Esweu says he has agreed with his wife that they will not have any more children and will consider family planning.

Arawo is not convinced he will allow it, and worries she may suffer complications from using contraceptives because her husband does not want to use condoms. She is worried any complications may lead to an operation, and with that comes the fear that she won’t survive it.

NACWOLA is urging the government to do all it can “to increase the supply of food in this region” and to give priority to people like Arawo living with HIV/AIDS.