Thirty one years after the discovery of HIV, a cure still remains a distant reality.
The very complicated nature and variety of HIV has meant that the virus has resisted even the most vigorous of attempts by scientists to eliminate it and to quell its spread.
That a cure has eluded scientists this long, is in a way, an indictment in itself, but it is worth noting that there have been real glimmers of hope, in recent years, principally in the area of scientific research on drugs to mitigate and suppress the deadly virus.
Those glimmers of hope have manifested in the radical advances made by scientists in developing antiretroviral therapies that control HIV viral replication in a person’s body and allow an individual’s immune system to strengthen and regain its capacity to fight off infections.
The antiretroviral therapies may not be curative but they have, by and large, led to favourable outcomes amongst many people living with HIV, not only in Uganda but world over.
The upshot has been many of them living longer.

By Richard Wetaya
The idea of personal branding has been gaining traction in recent years.
Many proponents

The Ministry of health in Uganda has secured $20 million from the Global Financing Facility to foster the result based financing initiative, which aims at improving the quality of health care at health facilities country wide.
Prof. Anthony Mbonye, the Director of health services in charge of Clinical and Community Health in the Ministry of Health revealed this while addressing Journalists at the first national symposium on universal health coverage that took place last week at Silver springs Hotel.

“The hope is that more private and public health facilities will get accreditation because the more a facility avails services to pregnant women and children of immunisable age, the more funding it gets. This performance based funding is meant to improve quality of care at health facilities and to make sure health workers get allowances, uniforms and buy supplies. This will be one of our stronger paths to universal health coverage,”He said.

 At the symposium, there were further earnest deliberations on how best Uganda can build an understanding on attaining universal health coverage. Universal health coverage, according to the World Health Organization (WHO) is the goal that all people have access to health services and do not suffer financial hardship in paying for them. It ensures that all people have access to needed promotive, preventive, curative and rehabilitative health services of sufficient quality. The symposium was convened by Makerere University School of Public Health under the umbrella of the Supporting Policy Engagement for Evidence-based Decisions (SPEED) project- an initiative that focuses on advancing Universal Health Coverage in Uganda.

Speaking on the opening day of the symposium, Prof. Freddie Ssengooba of the Makerere University School of Public Health, College of Health Sciences (MakCHS) noted that the trajectory towards achieving universal health coverage in Uganda is gaining momentum, notwithstanding the many challenges, the country faces.  "As a nation, we need to begin positioning ourselves on how best to achieve this development agenda. Universal health coverage is central to the question of how health should be represented in the new development agenda that will succeed the Millennium Development Goals this year," said Ssengooba.

"The process of developing the new Health Sector Strategic and Investment Plan (HSSIP) of 2015-2020 by the Ministry of Health is a welcome development and a step in the right direction. The goal of Universal Health Coverage which is being inserted into Uganda's health policy is still new to many. These deliberations are meant to help us understand the idea of Universal Health Coverage and what its implications are for the different stakeholders like the government, the private sector and academia."

       Whilst everyone acknowledges that the goal of attaining universal health coverage will be no mean feat, the government seems intent on making it feasible and bringing changes to bear especially as regards the provision of cost effective health interventions for the poorest of its citizens, a key prerequisite if the programme is to fall in line with the requirements of the WHO. Mbonye noted that the government was obliged to provide interventions such as antenatal care, family planning, curative and rehabilitative care to all its citizens. "In South Eastern and Eastern Uganda, a Voucher system has been introduced to enable poor pregnant women to access antenatal and delivery health care services at every visit. A woman will only be required to pay 3000 shillings. The Voucher scheme will be rolled out in the next six months countrywide," Mbonye said.

"The pilot project registered many successes. It is on the basis of that, that we were able to get funding from the World Bank for the scheme. We are also working on the National Health Insurance Initiative, which essentially aims at improving our health indicators. It is now with the Parliamentary council and there is green light from the Ministry of Finance regarding funds for it."   Dr. Patrick Kadama, the Executive Director of the Platform on Human Resources for Health at the African Centre for Global Health and Social Transformation underscored that for Uganda to accelerate towards universal health coverage (UHC), a number of critical reforms need to be put forth to achieve equity.  "There is need for reforms to manage the social determinants of health through stronger inter-sectoral action. We also need reforms to introduce patient centered or family based health care services, and reforms to strengthen health governance and management," Kadama explained.

 SOME OF THE CHALLENGES HIGHLIGHTED THAT MAY IMPEDE PROGRESS TOWARDS ATTAINMENT OF UNIVERSAL HEALTH COVERAGE IN THE NEXT 5 YEARS

Low access to safe, clean drinking water and sanitation
          Dominic Kavutse, an engineer from the Directorate of Water Development, Ministry of Water and Environment noted that the current access to safe water supply and sanitation in Uganda stands at 65%. 
          "That leaves 35% of the Ugandan population with access but not safe access.  That translates into 10 million Ugandans exposed to water-borne diseases due to consuming unsafe water. There are 110,000 water points in the country.  Out of the budget we have we are able to produce new water sources for about 800,000 people per year but the population increases by at least 1.2 million people per year. At the present rate of investment, the coverage of water supply and sanitation is going down," Kavutse said.

The inaptitude of the health system in Uganda
            Dr. Stephen Lock, the acting head of Cooperation, Delegation of the European Union noted that whilst there have been notable declines in the infant mortality ratios and HIV related deaths, the health system in Uganda is still lagging behind in terms of providing assurance to Ugandans of adequate social protection.  "Deaths for example related to pregnancy and child birth remain unacceptably high with an estimated 20 women dying daily while giving birth in Uganda. There are still pertinent questions to answer regarding the functionality of public hospitals which are the most visible aspects of health system capabilities," Lock stated.
 
Out of the pocket payments as a major barrier to health access
       "Direct payments have serious implications for health. Making people pay at health facilities or other points of delivery dissuades them from using services (particularly health promotion and prevention). That in essence means they do not receive treatment early and they steer clear of health checks. The absence of financial protection in Uganda's health system calls for concerted action aimed at reducing the large proportion of out-of-pocket payments currently present in total health financing." Ssengooba observed.

By Richard Wetaya
If there is, at present, a suburb in Mbale enjoying unprecedented growth, it is

The early part of Saturday (last week) got me curiously wending my way through Boma Ward, the once famous and glistening Mbale suburb. Boma ward-commonly known as Senior quarters is found in Wanale Divison.
Many people, who grew up admiring the beauty and peace of this place, feel it has, in many ways, lost its sparkle.  To all appearances, they are right. For starters, Senior quarters, Mbale was and probably still is the hub of Mbale’s rich, more like what Kololo is to Kampala.
Therein, you will find residential homes for Mbale’s rich and famous. Stephen Wekomba, owner of Mt. Elgon Millers is on that A-list. He owns several rental houses and other buildings in the area.
Senior quarters is also home to several senior civil servants and many of Mbale’s upscale and affluent hotels, to wit Mbale Resort hotel, Crown Suites, Kayegi hotel and Mt Elgon hotel.

Senior quarters is also where you will find the famous Mbale Presidential lodge. It is a place almost every student wants to visit, especially when they know the President is around Mbale. Here you will also find Mbale’s most popular and classy night hangout spot, the Thatch gardens, owned by the famous Mbale Doctor, Dominic Martin Waburoko. Through the years, Thatch gardens has obtained a footing as Mbale’s number one happening place, hosting parties, concerts, weddings and conferences.

Whilst it is fair to state that Senior quarters has gotten more residents through the years, it is out of the question to state that it has improved infrastructure wise. Moving around, I bore witness to many of the quarter’s infamous poor roads. Many residents I had spoken to earlier had lamented about the poor state of the roads in the area, principally the road from the Presidential Lodge to town via the Resort Hotel. That evidently is not the only bad road here. The road from the Presidential Lodge to town via Mooni has also been in quite a sorry state for some time.
 “Good roads used to be this area’s claim to fame in the days of old. A little tarmac was laced on the road between Mooni to the area where Mount Elgon Hotel is located but it was substandard. The road was heavily pot holed, yet the President uses it whilst going to rest at the Lodge. Concerned residents speculated that the President’s vehicles have strong shock absorbers and he never felt the impact of the pot holes whenever his car rode through the road,” Fred Bwayo, a resident, says.


Sam Wamutu, Chairperson of the Boma ward development committee says a feasibility study has been done and the road, right from Mbale’s regional block is going to be worked on in due course.
All that awaits is the funds to be released, Wamutu adds.
 
The Senior quarters of today also has quite a number of old and dilapidated buildings.
“In the good old days, you would be hard pressed to find old and unpainted buildings in this area. There is increased apathy on the part of the owners of some of the old buildings” Bwayo says.

Lots of new buildings are being constructed but they are evidently juxtaposed with the old ones.
In the colonial days, Senior quarters housed the colonial administrators sent to Mbale to oversee the governance of the Eastern region. The area according to old Legend had state of the art recreational facilities wherein the colonial overseers invariably went to parlay.
“Senior quarters was unquestionably Mbale’s cleanest suburb, especially in the times when Mbale was the cleanest town in East Africa. It was serene and its lush greenery was second to none. Many people always wanted to come and visit on account of that. There were no old buildings and bad dusty roads as is the case today. The place lost its glory, just like Mbale town did,” states Wangota Khaukha, an elder in Mooni, an area neighboring the quarters.

Tales are told also of how Semei Kakungulu used to frequent the quarters, often coming to consort with and consult the colonial masters. Kakungulu it is said planted many of the area’s existing eucalyptus trees, just like he did in many other areas in the East.
“The trees Kakungulu planted added to the beauty of Senior quarters. The road leading up to the Presidential Lodge was a boulevard, with well manured trees on each side. Obote as well was fond of Senior quarters. During his Presidency, he always visited and hosted visitors at the lodge. The road was in a good state in the 80’s. Much as the area has lost its splendor, we are happy Hotels like Resort and Kayegi have been taken root. Resort particularly is a modern hang out,” Khaukha says.


SCHOOLS
Senior quarters is also the place where you will find the famous Fairway Primary school.
Almost everybody who grew up in the early 90’s in the East heard of this prominent school. It was always in the best of the bunch academic wise.
Though it has lost some of its sparkle, it still stands in a good stead with many people.
“Fairway is one of the few schools existing in Senior quarters. Understandable being that the area is mostly residential. There is also Boma primary school and 4 to 5 other private schools,” Wamuttu says.

SECURITY
Security wise, Boma ward is safe and sound, albeit there have been sporadic incidents of crime reported, especially in areas neighboring less affluent suburbs like Mukhubu, Mooni and Busamaga. 
Wamutu says whilst there have been security lapses; the general peace of the area has not been compromised a lot.
“That problem is being looked into. Most of the area’s security problems are caused by thugs emanating from neighboring suburbs,” Wamutu says.

SANITATION
In terms of sanitation, the area has not done badly though Wamutu says they are waiting for the area’s sanitary sewer system to be connected to the main Namatala carriage system.

LAND PRICES
Though land prices have been fluctuating through the years, an acre of land in Senior quarters goes for about 150-200 million.

Clean and safe drinking water is a hard to comeby commodity in many hard to reach and distant villages in Bududa District, Eastern Uganda. In many of the villages, water shortage is a part of daily life, notwithstanding the fact that Bududa is richly endowed with rivers and other abundant water resources.
Fresh water sources in villages like Bushegi, Bunabuniu in Bushika subcounty and Bunakasala in Bulucheke subcounty are few and far between. As I moved around, I noticed there were many abandoned and non functional domestic water points.
Many of the hilly area’s potential for water supply is principally through rain water harvesting. Making do with harvested water is not bad in itself, but the containers I saw the villagers using to collect water were far from clean. In effect, this puts the lives of villages at a risk of e-coli and water borne microbes associated with diarrrhoea.

When the dry season sets in, usually at the threshold of each year; the few water sources in villages like Bunanyuma, Bushegi and Bunakasala are left half dry or completely dry.
Most of the water springs and wells as it seems, dry up due to the drought.

The little water the villagers struggle to fetch is itself far from clean but that does not seem to bother the children and people I saw queuing up to draw water. Unwittingly, they also expose themselves to water borne pathogens, which the World Bank says contribute to the high child mortality rates world over.
According to water aid.org, 12,000 Ugandan children die each year from diarrhoea caused by unsafe water.

These unprotected water springs are our lifeline. It is the only water we have, rationalised Piyo Kuloba, a resident of Bunakasala village. “What do you expect people here to do? They have no choice but to use the little spring water at their accessibility however unsafe it may be. The springs are not protected and there are no boreholes or piped water systems in most of the villages around Bunakasala. During the dry seasons, the situation exacerbates as villagers are compelled to move long distances to get water. Moving from a hilly area to fetch water downhill is a tall order. When the rains come, the situation in a way improves because people can at least harvest water, though most do not have big containers that can store water for long,” notes Kuloba.

Water from river Manafwa is also in high favour with many people especially those living alongside its banks. I bore witness as children from Namasho village in Bulucheke subcounty drew water from River Manafwa using dirty containers for home usuage. All the while, other children swam in the very water. My attempts to dissuade those drawing water fell on deaf ears. Seemingly, Domestic animals also pollute the river’s waters going by the animal excrete I saw near the river’s banks.

In 2010, a ministerial statement presented to Parliament revealed that River Manafwa was contaminated. Most of the pollution the statement noted was from human feaces emanating from the pit latrines constructed near the river. In many respects, water from river Manafwa is still unsafe for usuage considering the continuous dependence on the river’s water’s for activities such as bathing and washing. That in essence means people living along the river’s banks are invariably at risk of water borne diseases such as cholera, typhoid, skin diseases, eye infections and infestinal diseases like schistosomiasis.

In some parts of Bududa, ill advised traditional attitudes still govern the usage of water, especially water from river Manafwa Unboiled water from the river is traditionally thought of as tastier than treated water. As such some people would rather drink it, than treated or boiled water.
“Many people use river Manafwa as a primary source of water. It is used for household consumption because people have waited for the piped water and the gravity water systems in this area as promised by the government for long. The government needs to redeem its pledge to build a gravity water system from the nearby mt. Elgon area. That needs to be fast tracked. The ignorant belief that water from river Manafwa is more tastier has been there but that can be stemmed through concerted educative drives in the villages concerned,” notes Wilson Wangota, an elder in Kushu village, Bulucheke subcounty.

Families living in the hilly and distant areas are hard pressed in going downhill to fetch water. The problem is areas downhill are also grappling with problems of access to safe and clean water. There is almost no guarantee that one will find safe water when they head downhill.
The gap between Bududa’s population without sustainable access to safe drinking water and those with access has gotten wider through the years. Manifestly, Bududa is amongst the districts where safe water coverage is still hovering below the 64% national average and where access to safe water has stagnated.
Five years back the situation seemed better. 
A 2010 report by the Directorate of Water Development, Ministry of Water and Environment, showed that 66 % of Bududa’s population had access to safe and clean water.
Recent records from the Ministry of Water and Environment however paint a grim picture. Recent accounts show that access to safe water in Ugandan rural areas has stagnated at 65%, in the past two years, yet Uganda’s target is to increase access to safe water in rural areas to 77% in 2015 in line with its millennium development goals.

“The government’s investment in the water sector especially in the rural areas needs to be improved. Interventions also need to be fast tracked especially when people are facing a problem like it is in Bududa. The government as well needs to invest in water purification schemes for the rural areas. Communities should be helped to protect their wells. Access to safe water is a critical disease prevention investment and a recipe for good health. It can go a long way in helping communities in Bududa and other areas around the country to confront the health based poverty trap. With the construction of the first phase of the Bududa-Nabweya Gravity Water Flow Scheme, there will hopefully be a new lease of life in the above sectors,” says John Okumu, a water and sanitation engineer in Manafwa.

According to UN Water.org, Investments in water and sanitation services result in substantial economic gains. The return on investment of attaining universal access of improved drinking-water is estimated to be 2 to 1. To cover every person worldwide with safe water and sanitation is estimated to cost US$ 107 billion a year over a five-year period.

The Bududa district Community Development Officer in charge of Water and Sanitation, Anthony Wakholi says the district in unison with the Government is working on a gravity water flow system, which will pump and generate water from Mt Elgon.
“Water will be supplied to different areas using this system. It will cover 6 sub counties, namely Bukigai, Bududa, Nabweya, Bushiribo, Bushiyi and Bulucheke. The district has developed protected springs, groundwater wells and gravity flow systems before in some sub counties like Bukibokolo. There is also the Bukalasa gravity flow scheme, which covers 3 sub counties. Drilling boreholes in hilly areas is a hard task. That explains why there are few of them. Rain water harvesting as recommended by the government has however been gaining currency amongst the people. As regards the usuage of water from river Manafwa, people do not do it on purpose. It is largely because they have no choice and because they are averse to messages dissuading them from using that water,” Wakholi says.

Wakholi however says some of the water problems in Bududa are sometimes brought about by the residents themselves.
“There is generally a problem of poor water supply management in some of the villages. Counterproductive activities like the cutting of underground water pipes in some villages has adversely affected the sector. These pipes transport water down from the hilly areas but certain mischievous people have continuously tampered with them. In some areas, people have continuously cut the water pipes to irrigate their crops,” Wakholi says.
 
Many people’s livelihoods have also been affected as a result of the lack of water in many of Bududa’s villages.
In Bunakasala for example, crop diversification has become a problem. Villagers barely grow crops that depend on rain or water to flourish. The lack of water has in some ways also led to a reduction in the usuage of land in many of the villages, though families still subsist on staple crops that grow without much rain.

By Richard Wetaya

The Namisindwa cave in Matuwa,

It is a piping hot Saturday morning and I find myself treading through the hilly Bunanyuma village in Bushika sub county, Bududa District. There is not much semblance of human activity but the vestiges of an ominous landslide are clearly discernible. The landslide which occurred in June last year, left in its wake huge land fissures. The land fissures cover a surface area of about 35-45 metres. Huge swathes of rocks were swept downwards when the landslide struck.  Homes, crops, water sources, eucalyptus trees and livestock were laid to waste. Many residents were however able to evacuate in time, partly in response to a distress call from a fellow resident at the pinnacle of the hill.

“There was a heavy downpour that night. The rain lasted over four hours. Rocks were coming down from the apex of the hill with a vicious force. That was a cue for us to flee and to evacuate. People’s homes, livestock, coffee trees and a family of 7 were swept away, never to be seen again. This area has a history of landslides and when it rains, it floods. That was the third time; landslides were ravaging the area. Geologists and a team from the office of the Prime Minister came here in 2014to access the situation. They advised us to relocate, noting that there was a contingency plan to deal with the situation. We told them we are ready to move but no course of action was taken. The landslide occurred in 2014 just a few days after they had left,” states 63 year old Wilson Manga, a resident of Bunanyuma.

Against that backdrop and with the rainy season now fast on the horizon, one would expect the residents to be making arrangements to leave. One would also expect the government to come to these people’s rescue. At the moment however, there is no sign that any of the above is happening.
The residents I managed to talk to are apathetic to say the least. Much as there is a mood of apprehension, many seem resigned to fate, reasoning that they rather stay than move to other areas, where their safety, freedom and health is not guaranteed.

“People are reluctant to move on account of the stories they have heard about the conditions in Kiryandongo and the nearby IDP camps in Bulucheke and Bukalasi. Acclimatizing to a new area far away from your home area is a tall order. We would move if the conditions in the camps are improved. Many people are also reluctant to move for cultural and ancestral reasons,” states Luwulendi Wakinya, an elder in Bunanyuma.

Similar sentiments are echoed by some residents of Bunakasala village, Bumwalukani parish Bulucheke subcounty Bunakasala bore the brunt of landslides on the 25th of June 2012. 12 people died and many remain unaccounted for. Unlike Bunanyuma, the landslide in Bunakasala occurred at day time.
Kuloba James, a resident of Bunakasala says his family escaped by a hair’s breadth.
“My house was grazed by huge stones as the landslide swept. Fortunately only one side of the house was destroyed. The kraal for my cattle and my banana and coffee plantations were completely destroyed however. I also lost chicken. It rained heavily but nobody ever imagined the damage the rain would cause. I and my family of 6 survived narrowly. A family of eight who were my immediate neighbors were all killed in the landslide and their bodies, like those of many other victims were never recovered even when the bull dozers and excavators were brought. The rains are imminent but I do not see myself moving to any other place. I would relocate again if conditions were favourable in the places where the government wants us to go and if there is compensation. I was in an internally displaced people’s camp only last year but the foods the government disbursed were few and far between. When the food rations ran short, many of us were compelled to leave. The pit latrines were inadequate; there was inadequate access to safe water, sanitation and hygiene. Water was hard to come by in the camps even with the gravity system,” Kuloba says. 

In the same breath, water seems to be a problem in Bunakasala and Bunanyuma villages. All the water sources seem to be drying up or have dried up. Around the villages, young children can be seen queuing to fetch little drop of water from makeshift wells and water ponds that look far from clean.
Fresh water sources seem to be a real problem and the hilly terrain does not help matters. Families are hard pressed in going downhill to fetch water. Kuloba regrets that the promise made to them by the government to avail a gravity water supply system has not been redeemed. As such locals have to make do with the little unclean water at their availability.

Geologist Sam Owach says landslide losses can be avoided if the problem is recognised early. “Landslide susceptibility assessments need to be done at various spatial scales in Bunakasala, Namakansa, Bunanyuma, Namitsi and in all landslide prone areas around Mount Elgon. With the rainy seasons imminent, that needs to be fast tracked. Most landslides in the Bududa area are triggered by heavy rains and to larger extent by counterproductive human activities like digging in the hilly areas. By now, there should be contingencies in place to gauge the likely intensity and duration of the forthcoming rains, so as to avert any calamity. There should be continued assessment of soil depression and the land fissures like those in Bunakasala and Bunanyuma. If they are deemed dangerous as indeed they are, early preparations should be made to relocate the communities in those areas to safer zones. The residents of Bunakasala and Bunanyuma need to stop cultivating in areas around the cracks and in areas far up on the hills,” Owach says.

At 5 p.m, Bunamasongo Village was crawling with Initiates and their

Initiates dancing their way to Manhood during the Inemba dance rituals in Bushika subcounty,

Initiates from Bukhaukha village join in the Inemba Dance in Bushika. Photo by

One of the Initiates is taken through the mill of the Inemba dance. Photo by

By Richard Wetaya

Friday, march, the 13th was a memorable

By Richard Wetaya

22 year old Claire Lamunu has the

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BY RICHARD WETAYA

Victor Ochen, a Ugandan grassroots activist has been basking in the glow of his nomination for the 2015 Nobel Peace Prize.
Ochen was nominated on the 17th of February by the American Friends Service Committee, an organization that promotes lasting peace with justice, as a practical expression of faith in action.
Online stories about Ochen and his work have been going viral and there have been congratulatory messages galore.
Venerable personalities such as Desmond Tutu, Fatou Bensouda, the International Criminal Court prosecutor, Ruhakana Ruganda, Uganda’s Prime Minister and Trust Africa, an independent foundation that works to secure conditions for Democracy and equitable development throughout the African continent, have all come forward to endorse and drum up support for Ochen.

Desmond Tutu has said Ochen is in the top pick of the bunch as regards being amongst the new breed of dynamic African youth leaders.

Ochen becomes the first Ugandan to be nominated for the prestigious Nobel Peace Prize award, which in the past has been won by eminent personalities such as former United Nations Secretary General, Kofi Annan, Liberian President Ellen Johnson Sirleaf and United States President, Barrack Obama, amongst others.
For the award, Ochen is pitted against esteemed people like Pope Francis, Ban Ki-Moon, Edward Snowden and the World Health Organisation, among others.
The winner will take home a Nobel medal and cash prize of $ 1.2 million. The winner will be announced in October.

By Richard Wetaya

Mazzi Wampamba is a

By Richard Wetaya

The expression, “an ounce of prevention is worth a pound

By Richard Wetaya
Often it is

23 year old Sharon Karungi has all the makings of a great Basketball player. Her agile dynamism, competitiveness, prance like walk and stellar physical play have endeared her to basketball fans, not only in Uganda but also in the United States, where she currently plays.

By Richard Wetaya

Dark ominous clouds had enshrouded the horizon, as me and