Refugee camps in southwestern Uganda are experiencing overcrowding which is taking a toll on HIV medical services.
Severe personnel shortages in Nakivale and Oruchinga refugee settlements have led to long queues at the clinics and placed a heavy burden on the few health workers available, many of whom often have to take double shifts to meet demand.
“It’s the same staff to do ward work and carry out sensitization and awareness campaigns to increase the refugees’ understanding of HIV/AIDS, and how to prevent transmitting the disease,” said Dr Chris Omara, health coordinator for Medical Teams International (MTI), a medical NGO that works in humanitarian emergencies.
MTI runs two clinics of its own and supports three government health centres in the settlements. Some 180 health workers, only three of whom are doctors, are responsible for a population of over 139,000 people – 63,749 refugees and more than 76,000 local residents – in the area, which has an HIV prevalence of 6 percent.
The UN Refugee Agency, which provides MTI with US$2 per refugee per year for medication, says it difficult to recruit and retain health personnel to work among Uganda’s refugee populations.
Dr Isaac Odongo, MTI’s regional programme manager for southwestern Uganda, noted that the need for information on HIV and sexually transmitted infections (STIs) was crucial for refugees, many of whom came from conflict-prone areas of the Democratic republic of Congo (DRC) where such information was hard to come by.
“The HIV infection rates are generally low among the refugees when they just come [but] with time, they get into reckless activities [unprotected sex] with locals and they get infected,” he said.
Uganda suffers from a chronic shortage of health workers – less than half of the vacant health positions are filled – but the recent influx of refugees fleeing violence in neighbouring DRC has put even more pressure on Isingiro’s health services.
MTI replaced the German NGO, Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) [German Agency for international Cooperation] in the area three months ago, and one MTI official, who spoke on condition of anonymity, said the transition had also affected the smooth provision of HIV services to patients.
“We have just been in the field for three months. It’s not easy to have all the patients on board. There are also issues to do with procurement and requisition of ARVs [antiretrovirals] and TB drugs,” said the official.