Persistence wins the day

Dying teenager, Janet had no hope: she had lost her mom, and her indigent father – himself on ART, who refused to even take her for screening. But Janet’s case is a C3 (Clinic Community Collaboration) success story. A tipoff from a concerned neighbour mobilised a counsellor, who in turn had to call on a Community Development Officer and the police to help Janet access treatment. Still, victory was far from reach: Janet had an adverse reaction to her TB medication at first and felt that battling several comorbidities and starvation made her ART seem pointless. She wished just to slip away. However, the VHT rallied, found a way to ensure she was nourished, and her treatment began under the watchful eye of a YAP. Now, she’s stronger, and with the help of an OVC organisation, her home situation improved and…she’s back in school. Janet’s team of angels never gave up: together they pooled all the resources available to win back another life.

Community is power

Adolescent, Mumbani, has been on ART for half his life, but his viral load was consistently dangerous until recently when loving support made all the difference. The PDP team at Mitooma Health Centre IV followed up on Mumbani in 2023 and discovered he was an orphan living with extended family, battling hunger regularly. This, coupled with the absence of an involved caregiver, resulted in poor adherence to treatment. Mitooma senior nurse, Mary Kyomugisha, asked a community health worker and peer educator to identify a secondary caregiver for the teen, who promptly found an aunt willing to take him in. But, despite his health improving with Mama Thembi, Mumbani’s problems continued when his family demanded him back. Aware of the threat to Mumbani, concerned community leaders used their mandate to overrule the family. Safe again with his loving caregiver, Mumbani’s viral load decreased rapidly, and today, the once abandoned child, is now an energetic and hopeful young man with a future ahead of him.

Promising futures

Maria was a frail 6-year-old when she was found to be HIV positive during a routine community engagement. Maria was in the care of her elderly grandmother, who had not realised that she was seriously ill. Little Maria’s results showed a very low CD4 count, and she had opportunistic infections that needed immediate treatment. The VHT mobilised to find Maria’s mother and re-engage her in the care of her daughter, offering the full spectrum of counselling to help the family with Maria’s positive living. Maria is now a thriving teen with big dreams to study medicine and expresses her appreciation of the support the VHT provided. The aspiring young “doctor” says it is not just her who is doing well, but many other children on ART as a result of this work in her community. She remembered the frequent follow-up visits by the VHT and events like treatment adherence sessions in their community, which she believes, made all the difference. Quite right, Dr Maria!

Oldies, but goodies – bringing back campaigns that worked

Some high-impact interventions at community and facility level just work. “Bring Back the Mother-Baby Pair” (BBMB) is a strategy that has been around since before the launch of the Breakthrough Partnership and is still improving retention in care. BBMB activities empower pregnant and lactating women with knowledge about eMTCT and paediatric HIV care, along with increasing the demand for paediatric services. The combination of community dialogues, awareness campaigns and household visits provides necessary education and links women to testing services. The Uganda teams make special mention of the effectiveness of VHT attachment: VHTs know the children and households of PLHIV in their communities and specifically the children who are living with HIV, which empowers them to reach out, offer peer support and promote treatment adherence. Uganda’s BBMB figures show improved adherence to treatment and paediatric viral load suppression among the children.

Mary Kyomugisha

“14 out of 106 in 2023 – that was too high,” says Mary Kyomugisha is the nurse-in-charge of the ART clinic at Mitooma Health centre IV.
Like other BP teams, Mary and her colleagues want every young person living with HIV to get the care they deserve.
When Mary and her team discovered that despite long-term treatment and psychosocial support, 14 minors on ART were still not virally suppressed, the Mitooma team investigated. Mary says they quickly discovered multiple problems at home: stigma most especially for families expecting the youngsters to die soon, caretakers ignoring medication schedules, inept caregiving and poor treatment literacy, most notably.

A concerted campaign to save the young clients followed, with Mary’s team implementing an intensive community engagement approach. Community leaders brought their insight into the cultural and social contexts of the children, helping to make case management more holistic and effective. And with the families’ consent, they identified secondary caregivers. This made all the difference and today, Mary exclaims proudly, “It worked! We are on the path to a great future with this approach!”

Michael Senyonga

Advocacy is everyone’s business, according to this extraordinary young achiever. As a Youth Representative on the Global Fund CCM Board, Michael weighs in on matters of policy and key messaging at the highest echelons but also speaks passionately about disclosure and advocacy at community level.

“We need champions who are going to publicly disclose their status and inform communities that we are still human, we can still live, and that having HIV is not a limit to what we do, or the end of life,” Michael told listeners in an interview on RX Radio.
Michael’s energy is both inspirational and infectious! Apart from his work with The Global Fund, carrying the flag high since winning the Mr. Y+ Ambassador for Uganda title in 2019 and working tirelessly as a national YAPS trainer, Michael represents the interests of children and young people on the 2020-25 board of NAFOPHANU (the country’s National Forum for PLHIV).