Living in Hope: HIV/AIDS in Uganda and St. Francis Health Care Services

This red dirt road leads to St. Francis Health Care Services, an HIV/AIDS clinic in Jinja, Uganda, near the source of the Nile River.  (Video story at the end of this blog post.)

At the end of a red dirt road, near the source of the Nile River is St. Francis Health Care Services, an HIV/AIDS clinic serving some of the poorest people in Jinja District, Uganda. The power is out at the clinic, but no one is fazed.

The pharmacists continue to dispense medicine to their patients out of their small office, as sunlight streams through windows despite the drawn curtains. The medical assistants continue to diagnose patients, who wait their turn while sitting in blue plastic chairs in the hallway. And Faustine Ngarambe -- founder and executive director of St. Francis Health Care Services -- continues to work on plans to expand the clinic's programs, which serve about 600 people per week.

"HIV is not only a health issue; it’s economical, it is psychological, it is even a cultural taboo -- all of those things," said Ngarambe. He doesn't have a medical background, but in 2009, he won the Parliamentary HIV/AIDS Leadership Award from Ugandan President Yoweri Museveni.

St. Francis offers its patients services that heal not only the body, but the mind as well: counseling, nutrition and agriculture education, financial assistance, support groups for young people and grandmothers, and more. It's this kind of holistic approach to HIV/AIDS care that has made Uganda an oft-cited role model for decreasing HIV/AIDS rates. HIV prevalence in Uganda is currently at 6 to 7 percent, according to a UNAIDS report released yesterday, down from about 14 percent in 1990, according to this UNAIDS study from 2010.

Ngarambe became interested in HIV/AIDS care in 1989 while working as a missionary in Kenya. A Ugandan friend was HIV positive, but wouldn't disclose his diagnosis; the stigma was too great.

"He was dying silently within himself," said Ngarambe. "And when he was brought back to Uganda for burial, even his parents did not even view the body."

When Ngarambe returned Uganda, he and four colleagues started St. Francis Health Care Services. The clinic has grown from just five staff members and no permanent facilities in 1998, to 37 staff members, 100 community volunteers, and two permanent treatment facilities in 2011.

In a grassy field near St. Francis's main building sits Ngarambe's latest project: A maternity ward -- half-finished and in need of more funding -- that will specialize in prevention of mother-to-child HIV transmision. The ward is a result of the United Nations designation of Uganda as one of 22 priority countries for eliminating mother-to-child transmission.

St. Francis receives financial support from local and international sources, including the Stephen Lewis Foundation and Nile Breweries, but finances -- as well as a lack of enough equipment, space, and staff -- are always a concern. In addition, The Global Fund to Fight AIDS, Tuberculosis and Malaria said last week it will cut funding to several countries, including Uganda. This could hurt the nationwide effort to fight AIDS.

Still, Ngarambe presses forward.

"The thing that motivates me very much," he said, "is because I've touched peoples' lives and restored -- as our slogan -- restoring hope and dignity of the people who have been devastated by the HIV/AIDS epidemic."

Laura Elizabeth Pohl is multimedia manager at Bread for the World.