By Hope Mafaranga
When I tested HIV positive in 1991, I wanted to end of my life. I came from St. Mary’s hospital Lacor determined to end my life and that of my children.
I cooked food, crushed radio batteries and mixed it and fed my five children so that we can all die and end my suffering on earth.
These are the words of Evelyn Lakot 50, a resident of Opit village, Odek sub-county in Gulu district who has lived with HIV since 1991.
She got to know about her HIV status following the sickness of her husband who was admitted at Lacor hospital in Gulu.
“My husband presented strange rushes, had diarrhoea and he eventually died. The health workers attached from Comboni Samaritans attached to Lacor hospital advised me to test. I never liked the results,” she said.
Lokot was depressed and devastated because of the virus. She is one of the many whose mind was destroyed by the HIV virus at an early stage.
However God saved her family and the mixture did not work and none of her family died of that poison.
She has to endure a lot of rejection from her neighbours and relatives to cope with virus.
In 1997, she started taking ARVs, a drug that prolongs the lives of people living with HIV but the stigma was more of killer that the virus itself.
“One day I came from the hospital, too tired and I stopped at my neighbours place and requested for a drinking, a boy gave me the water but when his mother came out of the house and found me taking water from her cup, she grabbed it from me and threw it away saying I was going to infect her family.
This is one of the days that will stay in my mind and when I remember that incident the pain comes back,” she adds.
Severino Ocan a resident of a resident of Lugum B village, Pagwok parish, Namukora sub-county, Kitgum district is another traumatised person because being positive with HIV/AIDS.
He lost his wife in 2003, then also all his parents followed. He became alone and began seeing his life being useless.
He could not sleep at night and thought that suicide was the best thing to do since no one was there to assist him.
HIV and mental illness are cousins
According to Dr. Etheldreda Nakimuli a senior lecturer and psychiatric epidemiologist at Makerere University College of Health Sciences (MakCHS) in Kampala, said Lakot and Ocan are some of the people whose brain was destroyed by HIV at an early stage.
Have worked at Butabika hospital, Dr. Nakimuli described the situation of people who turned up at the hospital with mental illness as so sympathetic.
She says people who were mentally illness and were HIV positive not knowing or knowing, upon being put on mental health treatment, the side effects were so severe and required an emergency attention.
“ Some of them , we did not know their HIV status but after putting them on anti psychotic treatment that is used in treating mental illness, the reactions were so severe. In fact some got excessive stiffness in the neck, trembling, eyes could go up as if someone is dying and we had to give them an emergency attention,” she said.
Screen HIV people of mental illness
This situation prompted her to do research on mental health among the people living with HIV called Group Support Psychotherapy (GSP).
The study revealed that out of 100 people who tested HIV positive, 30 presented signs and symptoms of mental illness.
GSP research was conducted in the districts of Gulu, Pader and Kitgum in northern Uganda with an aim of treating depression among the people living with HIV.
They also discovered that HIV destroys the brain at an early stage of infection, as reason to why many people who test HIV positive for the first time attempt to commit suicide, some stay in a denial state, others resort to risk behaviours like drinking and reckless sex.
She explains it’s important to screen mental ill persons of HIV, because the brain cells called macrophage attract the virus.
“It is important to screen mental ill people of HIV because the virus penetrates the blood brain barrier into the brain causing mental illness,” she said.
She urged government to integrate GPS into its development plans because it teaches people how to care about their emotions, scoping skills, planning, socialising and health living.
Sign and symptoms
Febiano Oburu, the TASO psycho social service coordinator said after the research they have been empowered to identify HIV clients who are depressed and health workers have also been trained to screen depression.
He said they ask questions which lead them to some one’s life style. He says some abandon taking their drugs, silence, hunger, resort to domestic violence among others.
He said they counsel them and encourage them to disclosure to their family as they will need their support one day.
They also put them in groups where they counsel each other (peer to peer counselling) and visit them often to access how they are doing.
“This has helped in fighting stigma among HIV and mental patients and helped them to cope with drugs and have achieved adherence amongst themselves,” he said.
People die in silence
The in charge of mental health at the ministry of health, Dr. Sheila Ndyanabangi said depression is high in northern Uganda because people who are suffering die silently without sharing their problems.
She blames leaders for not have included psycho-social support to people in northern Uganda under Peace, Recovery and Development Plan for Northern Uganda (PRDP) project.
“Most people who have severe depression are people living with HIV/AIDS because of isolation and fear of stigma,” Dr. Ndyanabangi said.
She said the ministry wants to reintegrate mental health in all health facilities from national hospitals, regional, district and health centres so that health workers can screen for depression.
“We are putting priority on HIV/AIDS patients because if they are depressed, they don’t take ARV drug, their viral load go high and can transmit the virus to others if they have unprotected sex”, she added.
Martin Ojara Mapenduzi, the chairman L.C 5 Gulu district said a lot of money under PRDP sent from the office of Prime Minister (OPM) cannot be diverted to other sectors because it’s come with it priority.
He concurred with Ndyanabangi on the importance of GSP programmes.
“In 2013, there were high cases of suicide in Koro sub-county in Gulu district because of depression. 50 percent of those who committed suicide were HIV positive while others were traumatised by the LRA war”, Ojara said.
Dr. Nakimuli said in the GSP intervention, said they have trained health workers, village health teams (VHT) on how to identify people with depression.
The identified people are placed in groups, given psycho education, discover their personal problems, do positive coping skills, problem solving and skills to reduce stigma and give them basic livelihood skills with the resources that they have.
Acholi Muslim Khadi, Sheik Musa Khalil said there is need for people to have both spiritual and psycho-social support to reduce trauma and depression in northern Uganda.
Khalil who is the vice chairman Acholi Religious leaders’ peace initiative (ARLPI) said as religious leader they had been doing trauma healing program with support of USAID.
Dr. Nakimuli said HIV actors did not care much about mental health yet it affects 30 percent of people living with HIV.
“Donors focused their efforts on the search of vaccines, and treatment and no one wanted to hear the mental health, yet it affects the adherence of people living with HIV,” she said.
However for Topista Acora a 24 and resident of Kasubi was making a decision of taking drugs. However she is now looking forward of getting a man of her same status so that she does not spread the virus.