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.
Group
helps
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.
Intervention
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.
Challenges
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.
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