Before Uganda’s coronavirus lockdown, Matina had a morning routine. After waking, she drank tea, ate a little, and took her antiretroviral drugs as doctors instructed. Matina is HIV-positive.
But when the country introduced restrictions to stop the spread of COVID-19 in March, her situation changed. Because she had nothing to eat, she avoided her medicine as it makes her feel nauseous and dizzy if taken without food.
Matina is 67 and asked that her surname be withheld due to the stigma of being HIV-positive. She lives in a small grass-roofed home in a poor part of Gulu, northern Uganda. She says her relatives cannot work due to rules against travel and non-essential services. She supports seven children who eat at most one meal a day.
Matina says: “Corona has brought so many problems to me.… Getting food is not easy. I cannot buy beans because the price has increased and I cannot afford it. There’s no money. Maybe corona is better because the hunger will just kill you.”
After two months of lockdown, many Ugandans are struggling. But some of the lockdown measures are now lifting. The ban on public transportation was ended in early June.
In Uganda, about 1.4 million people, or just over 3% of the population, are living with HIV, according to government figures. This is one of the highest rates in East Africa, with about 23,000 people dying and 50,000 new infections every year.
Women are disproportionately affected, accounting for nearly 60% of adults living with HIV. The rate of new infections among young women aged 15–24 years is more than double that of young men. Stigma against those with HIV is rife.
But Uganda has made major strides to combat HIV and AIDS, bringing the infection rate down from 18.5% in 1992, according to UN data. One million people are on drugs to slow the development of HIV and avoid it progressing to AIDS.
To counter the fast spread of the coronavirus, Uganda introduced a nationwide travel ban. The ban was imposed with only one hour’s notice, leaving no opportunity to plan. Local authorities said they had no time to make proper provision for people with chronic illnesses, or those who needed emergency healthcare. At least 11 pregnant women have died because of problems accessing maternal healthcare, according to the Kampala-based Women’s Pro-Bono Initiative.
Dr. Kaggwa Mugagga is the HIV advisor to the World Health Organization in Uganda. He says, “This element was not addressed at the initial stage of this lockdown due to pandemic.”
Authorities are now reviewing the impact of the lockdown on various programs. Dr. Mugagga notes that there were problems distributing medicine for AIDS at first, but that volunteers or motorcycle drivers increasingly delivered drugs. Uganda’s Ministry of Health also set up a program to allow community health workers to collect HIV pills for patients.
More recently, Dr. Mugagga said he has heard increasing reports about food shortages due to people being unable to work. He says this uncertainty is “psychological torture” for people with HIV.
Dr. Joshua Musinguzi is the AIDS control manager at Uganda’s Ministry of Health. He said the government has been trying to address problems with food as well as supplying people with the drugs they need. The government has also urged the public not to relax efforts to combat HIV and AIDS despite all energies being targeted towards fighting the COVID-19 pandemic, which had infected about 730 people as of mid-June.
Dr. Musinguzi says, “We are not in normal times so it is possible that not all of them are being reached … there could be gaps and patients could be experiencing hardships.”
Acen laughed sadly when asked what she has eaten during the lockdown. This single mother of five children boils plants once a day, and it’s not enough.
She says, “We’re hungry, the children are complaining, there’s nothing to do because it’s not there, there’s nothing available to give them.”
Acen is 36 and has battled HIV for six years after contracting it from her ex-husband. While she continues to take her antiretroviral drugs, she says it has been causing problems. She explains, “It’s punishing me a lot when you take a medication on an empty stomach. It gives you a funny sickness.”
Before the pandemic, she helped out in people’s houses in return for a small payment. Now, she cannot afford a mask, which she is obligated to wear even to collect her medication. She says, “We would rather buy food.”
This story is adapted from an article originally written by Sally Hayden for Thomson Reuters Trust and titled “Ugandan women fear food storages will make coronavirus and HIV a deadly mix.” To read the full story, go to: https://news.trust.org/item/20200521041801-kvrmq 
Photo: Antiretroviral medicine. Credit Thomson Reuters Foundation / Sally Hayden