Friday, October 31, 2014

Article 25: Global Day of Action

By Orrin Tiberi, Global Health Corps Fellow

Though not a holiday anywhere, October 25 has been enshrined by the United Nations as the Article 25 Global Day of Action to promote health as a human right.  More than 65 countries celebrated with rallies, marches, health promotion, and advocacy.  Julius and I were lucky enough to help coordinate and participate in an Article 25 event on Kaaza and Serinyabi Islands in Lake Victoria both to gather signatures requesting better health access and to provide basic health services on the islands. Uganda Development and Health Associates, a public health NGO based in Iganga that provides periodic health services on the islands, orchestrated the event and funded much of our time there.

Article 25 is just one of the 30 articles that comes to us from the United Nations Declaration of Human Rights.  It states:

“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”

The basis of the Day of Action is to confront the inequities and injustices in global health and foster the movement for health equity that has been gathering momentum around the globe. Because many of the issues with health are man-made, there should also be human-centered solutions to the same problems.  For more information on the aims of their program you can check out their website here.

Uganda Village Project was able to donate two boxes of condoms to the events on Kaaza and Serinyabi islands, providing access to condoms for more than 600 individuals.  This is extremely important in an area where there is very little health access and the nearest clinic is a forty-five minute boat ride away - a ride that can cost up to 40,000 shillings for emergency trips.  For fisher folk who live on the islands that cost is prohibitively expensive, and because of the physical and financial barriers to health services the fishing islands of Lake Victoria have some of the highest rates of maternal mortality in Uganda.  Being so isolated from services, they also have very high rates of HIV, TB, and other preventable diseases that regular check-ups can diagnosis and provide treatment for. 

Regular access to antiretroviral therapy (ART) is also a problem for many of the islanders that have HIV.  The district officials come once a month to distribute the therapy, but the dates of each visit is not a consistent 30 days, and they only hand out a months supply each time.  This leaves all HIV+ individuals missing 5 to 10 days of their treatment each month, which may have profound impacts on the future of HIV treatment on the islands.  With each cycle of non-adherence the islanders are allowing the HIV in their body to adapt to the current regime they are given and become drug-resistant.  If the HIV is then spread to a new individual it means that they will have to be on a completely different set of ARTs for the desired effects, which usually means a more costly treatment.  By building a health center in a more proximal location it would allow the medications to arrive on a consistent basis, and keep a budding problem from emerging any further.

Though a collaboration of Uganda Development and Health Associates, Mercy Clinic, Uganda Village Project and Global Health Corps (the organization that is sponsoring both Julius and I), we were able to test and counsel more than 350 people for HIV, provide ANC for expectant mothers, give immunizations to newborns, and have a great time getting to know the community and their lives.  In addition to the health services provided, we gathered more than 1,600 signatures to request a health center be built in closer proximity to the island communities.  Our days on the island were but a jumpstart to the momentum that needs to be built to motivate the local government to construct and fund a health center.  It will not be an easy process, as the government of Uganda is already underfunded and over stretched, but it can be done.  With the passionate voices and stories of all the amazing individuals we came to know in our short time on the islands, and in the Uganda in general, I have high hopes of a future for Uganda that includes the voices of such populations in determining healthcare choices and access.

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