Camp closures worry HIV-positive IDPs

The imminent closure of internally displaced persons (IDP) camps in northern Uganda is causing concern among HIV-positive residents, who fear they may not have access to vital health services when they return to their villages.

The decommissioning of the IDP camps started in the region on 1 October, with six closed in Gulu district. The camps have accommodated more than one million people for the duration of the 20-year war between the government and the rebels of the Lord's Resistance Army; peace talks between the warring parties and more than two years of sustained security in the region prompted the decision to close the camps.

"I don't know what is going to happen to some of us on ARVs; we are not being told where to access these drugs from our villages," said Joseph Ochieng*, who lived in Bobi camp, in Gulu district, until its recent closure.

No services at home

"There are no health or distribution centres for these drugs in the return villages," said Jane Atimango*, another former IDP. "We have no option but to travel long distances to look for these drugs."

Organizations working in HIV have also expressed concern that monitoring their clients may become more difficult as they disperse to places lacking easy access to health centres.

"In camps the facilities were in abundance, but now we need transport for proper monitoring as people are scattered in the villages," said Louis Okello, a representative of people living with HIV in Patiko sub-county, Gulu district.

Prevention services are needed as well. Recent research by the AIDS, Security and Conflict Research Hub shows that the transition from war to peace can increase risks of HIV transmission as refugees go home, soldiers leave the army, relief agencies wind down, and rapid economic growth occurs around key urban centres.

According to the Ministry of Health, HIV prevalence in Uganda's northern-central region is just over 8 percent, higher than the national average of 6.4 percent.

Government officials say there are plans to roll out health services to the community by building new health centres and improving the capacity of existing ones.

"There are already health centres in the return areas, although they are not sufficient," Kabakumba Masiko, the Minister of Information and National Guidance, told IRIN/PlusNews. "The government is committed to the rehabilitation and development of the region."

More on IDPs in northern Uganda:

Going home a mixed blessing

Post-conflict HIV programmes needed in the north

Christine Akello: I pray that a health centre is brought nearer our village

Forced to Flee

"At the moment the services are only available at health centres … in county headquarters," said Stephen Oloya, chairman of Gulu District's camp phase-out committee.

"For VCT services [voluntary counselling and testing], we are expanding them to sub-county level as we have tried to operationalize all the health centres at sub-county level," he added. "We are also planning to open health centres at parish level."

Community distribution

One local NGO, however, has already put in place measures to ensure people in its care continue their treatment uninterrupted; the AIDS Support Organization has opened community drug distribution points in various villages where patients can collect their drugs as well as seek psycho-social support and medical care.

"We have the capacity to map and follow the clients to the places they will go; to make our work easy, we encourage them to give us maps to their places," said Sam Emukok, a TASO public relations officer. "TASO will continue delivering services to the registered clients regardless of where they will go after camp decongestion."

Emukok said most HIV-positive IDPs would be happy to return to their homes, where they could cultivate their own food and eat a more balanced and varied diet than in the camps.

"People who are living with HIV and are under our care know the importance of camp closure given the challenges they have faced in the camps; they can now engage in agriculture to get food to supplement their diets," he added. "We give this information during health education in the clinics, outreaches and during radio talk shows."

More than two-thirds of the IDPs in the region have already left the camps - some returning to their original villages and others to satellite camps between the IDP camps and their villages.

so/kr/mw

* not their real names