The AIDS Support Organisation of Uganda - Essay Example

? Case Study: the AIDS Support Organisation (TASO) of Uganda Table of Contents Introduction 3 Government efforts in the fight against HIV/AIDS 4 TASOinvolvement in HIV/AIDS management 6 Achievements of TASO in Uganda 7 Challenges facing TASO in Uganda 9 Remedies of TASO in Curbing HIV/AIDS in Uganda 10 Conclusion 12 Bibliography: 13 Introduction After many years of civil war, that left and estimated 300, 000 people dead, President Yoweri Museveni took over power and tried to realign the government in the effort to reduce the violence. During his tenure, president Museveni decentralized political, administrative, and fiscal responsibilities to the district level. This aimed at improving service delivery; broaden democratic space, and general rural development in the country. At this time, the life expectancy at birth was at about 46.5 years, in the 1990s (Barnett and Blaikie 1992). However, in 2006, the expectancy had risen to 48 years for males and 51 years for female. It was estimated that, the leading cause of death of all ages was HIV/AIDS accounting for 9.4% and malaria following accounting for 4.1%. In his bid, to realize these objectives, Museveni and his government established a good relationship with the donor community. The international monetary fund (IMF), World Bank, and other donor governments were in support of the Ugandan effort to reduce poverty (United Nations 2004). Museveni’s government managed to put an end to institutionalized human rights abuses and liberalized the economy to higher standards that there were in the previous regimes. In fact, upon independence the Ugandan government witnessed infrastructure decay with healthcare delivery largely dependent on humanitarian aid. After taking over power, President Museveni strategically decentralized health system with much of health care leadership being given to provincial authorities (Barnett and Blaikie 1992). The new strategic health plan included village health provision. In addition, provision of health services was a joint responsibility between government, private non-profit organisations, and private profit organizations (Engelberg 2001). Government efforts in the fight against HIV/AIDS Alongside these achievements by the Museveni’s government, some improvements have been witnessed in terms of the fight against AIDS (Hope 1999). The first incidences of AIDS death were reported in 1982. It is noted that HIV spread quickly along major highways with Ugandan armed forces and rebel groups facilitating its transmission (Ntozi et al 1997). In 1986, President Museveni introduced a proactive prevention campaign that emphasized AIDS was a patriotic duty that required openness, and strong leadership at all levels. The formation of national control program for AIDS (NCPA) included representatives from nongovernmental organizations, academics, and faith based organizations. Its mission was to create HIV/AIDS control plan that included policy guidelines, campaign for safe sexual behavior, and care and treatment programs (Hope 1999). However, after some time, the NCPA was dissolved and replaced with the national AIDS control program (ACP). In addition, the ministry of health established a national HIV/AIDS surveillance system. Nevertheless, the HIV prevalence rose in early 1990s, with as high as 25% rates being witnessed in urban areas (United Nations 2004). In 1992, national prevalence was estimated to be 18.3%. In 2003, a total of 530,000 people were infected with HIV/AIDS. A total of 78,000 had died from AIDS related illnesses. However, the government through the ministry of health instilled measures to improve the situation and by 2005, 90% of people aged 15-49 had heard of AIDS and could identify several ways of preventing HIV transmission. However, during the same year, only 13% of adults had tested for HIV with 70% of the estimate 1 million people infected remained untested. In 2006, the WHO reported that over 1 million Ugandans were living with HIV. Prevalence was reported to be higher in urban areas mostly in young women, commercial sex workers, and in military personnel. It is noted that, in 1991, Uganda was the first country to offer voluntary counseling and testing (VCT) through the AIDS information center. In 1997, in its findings, the government estimated that over 600 non state actors were involved in AIDS related matters mostly on direct service provision (Nkumba University 2002). It is also apparent that, by 2000, Uganda was among the first countries to participate in the provision of antiretroviral therapy (ART) in the sub-Saharan region. In addition, the government added prevention of mother-to-child transmission and care and support services to its national strategy. Distribution of condoms was by then free with classroom curricula on AIDS related issues put in place. In 2005-2006, an estimated USD 222.1 million was spent on AIDS in Uganda. These funds were dedicated towards care and treatment and program management and administration. It is also reported that Uganda was the first country in sub-Saharan, Africa to register a decline in adult national prevalence (Ntozi et al 1997). By the end of 2003, about 10,000 infected Ugandans were receiving ART. Some were receiving treatment for free while others paid out from the pocket. In 2004, the US president’s emergency plan for AIDS relief (PEPFAR) started to fund nonprofit AIDS programs in Uganda. Among the organisations that received the funding was TASO. In 2006, TASO was among those organizations that contributed to the national response (Patterson 2005). At that time, 39% of people with advanced HIV infection were receiving ART, 12% of positive pregnant women were receiving prevention of mother-to-child transmission care and treatment (Boyarinova 2007). TASO involvement in HIV/AIDS management The AIDS Organization (TASO) of Uganda was founded in 1987 as a small group of volunteers to support people living with HIV/AIDS (TASO 2012). In the previous years, HIV/AIDS had been an epidemic in Uganda and other parts of South Saharan Africa. TASO engaged in familiarizing the entire community about the disease and above all, helped the victims to come up with projects to enable them live positively with HIV/AIDS. Its services have since its formation cut across all age brackets and sexes (Bitangaro 2005). In this course, they it has managed to curb the disease by opening various voluntary community services (VCT), which offers counseling in order to reach out to various communities across Uganda. The TASO philosophy entails living positively with HIV/AIDS and dying with dignity. Its mission is to contribute to the process of preventing HIV infection, restoring hope, and improving the quality of life of persons, families, and communities affected by HIV infection and disease (TASO 2012). TASO has been funded by various individuals and donations from other organizations like UNICEF. The following context has been subdivided into sub topics that show the proceedings of TASO in fighting against HIV/AIDS, these include: achievements and strategies they have put across in order to meet their ultimate goals: to deter the spread of HIV/AIDS and the challenges they encounter in the process (Morisky et al 2006). It is apparent that in order for TASO to maintain the competitive advantage in the fight against HIV/AIDS, it is important for the organisation ensure that clients’ issues continue to be prioritized (Barbara 2001). For example, there is a need to focus on emerging trends of ways in which AIDS affect the patients. Achievements of TASO in Uganda By the time Coutinho became the executive director in 2001, TASO had made some improvements to a level of being an official nonprofit organisation (Bitangaro 2005). By then, the organization had 25,000 HIV positive beneficiaries and 300 staff. As part of its development strategies, in 2004, TASO started offering antiretroviral therapy (ART), emphasized on home-based care, adherence monitoring, and individual-tailored social support. It is noted that, by the end of 2006, 94% of the clients that had enrolled in ART were on constant treatment (Wilbur 2008). By then, the staff members had increased to 1000 and the annual budget had risen to over USD 25 million. By 2003, TASO had become the largest NGO care and support organization in Africa (Bitangaro 2005). At that time, 90% of its clients were from rural areas, 90% lived below the poverty line, and about 64% were women. Some of the TASO activities included counseling services that helped their clients to assess their risks of transmission. The main areas addressed through counseling were intercourse, mother-to-child transmission, blood transfusion, and sharing needles. In addition, there was a course to discuss and reinforce safe sexual behaviors like use of condoms, abstinence, and monogamy (Ntozi et al 1997). In subsequent years, the organization gradually started decentralizing its services to several areas outside Kampala. This aimed at improving its performance and cost effectiveness of each center. This was enabled by continued formulation of policies from head office, which fostered guidance, monitoring activities, standards, and coordinated fund raising (Morisky et al 2006). Regional offices aimed at increasing service delivery in areas where TASO had not started its operations. In addition, TASO offered support to community based organizations through capacity building and training. As time went by, TASO joined forces with the world food program (WFP) in its bid to offer nutritional support for some of its clients. In addition, after joining TASO in 2001, Coutinho introduced the idea of incorporating ART into TASO service package (Boyarinova 2007). However, this did not come without challenges. On the international scene, there were arguments that, making ART accessible to developing countries would only intensify the HIV epidemic. Assistance ranging from personal, community, family and international levels has been realized hence reducing the rate of infection in Uganda (Essex et al 2004). TASO has managed to give personal assistance to Ugandan citizens through establishing a one-one method of counseling to ensure that people living with HIV/AIDS are empowered to make adequate decisions that can better their health positively (TASO 2012). This also ensures that such decisions facilitate the idea that AIDS victims are informed of their rights and responsibilities too. Furthermore, it has provided the early diagnosis and treatment for opportunistic diseases hence providing an opportunity for infected patients to live and die in dignity. The organization has also ensured that families undergo counseling in order to prevent traumatization of family members and to reduce fears of being infected by the disease. Such programs ensure that family members are readily prepared psychologically during the bereavement period and afterwards (Harris and Cochrane 2009). TASO has also provided affected families with a home nursing care together with the nutritional materials as well as educating them on the need to have a balanced diet. This program alone has attracted a large number of people living positively to come out freely for such services. Similarly, it has also played a role in advocating for better access of treatment facilities for the AIDS patients, as well as championing for training appropriate personnel who can offer better service delivery. TASO has also offered education to both clients and their attendant’s too. Its education entails changing the eating habits. That is, to teach their clients to embrace the use of locally available foods rich in all nutrients in order to boost their immunity levels (Boyarinova 2007). The organization has also involved itself in community development services. This is after realizing that the clinic based services are inadequate to meet the client’s needs. TASO came up with a strategy that involves working with the selected sites which are basically within 35kms reach of TASO centers. By doing this, it made sure that its clients become a connection between the TASO and the community. Even though, most of such volunteers have not achieved a high level of education, for instance, high school education, most of them are committed to better the lives of people living with HIV/AIDS in their communities. Challenges facing TASO in Uganda Since the establishment of TASO, a lot of challenges have come its way. For instance, despite the organization coming out so clearly to ensure its clients benefit from the social support program, its commitment to promote guidance and counseling to the victims of HIV/AIDS, the program has had some major setbacks since most of its new clients have failed to disclose their health status for fear of discrimination and any violent related cases (Harris and Cochrane 2009). It is unfortunate that most of the patients are not only desperate for food, but they are also in dire need of other basic necessities. It is from this reason that, some of them would rather trade their homes for such needs. For instance one is forced to migrate from one village to another in their sickly status just to get a double share of the necessities (Essex et al 2004). Despite the efforts of TASO to empower its clients economically, it has lacked funds to monitor such projects hence leaving the clients miserable in their businesses and farms too. In the education sector, the organization lacks adequate funds that enable the child support program to run smoothly. For instance, the TASO Rukunjuri program is faced with the challenge of the increasing number of orphans. In this regard, assessing a child’s progress academically becomes a problem (Harris and Cochrane 2009). Remedies of TASO in Curbing HIV/AIDS in Uganda TASO is keen on seeking funding from other organizations to ensure a clear and smooth running of its day to day operations. In the education sector, it has joined hands with Barclays bank, and through this partnership, a total of 192 students have been generously and fully supported (TASO 2012). Moreover, their counselors have encouraged their parents to support their children. This is by encouraging them to put effort and start income generating enterprises. It has also ensured that women are empowered with life skills especially for young girls while it also ensures that economic independence for women is ensured too. In addition, TASO has encouraged the formation of farmers based groups. Their clients are given elementary training for an improved way and methods of farming for a higher output. To make this possible, TASO, through its networks with Agricultural officials has joined hand to take charge in monitoring such programs (TASO 2012). TASO has also continuously played a role in support for the rights of people living with HIV/AIDS, especially now that they solidly have a representative in the legislature, who coincidentally happens to be the chairman of the TASO. With this in mind, their representative has always kept the legislature on toes to ensure that the laws passed do not oppress the people living with HIV/AIDS in Uganda. Although most of the patients in Uganda have not accessed the drugs, for instance, in TASO Rukungiri branch, whereby the program is yet to be embraced, more efforts are being put in order to avail the drugs to every patient (Harris and Cochrane 2009). The organization has already started distributing the drugs to its clientele base; such progress has created a positive move in those living with HIV/AIDS because the organization has enlightened them on the importance of using drugs. In doing this, TASO has enabled the patients to carry a normal life just like other individuals of the society (Engelberg 2001). TASO plays a forefront role in awareness programs educating people on the brutal consequences of HIV/AIDS. It has kept the campaign alive by enlightening people on the importance of abstinence, use of condoms, and monogamy (Morisky et al 2006). TASO also engages in educating the society to shun away from the act of stigmatizing of those living with the disease. AIDS is a national disaster and its takes the effort of all everyone to fight. With such deliberations, it is apparent that TASO has to continue improving its leadership style by a way of adjusting its operations in all its locations. Leadership is a critical aspect in any organization. Therefore, TASO leaders must employ the required leadership style in order to have the organization learn smoothly. This can be done by appraising employees’ wellness and leading from front. When employees’ wellness is well articulated upon, they tend to be motivated thus improving service provision to the organization clients. The organization should also use evaluative measures in order to come up with ideas of how it can overcome new environmental challenges. This is arguably important because, according to Barbara 2001, environmental factors fall under the external factors that undermines or affect the operation of any organization. Equally, it is also evident that many nongovernmental organizations face a challenge of control of their operations by the government. In this regard, it is vital that TASO prioritize on service provision and keep off from external politics that can affect its operations. Since culture is a critical phenomenon in organization’s operations, there is a need for TASO to have a clear understanding of diverse culture especially in all its branches. It should recruit and train employees with clear understanding of how to handle different people from different cultures. With all these in mind, it is likely that TASO will continue to thrive in its treatment model. Conclusion After AIDS was witnessed in Uganda, President Museveni introduced a proactive prevention campaign that emphasized AIDS was a patriotic duty that required openness, and strong leadership at all levels. In 2003, a total of 530,000 people were infected with HIV/AIDS. Among the leading organizations that have been fighting AIDS in Uganda is TASO. TASO have engaged in familiarizing the entire community about the disease and above all, helped the victims to come up with projects to enable them live positively with HIV/AIDS. As part of its development strategies, in 2004, TASO started offering antiretroviral therapy (ART), emphasized on home-based care, adherence monitoring, and individual-tailored social support. As time went by, TASO joined forces with world food program (WFP) in its bid to offer nutritional support for some of its clients. However, TASO has faced several challenges. For example, despite the efforts of TASO to empower its clients economically, it has lacked funds to monitor such projects. In the education sector, the organization lacks adequate funds that enable the child support program to run smoothly. Bibliography: Barbara, S., 2001. Organisational change. Harlow: Financial Times Prentice Hall. Barnett, T and Blaikie, P., 1992. AIDS in Africa: its present and future impact. New York: Guilford Press. Bitangaro, B., 2005. The role of gender relations in decision-making for access to antiretroviral. A study of the aids support organisation (TASO) clients, Kampala district, Uganda. Accessed on 23rd Nov 2012 from: http://etd.uwc.ac.za/usrfiles/modules/etd/docs/etd_init_8918_1174285061.pdf Boyarinova, G., 2007. 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