After a morning at the Foundation for Human Rights Initiative and a lunch of typical Ugandan fare at MUBS, we boarded Big Blue for TASO, The Aids Support Organization. The non-government organization was founded in 1987 by Christopher and Noerine Kaleeba with a mission to restore hope and improve the quality of life for those infected with HIV while also preventing further infections. From 16 founding members 23 years ago who met to support one another through fighting the disease and its stigma, TASO has blossomed into an organization with 11 centers like the one we visited today at Mulago.
The Drake and MUBS students came to visit on a ‘clinic day’ when about 200-250 clients come for care from either the counseling or the medical wings of TASO Mulago. In the medical wing, doctors primarily address administration of antiretroviral therapy (ART) and treatment of opportunistic infections like Kaposi’s sarcoma, tuberculosis, staph infections, thrush, and many other infections that a strong immune system can typically fight off. When an individual has HIV, however, the virus targets CD4+ T cells that are the central immune system activators; without them, patients cannot mount a proper immune response. Antiretroviral drugs are scarce in Uganda, as they are all over sub-Saharan Africa, so TASO follows WHO standards only administering ARVs when the CD4+ T cell count has dropped below 200µg/dL (350µg/dL for pregnant women) or the client has already fallen victim to opportunistic infections. All therapies are free for the clients. In the counseling wing, staff members work to encourage positive living, disease-state monitoring, goal-setting, and guidance. They also provide basic counseling for prevention, children, couples, families, loss, crisis, and support. Research for data, evidence, and donor accountability is also based out of the counseling department of TASO.
As we filed into the main building, there were many people waiting for their number to be called to receive services. We were informed that the organization serves 36,000 clients at Mulago. Six to eight percent of these are children aged 17 and younger. Of their client base, about 68% is female, and 32% is male. The presenter explained to the seminar’s students that the disproportionate nature of the service based on gender resulted from stigma; women have less of a choice about ‘coming out’ and are not as highly affected by the AIDS stigma as men.
After a brief informational presentation, students enjoyed a performance by TASO’s drama group, which was initially formed in 1992 and has turned into a center-wide project with professional training. Before singing their opening songs, Light and Hope and Trumpet Call, a spokesperson from the group explained their mission to spread the word about positive living, awareness, and eliminating stigma. He stressed that it’s important to realize that even if you’re HIV positive, you can do something positive. Smiling and full of energy, the groups sang their first two pieces in beautiful harmony demonstrating their talents and dedication to spreading the message to fight AIDS. It was very interesting to listen to how the singers included lyrics that encouraged actions to promote HIV awareness and detection, such as talking to a spouse and getting blood work done.
Gertrude, a member of the drama team, was then introduced to tell her story. She explained in candid and heartfelt detail how she had contracted HIV from a man who falsely promised to pay for her school and then proceeded to take advantage of her sexually. Her story was inspiring, though, as she explained how TASO helped her to rebound from losing her job because of stigma, reclaim her life with positive living, marry, and even have a healthy child of her own.
After Gertrude’s testimonial, the drama team performed several more musical numbers. One addressed AIDS stigma with solos from various members highlighting their traumatic experiences with stigmatization. One member sang about losing his friends, and another woman related in her native language her story about being kicked out of the home that she and her deceased husband had built. Another piece emphasized the power that comes with knowledge because even if you are HIV positive there’s still life to live and everybody will die at some time. The closing song had everybody clapping, and finally standing together, perhaps symbolizing us all standing against AIDS. After the music finished, the group members each introduced themselves and stated the year they were diagnosed. Some were diagnosed and joined TASO as early as 1990, 14 years before antiretroviral drugs (ARVs) were introduced to Africa. One man diagnosed in 1995 was even able to boast a CD4+ Tcell count of 1,119µg/dL without ARVs, showing the effectiveness of TASO’s ‘positive living” method which encourages eating healthy foods, taking medications, no smoking/drinking/drug use, mild exercise, acceptance, socialization, not blaming others, not feeling guilty, avoiding depression, and basically leading a normal, healthy life.
After the group closed their performance, students were allowed to ask questions and browse the jewelry and crafts that were made my clients of TASO and for sale to benefit the organization. The afternoon’s performance and messages, hopefully inspired students to consider the possibility of TASO’s vision coming true, the possibility of a world without AIDS.
Perhaps as you consider whether or not TASO’s vision is realistic, you can consider other questions regarding their organization and HIV/AIDS in Africa. How were you touched by the music of the drama group? Did Gertrude’s story inspire you? Were you surprised by the appearance of those with HIV/AIDS? Do you think stereotyping and stigmatizing is an issue in the United States because of our expectation of what they would look and act like? What do you recognize at the biggest challenge to fighting AIDS in Uganda? Do you think stigma is still a major factor affecting an HIV-positive individual in Uganda? If so, what did you recognize TASO doing to combat stigma? If not, what do you recognize as factors that are helping to reduce stigmatization?