view this video

i urge you and Joshua and the KACHEP staff and BOT to view this video - excellent. I would think it wise for your team to look into this -we shall share more when i visit.

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Livelihood Dynamics in Northern Karamoja

A Participatory Baseline Study for the Growth Health and Governance Program

By John Burns, Gezu Bekele, and Darlington Akabwai
August 2013
This report documents the findings of a livelihoods assessment carried out as part of the USAID funded Growth, Health and Governance program being implemented by Mercy Corps and partners in the Karamoja sub-region of Northeastern Uganda. The assessment is one component of a broader research and learning agenda involving a set of livelihoods, impact and gender studies. The research is being led by the Feinstein International Center with the overall objective of informing the design and implementation of program interventions and assessing impact.
The study was conducted during the first quarter of 2013 in seven markets and thirty-one villages in Abim, Kaabong and Kotido districts. Focus groups were carried out in all villages using semi-structured interviews complemented by participatory exercises including community mapping, timelines and ranking and scoring exercises. The study also included a number of visits to market centers as well as key informant interviews.
The study set out to identify the major opportunities and constraints to production and marketing in the study area and to investigate what productive resources are currently available and how these are being utilized. The assessment also set out to investigate recent events and longer-term trends with the objective of understanding how these might have an impact on production and livelihoods. The study also looked at the current utilization of different products and services from the perspective of program participants. This was done to assess the availability, accessibility and quality of existing services both to inform programming and to establish a service delivery baseline against which to measure impact against. The study also set out to investigate perceptions of poverty and inequality and to quantify the proportion of study participants belonging to different wealth categories. This was primarily done to enable changes in relative wealth to be captured as a proxy for project impact during future assessments.

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Uganda Food Security Alert - September 4, 2013

A second consecutive year of poor crop production expected in parts of Karamoja
For the second consecutive year, poor rainfall distribution and prolonged dry spells early in the production cycle have resulted in planting delays and crop damage throughout the Karamoja region. FEWS NET anticipates that the 2013 main harvest could be 30-50 percent lower than average, providing only temporary relief in areas where food security is already Stressed (IPC Phase 2). The combined impact of poor production, below average incomes, prolonged market dependence, and depleted assets is likely to result in Crisis (IPC Phase 3) by February in northern and central Karamoja.
The 2012-2013 consumption year in Karamoja began with below-average harvests in August/September 2012. As a result, poor households had significantly less food stocks and less seasonal income than normal from on-farm and casual labor than normal, leading to an early start to the lean season (Jan/Feb instead of Mar/Apr). Poor households are currently in the eighth month of what is typically a five month lean period. Despite ongoing food aid distributions, households have been heavily market dependant for 6 months, straining already low purchasing power despite lower than usual staple food prices. Due to the combined effects of a below-average main harvest in 2012, a delayed green harvest in 2013, poor purchasing power from low seasonal on-farm wages, and depletion of livestock assets over the last year, Stress (IPC Phase 2) is currently prevalent throughout the region.
Heavy, erratic rains at the start of the 2013/2014 agricultural season (March/April) waterlogged newly planted seedlings across the region. These heavy rains were then followed by a 30-45 day dry spell in May-July (Figure 1) which stunted the development of surviving crops (sorghum, maize, beans), particularly in Kotido, Kaabong, Napak, and Moroto Districts. Replanting took place in July and August, but was limited by a lack of confidence among household producers regarding rainfall during the remainder of the season. Currently, the status of planted crops areas is highly variable, with southern Karamoja expecting a near-average harvest, while in the remaining districts, production depends on better-than-average performance of the rainy season through October. Rainfall has been sufficient to allow for normal pasture regeneration.
In the most likely scenario, forecasts suggest that Karamoja will receive average rainfall through October. This will be insufficient for full crop development, particularly in the four districts listed above, given the poor start of season and below average replanting rates. Main and green harvests will be below average and up to two months late (October instead of August), providing only short-term relief to poor households. Poor households who own livestock have already sold animals to increase purchasing power, but these strategies are limited due to small herd sizes and constrained market access. Although food security will improve slightly in the post-harvest period, most poor households are likely to remain Stressed (IPC Phase 2) through December. A small proportion (<20 3="" crisis="" during="" households="" may="" of="" p="" period.="" phase="" reach="" this=""> In January/February 2014 the lean season is expected to begin early for the second consecutive year as households revert to early market dependence and food security outcomes deteriorate. Crisis (IPC 3) is expected to be more widespread, and humanitarian assistance needs are likely to increase to nearly half a million people by February 2014. Well-targeted and well-timed food and livelihoods assistance should be considered to mitigate the impact of two consecutive years of poor seasonal performance and below average staple food production on poor households.

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Karamoja Integrated Disarmament and Development Programme

KIDDP (Karamoja Integrated Disarmament and Development Programme) is a medium term development framework specifically tailored to address the unique context and development challenges in Karamoja region. The overall goal of the KIDDP is "to contribute to human security and promote conditions for recovery and development in Karamoja". KIDDP takes cognizance of the National Development Plan and the Peace, Recovery and Development Programme (PRDP).

The KIDDP harmonizes the various development interventions by Government, bilateral and multilateral development partners, international and national NGOs and CBOs. It therefore represents an attempt by the Government of Uganda to integrate gun collection (Disarmament) with development interventions; conflict management and peace building. Hence, using development to achieve peace.  

Programme Goal:
Contribute to human security and promote conditions for recovery and development in Karamoja, by deliberately working towards sustainable peace, stability and development.  

Programme Purpose:
Develop and implement a comprehensive, coordinated and sustainable disarmament programme that enhances peace building and development in Karamoja.  

The genesis of the KIDDP:
The government of Uganda undertook a disarmament exercise in 2001-2002 in order to address the problems of illegal arms in Karamoja. However, the programme was suspended due to operational problems. In September 2004, H.E the President relaunched the disarmament exercise and a large number of guns were recovered. After the initial successes, the need for a sustainable programme became a major concern both for government and other stake holders that led to the design of the KIDDP in 2005.

Legal and policy framework:
The KIDDP has been developed in accordance with the objectives of PEAP pillar 3. i.e. Security, conflict resolution and disaster management. The programme also builds on the proposals contained in the National Strategic Plan for Karamoja, discussion paper No.8 on Post Conflict Reconstruction by MpFPED. The KIDDP elaborates the Karamoja component in the PRDP and was formally approved by Cabinet and Parliament in October 2007.

Design of KIDDP:
The first draft of the KIDDP was commissioned for review by OPM in June 2005 in which conceptual linkages between small arms, human security and development were highlighted. Between 2005 and 2007, OPM conducted a series of consultative and review workshops and meetings to generate consensus among different stakeholders. The main collaborating partners that contributed to the final KIDDP document were Ministry of Defense, Sector Ministries (Works, Water, Education, Health, Gender, Environment), Karamoja Donor Technical Group, Karamoja Parliamentary Group, District Local Governments, CSOs and Karamoja communities etc.

Implementation of KIDDP:
Following the launch of KIDDP by the Rt Hon. Prime Minister in April 2008, OPM in collaboration with Line Ministries and Development Partners mobilized a substantive amount of resources to support the implementation of the below-mentioned programme components. 

Programme Components:

1. Provide and Ensure Adequate Security for the People of Karamoja
2. Establish Law and Order in Karamoja
3. Support the Provision and Delivery of Basic Social Services to the People of Karamoja
4. Support the Development of Alternative Means of Livelihood for the People of Karamoja
5. Undertake Stakeholder Mobilisation, Sensitisation and Education in Karamoja
6. Enhance the Coordination, Monitoring and Evaluation of KIDDP Interventions
7. Crosscutting Issues

When students miss classes to find water

Children line up to fetch water in Kisoro District recently. Most districts in western Uganda are facing a water crisis as a result of the prolonged drought. PHOTO BY ROBERT MUHEREZA

Mbarara

For many schools in rural areas, getting clean water can be a hustle. For the lucky few, the only source of water is a dam or a well. During the dry season, the situation becomes harder as some of the water sources get dry.

At Bright Ideas Primary School in Kiruhura Town Council, Kiruhura District, students and pupils have to juggle school activities and fetching water after an acute water shortage hit the district following a dry spell that has gone on for about two months.

Classes start late while time for games has been scrapped because pupils and teachers have to fetch water from sources, far away from the school.

“The nearby dam has dried up. Together with the pupils, we fetch water from wherever we can get it,” says Mr Bright Sheith Besigye, the school proprietor. “The games time is not fun anymore because pupils use that time to find water,” he adds.

The school which has 240 pupils, uses about 250,000 litres of water every term. The main source of water for the school is a dam which is currently dry due to insufficient rains.
Although Kiruhura Town Council authorities plan to bring tap water, the project has not progressed since December last year when it was unveiled.

This is the situation faced by residents of most districts in western Uganda during the dry spell that starts around May and runs up to August every year. July is the peak of this period.

From rural communities in Ibanda, Kisoro and Kiruhura districts to urban dwellers in Mbarara District , water is very scarce. Some children nolonger attend school regularly as they have to keep at home to help their parents in searching for water a distance far away, probably three kilometres or more at the only valley dam that still has water and serving the entire sub-county or even beyond.

For communities and homes that rely on National Water and Sewerage Corporation (NWSC), supply is intermittent during this time because water levels in rivers reduce like is currently the case with River Rwizi, the company’s source of water.

Mr David Opoka, the NWSC Mbarara area manager, says the company fails to meet the overwhelming demand for water during the dry spell.

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46 dead as hunger pounds Karamoja, Teso

Heard from Mukisa that 46 people have died from starvation.

A group of elderly people and children in Moroto District wait for relief food that was distributed by the government on Saturday. PHOTO By Steven Ariong 

As the rains began showering Karamoja and Teso sub-regions, it was welcomed as a blessing, since crops were going to grow. But as the rains continued, the joy was turned into uneasiness as the heavy downpour started flooding gardens, washing away crops and roads. What that later meant was that there would not be any crops to harvest this season. That was in the first quarter of this year.

Today, the thousands of residents in Karamoja are going for days without food, while others are on the brink of death as a result of starvation. The severe hunger has so far killed 46 people in Karamoja in the last two months, according to local authorities. The worst hit district is Kaabong, where 20 people have been confirmed dead due to starvation. The other affected districts are Napak and Moroto.

The severe food shortage has forced more than 5,000 Karimojongs to flee the country into neighbouring Kenya, where the government is supplying food to its citizens. The government, through the Disaster Preparedness ministry, at the weekend launched an emergency food distribution initiative with the aim to rescue hundreds of starving families in the seven districts of Karamoja.

read more here 

Public urged to play more role in fighting corruption

Public urged to play more role in fighting corruption

Bank of Uganda Issues Sh1, 000 Coins

Better than the filthy 1000 shs notes......

Bank of Uganda Issues Sh1, 000 Coins

Veterinary Symposium in Kampala

17-23rd September Oliotya!

 Heya, from Kampala, Uganda at Mackerere University, where I have spent this last week, listening to lectures, meeting other veterinary students and doing surgery practicals in the afternoons. The program has been run by the Ugandan Christian Veterinary Mission and has been fantastic fun; learning, laughing and loving each other (as my new US friends say). Five Americans flew over for the time (some are staying a bit longer as well) on a mission trip, they're mostly small animal veterinary surgeons who have been doing the lectures & surgeries (they brought all the vet materials we're using over with them!).

The week has also been a great opportunity to hear of the faith of the students and to fellowship with them. The lectures have been on many different topics, ranging from 'client communication' to complex surgeries to common skin diseases. In most of the lectures we've looked at the theoretical side of certain surgeries; cystotomy, gastrotomy, enterotomy, intestinal anastamoses, speys, neuters, opthamological surgeries, even fluid therapy for post operation, etc.

The students seemed really excited that I was a student too (as all the other mzungus we're real docs haha) and very interested to hear what vet work in Karamoja is like! Many of the students still hold to their culture of segregation of the Karamajong even subconsciously looking down on them as lesser than they are, which comes out when I speak to them about my work. Back home we have such a culture of being politically correct and even if you secretly think badly of someone you would never show it or say it. Of course, ignorance in what the K'jong are really like (these students and most of the Ugandans living outside of Karamoja have never been or met a traditional K'jong, they just know what they've been told of them) will always breed distance and even disdain or fear. That seems to be a fact of culture clashes throughout history and throughout the world today, even a funny example of this is the way the Karamajong harshly judge a woman for wearing pants. To the women down here at the bottom of Uganda in Kampala, wearing pants is a sign of an educated woman. To the Karamajong, wearing pants is saying that you are basically a prostitute (no joke, from their mouths not mine), showing the shape of your legs is very provocative. A simple thing like that means two very different things to two different people of the same country.

read more here

Ebola Outbreak Prompts Ugandans to Stop Kissing ABC News - 30 Jul 2012

The president of Uganda is calling on people in the East African country to avoid physical contact, including handshaking and kissing, to prevent the spread of the deadly and highly contagious Ebola virus that is believed to have killed 14 people in the last few weeks.

The disease has no known cure or vaccine and some strains can kill up to 90 percent of victims within days. Ugandans are so fearful of the disease that residents in Kibaale province where the outbreak was reported said that people immediately fled the hospital after hearing patients with Ebola were there.

In a nationally televised speech today, President Yoweri Museveni said health officials are working to contain the disease to the rural district where the outbreak was confirmed Saturday, but at least one of the suspected victims was taken to a hospital in the capital city of Kampala. Now, nearly two dozen medical workers at Mulago Hospital are being held in isolation.

"We have asked people in the whole country to be careful and aware of those who present with symptoms. We have informed health facilities of the right way to respond," said Dr. Anthony Mbonye at Uganda's Ministry of Health.

[Related: 5 things you should know about Ebola]

Mbonye said no other patients at Mulago Hospital in Kampala are at risk, and he is optimistic the outbreak in the Kibaale district 125 miles west of the capital city can be contained soon.

"I have hope because since Friday we have not had any new suspected cases of Ebola," he said.

However, another health official from the affected district told the Associated Press up to six more patients suspected to have Ebola have been admitted to a hospital there and said people in other villages are reporting possible Ebola infections.

Mbonye said people are frightened because many illnesses that are common in the region, such as malaria, have the same symptoms as Ebola. He said health officials have to balance the need to inform the public while not wanting to cause unnecessary panic. In Kibaale, schools are closed and social gatherings have been cancelled.

Experts from the World Health Organization and the U.S. Centers for Disease Control and Prevention are in Uganda to advise health officials responding to the outbreak.

[Related: Mysterious nodding disease afflicts young Ugandans]

People infected with Ebola usually have flu-like symptoms at first. They can then begin bleeding internally and externally as their vital organs shut down.

Ebola was named for the river near where it was first reported in the Democratic Republic of Congo in 1976. Scientists believe an Ebola outbreak usually begins when a human contracts the disease from an infected animal.

The CDC operates a laboratory in Uganda where a team of scientists is studying Ebola and other deadly viruses in Africa. In the past couple of years, U.S. defense officials expressed concern that terrorists could try to use Ebola as a biological weapon. The threat posed by Ebola and other little understood viral diseases has been dramatized by best-selling books such as "The Hot Point" and Hollywood movies like "Outbreak" and "Contagion."

This is the third outbreak of Ebola in Uganda since 2000 when 224 people were killed. At least 42 people were killed in another outbreak in 2007, and there was a single confirmed case in 2011.

The Serious side of malaria

But seriously, malaria is nothing to laugh at. When the parasites get into your blood they attack the red blood cells. When the parasites reproduce they explode the red blood cells. This causes many of the symptoms: aching joints, headache, fatigue etc. The overall weakness and fatigue makes the desire to go and get treatment be replaced by the desire to sleep and rest. This gives malaria the opportunity to get the upper hand on the system. The fever comes as the body battles against the increase in parasites. So you get this cycle of fever spikes which get closer together as more and more parasites breed and the body gets too weak to fight.

Malaria takes it greatest toll on kids. They are fine, running around and playing and then in a matter of a couple of hours they are on death’s door. They lie down to nap or go to sleep at night and then they are too sick to get up. If you live in the village where there is no transport how do you get a sick 2-5 year old someplace for treatment. Most villagers can’t afford the frontline medicines that I get to take. So they give their child chloroquine or fansidar which are now less then 20% and 40 % effective. And the child worsens until it has to go to a hospital or clinic for intravenous treatment with quinine.

It is malaria’s ability to resist drugs that makes this disease the number one killer in Sub-Saharan Africa. Parents can’t afford the proper medicine let alone a blood test to confirm that it is malaria so at any sign of fever the malaria medicine that is cheapest or most easily available is given, usually in less than full dosage and that builds the drug resistance in the parasites. The government here tries it’s best to keep effective medicines in stock but it takes so much of its funding that it can’t possibly keep up.

Malaria also mimics many others diseases and often gets ignored as a cold or flu until it gets too advanced to treat and cure easily. That is why many doctors take the position treat for malaria first then, if there is no response, treat for another disease. This also leads to drug resistant strains of malaria.

It is estimated that 95% of malaria can be prevented by sleeping under a mosquito net. But getting nets out to the rural people is not easy. When the government can give away nets many sell the nets to get income for other needs.

It all needs God’s intervention. He is where our hope lies. He is the healer and divine planner. Pray for the kids of Africa. Pray that God’s mighty hand of protection will cause malaria to end. Pray for medicines that are effective and cheap. Pray for a vaccine. Pray for good officials to distribute what God provides. Our hope is in Jesus. He is the answer to all our prayers.

From here

Amias Project

For centuries, the nomadic Barabaig tribe of East Africa has roamed the plains and savannas, adorning themselves with beautiful rings, bracelets, and jewelry. Through the Amias Project, the Barabaig now want to send their beautiful things and their stories around the world.

On one return to Tanzania, Nichole Smaglick, founder of Amias and Another Land, was reunited with a wise, old Barabaig woman named Udada. She gave Nichole a bracelet and told her, "When you go home, use this to tell others about me." With that, the idea of Amias was born.

Since then, the project has mobilized over 200 Barabaig men and women in central Tanzania to design and craft jewelry and handbags inspired by traditional fashions. The project aims to uplift and empower traditional culture. It also helps generate significant income and educational opportunities for disadvantaged communities.

Amias and its fair trade mission have allowed families to find stability in a region wracked by hardship and frequent drought. More parents now send their children to school, and they have enough food in times of need. They are increasing their livestock and making plans for the future.

Amias, in the ancient language of the Barabaig, means "beautiful." So when wearing Amias jewelry or handbags, always remember that you are wearing hope, the story of the Barabaig, and something beautiful.

More here 

Birthday

Happy Birthday Naomi

The Truck-Team and Tom and Jean wish you a nice Birthday!!!!
Sorry we all are not around but we are thinking of you

Karamoja's Enduring Battle to Educate

Achieving Millennium Development Goal on Education (MDG2) for Karamoja remains a wild dream, less than three years to 2015.
MDG2 states: “Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling”.
For Karamoja, if MDG objective two was: “to ensure that by 2015, parents everywhere will know the importance of education”, it would have good chances of being achieved by 2015.
With a static illiteracy rate of 88-90%, Karamoja’s 2015 goals are a distant dream.
Not that government and other development partners have not made their attempts, but that the underlying issues are complex wherein trial and error approaches are commonplace.
Karamoja continues to have the most children out of school in Uganda, with the few in school dropping out before completion of primary school.
During the ‘Go Back to School’ campaign in Kotido in January 2012, the Kotido District Education Officer, Ambrose Lutuke disclosed that out of 17,000 pupils who had enrolled in primary school in his district in the beginning of 2011, only 10,000 completed the year, representing an annual dropout rate of 41%.
Efforts towards achieving success in education in Karamoja come face to face with a number of hindrances including poverty, poor infrastructure, nomadism, economic activities that occupy children of school going age and a culture that does not encourage girl-child education.
All these could be issues of the past.
There is a heightened resolve by the Karimojong to take their children to school, amidst all these challenges. Even more, the ‘enlightened’ are encouraging others to do so.
The ‘Go Back to School’ campaign of January/February 2012 was one such campaign where people showed solidarity and came out on the streets to support the campaign supported by development agencies including the United Nations International Children Education Fund (UNICEF). Together with local leaders, they called upon the rest of the population to send their children to school and keep them there until completion.
Participants at this year’s International Women’s Day celebrations at Nakapiripirit District took the chance to campaign for education, showcasing the challenges and the benefits of achievement.
And the struggle to shoot down the high illiteracy rates seems to have become an issue of daily struggle amongst the Karimojong. This is a battle the world has to continue supporting.

 More here

Compensate Ngikarimojong who lost animals in UPDF protected kraals

On the night of January 28th 2010, hundreds of cattle owners and families in Namalu Sub County lost an estimated 5000 herd of cattle to suspected Pokot raiders at a UPDF protected kraal at Kagata, Namalu Sub County. Subsequent attempts to recover the cattle by the UPDF were futile, and less significant in a number of ways.
During disarmament, especially in the phase of the infamous “cordon, search and disarm” operations, government and the UPDF asked communities to bring their cows to one point, that became referred to as ‘protected kraals’.
In Pursuit of justice, the owners of the Kagata kraal cattle are now processing a civil suit against the government, seeking compensation.
There were dozens of protected kraals in Karamoja from March 2006 to the end of 2010. These protected kraals became a harbinger for rapid losses of animals all over Karamoja since raiders within and even across the Ugandan border easily targeted them. The ‘protected kraals’ soon became empty, heralding an apparent reduction of cattle stocks all over Karamoja. 
The initial success of disarmament was premised on a number of factors, one of which was the promise by the government to protect the lives and property of the disarmed. Recorded negligence by government to protect these very herds should be ground for compensation.
While it is a fact that intra and inter clan raiding has existed in Karamoja, the thousands of animals in ‘protected kraals’ without guns in the hands of owners were even more vulnerable.
The government was never going to guarantee the safety of herds in these kraals, and rode on an important programme approved and supported by Parliament, the local population and Civil Society to ensure the cattle were handed over to them in the first place.
There is vivid and compelling evidence that the UPDF neglected security of cattle in protected kraals, the Kagata example provides a number.
Only four UPDF soldiers on the night of the raid were manning the cattle that were evenly spread over an area the size of six football pitches. The armored response to the midnight raid came at five O’clock, in the afternoon of the next day, in good time for the raiders to cross in to Kenya.
During and after the Cordon, Search and disarm phase of the disarmament exercise, there were widespread accusations regarding the inability of the UPDF to follow and recover stolen cattle.
The communities and owners of these cattle have been vigilant during these times, giving information to the military before, during or immediately after raids but generally, attempts to recover these cattle have been unsuccessful, owing to either the lack of capacity or the military willingness to recover these animals.
For years since Ngikarimojong lost animals in the hands of government, they have heard only promises of compensation especially in the buildup to the 2011 General Elections but these are unyielding. Suffering in families has been wanton.
When the owners of the stolen cattle from that January 2010 day appear in court to lodge a civil suit against government, they will be doing something unprecedented in the cattle wars of Karamoja, but like I have talked to some of them, they are ready to give their best shot.
Their firm belief is that the government is responsible for the theft of those cattle, because it promised to take care of them, could have averted the raid or recovered the cattle but didn’t. Somehow, these poor peasants, some of whom septuagenarians who have witnessed their colleagues die waiting for the government to return their cattle have now contributed shillings 1,800 per cow to take care of legal fees.
They believe justice can be served. This is even though they are neither used to the craft of the courts nor have the connections that define Kampala High Court cases.
It is a far cry to government to compensate Ngikarimojong for tens of thousands, if not hundreds of thousands of cattle lost in the hands of the military in the so called ‘protected kraals’! 

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Pioneer Project Description

The Pioneer project aims to reduce both the number of cases of malaria and deaths caused by the disease through support to the Ministry of Health – and the National Malaria Control Programme – at national, district and community levels. Pioneer is being implemented by Malaria Consortium Uganda and funded by Comic Relief UK for four years from 2009 to 2013.

Pioneer operates in five districts in mid-western Uganda: Kiboga, Kyankwanzi, Hoima, Buliisa, and Kibaale.
Through the Pioneer project, 1.2 million people will be protected by malaria prevention measures and have access to life saving information and diagnostic-based treatment.
The project works to support systemic malaria control by increasing both supply and demand for malaria control tools in the region. By simultaneously ensuring the best available tools are accessible to the people who need them the most and increasing their understanding of the importance and effectiveness of these tools, Pioneer empowers families to take positive action for the health of their own households.

Pioneer is working to achieve two major outcomes:

• Ensuring families want to access the best tools: in Uganda, ensuring that families want access to LLINs is a long term process. Radio messages and communication with health workers are an important part of the Pioneer project strategy, but the project focuses on communications at the community level, the key to systemic and long-lasting change. 

• Ensuring families can access the best tools, now and into the future: to ensure sustained access to LLINs and information on malaria prevention, those tools have to be made available at community level and good systems  must be put in place to ensure quality of care and appropriate referral. To achieve this goal requires the cooperation of international donors and suppliers but critical of all is functional health system, especially lower level health facilities, village health teams and outreach services.

How we work
To find out more about how the Pioneer Project is achieving these outcomes and providing life-saving interventions in Western Uganda, click here

Uganda improves in malaria fight

By Francis Kagolo

Uganda has recorded strides in fighting malaria, with prevalence rates and deaths dropping compared to five years ago, according to a senior official in the Ministry of Health.

“Monthly reports indicate that deaths and morbidity rates are no longer comparable to what the situation was three years ago.

The numbers have reduced quite substantially,” Dr. Myers Lugemwa, the team leader for the malaria control programme, told New Vision online on Tuesday.

The news comes as Uganda joins the rest of the world to commemorate the 7th World Malaria Day today under the theme: “Sustain Gains; Save Lives; Invest in Malaria.”

The national function at Dokolo district hospital grounds will be presided over by the health minister, Dr. Christine Ondoa.

Claiming over 320 lives daily, malaria has been number one cause of sickness and death in Uganda for several decades.

The disease consumes 10% of the Ministry of Health budget and 25% of household incomes. Besides, it Is said Uganda loses over sh658m annually to malaria-related costs. 

However, Lugemwa said that although the ministry is to verify all statistics and compile a concrete report in December, raw data shows the problem is reducing.

“We have been to districts like Mubende where malaria-related deaths have gone below 20 from over 100 a month,” he explained.

“Even from laboratory diagnoses, the number of people with fever testing positive to malaria is not as high as it used to be three years ago.”

Increased mosquito nets access key

Lugemwa attributed the achievement to the increased access to insecticide-treated mosquito nets and indoor residual spraying in the north.

He revealed that the ministry had distributed 7.3 million nets in the past one year alone while another million is to be distributed in October this year.

Thus, the percentage of Ugandan households owning at least one mosquito net has risen from 2% in 2000, to 46% in 2010, according to the latest World Health Organization (WHO) global malaria report.

Among the most at risk population, at least 33% of children under the age of five sleep under treated nets, as well as 77% of pregnant women, says the WHO report released last year.

More funding needed

Lugemwa, however, challenged the Government to boost funding for malaria control. He said over 90% of the funds come from donors.

“Although we are making some progress, Uganda is still the third top contributor to the global malaria burden. This calls for more funding to scale up our interventions,” he noted.

In a Tuesday statement, minister Ondoa also commended the free Artemisin-based Combination Therapies (ACTs) provided in public health facilities, saying they had saved the situation.

“Management of fevers at community level has been strengthened with free access to ACTs in all public health facilities and those that are private not for profit,” Ondoa noted.

She said the World Malaria Day would provide a chance for malaria-free countries to learn about the devastating consequences of the disease and for new donors to join a global partnership.

“This day serves as a reminder to all of us that malaria is a major cause of sickness and death.”
More here

Malnutrition in Karamoja

MOTIONLESS, she lay on her mother's lap. She looked severely emaciated. The skin on her body is wrinkled, pale, and peeling off. And when she attempts to cry her voice can hardly be heard.  When she was taken to the therapeutic feeding centre, the 2 year old, Lucy Nasugai weighed only 3.2kg.

Nasugai is one of the over 29,7494 children in Karamoja who have been hit by severe malnutrition; a condition that occurs when the body fails to get the right quantities and proportions of nutrients for it to maintain health and proper function.

Malnutrition according to a briefing note from Food and Nutrition Technical Assistance (FANTA2) kills, causes diseases and makes disease even more severe.

Cyclic drought in the region has aggravated the situation, affecting both crops and livestock, causing food insecurity and severe malnutrition, especially in infants and children younger than five. Indeed, the child survival rate in Karamoja is among the worst in the world, according to UN agencies.

Both local and Health officials in Nakapiripirit,Moroto and Napak paint a grim picture of the severe  malnutrition situation in the three Districts.

An estimated 39 out of 375 children who were being treated for malnutrition in Matany Hospital are known to have died in 2011, while 22 escaped from the feeding centre, according to Ngiro Martin, a health educator for Napak District who is attached to Matany Hospital .

’Our major challenge here is that people look at malnutrition not as a deficiency but as a curse or withcraft,as most people are illiterate and the latrine coverage is low”,Ngiro said.

He pointed out that empty granaries are also a major challenge to the fight against malnutrition in Karamoja.

“The year is just beginning and the situation is already out of hand and yet we expect it to worsen from March upto June “,Ngiro notes.

In Nakapiripirit,the District Health officer,Dr.John Anguzu  said out of 1,397 cases recorded, 448 cases were admitted to various health units in the District.

“In September 2011, we had 301 malnutrition cases, 161 admissions and two deaths. In October we had 339 cases, 113 admissions and four deaths, in November we had 366 cases reported, 115 admissions and one death and in December 2011 we recorded 331 malnutrition cases, 59 admissions and one death. Our non recovery rate is at 16%”, Dr Anguzu said.

He adds that in January alone they recoded 2,004 cases of severe malnutrition.

Timothy Teko,a Nutrition Focal Person in charge of Napak and Moroto pointed out that though malnutrition was high in Karamoja it malnutrition has not yet reached a critical level.

According to the LC1 chairman of Nakapelem settlement, a suburb in Moroto town,Alibino Lobong,two out of 60 severely malnourished children in this village, mainly occupied by poverty stricken Karimojong have died due to malnutrition.

“Most of these children you see here are living at the mercy of God. Their families can hardly afford to prepare a meal in a day; they mostly live on porridge which is always taken at lunch time”, he told the visiting humanitarian services Country Director for The church of Jesus Christ of latter day Saints, Elder Karl Beckle who together with Sister Robin Beckle was in the area to handover nutritional food supplements on Saturday 4th and Sunday 5th.February 2012.

Church of Jesus Christ of the Latter Day Saints has given 100 bags of Atmit; nutritional food supplement for Tokora health Centre in Nakapiripirit, Moroto Regional Referral Hospital in Moroto and Matany Hospital in Napak.Abim,Kotido,Kaabong and Lira are also expected to benefit.

"Crop harvests this year have been affected by the heavy rains; otherwise we would be having some food here," said Moses Chuna , an elder from Napak.

According to the UN Children’s Fund (UNICEF), Karamoja represents a developmental and humanitarian challenge to Uganda 's stability and poverty eradication efforts. "Mortality and malnutrition levels routinely surpass recognized crisis thresholds," a UNICEF briefing note indicates.

John Lorot,the LC5 Chairman for Nakapiripirit District malnutrition has been compounded by last years floods which devastated the area and destroyed food crops which people were about to harvest.

“It’s now a double tragedy for us here, we lost our food crops to floods and also lost our cows to the cattle rustlers who frequent this area because the disarmament exercise has been largely a success here. We appeal to government and humanitarian organizations to rescue us. And also government should degazette the green belts here because all our fertile areas are under the game reserve for wild life conservation”, Lorot said.

Due to its semi-arid nature, villages are far apart and families seeking treatment for their malnourished children have to trek many kilometers to reach hospitals or food distribution points and the therapeutic feeding centres and nutrition services in a few of the region's health facilities.

“Karamoja suffers from one the worst rates of malnutrition in the world. In 2010, 16 per cent of children under the age of five suffered from acute malnutrition, and nearly 40 per cent of children in this age group were underweight” according to FANTA2 briefing notes.

The Mayor Moroto Municipal council, Alex Longona said malnutrition was equally prevalent in the urban area.

“Hon Minister, please consider us also in the urban centre for relief assistance. Some people think we people in town are well off. But as you can see we have many children here who are severely malnourished”, he said.

Over 60 children in Nakapelem settlement in Moroto Municipality are severely malnourished, according to local leaders here.

The Minister of State for Mineral Development,Peter Lokeris who is the MP for Chekwi County in Nakapiripirit District warned that the food situation in the whole of Karamoja may worsen in the coming few months.

”To make it worse even the food stores for UN World Food Programme in Nakapiripirit where we would have relied for some relief assistance are empty”, he said.

Musa Ecweru,the Minister of sate for Disaster Preparedness and Relief who visited Karamoja to assess the situation promised that government was going to feed the people of Karamoja upto to the rainy season.

“As government, we pledge that we shall feed these people until they are able to harvest their own food. We shall also give them planting materials. But as a matter of urgency, we are going to meet all the humanitarian agencies like UN World Food Porgramme,Food and Agricultural Organization and other stake holders to discuss how we are going to make a coordinated intervention in Karamoja”,he said.

According to the briefing note from Food and Nutrition Technical Assistance (FANTA2),  , at household level, the main causes of malnutrition are women having workloads so high that they cannot provide quality child care, poor sanitation, and hygiene, frequent pregnancies, and poverty caused by lack of livelihood alternatives in rural areas.

All these can be true of Karamoja where women are the major bread earners and are as well responsible for child upbringing as men go for hunting and looking after cattle.

From here 

25 April 2012 - UN in Uganda

25 April 2012 - UN in Uganda: Sustaining malaria control efforts in Uganda is an investment in the nation’s development

 

more on 

On Africa Malaria Day, which coincides today with World Malaria Day, the World Health Organization (WHO) and UNICEF call for continued commitment by partners to prevent and control malaria in Uganda, which will save lives and improve the wellbeing of communities.
The theme this year is “Sustain Gains, Save Lives: Invest in Malaria.” Sustaining malaria control efforts is an investment in a country‟s development, and continued effort now will propel us closer to zero deaths from the disease by 2015.
The global response to eliminate malaria has created unprecedented momentum and yielded remarkable returns in the past years. However, these gains are fragile and will be reversed unless the disease continues to be a priority for global, regional and national decision makers and donors.
The 2011 World Malaria Report indicates that out of 216 million malaria cases worldwide in 2010, 81% occurred in Africa. The report also indicates that 91% of the 655,000 malaria deaths globally took place in African countries.
But there is cause for hope. Uganda‟s WHO Country Representative Dr Joaquim Saweka says malaria deaths have been cut by at least one third in the Africa region during the last decade.
“Several countries like Zambia, Rwanda and Zanzibar have registered significant progress,” said Dr. Saweka. “However, others including Uganda still have a lot to do, and yet 2015 – the land mark year when we should have reduced malaria morbidity by 75% – is fast approaching,” he noted.
Malaria is responsible for more illness and death than any other single disease in Uganda, according to the 2006 Uganda Demographic Health Survey, and children under five years old are more susceptible to the disease. An estimated 190,000 children under five die in Uganda every year, and nearly 37% of those deaths are due to malaria.
“Malaria remains the biggest killer of children in Uganda mainly because the majority do not sleep under a bed net, while others do not receive the proper treatment for it in good time,” says Dr. Sharad Sapra, UNICEF Representative in Uganda, who observes that malaria is both preventable and curable – and therefore controllable.
UNICEF and WHO advocate for strengthening community-based health teams to educate people at the household level about the disease, to manage cases at the village level, and to refer complicated cases to health centres or hospitals.
The Uganda Government, with support from UNICEF and WHO, has continued to invest in malaria control, leading to significant progress in recent years. This effort has included training Village Health Teams (VHTs) in an integrated Community Case Management (iCCM) programme aiming to expand and improve the diagnosis and treatment of malaria at the community level. VHTs are equipped to appropriately diagnose and treat the disease within the first 24 hours of symptom onset, increasing the chances that a child will survive.
The use of insecticide-treated nets (ITNs) has also expanded in recent years, with ITNs considered the most cost-effective method of malaria prevention in highly endemic areas.
Equally significant is an increase in the proportion of children sleeping under bed nets. In 2006, only 9.3% children less than five years old slept under a bed net, compared to an estimated 43% in 2011, according to the preliminary results of the 2011 Uganda Demographic Health Survey. This has contributed to the overall reduction of child mortality rates.
Scientists are calling for more investment in monitoring and evaluation in order to be able to report on progress achieved in addition to research that generates new information and evidence.
In particular, researchers are concerned with cases of Artemisinin-resistant malaria in Southeast Asia, particularly along the Cambodia-Thailand border and the Thailand-Burma border. Artemisinin is the most effective component in treating the disease. Therapeutic efficacy studies should therefore be included in malaria control efforts.
UNICEF and WHO are also collaborating with the Ministry of Health and other partners to use innovative mobile technology (through the „mTrac‟ system) to improve data reporting on malaria case management and surveillance at community level.
# # #
For more information, please contact:
Ijuka Agnes Barongo
UNICEF Uganda
Email: abarongo@unicef.org
Benjamin Sensasi
WHO Uganda 
Email: sensasib@ug.afro.who.int

ACTS-resistant malaria comes to East Africa

By CHRISTABEL LIGAMI 

Posted  Saturday, May 12  2012 at  12:40

A strain of the deadly malaria parasite Plasmodium falciparum that is resistant to artemisinin, one of the most powerful anti-malarial drugs, has been found in East Africa.

The strain tested positive in blood samples from foreigners who had travelled in Kenya and Tanzania and nine other African countries.

This particular strain had been found at the border of Thailand and Myanmar and had been predicted to be spreading to India and then Africa as resistance to other antimalarial drugs has done before.

(Read: ACTS-resistant malaria on the rise)

The results, according to the researchers from St George’s, University of London, indicate that either the strain has spread to East Africa and the other African countries or the local parasite has developed resistance.

Although malaria control efforts have been scaled up in the region, the researchers say their findings are a further warning that the best weapons against malaria could be rendered obsolete.

Sanjeev Krishna, the study lead researcher and professor at St George’s, University of London, said resistance in parasite samples were taken from 11 of the 28 malaria-infected patients from East Africa and the other African countries.

“On average, artemether’s effectiveness was reduced by half. Each parasite was found to have the same genetic mutations,” said Dr Krishna.

The artemisinin group of drugs is the most effective and widely used treatments for malaria. The drugs in this group are most powerful and less likely to be resisted by the malaria parasite when used with other drugs as artemisinin-based combination therapies (ACTs).

The patients were infected by malaria parasite-carrying mosquitoes while travelling to East Africa and the other nine sub-Saharan African countries, home to 90 per cent of the one million people killed worldwide each year by malaria.

The researchers then later tested samples from patients infected with the Plasmodium falciparum parasite and the parasites were assessed for their sensitivity to four artemisinins — artemisinin itself, artemether, dihydroartemisinin and artesunate.

The results showed that 11 parasites showing artemether resistance had the same genetic mutations in an internal system called the calcium pump (this is used to transport calcium, crucial for the parasite to function).

“We already suspected that the calcium pump which we first showed was a target for artemisinins to work on in 2003 had the potential to develop artemisinin resistance. But this had been difficult to confirm until now,” said Dr Krishna.

“Artemether and ACTs are still very effective, but this study confirms our fears of how the parasite is mutating to develop resistance. Drug resistance could eventually become a devastating problem in Africa and not just in south east Asia where most of the world is watching for resistance.”

Dr Krishna noted that the effectiveness of the other artemisinins was not significantly affected by the mutations. This may be because they were able to work on other transport systems in the parasite, compensating for the effects of resistance mutations in the calcium pump.
“At the moment, we do not know if the other artemisinins will follow suit, but given the shared chemistry they have with artemether it is tempting to think that they would,” he added.

The scientists argued that the resistance could be a result of the increasing use of ACTs, 300 million doses of which were dispensed worldwide in 2011.

Greater use could offer the parasites more opportunities to develop genetic mutations that provide resistance. They say this could lead to a repeat of how the parasite developed resistance to pre-artemisinin drugs such as chloroquine. Incorrect use of anti-malarials, such as not completing the treatment course or taking substandard drugs, could aid this process.