Every year at GlobeMed at Northeastern, we have the same problem: We have trouble communicating WHAT Kitovu Mobile actually IS. We throw the words “self help groups” and “Masaka” around but, truthfully, we haven’t given Kitovu Mobile the attention or clarification it deserves. And while this brief summary doesn’t do it nearly enough justice, it should at least clear up the question of WHO is Kitovu Mobile and WHY do they exist in the first place?!
A Brief History of Kitovu Mobile AIDS Organisation, as Dictated by Charles Matovu, the Director of Human Resources, and With Some Added Information From a Letter Written by Sr. Ursula Sharpe, Kitovu Mobile’s Founder, Paraphrased by Allie Hillner
Kitovu Mobile was conceived in 1987 when HIV/AIDS was still a myth—- people were having strange, terrible symptoms that nobody had seen before, dubbed “Slim.” Rumors spread among Ugandans that recent trade with Tanzania brought cursed objects into the country (I’ll assume relations between the two countries are much better now). Sister Ursula Sharpe, a nun with the Medical Missionaries of Mary, was working out of a health center in Masaka when she began treating these people for HIV. At first, most of the infected shied away from the health center; Sister Ursula did not speak Luganda and on top of that she was white. Needless to say, Ugandans didn’t exactly trust this woman with their health, despite their condition. Gradually, though, people got better—the improvements were undeniable, and demand for HIV treatment at the health center grew. Obviously, Sister Ursula couldn’t do it all herself so she began training “Ka-ticks” (phonologically spelled) or the Masaka Diocese equivalent of monks, to administer treatment. Despite the increase in staff, there was a major gap in treatment: Those who were dying of the disease wanted to die at home but could not afford to make it there.
Ursula began renting a truck to deliver the dying to their homes. More often then not, people died on the very long journey home (and this year’s GROW team promises it is a LONG journey to these hidden villages), forcing Ursula to deliver corpses to their respective families. The sadness of this inspired a mobile treatment program: Cut out the cost of transportation and bring treatment out into the villages. Kitovu Mobile was born. Kitovu Mobile became a full-time operation with the following goal: To create a life and death of dignity for those living with HIV/AIDS. Kitovu Mobile did this holistically, providing people with medicine, counseling, and education/sensitization about HIV/AIDS (all components of the ART or Anti-Retroviral Therapy Program). The next step? Helping the orphans.
The loss of a parent to HIV/AIDS is incredibly complicated for a child. Most of the family’s money has been drained by medical costs, school is no longer an option, and children are left to raise themselves. Kitovu Mobile’s Orphan Program was created to help the health of these neglected, child-run families. And just like its ART Program, it was holistic—it sensitizes children to HIV, educates them on prevention, and provides grief counseling, school fees, and extra property to introduce the possibility of farming for income.
In 1996 Uganda underwent some education reform. All funding for the Orphan Program was now being allocated to the government— a government with no clue as far as education goes. Kitovu Mobile ran an assessment of the new government programs and found that kids were dropping out, engaging in risky behavior, and moving to Kampala (Uganda’s capital, a large, underdeveloped, and chaotic city) for cheap work. In their teenage years, kids couldn’t read, write, or do math well. Kitovu Mobile, in a stroke of genius, addressed this issue with a compromise: If they couldn’t help as many orphans get to school, they could at least help them when they dropped out. The farm school was born. Since 2006, dropouts have engaged in a four-year program involving regular meetings to learn basic agricultural skills, develop specialty crops, and marketing and business skills (implementing reading, writing and math!). They have access to a loan fund on the condition that they form business partnerships with each other (insuring implementation of their new farm skills; brilliant!).
Before I talk about the Hygiene and Sanitation Project (the project GlobeMed at Northeastern funds and works on during our internship), allow me to introduce the “Grannies” Project: In Africa, elderly women are regarded as useless. People stop caring for or about them, and many die in their isolated homes without medical help or company. Kitovu Mobile partners “grandmothers” with existing programs for elderly women (after their own program was too complicated). It’s still fairly new, but so far so good!
NOW. FOR OUR PROJECT. Self-help groups have long been a key for the flow of information between Kitovu Mobile and the people it serves. Here’s how it works: Kitovu Mobile assesses the needs of a community, and addresses it accordingly. Maybe they need more ART attention, or more counseling, or orphan help. A group of women from each village then meets regularly to discuss the progress in their community—Is the medical attention improving their quality of life? Are enough people getting tested for HIV? Are children still dropping out of school? How can they face these problems? On top of that, Kitovu Mobile trains a few SHG leaders to educate their groups about improving the health of the community. SHGs report back to representatives at the “cluster level,” or representatives for their sub-county, who then report at the federation level. Federation representatives are then able to advocate for policy change on behalf of rural villages all through this hierarchy of communication. As a result, the “poorest of the poor” communities (not a hyperbole) have a crucial role in their own health and well-being, and have a voice at the federal level despite their isolation.
Kitovu Mobile ran an assessment of the program: The overall health of the communities was improving, but progress was beginning to plateau and attendance was irregular. Some members, despite their newfound education and empowerment, were still getting too sick to meet on behalf of their communities. They were educated about HIV/AIDS, but found themselves getting sick anyway. The missing link? Hygiene and sanitation.
About one third of Ugandans lack access to clean water while more than half don’t have access to sanitation services (water.org, and those statistics include people living in urban, planned communities, so you can only imagine the gravity of this situation in isolated communties). To improve attendance at SHG meetings, Kitovu Mobile began training SHG leaders to host hygiene and sanitation workshops. Not only did attendance improve, but these valuable lessons made their way back to the villages. Kitovu Mobile found that they could not educate about HIV/AIDS without first teaching the most basic sanitation rules: Hand washing, water boiling, food storage, etc. This year’s GROW team is conducting a hygiene and sanitation competition for the women in the SHGs: We will enter the competitors’ homes and award “points” if they have a separate, outdoor pen for their animals, a container specifically for boiled water, a well-maintained pit latrine, etc. The woman with the most indicators that she practices good hygiene and sanitation will be rewarded. Now that SHG attendance is up, this competition aims to incentivize round-the-clock implementation of safe practices. About 150 women have registered, so let the games begin! Also, Kitovu Mobile has surprised us with news of a recently formed all-male SHG. ☺
Over the past 25 years, Kitovu Mobile has grown from 2 staff members to 85, 1 health center to 120, 1 car to a fleet of 12 cars and over 30 boda bodas (small motorcycles), and from 1 SHG to 80. Kitovu Mobile operates in 7 districts, serving about 8,000 orphans and 7,000 adults coping with the reality of HIV/AIDS. Every Monday, Kitovu Mobile’s offices are overcrowded with staff—all 85 meeting before they go out into the field. Clearly, the place does not look big enough. Then you realize: These people are here just for the morning prayer before a long journey on a boda boda, travelling where nobody else dares, caring for forgotten villages.
In a few weeks, there will be a conference in Kampala inviting all of the GlobeMed chapters and their partners that are in East Africa. Kitovu Mobile has been invited to present at the conference, sharing best practices with the other organizations. We are SO proud and SO excited!