Zero HIV; Zero stigma; Zero discrimination Plan ( Unusual Business)

Zero HIV; Zero stigma; Zero discrimination Plan ( Unusual Business)


Our Mission:

The Most at Risk Populations’ Society in Uganda (MARPs in Uganda) is a diverse, national human rights not-for-profit organization at the intersection of HIV/AIDS, Humanism, status in life and social justice. Together, we confront HIV/AIDS by mobilizing towards Zero HIV-related deaths, zero-discrimination & zero -stigma.

You are welcome!

Karibu!

Kalibu!

Karibuni!

Tushemereirwe!

Tusangaire!

Eladde!

Eriyo mabe!

We use narrative that is accessible and easy to follow as well as educative. You asked and we provide just that. Our websites, the blog and other social media platforms have been designed using simple templates. We wanted as many people as possible to be able to read what is on there. Our approach is unique. We are capturing stories of people or organizations that are not well funded or not funded at all but are involved in HIV work. As much as possible these are the stories we want to capture here as well, the information here will be more relevant to organizations or persons who work with HIV +ve persons but have never been provided funds above $ 2,000 in 6 months.If you are that kind of organization, we would like to work with you. This is not to say we do not work with anyone. We just want to not assume. We are a not-for-profit organization and we want to collect around us stories of pain, resilience, forging in and hard work as we move to end HIV. Come here if all you need to know is about grassroots HIV & Human Rights without Land-cruisers, without electric lights, where some homes go without meals, but where people have resilience as the best asset.

From 2004 we have strived to present the downstream side of initiative, leverage, appropriating, accessorizing and experiences of deprivation in the face of hunger, HIV and continued hope. You have heard of fate and destiny. Here you will read of experiences of fate and the community or individual reactions toward fate.

We had the only clinic-wheels and this approach enabled us to survive the time our office was vandalized, some of us tortured and  imprisoned for working and providing services to "homosexuals" in Uganda. We shall combine statistics with stories. No, no, we promise you this. Our website will not read like statistical report. granted we shall quote figures here and there but.......well, we believe stories pull at your hearts firmly. So, you are welcome!

MOST AT RISK POPULATIONS' SOCIETY-UGANDA

Smaller grassroots groups pooling resources together to forge a zero HIV-related deaths; zero HIV-related stigma; zero HIV-related discrimination path! Who can fault this?

Leadership 2007-2010 

Tom R.M.M                           

Peter Seguya 

Miriam Nagadya 

Kiyimba Brown     

Brendah Bagala          

James Owor 

Leadership 2011-2013

Tom R.M.M

Gorreth Anywar

Lucy Akol

Dr. Gerald Sebulime

Ahmed Bogere 

Leadership 2013-2019

Dr. Gerald Sebulime-Chief Executive Officer

Allan Muwonge-Operations Coordinator

Ian Lubega-HIV Focal Point Person

Rachael Siita-Liaison Community Health & Human Rights Education

Dr. Tom R. M.M.-Focal Point Person

Leadership 2019-2024

Emmanuel Ssebagala-Co- Executive Director

Chris Lwande- Operations Coordinator/Digital Security Officer

Rachael Siita-Liaison Community Health & Human Rights Education

Dr. Tom R. M.M.-Past  President

Contacts:

Chief Executive Officer: chiefexecutiveofficer@marpsinuganda.org

Operations Coordinator: support@marpsinuganda.org

Focal Point Person: focalpointperson@marpsinuganda.org

HIV Focal Point Person: hivfocalpointperson@marpsinuganda.org

Health Education & Human Rights Desk: humanrights@marpsinuganda.org

You asked for a platforms, which could be friendly and not so hard to open given the problems of internet connection and costs of internet connection. You asked and we heard. There are many interesting tips you will find here. We have as much as possible tried to leave it plain. We want you to have information accessible via any mobile device platforms.

This is who we are

One day, in 2004 we met as a group of three people and exchanged ideas on the meaning of "hard-to-reach" populations. My friends and I wondered what that meant. Was it that this "hard-to-reach" population was so far away, say, at the moon? No, it was not. We borrowed from a treasure trove of African proverbs that caution against tendencies to be dismissive. Distance, should never be a reason to not provide human love. 

We actually realized what "hard-to-reach"  meant was lack of funding to provide logistical and catalytic change. Money was denied these kind of populations and HIV raced through this category of population without any form of resistance. We used salaries we got from our own professions. We bout 5 motor bikes and one van. We started the "clinic-on-wheels." We copied this idea from Rwanda, where human rights groups used vans as venues for meetings.  We advocated, shouted on top of our voices, cried, quarreled, made friends, broke friends, made up, some were sore losers and at the end of five years knew what it meant to suffer desperately and miserably. 

We failed to convince donors and funders to provide us money. We still hang in there and finally, we came up with a name.  Thus began, an organization that kept on growing but losing people. At one time, around 2008, I met another healthcare worker who was at the STD Clinic talking about "at-risk" populations. We shared so much about what it meant to be labelled and left with the labels but not interventions. I talked of the downstream experiences where hands are forever soiled and this colleague rebuffed this experience. This friend remarked that all the good things were upstream. That was where it was appealing and the essence of running non-profits. The place where networks are held tightly by workshops, seminars, meetings, boardroom speeches, memos and press releases. This world is necessary but it is a world of satiety and convocation. This was not my world. Mine is a world of necessity, scarcity, adversity, invention, innovation and negotiation. Deep in my heart, I realized that we tend to miss the imperative of service organizations which is: to do little everyday to heal wounds; to dress sores; to apply band aid; and to break bread. 

HIV & Human Rights Approach:

Grassroots Communities On The Move To Entrench Zero HIV Strategies

1. How many communities are empowered to identify people living with HIV with an unconditional positive regard? 

Skillset: Community mobilization, Testing and less stigmatizing practices. 

2. What measures are in place to reduce on the numbers of infections? 

Skillset: Know your Epidemic; Know your MARPs and prevention systems. 

3. What number of men, women and children died of AIDS in your vicinity? 

Skillset: Know your community; Identified/empowered community Adherence support health workers and bereaved family support mechanisms.

4. How many community engagements has your organization provided to highlight needs for less costly ARVs and other medications for treating OI’s? 

Skillset: Know your Pharmaceutics, know your leaders and have civil engagement plans. 

5. How many opportunities to denounce corruption and embezzlement of Global Funds or other funds tagged for HIV Prevention and care has your organization been involved in? 

Skillset: Have a strategic plan of your organization in place; share your plans; join platforms that empower your communities to be transparent and; demand for accountability. 

6. How much does your organization know about Global Fund plans for your community? 

Skillset; Demand for transparency on ear-marked funding: linkage with international organizations providing information on funding getting into given countries and sticking to planned activities. 

7. How is your community using the knowledge that treatment with ARV’s is a prevention strategy? 

Skillset: Empowered elite PLHIV; Empowered Adherence support persons and; empowered adherence community support safety nets. 

8. How many positive pregnant women are empowered to access HIV Prevention services for themselves and the expected babies? Skillset: Male involvement in health issues of partners, Pre/Ante/post-Natal Delivery personnel/ Traditional Birth Attendants-TBA’s- involved in rolling out anti-HIV services and communities empowered to support expectant mothers. 

9. How is your organization's needle positioned at the 3 zeros? The year 2017, is two years after the three Zero’s were said to have become universal. 

Skillset: Set up anti-discrimination spaces, set up anti stigmatization spaces and set up a prevention chain involving leaders in a community. 

10. Have bi-annual performance indicator plans in place: 

Skillset: Generate plans with all ten points in mind; share plans with other organizations given a monitoring role and be open to learning and dealing with your challenges and failures. 

The typical memes highlighting who we are: 2004-2017

Typical day occurrences at our resource center: we dealt with victims of rape cases, assault and inhuman abuses. We documented these kind of abuses and were at a loss whether we in promoting wellness, we would not be breaking confidentiality pacts. Indeed HIV work exposed one to legal knots and quagmires.

Typical day occurrences at our resource center: we dealt with victims of rape cases, assault and inhuman abuses. 

Imagine, you have made plans to take medication to 14 households scattered all over Kampala suburb and then you get a phone call. The person on the other side calls hellfire, threatens you and tells you to go to hell. But, that doesn't stop you. You go on to provide much needed HIV care work. But, all this knowing that the Anti-Homosexuality Bill is about to become an Act in Uganda.

Then the mother of XyZ calls to tell you XyZ is dead. HIV-related deaths for a son who had never brought "........his girlfriends, all I see are his fellow boys….."

With whatever little we could pull up we formed ourselves into a bereavement-support group. We kept a vigil with the family but we could not help hear remarks that were denigrating to a section of  the population.

All cognition, all training as a medical doctor cannot prepare one well for the shock of deprivation faced by non supported community/ grassroots support groups, the dissimilarities of nonprofit goals as far HIV goes and diversion of funds to maintain capital overheads for some organizations that are as rich as government ministries in Uganda.

HIV-work, is a tail of two snakes. Deprivation faced by non supported community/ grassroots support groups on one hand and well funded organizations with change to maintain capital overheads.

It is important to have seminars, workshops, conferences and board room meetings. It breaks the burnout and rejuvenates. Am sure you agree.

Strengthening Malaria, HIV&AIDS, TB (SMAT) Community-Based Responses in selected parts of urban and rural Uganda 2017-2027

SCOPE:

Conducting a “KAP-related” strengthening around HIV transmission and use of safe space as empowerment opportunities in Uganda

Purpose: To conduct “KAP” Dialogue sessions, plan follow- up processes, identify/ train key mobilizers to own, scale up and sustain self-efficacy activities  and prevention skills against HIV/STIs.in 102 safe spaces

A brief overview of the MARPS IN UGANDA “SMAT” Programme

The Strengthening Malaria, HIV-AIDS and TB (SMAT) Community-Based Responses in identified spaces was piloted in 2004.  In 2006-2011, it became the standard roll out flagship. We encouraged formation of “Gender-Dignity Responsive spaces”, we worked at grass-root consistently targeting MSM in Uganda. We have worked as: Good Samaritan Uganda, SOGIAH-Uganda and MOST AT RISK POPULATIONS' SOCIETY IN UGANDA (MARPS IN UGANDA).  Unfortunately, circumstances beyond our control forced all of us to go underground. Advocacy work is not effective if one lacks resources. It is not easy advocating for safer sex practices; access to ARV's; documenting human rights abuses; and maintaining an organization. 

Between 2004- 2011, the combined beneficiaries reached were  7,000 MSM.  This number was all we could reach economically with targeted services. Good Samaritan Uganda was established in 1995 as a platform and safe space for marginalized sub-population to share experiences in Uganda. Topical issues such as roles and responsibilities toward elderly, Persons with disabilities, displaced persons, parents and children were raised. An internet-based/social media network was established when issues of sexuality and identity were introduced as action points. Explorations and social diagnosis of sexuality in different spaces around  Kampala were documented. There were health issues identified and all effort was done to address them. The quadruple tragedy of being being outed as gay; being HIV positive; stigma; and discrimination reared its large head. While, we confidentiality is important, the need for disclosure complicated care delivery. One solution was initiating informal partnerships with concerned people in spaces covering many parts of Uganda. As part of  the agenda development called for coming up with different groups such as Good Samaritan Uganda which continued to  pursue popularizing public health programming, consequential counselling themes among LGBTIQQ as well as maintaining membership to various professional list-serves.

SOGIAH-Uganda was established as early as 2008 as a CBO to specifically address needs around sexuality, orientation, gender, identity and health hence the name SOGIAH. 7,000 MSM formed our data-base (2004-2011) and were provided with targeted information, education and communication. 

A characteristic typology developed as follows: 4000 confessed to using non-ordinary forms of lubrication other than water- based lubricant; 3500 who were not circumcised but were willing to have that service done; 57 MSM living with HIV were attached to accredited ART facilities; 2700 MSM were between 17-26 years. Over 1700 were bisexual, above 22 years and engaged in some form of work. Over 1500 MSM were engaged in sex-work for favours including lodging, money and food. We witnessed or heard of 155 cases who were evicted from their homes and of these 129  benefitted from being given temporary shelter under our transitory home programme. 62 MSM experienced black-mail and extortion. 

A  Young MSM Club Uganda (YMCU) was formed to cater for the increasing number of young Ugandan males who sought services at MARPS IN UGANDA. MARPS IN UGANDA formally registered with the Uganda Registrar Office and had the following 3 permanent staffs: Chief Executive Officer, HIV/TB/Malaria Focal Person and Finance/Administrator. When it came to getting more staffs for activities, we contracted volunteers or had people come from other organizations who were willing to conduct community health education drives with us. The most sustainable approach was for us to train grass-root organizations to “own, scale up and sustain” their tailored programmes and then we do monitoring and evaluation. Thus began the seed and the origin of satellite support groups.

We continued providing IEC, Trainings in form of capacity building and referrals to other better established partners who had got support in form of funding to support a range of programme areas within Malaria, HIV prevention, care and treatment and TB management. 

Our SMAT Programme was the vehicle through which we did implement planned interventions by supporting community based organizations (CBOs). The support ensured alignment with international and national policy ranging from: Zero discrimination, zero deaths, zero infections, own, scale up, sustain, reduce sexual transmission (this is done through our own initiated “prevention of anal sexual transmission”-PAST-strategy with its 7 steps), Combination HIV Prevention and many other relevant policies. Our experience with the minority subpopulations was hinged on four themes: Policy, normativity, social services and community based readiness/response.

MSM in Uganda have some unique characteristics that included:

Significant contributors to HIV in Uganda (MOT Study, 2008) and an HIV  prevalence  of 13%  (Crane Survey Report, 2010)

High level of multiple concurrent sexual relationships.

High level of transactional sexual activity

Significant numbers disclose a history of early same sexual intercourse

Significant number are not circumcised

Significant number not aware unprotected anal sex is a transmission route for HIV/STIs.

Significant number are bisexual and have families or intend to have

Significant number are in closet

Significant number in sex-work (1500 by 2011; 800 being through telephone/internet based sex-work).

Significant lack of aggressive health seeking behaviour and few know their HIV status-378 last tested and knew their status (World AIDS Day, 2011).

SMAT has FIVE major objectives that include:

Increasing access to, coverage of, and utilization of quality comprehensive Malaria, HIV&AIDS and TB prevention, care and treatment services within district  health  facilities and their respective communities

Strengthening decentralized Malaria, HIV&AIDS and TB service delivery systems with emphasis on community outreach.

Improving quality and efficiency of Malaria, HIV&AIDS and TB services delivery at grass- root

Strengthening networks and referral systems to improve access to, coverage of, and utilization of Malaria, HIV&AIDS and TB services

Intensifying demand generation activities for Protection, leadership, empowerment, attitude- enhancement, education for skills development, Malaria, HIV&AIDS and TB prevention,  care and treatment services.

Background and Problem

Uganda has an overall national adult HIV prevalence ranging from 6% to 7%. World bank figures for HIV/AIDS prevalence for people aged 15-49 years in Uganda which according the World Bank is now 7.6% from 6.5%, with an estimated 70, 000 HIV/AIDS-related deaths (2015).

we hope to use this opportunity to popularize appropriate downstream anti- HIV Community actions. We shall train groups to become support spaces to break the cycle of infections partly due to extensive risky sexual behavior. While Uganda has implemented HIV prevention interventions for over 3 decades, the country has not yet attained universal access to HIV prevention services; and some of the prevention interventions have not adequately focused on the sources of new infections. When appreciating the scale up of care and treatment services, the long-term sustainability of the national HIV/AIDS response lies in intensifying and enhancing the effectiveness of HIV prevention that are evidence-based and context specific. There are still sections of the population that are at a relatively higher risk of HIV infection compared to the general population. Unprotected anal sexual transmission (most especially among MSM) is scientifically known to contribute to prevalence of HIV&AIDS. National data on the prevalence rate is still not available, reported prevalence from  MSM participants of project studies shows the rate is higher than the national average. MSM are characterized with risky sexual behaviours that make them more vulnerable to HIV infection than the general population. Lack of sufficient prevention and population based information on this specific sub-population  to  guide  development  of  effective  interventions  contributes  to  this.    

SMAT is MARPS IN UGANDA approach to fill in a gap to conduct a Knowledge, Attitudes and Practices (KAP)-related sessions to empower minorities adopt prevention skills.

Purpose:

The purpose was to design Malaria, HIV-AIDS and TB prevention interventions that are evidence-informed and population-centred.

Intervention areas:

SMAT will always seek to provide:

A mosaic of minorities by geographical location, sex, age and population type and nature and level of their vulnerability.

Understanding of unique needs.

Drivers and predictors pointing towards commercial and other risky sexual activity in target communities and factors associated with the vulnerability.

Knowledge into behavior and what influences their behavior, what they know, believe, and think about involvement in work, contribution to community activities, Malaria/TB/ HIV, their causes, impact and prevention.

Information on what makes it easier to access the needed HIV prevention services and what their unique HIV prevention needs are.

Specific objectives/Deliverables/Outputs:

Specifically, SMAT will help to;

Characterize and categorize selected minorities by geographical locations, type and facilitate development of focused and contextual interventions.

Provide understanding into the Knowledge, Attitude and Practices (KAP) in relation to  HIV&AIDS and perceived vulnerability to facilitate development of an effective behaviour change and communication strategy. In this case ours have been the PLEASE and PAST Strategy (Strategies that enable policy/programme look into issues of protection, legal, empowerment, attitude, education for skills, risk reduction messages, address appropriate needs and a documenting culture)

Obtain and provide sexual reproductive health commodities

Contribute to the National HIV Prevention Strategy and Action Plan.

Design appropriate capacity building strategies that increase knowledge, skills and ability of community structures, local government structures, households as far as access and sustaining local response to HIV prevention is concerned.

Make recommendations pertaining to sustainable care and wellness.

Methodology:

Geographical scope /coverage

Work will be among 102 identified spaces covering many parts of Uganda and among selected key informants that include district local government and civil society personnel as well as the general population.

Populations, Approach and locations

SMAT interventions to target:

At-risk adults who engage in unprotected anal sexual behaviour.

At-risk adults who are in bisexual relations

At-risk adults who engage in transactional sex

At-risk adults who normally work away from their designated home areas or education  settings.

At-risk youths ( having more than one sexual partner or those engaged in cross-generational sex or those engaged in both behaviours)

We target minorities who will come to our resource center as well as at our outreach spaces located at various spots (including the internet social spaces) in Uganda though with more emphasis through their networks, entertainment sites, highway truck stops along the Transport Corridors (Major highways), residential estates, boarding facilities (including education institutions, in-mate correctional houses..), an established hotline and through our partnership outcomes with the 5 East-African countries.

Roles of Our partners

Provide support in form of financial resources and other logistics needed to execute the exercise from 2017-2027.

Empower MARPS IN UGANDA, share experience and technical expertise.

Reviewing reports and providing feedback.

Supervision and Management:

The CEO (also the Community mobilization and health Promotion Focal person) is the focal point person to handle all partnership functions. The HIV/TB/Malaria Focal Person will provide the overall implementation functions. They form part of the management committee in addition to a person/s from Partnership organizations. All queries/ clarifications needed on this will be channeled through the CEO

MOST AT RISK POPULATIONS’ SOCIETY IN UGANDA-MARPS IN UGANDA

MOST AT RISK POPULATIONS’ SOCIETY IN UGANDA RESOURCE CENTER

Plot 22 Kampala Road Zone, Lubaga Division, Kampala City Council Authority Box 25730 

Kampala

Uganda

Products/Services:

We believe that good health and health care are fundamental measures of achievements. We also believe documenting needs with the participation of those in need is a mark of organization. We believe that good health, health care and organization go hand in hand. 

We shall support small groups with reporting skills’ empowerment as part of building capacity for grassroots to increase on critical numbers of  resource persons who can effectively and sustainably initiate and maintain programming that targets Key Affected Populations; improve on mobilization, referrals and follow up  for optimal health services access and utilization; strengthen operational research documentation and publication using all ranges of social media, mass communication and public speaking media; make safer sexual option seeking part of quality life planning; and customize HIV care, treatment, prevention and support services to suit downstream praxis. 

Use of Social-Behavioural Heuristic-Algorithm Training to Strengthen Accountability Culture for Grass Root Groups in Uganda  2017-2020

Objectives:

Identifying present needs (intragroup)

Identifying resources for present needs (Intragroup)

Reconciling resource base and needs (Intragroup)

Shelving off (Intragroup)

Identifying opportunities to work with other resource groups (Scaling)

Intercultural communication Competences (maintaining scaling)

Positioning for feedback and dissemination ( controlling verbal and nonverbal cues)

outcomes:

Track productivity

Track relevancy 

Track competence

Track resource use

Heuristics are tools that motivate users to conduct brainstorming, consultation and they engender role sharing by teams using them. They are experience-based techniques that help in problem solving, learning and discovery. 

A heuristic method such as: a list of needs; social mapping; resource mapping; and self analysis enable groups to identify resources to address their needs. Heuristic tools enable a comparison of existing cultural norms to see if they are also solutions that may apply to majorities and those that are unique for minorities. 

Heuristic algorithm is an algorithm that is able to produce an acceptable solution to a problem in many practical scenarios, in the fashion of a general heuristic, but for which there is no formal proof of its correctness.

Social-Behavioural Heuristic-Algorithm combines problem-solution statement  and motivated sequence narration. It is an analytical tool designed to make a rain check for the purposes of testing readiness, integrity and status of organizations. It is a tool that enables organizations measure social-behavioural value they contribute by doing their work over a given period of time. 

What dates have you marked on your calendar to visit your  priest, herbal medicine provider, your confidant, personal physician, counsellor of social worker?  How are you positioned to deal with basic health needs manageable within your  own communities?  Uganda’s health sector staffing situation is below the established norm. The lower cadre providers are overworked and demotivated. How do you use this fact to plan for your own health and HIV needs?  How has community-based empowerment initiatives turned into opportunities allowing communities to manage basic needs. How is this documented? Do communities have plans to engage in such trainings that increase on critical numbers of life promoting events or value addition? This is where we come in. We train you to plan for being part of the solution.

Position yourself to address HIV by:

1.  empowering yourself as a consumer with knowledge and skills

2. Seek out and establish mechanisms to have infrastructure in place to increase your autonomy to demand or supply life promoting products.

3. Which population category of level do you deal with on a day-to-day basis? Is your work tackling sexual Orientation; gender; race/ethnicity; age; and sexual-behavioral? Has this facilitated knowing your  HIV status? Remember, Increasing the number of persons who are aware of their status is a strategy for preventing HIV infections.  

4. When it comes to testing have you planned or do you knowledge about where HIV Testing is done? Do you know when pregnant women, teenagers, tweenagers, adolescents and disabled can be tested and where? 

5. In order to continue informing the impact of programming is your organization or you as an individual skilled enough to write, report or enable the formation of information? 

6. Do you know how many people you care for are HIV positive? How many of those living with HIV actually know their serostatus? 

7. Prevention is linked to ART. So, as an organization how are you positioned to increase participation by your members in HIV prevention strategies?

8. What specific plans do you have which aims to achieve the greatest possible reductions in HIV infections by making sure that resources include: those that support adherence, nutrition, exercise, psychosocial support? 

9. Two years after 2015, we are supposed to be two years old after the 3 zeros were launched. Where is your needle pointing?  How much HIV-related funds or services have been provided to you or make up part of your defining pillars as an organization?

10. Is your organization really providing services to Lesbian, Transgender, Gay, bisexual people, sex-workers and substance users? Or to you it is just a joke? You will need them during conferences and seminars only? Have you provided a tailored results-oriented management training to their leaders?

Let us be candid. Zero HIV; Zero stigma; Zero discrimination call for that!