Mary is 75 years old and lives in a remote community in Wadufana in Luwero district in central Uganda. The Luwero triangle, an area of Uganda to the north of the capital Kampala, is renowned for a conflict between 1980-86, which led to the deaths of between 100,000 and 200,000 civilians and the detention, torture and assault of thousands of others.
Many health workers were killed or fled the region, and health centres were destroyed or ruined by neglect. Family units broke down and thousands of people were displaced. All of these factors had a devastating effect on HIV, TB and malaria rates.
Like many women of her age, Mary lost all of her children to these illnesses, leaving her as the sole provider and carer of sixteen orphaned grandchildren aged between two and seventeen years.
Malaria is a constant threat to their health, especially for the younger children, who have yet to develop protective immunity and are at greater risk of contracting clinical malaria. But until very recently, she had no way of properly protecting them from the disease.
Mary explains: “I would take off my traditional dress at night to cover the younger children, but this did not adequately protect them while they slept. Mosquitoes would still bite them and they would often get malaria. I would carry them to the nearest clinic which is five km away to get treatment but if one child was cured, another would get malaria.”
Often Mary would be carrying two children at once for treatment at the health centre and was known by the community as the ‘mother with two children’. Mary explained how she was getting more and more depressed and desperate as all her grandchildren gradually fell ill with malaria -
“I was feeling so low and helpless that at one point, I took poison to end my life.”
She was rescued by one of the villagers and taken to the nearest health clinic where AMREF identified her as needing support. Samuel Sewaya, a volunteer community health worker trained by AMREF, started to visit Mary at her home. He provided Mary with mosquito nets for the children, gave her psycho-social support and educated her about the prevention and control of HIV, TB and malaria.
“James has provided me with incredible support,” explains Mary. “He has explained some of the simple ways to prevent malaria and given me useful information on the link it has with other diseases including TB and HIV/AIDS. He has given me good advice on how to diagnose and treat the disease.”
AMREF is training village health teams to improve community knowledge and practices related to malaria, HIV/AIDS and TB, as part of a five-year project supported by AstraZeneca.