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Home Care Impossible in Slums, Community Improvise With COVID-19 Sickbay

Bahati says they have resigned to prayer and herbal concoctions after they realized they can’t afford to self-isolate or even social distance with their nature of households where in many cases families share a single room. On average, she says, there is one room for a family of five in the areas of Kafumbe Mukasa, Katwe and Ndebba where she is designated as a VHT.

Audio 6



While COVID-19 cases are on an increase with single day infections reaching highs of 1000 positives, Abbasi Kiyingi, the LC1 chairman of Kiti Zone in the Kampala slum of Kisenyi says the picture in his community of 382 households is different.  

They no longer hear of any new infections in his locality and yet the heavily populated village is among those that had Uganda’s earliest positive cases of the viral respiratory disease in April and the country’s third death in July.

 

Kiyingi says the story has changed as he no longer hears reports of people testing positive and now all he hears about lately are members of his family or friends falling sick.  

///Cue in: “Waliwo kale enyumba ……   Cue out: ……. Abantu tebamanya”. //  

Kiyingi’s revelation is not different from that of Voluntary Health (VHT) Team member Shellinah Bahati who works in St. Balikuddembe market and resides in Katwe, equally a slum.  Bahati says ever since government stopped free testing, the number of positive cases reported in her area have gone down and yet there’s high complacency as hand washing facilities have since been removed and mask wearing gone down. 

Being a VHT, Bahati would be knowing the people testing positive in her neighborhood, especially those that are quarantining from home as per the Ministry of Health homecare guidelines which gives a VHT a responsibility between them and the patient.

But, Bahati says, they have resigned to prayer and herbal concoctions after they realized they can’t afford to self-isolate or even social distance with their nature of households where in many cases families share a single room.  On average she says there is one room for a family of five in the areas of Kafumbe Mukasa, Katwe and Ndeba where she is designated as a VHT. 

///Cue in: “Quarantine eyo ewaffe …….     Cue out; …… kukisa kya mukama”. // 

In such areas, experts say transmission of infection is difficult to halt unless people take extreme caution but the residents say their hands are tied that even when they fall sick, they cannot afford home care as the Ministry is currently recommending that only those with severe disease will be isolated at the hospital.  

However when this was put to the technical officer in charge of Health Promotion at the Ministry Arthur Kiconco  Bukiriro,  he said  they are brainstorming on how such communities that can’t abide by the home care guidelines can be helped.  

///Cue in: “When it comes …..   Cue out: ……for home isolation”. //

 

But having isolation centers for the sick is not the solution according to Dr. Aloysius Ssenyonjo, a lecturer and Health Policy researcher at the Makerere University School of Public Health. He says a lot of those people are sick, and their right to know their status was depleted when government introduced testing fees. Even as they say contacts of the positive can be tested free of charge, he says the reality on the ground now is different especially that people can no longer trace who exactly infected them.

He recommends free community testing for key population.  

///Cue in: “What we see as …….     Cue out: …… in these communities”. //  

He says home care solutions for slum dwellers should have a strand on their survival since any of them live a life of hand to mouth. 

///Cue in: “There are also …….   Cue out: …… out of their self- isolation”. // 

 

Kiyingi says his residents cannot wait for all this to happen. He says they took a revolutionary initiative, copied the sickbay model in schools and came up with a community isolation facility of their own standard.

///Cue in: “Wali wenkugambye ….. 

///Cue in: Naye tetunafuna”. // 

But alas! no one has ever been isolated there as they don’t know their status.