AIDS Palliative Care in Uganda:

The World Health Organization (WHO) estimates that there are over 12 million HIV positive people worldwide, 75 % of them in Africa; and that by the year 2000, between 38-110 million adults and 10 million children will be HIV positive. Twenty million adults worldwide will have AIDS. In Uganda, a country the size of Oregon with 18 million habitants, 10 % of the population are HIV positive and 10,000 cases of AIDS develop per month. Most cases of AIDS, known as SLIM in Uganda, because of extreme wasting and weight loss, involve 20-40 year olds and are contracted through heterosexual contact. The Ugandan health care system is recovering from the effects of a lengthy civil war and is attempting to manage AIDS care with limited resources. In August of 1993, at the invitation of the Anglican Archbishop of Uganda, Yona Okoth, I visited Uganda with a group of hospice nurses to review and make recommendations to the Church of Uganda on the development of a palliative care program in rural areas (where major AIDS-related care takes place). We travelled throughout Uganda talking with physicians, community health workers and patients