Outposts: Slim Disease

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· by Nuala

It’s kind of difficult to describe the past 24 hours that included crossing the equator, visiting a unique AIDS research and patient facility, hearing some hair-raising stories about witch doctors and attempting to dance to Ugandan and Congolese reggae (no pictures please), but here goes. I’ve managed to score an Ethernet cable, which makes the job much easier.

We left our hotel in Kampala really early yesterday morning. I must remember to tell you a little about our hotel at some point, it’s got a tale or two. But not now. So, yesterday we got up early and hit the road toward the rural district of Rakai in southwestern Uganda.
Dr. James Ntambi sat beside me on the bus ride and recounted the following story. In the early 80s a number of people started getting very slim (in a culture that adores curves – they even add a few pounds to the store mannequins). These very thin people died after a relatively short time, but nobody could figure out what was ailing them. The disease became known as Slim Disease in Uganda and really baffled everyone as to the cause. There was a number of rumors including witchcraft, but none could be substantiated. Here’s where Rakai comes in. Two Ugandan researchers, Drs. Nelson Sewankambo and David Serwadda from Makere University in Kampala, noticed the particular severity of the epidemic in the rural Rakai district in southwestern Uganda. They began extensive research on the people of Rakai, and through their work discovered the first case of HIV in the country by making the connection between Slim Disease and HIV. Drs. Sewankambo and Serwadda then planned an investigation into the baffling disease and set up shop in 1987 in a rented room at the Milano South-View Inn in Kyotera.
That tiny clinic, lit (when there was electricity) by a 40 watt bulb and home to blood samples spun by a hand centrifuge, grew to be a leader in HIV/AIDS research and prevention. The clinic is now in direct partnership with the NIH and CDC. The area became the epicenter of HIV and AIDS in Uganda, both in cases and research, and even slipped in Ugandan vernacular. If you wanted to insult someone, calling them 'Rakai' or 'Slim' was an effective way.

We were fortunate to visit the Milano South View Inn yesterday in the middle of a health mobilization meeting. The meeting brought together health mobilizers from the neighboring regions who were chosen through local elections in their districts.

The health mobilizers then come to Rakai to get the latest information on prevention of HIV/AIDS and bring that information back to their villages.

I also got to interview one energetic young man, Siraje Ssenyonga.
Siraje took his role as a mobilizer as a prestigious honor, and was delighted to share how his thoughts on his village’s reaction to HIV prevention information. What were those thoughts? All will be revealed in the next post!