| Rev Alan Bain is Vicar of St Philip and St James’ Church in Bath and a founder member of CHAA (Christian HIV/AIDS alliance). He was Religious Affairs producer for BBC Radio Bristol and now presents a live weekly programme for Trans World Radio. He travelled to Uganda to make a radio programme to be broadcast on World AIDS day and sent us this report. |
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A small girl, attractive and vibrant in a light blue dress runs to greet us. Her energy is infectious. She smiles with a broad white grin, her face shining in the brilliant Ugandan sunshine. She leads us through coffee bushes sprouting in the forest and jackfruit hanging like huge cricket bats from the trees to find her home in a straw roofed mud-brick hut.
Grace is 16-years-old and cares for five brothers and sisters on her own in a tiny Ugandan village. Her mother died from AIDS two years ago and her father two years before that. The children are now alone with no parents, guardians or relatives to care for them. Tradition requires that the father’s relatives assume responsibility but as he had none the children became one of many thousands of “child-headed families” throughout Uganda. AIDS has taken its deadly toll passing amongst and decimating the generations. |
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| I move through a darkened doorway into her house; a small building around four metres square with a bare floor and a small wooden bench. Two tiny rooms lead off, one with a bed and sewing machine, the other with two small wooden beds with no mattresses covered in rags. This is the family home. The bed clothes are soiled and dirty and I hesitate in the gloom. There are no lights, water or sanitation. Grace’s mother with great foresight taught her to sew before she died so she would have the skill to earn money and support the family. |
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The elder of the village tells me they try and look after the girl. But she is vulnerable. Many in similar situations are raped and abused. The five children are completely dependant on Grace and her health. Local Mildmay volunteers unload beans and cooking oil donated by the US government to help the child and her young family; enough perhaps to feed them for a few weeks.
This is just one of the situations uncovered by the Christian HIV/AIDS charity Mildmay and its community work in Uganda. Molly Eriki directs the work from the central ‘Jajja’s Home’ site near Kampala. Jajja’s Home, derived from the Luganda word for ‘Grandmother’, is Mildmay’s specialist HIV/AIDS care and training programmes for severely sick (and mostly orphaned) children. The Jajja’s Home site consists of three age-related day care units and a 14-bed rehabilitation/terminal care hospital for children who are referred from the neighbouring Mildmay Centre, plus training facilities. The Mildmay Centre meanwhile runs specialist HIV/AIDS outpatient clinics for both children and adults and a regional training centre. Travel in Uganda is difficult and with thousands of remote villages in the bush it became obvious that Jajja’s Home ‘needed wheels’ and should work in the villages as well as in the Centre. The result is that they now work in three other communities as well as their own. |
| Molly explained: “Jajja’s Home proved that it could work. Children in the villages are neglected and there is a lot of stigma when their parents die so it is important that we set up programmes in the locality.” |
| The outreach near Jinja uses government-loaned buildings. Molly said, “We have an outpatients centre where patients are treated and as the children come we identify those infected by HIV that are not feeling well. We also have health workers who we train in palliative care and the handling of children. We collaborate with local organisations but there are few that handle children so we work with the local village council and the Mildmay volunteers to bring the situation more under control.” |
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Jenny is a counsellor at the outreach. She explains: “It is an ongoing work and we have to tell the children to live positively, accept they have the virus but know how to get early treatment and proper food. We tell the older ones to abstain from sex or use a condom if they cannot and to avoid alcohol. We teach them handicrafts so they can earn a living and it also gives them a sense of worth. Just getting them together helps so that if anyone feels sick or sad the others can help them. Most of the children have lost their parents so I counsel them to accept what has happened.” |
| Recreation is an important part of the work and the community health centre resounds with singing and children’s games. Molly explained: “Because of stigmatisation the children have no one to play with, so we provide it here.” |
| Children like Grace are allocated a volunteer to support them and Jajja’s Home gives her food. Joyce is Grace’s community volunteer. She plans her work so she can spend two days a week visiting children infected with HIV/AIDS. “The first day I visit those who are near and the second those at a distance. It is pathetic to see the children. I have two child-headed families I look after. They don’t get food or parental love and don’t go to school.” Joyce feels that Grace’s brothers and sisters could be HIV positive but children under 12 cannot be tested for the virus.” “I am so happy about the programme but it’s difficult to cover the distances and I really need a motorbike.” |
| Mr Idja the local council leader of the outreach pointed out that it was still not easy. He works with the volunteers from home to home to try and find children infected and encourage them to come to the centre for treatment and counselling. “There are many difficulties caused by AIDS here. Four or five people a month die of AIDS in the village and many children are orphaned. We try and give food to child-headed families but now because of little rain there is not much food in the village and we are not able to help as much as would like to.” |
| The Christian faith gives the momentum to Mildmay’s work and it is difficult to go anywhere in Jajja’s home without hearing the sound of worship and singing. Ruth Sims, affectionately known as “Jajja Ruth” began her work in HIV/AIDS care in 1987 as matron of Mildmay Mission Hospital in London and 4 years later she became Chief Executive. In those early days Mildmay decided to pioneer care of those living with HIV/AIDS when some in the church saw it as God’s judgement. It was a difficult time as Ruth explains; |
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“Some Christians thought we shouldn’t be caring for people with AIDS because of their lifestyle. We believed God called us to do this work and he told us not to judge but to be loving and to care for them. There was a lot of fear in those days. Ambulance men dressed up like spacemen when they brought the first patients and one funeral director refused to take a body. The fear was caused by ignorance.” |
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Many of the patients in London were of African origin and Ruth felt uneasy with the way they were treating them. “We knew that our mode of caring was not something they were comfortable with. So we took a team out to Africa to learn and teach there.” Soon afterwards, they were invited by the British Council to bid for a teaching contract and the government of Uganda invited Mildmay International to take over a piece of land to establish a centre in Uganda. |
| Jajja’s Home began when they realised how many children were attending the Mildmay Centre’s outpatient clinics who needed ongoing care. They now look after over 2000 children. Ruth said; “Many of the children were too sick to go home so we needed to provide more for them. We now have over 100 children coming into day care and we provide holistic rehabilitation for them. Because of that the children are able to stay in their own communities with their families and not be cut off from their roots and sense of belonging in their communities. There are known to be 150,000 children living with AIDS but there are probably many more. We want to extend our community care into 20 more districts to monitor the social care and pick up on things like the child-headed families, neglect, abuse and ill health” |
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‘Jajja Ruth’ smiles gently. She doesn’t feel her age and sees ‘a young person still inside of her’. Many years of care have made her the person she is and her faith shines through. As a motherly woman with her origins in Essex she seems an unlikely person to find in East Africa. Now retired she refuses to take a salary and lives on her pension whilst continuing the work. She is dismissive of her 60-plus years. “ When we are in Christian ministry we never retire, we move from one sphere of work to another. I retired so that I could give something to God for all he has given me and not be paid for it and develop the passion of my heart, which is to care for sick children.” |
| Ruth has many stories of faith that has moved mountains: “ I remember when I first saw the children coming to Mildmay who could not be treated for lack of money. We decided, with only £50 in the kitty, to treat all children free. Within a fortnight we had £50,000 and the amazing thing is that the money has never run out. We treat the children free of charge and (at The Mildmay Centre) all adults who have no means of payment. The provision of God is amazing. You see children come to us that are clearly dying but now we see 67% being rehabilitated. Perhaps they can’t speak or are semi-conscious or unable to walk and within a few weeks they are running around playing with toys coming up to you and saying, ‘Jajja, did you know I am going back to school?’ You really feel that we are doing something that makes a difference. I have seen prayer change things and we need the prayer of the churches in Britain who need to know that their money makes a huge difference out here and not a penny of it is wasted.” |
| Back in her village Grace grins, reflecting the warm Ugandan sunshine. She appears full of hope as she sews intently in the darkened shell of the mud brick house - the whirr of her sewing machine blending with the excited chatter of children around about. She wants to sell the garment at the market some miles away – this will be her slender meal ticket for her family. |
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I ask her what her ambition is for the future. Will she marry or get a job? “No,” she replies. “My mother left me with the responsibility to look after these children and I hope to earn my living with this machine. I am praying hard and don’t intend to get married yet because of my responsibilities.” |
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No one can predict what the future will bring for this brave 16-year-old and the children left to her by her mother’s legacy, but it won’t be easy - Grace was diagnosed HIV positive just a week after we left. |