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Last Updated: Tuesday, 29 June, 2004, 09:33 GMT 10:33 UK
Ugandans fight Aids depression
By Orla Ryan
BBC, South-western Uganda

Juliet Nakayembe takes great pleasure in the many plants which now adorn her house in south-western Uganda.

Nanyange Paskazia
When Nanyange's husband died, his relatives forced her out of the house
Months earlier, her garden had been overgrown. She struggled not only to grow food, but also to find a reason to live.

Then, she did not know what was wrong, she did not know the word for depression. She just knew she could not sleep and could not find the energy to work.

Inside her house now, voices are rising. A woman is crying as she talks about how she wants to abandon her children and leave Gayaza village.

The land is too old to till, she says. The women sitting on straw mats are vociferous and practical in their advice.

Describing depression

Women meet weekly in Juliet's house in Gayaza in Rakai district. In psychological jargon, this is an interpersonal psychotherapy group.

In practice, it resembles community support and friendship, the kind of network which has been destroyed by the HIV/Aids pandemic.

[Aids] has broken all the social norms
Christine Nanyondo
World vision
The success of these groups in combating depression and boosting productivity means that they will be rolled out to the other Ugandan districts of Luwero and Mpigi later this year.

Relief organisation World Vision had long found a poor take-up of development programmes in the Masaka/Rakai area, one of the areas of Uganda hardest hit by HIV/Aids.

Research carried out with John Hopkins University in America found that 20% of the people World Vision worked with in these areas showed the symptoms of depression.

Until the survey, no word for depression had existed in the local language, Luganda.

The process threw up a word, Okwekyawa. The word is only needed now, because the traditional networks of support have been broken by the HIV/Aids pandemic.

Rising productivity

World Vision group facilitator Christine Nanyondo said: "Before, there were relatives, they could give you suggestions. Relatives have died, even the neighbour you run into, he is depressed... It has broken all the social norms."

Two years ago, Columbia University experts began training group facilitators in Uganda.

Fred Wasajja
Fred Wasajja used to think that only cowards talked about their feelings
The first groups met once a week for a few hours in the presence of a facilitator.

At the end of 16 weeks, only 6.5% of people in the psychotherapy groups still showed symptoms of major depression, compared with 86% previously.

Productivity in the area has also improved, Grace Onyango, World Vision's psychosocial specialist said.

She sees a clear link between depression and development.

"Without behaviour change and attitudes, as much as NGOs will give out help, they are creating dependency systems. We want them to start working for themselves," she said. "It [depression] is a great hindrance to development."

Those who took part in the groups say it gave them hope on what had previously looked like a grim future.

Test fears

Nanyange Paskazia lost both her husband and her parents to the disease. When her husband died, his relatives forced her out of the house.

She spent her days crying, failing to find the energy to grow food for her three daughters to eat.

She thought she might be ill but was afraid to be tested. "What if they tell me I am HIV positive? Won't I kill myself?" she told me through a translator.

Through the 11 members of her group, she found "hope and courage."

Now she sleeps regularly and has started working again. She is happy, she says, and wants a future where she is healthy and can look after her children.

In Ngono village, Namujuzi Gaida Kabogaza struggles to find money to keep her nine children in school.

She lost seven of her brothers and sisters to HIV/Aids. After their deaths, she found herself fighting with her husband, who drank and complained of her lethargy.

Before she joined the group, she feared people would gossip if she talked about her problems. Slowly, she regained her energy to work.

Support network

Cowards talk about their feelings, or so Fred Wasajja thought before he joined the group in his village.

He has lost his eight brothers to HIV/Aids and is looking after eight of his nieces and nephews.

The burden is great, he says, and he and his wife struggle to meet it. At times, he has thought of suicide and he also fears he has the disease.

He has not been tested yet, and is thinking of taking the test in Kampala, a three-hour trip away.

"Would it not be better to know?" I ask.

"Yes and no," he says.

When he does find out the truth, he now knows there will be people in his village he can turn to for support.

Uganda Aids education 'working'
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11 Jul 03 |  Africa

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