Nakiwogo Landing Site Residents Fear for Their Lives Over USAID Funding Pause

Residents of Nakiwogo Landing Site in Entebbe are living in fear of exposure to HIV/AIDS as the U.S. government pauses the activities of its humanitarian funding agency, the United States Agency for International Development (USAID), for at least 90 days. In Uganda, most of USAID’s support goes to the health sector, funding over 80 percent of HIV/AIDS programs.

The halt is set to hit hard in slums and fishing communities like Nakiwogo, where HIV/AIDS prevalence has persistently been higher than in other areas. Against this background, fear has started boiling up in these communities over how to acquire prevention and treatment for this deadly disease.

The high rate of prostitution in these communities is the major predisposing factor exposing residents to the disease. A sex worker, only identified as Komugisha, expressed that by the nature of her trade, condom use is a must if life is to be preserved. To her, the pausing of USAID activities means inviting death. “We have been using condoms to protect our lives, and now if they are going to be stopped, how are we going to survive?”

She added that it is difficult to get out of prostitution because it supports her livelihood and the children she left in the village. “I know that HIV/AIDS kills, and I am aware of how it is transmitted, but what should I do when I come from the village to look for money? Here at the landing site, everything needs money, and the children I left in the village call for financial support all the time,” she said.

She further stated that her other worry is about the support that was being extended to HIV/AIDS patients, which, to her, has been a ray of hope as well as a reason to go on and fulfill their dreams. “Yes, we have the government medical centers built around, but now what we mainly need is medication, and the information we are getting worries us.”

Martha Namugwanya, another resident, mentioned that it is very difficult to avoid prostitution in the area because of the money temptation from fishermen, and many girls, especially the young ones, have fallen prey, with their only hope being the use of STD preventive measures. However, this might come to an end. “I am scared because when the disease spreads without control, even those who are not involved in prostitution will be affected through the sex chain.”

Namugwanya added that along with HIV/AIDS, there is also the problem of unwanted pregnancies, many of which lead to unsafe abortions, resulting in severe health complications or death. “Imagine, even with the availability of contraceptives, we have been experiencing unwanted pregnancies. We find unborn children cast in garbage pits at least once every week. Some women have even died due to abortion complications. Now that these measures are going to stop, we expect the worst.”

Suzan Namayega, a volunteer advocate from the YouthPlus Initiative, who operates a Sexual Reproductive Health Primary Health Care kiosk in the area, mentioned that the pausing of USAID funding has also broken them as people involved in the HIV/AIDS prevention movement, especially in disadvantaged communities where people are uninformed and literally depend on handouts. “Here at our center, all services and commodities have been free of charge, including counseling, condoms, Pre-Exposure Prophylaxis (PrEP), and Post-Exposure Prophylaxis (PEP). Now, since the announcement, clients are worried about whether this will continue or not.”

According to Namayega, at least 100 pieces of condoms are collected from her kiosk’s dispenser every six hours, which, to her, is an indicator of how badly the community needs sexual health services and commodities. She added that from her testing statistics, most new infections are among young girls, especially from the island areas.

Speaking at the Moonlight Outreach, Polyne Nabwire, the Head of Programs at the Family Medical Point Program, mentioned that as the U.S. government changes its humanitarian strategy, the Government of Uganda must take urgent steps to address the SRHR needs of marginalized communities. Key among these is increasing the health budget to ensure the availability of SRHR commodities and services and strengthening domestic financing to sustain healthcare access in the face of funding cuts.

“The government should implement policies to reduce stigma and discrimination against sex workers and other vulnerable groups, as well as expand community-based SRHR programs to ensure broader outreach and service provision,” she added.

According to the Uganda AIDS Commission (2023), there are approximately 1,500 sex workers in most fishing communities. HIV prevalence remains alarmingly high at 37% among sex workers in these communities, compared to the national average of 5.4% (UNAIDS, 2023).