Water
WHO Supports 16 African Countries to Protect Against Listeriosis
The World Health Organization (WHO) has reached out to 16 African nations to provide support for preparedness and response to a listeriosis outbreak that started in South Africa in 2017 but is now threatening other countries on the continent.
The 16 countries are Angola, Botswana, the Democratic Republic of the Congo, Ghana, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Nigeria, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe.
Nearly 200 South Africans have died since January 2017 as a result of contaminated ready-to-eat meat products that are widely consumed in South Africa and may also have been exported to two West African countries and 14 members of the South African Development Community (SADC)
South African health authorities recently declared the source of the outbreak as a factory in Polokwane, South Africa. This prompted a national and international recall of the food products. However, in light of the potentially long incubation period of listeriosis and the challenges relating to large scale nationwide recall processes, further cases are likely to occur.
Namibia has reported one confirmed case of listeriosis, a man who was admitted to hospital in early March. An investigation is ongoing to determine whether the case is connected to the outbreak in South Africa.
WHO’s Health Emergencies programme, the Global Outbreak alert and Response Network (GOARN) and the International Food Safety Authorities Network (INFOSAN) are working with the 16 priority countries to improve their ability to prepare for, detect and respond to potential outbreaks.
Immediate steps will include increasing awareness on listeriosis, enhancing active surveillance and laboratory diagnosis, ensuring readiness of Rapid Response Teams, and strengthening coordination and contingency planning. Experts have been deployed to South Africa, Lesotho and Swaziland to support these efforts.
“This outbreak is a wake up call for countries in the region to strengthen their national food safety and disease surveillance systems,” says Dr Matshidiso Moeti, WHO Regional Director for Africa.
The Ministry of Health in Uganda in mid-March, 2018 warned Ugandans against consuming imported meat products mainly imported from South Africa in a bid to avoid the spread of the disease to the Country. No case of Listeriosis has been reported in Uganda as of 22nd March, 2018.
The link between the contaminated products, the producing company and strains of Listeria isolated from the patients was made by the use of whole genome sequencing of isolated strains of the Listeria bacteria. WHO is supporting further genome sequencing to determine which cases are linked to this on-going outbreak.
In March, South Africa hosted a meeting of SADC health ministers to address regional preparedness and response to listeriosis. Ministers committed to regional collaboration, exchanging information and strengthening national food safety systems in line with international standards.
WHO does not currently recommend any trade related measures in relation to the current outbreak of listeriosis in South Africa, other than the recall of products identified as sources of infection.
Countries are encouraged to pay more attention to common foodborne pathogens such as Salmonella, Campylobacter, E.coli and Listeria, to notify WHO of listeriosis outbreaks in line with the International Health Regulations (2005), and to make use of WHO guidelines to strengthen surveillance of and response to the foodborne disease.
About Listeriosis
- Listeriosis is an infectious disease caused by the bacterium Listeria monocytogenes.
- Listeria monocytogenesare widely distributed in nature. They can be found in soil, water, vegetation and the faeces of some animals and can contaminate foods.
- High risk foods include deli meat and ready-to-eat meat products (such as cooked, cured and/or fermented meats and sausages), soft cheeses and cold smoked fishery products.
- Pregnant women, the elderly or individuals with a weakened immune system, such as people with immuno-compromised status due to HIV/AIDS, leukaemia, cancer, kidney transplant and steroid therapy, are at greatest risk of severe listeriosis and should avoid high risk foods.
- Listeriosis is a serious, but preventable and treatable disease.
Source: World Health Organisation
Additional Reporting by Cliff Abenaitwe
URBAN FLOODS: A WAKE-UP CALL FOR UGANDA BUT ARE WE READY TO ACT?
Cliff Abenaitwe
Traditionally, rainfall was celebrated because it is believed to be a blessing from the creator. For farmers, it should be celebrated much more since over 85 percent of farmers in Uganda depend on it for agriculture. Even in urban areas, rainfall would mean life to urban farms and gardens, more rain water – hence a saving on the water bills and much more.
However, the situation has over the years been changing from good to bad and now it is worse. Rain is now more cursed than cherished in both urban and rural areas. What a pity!
A modern saying in Uganda goes that ‘Water is life when you are not staying in Bwaise’. Bwaise is one of the suburbs of Uganda’s Capital City- Kampala that is prone to floods.
What used to be a Bwaise problem however is now in many other urban areas.
In March 2018 alone- Mbarara, Rukiga (Muhanga town) and Kabale towns among others saw the worst floods in their recent past and this is a sign of what has gone wrong over the years and what is likely to come.
In rural Uganda, the writing has for long been over the wall. The rate of environmental degradation has been growing to alarming levels presently. Hill slope forest cover has been decreasing daily, the hill slopes are poorly cultivated, bush burning has persisted while the wetlands in the low lying areas have been encroached on for agricultural practices- making mudslides, soil erosion and subsequent flooding inevitable. These floods for many years have been far in rural areas, away from the public limelight and wide mass media coverage.
However, now that the ‘flood spirits’ have invaded the urban areas, where mass media coverage is high, it is now time to wake up to the mess that has befallen our areas.
Much talk has for years centred on the rate of environmental degradation in rural areas but this phenomenon is real in urban areas. The biggest portion of wetlands in urban areas have been degraded mainly for human settlement and many forests have been degazetted. This is dangerous for our urban areas. To make matters worse, our urban areas have no adequate planning for drainage channels as well poorly planned human settlements.
Way Forward
In many of the big urban areas, the damage has already been done and little can be done to lessen the flooding cases- but still something can be done and must be done immediately. All buildings should have a rain water harvesting system or plan in place. This would ultimately lessen the amount of water from the roofs to the surface. Also, urban drainage channels must be opened and maintained. We cannot afford a situation where rain water finds its way to wherever it wants. Our urban areas must have more trees planted and more green belts while all buildings must be on plan and the approval of such plans must be based on technical guidance not corrupt tendencies. For the growing towns, this is the time to have the necessary plans in place to mitigate future problems like this. If such floods are not lessened, loss of lives, destruction of infrastructure, disruption of transport and business as well as spread of water-borne diseases will continue in Uganda.
In a nutshell, urban and rural floods are a sign of something gone wrong. We must take them as a warning of more danger to come and a springboard to action. In Uganda, we are found of calling government to act but in this case, government alone cannot do much. We all must join hands to protect the environment and promote sustainable urban growth.
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Kidney Transplant Survival Up Among Babies
Survival rates for children who get kidney transplants have improved significantly over the last half-century, a new study finds.
“The outlook for infants and children with end-stage kidney disease was once dismal, with poor survival rates after transplant. There has been great progress in pediatric kidney transplantation, and now the patient survival rate is almost 100 percent,” said the study’s principal investigator, Dr. Srinath Chinnakotla.
Chinnakotla is an associate professor of surgery at the University of Minnesota Masonic Children’s Hospital in Minneapolis, where the study was done.
Since 2002, 97 percent of children who had kidney transplants at the hospital were alive a year later. That compares to 85 percent 40 to 50 years ago, the study showed. Read More..
Comment:
This is absolutely good news and light at the end of the tunnel. With this break-through, more children will survive kidney transplant and this is a strong foundation for further improvements in the entire health system. However, as we celebrate this good news, it is equally important to think about thousands if not millions of disadvantaged children who desperately need a kidney transplant but cannot be saved either because of the poor economic nature of their families or lack of such services in major health facilities nearby.
Source: MedlinePlus
Comment by: Cliff Abenaitwe
Cutting Salt a Health Boost for Kidney Patients
Blood pressure and fluid retention improve in those counseled by dietitians, small study shows
Encouraging people with kidney disease to reduce their salt intake may help improve blood pressure and cut excess fluid retention, at least for a while, a new study suggests.
Study participants lowered their systolic blood pressure (the top number)
by almost 11 points, on average, on a salt-restricted diet versus their usual diet. They also flushed out a liter of water (about one-quart) from their bodies, on average, by slashing salt in their diets, researchers said.
Having high blood pressure and retaining excess salt and water in the body stresses the heart and blood vessels, explained lead author Dr. Rajiv Saran of the University of Michigan.
For kidney disease patients, high blood pressure (or “hypertension”) and excess fluid in the body can be a toxic combination. “They die predominantly of cardiovascular disease,” said Saran, a professor of internal medicine and epidemiology in the nephrology division.
Yet doctors rarely have time or make time to counsel each patient about salt-restricted diets, he said.
Saran and co-investigators wondered whether having trained dietitians talk to patients with chronic kidney disease by phone or in person about ways to lower daily sodium intake would make a difference. Read More
SOURCE: medlineplus.gov
New clinical guideline issued for treating low back pain
Low back pain affects millions of people in the United States, and the condition is one of the most common reasons for people missing work. 
New guidelines from the American College of Physicians recommend noninvasive ways of treating nonradicular low back pain.
The American Chiropractic Association (ACA)
report that approximately 31 million U.S. individuals experience low back pain at one point during their lives. The ACA also note that low back pain is the leading cause of disability across the world, as well as one of the most popular reasons why people miss work.
The condition accounts for a large proportion of all doctor visits in the U.S., and almost 25 percent of the entire adult population in the U.S. has experienced at least one day of low back pain in the past 3 months.
Quote: medicalnewstoday.com
ROTARY BOOST GLOBAL FIGHT AGAINST POLIO
The fight against Polio has been boosted by a new grant from Rotary International- the largest group of committed volunteering men and women committed to serve and change the world.
Rotary has announced $35 million in grants to support the global effort to end polio, bringing the humanitarian service organization’s contribution to $140 million since January 2016.
Nearly half of the funds Rotary announced January 2017 ($16.15 million) will support the emergency response campaigns in Nigeria and the Lake Chad Basin (Chad, northern Cameroon, southern Niger and Central African Republic). Four cases of polio were detected in Nigeria in 2016, which had previously not seen a case since July 2014.
With these cases, funding is needed to support rapid response plans in Nigeria and surrounding countries to stop the outbreak.
While significant strides have been made against the paralyzing disease, with just 35 cases reported in 2016, polio remains a threat in hard-to-reach and underserved areas, and conflict zones. To sustain this progress, and protect all children from polio, experts say $1.5 billion is needed.
In addition to supporting the response in the Lake Chad Basin region, funding has been allocated to support polio eradication efforts in Afghanistan ($7.15 million), Pakistan ($4.2 million), Somalia ($4.64 million), and South Sudan ($2.19 million). A final grant in the amount of $666,845 will support technical assistance in UNICEF’s West and Central Africa Regional Office.
Rotary has contributed more than $1.6 billion, including matching funds from the Bill and Melinda Gates Foundation, and countless volunteer hours since launching its polio immunization program, PolioPlus, in 1985. In 1988, Rotary became a spearheading partner in the Global Polio Eradication Initiative with the World Health Organization (WHO), UNICEF, U.S. Centers for Disease Control and Prevention, and was later joined by the Bill & Melinda Gates Foundation. Since the initiative launched, the incidence of polio has plummeted by more than 99.9 percent, from about 350,000 cases a year to 35 confirmed in 2016, and no cases in 2017 so far.
What is Polio?
According to the World Health Organization (WHO), Poliomyelitis (polio) is a highly infectious viral disease, which mainly affects young children.
The virus is transmitted by person-to-person spread mainly through the faecal-oral route or, less frequently, by a common vehicle (e.g. contaminated water or food) and multiplies in the intestine, from where it can invade the nervous system and can cause paralysis.
Initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs. In a small proportion of cases, the disease causes paralysis, which is often permanent. There is no cure for polio, it can only be prevented by immunization.
Key Facts about Polio
- Polio (poliomyelitis) mainly affects children under 5 years of age.
- 1 in 200 infections leads to irreversible paralysis. Among those paralysed, 5% to 10% die when their breathing muscles become immobilized.
In a small proportion of cases, the disease causes paralysis, which is often permanent.
- Polio cases have decreased by over 99% since 1988, from an estimated 350 000 cases then, to 74 reported cases in 2015. The reduction is the result of the global effort to eradicate the disease.
- As long as a single child remains infected, children in all countries are at risk of contracting polio. Failure to eradicate polio from these last remaining strongholds could result in as many as 200,000 new cases every year, within 10 years, all over the world.
- In most countries, the global effort has expanded capacities to tackle other infectious diseases by building effective surveillance and immunization systems
About Rotary
Rotary brings together a global network of volunteer leaders dedicated to tackling the world’s most pressing humanitarian challenges. Rotary connects over 1.2 million members of more than 35,000 Rotary clubs in over 200 countries and geographical areas.
Zika outbreak: The mosquito menace
The mosquito, Aedes aegypti, 
is causing widespread fear in Brazil where it is spreading the Zika virus that has been linked to thousands of babies being born with birth defects.
So what do we know about it?
It loves our cities
This is not some jungle-dwelling insect that rarely comes into contact with people.
It is one of those animals, like cockroaches, pigeons and urban foxes, that thrives in built-up areas.
It does not need natural water sources to breed as it can lay eggs in the small and plentiful pools of stagnant water, such as gutters or flower pots, found in cities . Read more
Close But Too Far: The Health Tale of the Batwa in Uganda
Who is talking about this. Leaders, civil society organizations, the media and every body, its time to advocate for a better life for people suffering as a result of historical injustices.
By Cliff Abenaitwe
The 1995 Constitution of Uganda (Third schedule) recognizes 56 indigenous communities that existed in Uganda as at 1st February, 1926. One of these communities is the Batwa tribe- a unique group of indigenous people.
For generations, the Batwa lived in the forests of the Kigezi region (Kabale, Kanungu and Kisoro districts in Western Uganda), Eastern Congo and the forests of North Western Rwanda. Their way of life entirely depended of the forests.
These areas were not only for shelter but were sources of food, medicine as well as worshiping places. In the early 1990’s government gazetted areas where they lived as conservation areas paving way for the creation of EChuya Forest Reserve, Bwindi Impenetrable Forest National Park and Mugahinga National park. This was the turning point for the Batwa for good or for worse depending on the side you are looking at. One aspect to note about…
View original post 3,268 more words
Why Sleeping in Could Make You a Better Worker
If you find yourself hitting the snooze button every morning, don’t blame yourself. Your work schedule could be to blame.
A growing field of research now shows that, for many of us, our work schedules are wildly out of sync with our natural body clocks — and experts are urging employers to take notice.
Sleep is a “strategic resource” that most companies are ignoring, according to a white paper by Christopher Barnes, a management professor at the University of Washington’s Foster School of Business in the US (Read more)
Source: bbc.com
Close But Too Far: The Health Tale of the Batwa in Uganda
By Cliff Abenaitwe
The 1995 Constitution of Uganda (Third schedule) recognizes 56 indigenous communities that existed in Uganda as at 1st February, 1926. One of these communities is the Batwa tribe- a unique group of indigenous people.
For generations, the Batwa lived in the forests of the Kigezi region (Kabale, Kanungu and Kisoro districts in Western Uganda), Eastern Congo and the forests of North Western Rwanda. Their way of life entirely depended of the forests.
These areas were not only for shelter but were sources of food, medicine as well as worshiping places. In the early 1990’s government gazetted areas where they lived as conservation areas paving way for the creation of EChuya Forest Reserve, Bwindi Impenetrable Forest National Park and Mugahinga National park. This was the turning point for the Batwa for good or for worse depending on the side you are looking at. One aspect to note about gazettment of these areas is that the Batwa were never compensated contrary to the statutory provisions on land acquisition by government.
The 2012 National housing and population census indicated that Uganda had 6,700 Batwa. The 2007 survey by the Organization for Batwa development in Uganda (OBDU) reveals that there are 3135 Batwa in South western Uganda with Kisoro district home to 1937 of them.
Today, that Batwa are mainly living in the districts of Kisoro, Kabale, Kanungu, Bundibigyo, Mbarara, Ntungamo, some in Lwengo and Mubende- in other words; they are scattered.
In all these areas, they are landless and this has negatively impacted on their political, social and economic aspects of life.
WAY OF LIFE
Majority of the Batwa are living as squatters. Their relationship with the land owners (the non Batwa) is that the Batwa stay on the land (where they build a small semi-permanent house and do some small scale subsistence farming) in exchange of cheap labor. This symbiotic looking but parasitic relationship has left the Batwa vulnerable, unsettled and poor.
During my visit to Batwa communities in Kanungu, Kisoro and Kabale districts, I found out that the moment the land lord is not satisfied with the output of the squatter, the relationship is terminated at will and the Mutwa’s family has to look for somewhere else to live. “I cannot for example grow long term crops like coffee or a banana plantation on the land that is not mine. The owner will not allow me or I might be chased before I enjoy the benefits of my sweat. Any time, you can be chased away. We cannot be sure of tomorrow”, a visibly worried Gad Bagaraya, a 32 year old father of six living in Ruceri village in Kisoro district told me. We just live today and when the land lord decides to terminate the relationship, you move to another area for another good Samaritan who will allow you to stay on his land, he elaborated adding that “ we are loved because of our energy and hard work character”.
Except the lucky few who have been resettled by some Non-Governmental Organizations (NGOs) that bought land for them, many others live like this but they hope for a brighter settled future.
Health Status of the Batwa
Health is an important aspect of every community. I took a keen interest in the health status of the Batwa Community in Kisoro district which has the biggest number of this unique group of people. Ruceri village in Nyarusinza Sub County is home to over 20 Batwa families each with an average of 5 members. It is about 25 kilometres away from Kisoro Town but because of the poor road (which stops somewhere before the village) and the distance you must walk up the mountain to the village, its takes over one hour to reach.
Residents here somehow managed to put up where they call home on what they say is government land. Some in this village built of land belonging to the non- Batwa residents. Being a mountain, it’s too rocky and cultivation is impossible. They work for the non-Batwa in the villages near-by to get food or small pieces of land to cultivate. As a result, their nutrition leaves a lot to be desired. “We eat once a day and our children have little to feed on”, Nyirandufiye Celina, a 38 year old mother of six told me during my visit to the area on a relatively warm Sunday morning.
According to health experts and the World Health Organization (WHO), breast feeding mothers ought to feed well to perform this task well. Just imagine what a baby would get from a mother who spends hours working but gets one insufficient meal a day!
In a community like this, housing will always be a challenge. Whereas a few through hard work and much austerity measures have managed to construct iron roofed houses, many stay in grass thatched or old tuplin thatched houses that leak when it rains. The temporary houses are small but a family will somehow find away to stay in. “I have worked and saved for years to get money to buy iron sheets for my house. It’s not easy. That is the reason why many people in our community stay in temporary shelter. They are also difficult to put up because grass and banana fibres for roofing are hard to get these days. They use the little they get and the houses leak when it rains”, Sserutokye Stephen,
the Ruceri village vice chairperson explained.
During the visit, I entered 7 houses (both the iron roofed and the temporary roofed) and I noticed that clothing is inadequate and so are beddings while ownership and use of mosquito nets is a distant dream for all.
Latrine Coverage
The national latrine coverage stands at an average of about 77 percent. This is not a good figure but there are many areas doing badly in latrine coverage including Kisoro district. The Kisoro district Chairperson Ben Mutabazi puts the latrine coverage at about 55 percent- way below the wanting national average. The latrine coverage among the Batwa is however worse. It is less than 30 percent in Ruceri village in Kisoro district and in other Batwa communities I visited in Kisoro, Kabale and Kanungu districts.
In the Ruceri Village (Batwa community), only three households have pit latrines. The chairman, the vice chairman and one resident are the only ones with pit latrines. However, they are shallow and temporarily built with no roof. Their quality notwithstanding, these homes are better than the rest where members defecate in bushes.
This is a great health risk to the people of this area. Records at Mutorere Hospital in Kisoro District reveal that diarrhea cases account for the highest number of disease cases among children.
The world health body denotes that many diseases are associated with poor sanitation.
“Inadequate sanitation is estimated to cause 280 000 diarrhea deaths annually and is a major factor in several neglected tropical diseases, including intestinal worms, schistosomiasis, and trachoma. Poor sanitation also contributes to malnutrition”, WHO elaborates.
It’s inexcusable for a family and a community to be without a latrine in the modern day age but the reasons advanced by this community deserve a hearing. According to Ruceri village Chairman John Haguma-Imana, land is the greatest problem. “The owner of the land gives you a little portion of land to build your home and establish a small garden- so you find yourself with no land for a latrine.
Besides, these people are temporary here. Am not trying to justify our problem but the people here are facing a number of challenges”, Haguma-imana explained.
An old adage goes – Health is made at home and repaired at a health facility. From the above experience, a Mutwa in Kisoro has the health facility to rely on for his well being. I took some time to look at the health services available and accessible to these people.
Nyarusinza health centre Three is the closest health facility – about 7 kilometers from Ruceri village. It’s a government health facility but just like many other public health centres, it has several challenges that negatively impact on its capacity to deliver and consequently it has failed to attract the confidence of the community including the Batwa.
Perhaps the biggest gift to the Batwa came in form of the Combating Child Mortality Among Batwa in Kisoro district (CCMB) program- an initiative of St. Francis Hospital popularly known as Mutorere hospital and its partners.
The arrangement under this program is that when a Mutwa falls sick or wants to access any health service including but not limited to testing, screening and child delivery, he or she simply walks to Mutorere hospital, is served for as long as it takes and the bill is footed by the hospital and its partners in this program.
For the pregnant mothers who definitely have to spend a couple of days as well as those who are admitted, the project takes care of their feeding as well as the feeding on the attendants for the longevity of one’s stay at the facility. It’s this treatment that makes the Batwa feel free, access quality medical care, stay healthy and hope for the best. “The services at Mutorere are excellent, a reason why we are healthy and few mothers and children die during and after delivery”, Nyiraneza Mereth, a resident of Rubuguri in Kisoro district who I found at the hospital attending to her pregnant aunt told me.
This facility is about 5 kilometres away from Kisoro town. Depending on the Batwa community you are from, people trek a good distance to come here. Ruceri village is about 30 kilometres away and many people from this village also walk to get service at Mutorere while a few afford parting with over 6000 shillings hiring a motor cycle for a single route journey for one person.
Ssendegeya Emmanuel aged 29 years comes from Birara Batwa Community which is about 27 kilometrers from this hospital. He is a carpenter but I found him at the hospital because he is on TB treatment.
The day in found him at this health facility (10th December, 2015), he had been there for six days with his wife attending to him. “I have been here with my wife for close to a week now. All is well. I get medicine and am regularly checked on by the professionals. My wife and I get food from these people (the hospital management). I hope for a quick recovery and hope to be discharged soon”, a weak toned Ssendegeya told me from his hospital bed in the isolation wing.
CCMB Project at a Glance
Credited for changing the lives of the Batwa, this project started in 2009.
According to Katto Justine- registered nurse and midwife who is the project coordinator the need for this initiative emanated from their observations and findings during the numerous community outreach projects they used to carry out as a hospital. “We found out that the Batwa are poor and they had difficulties accessing health services. Mortality was high in the Batwa communities especially among women and children. It is this that made us think of ways to help these people” she narrated.
In 2009, the hospital patterned with CARE- an international NGO to scale up community health out reaches in the Batwa communities. “We started with 12 community outreach centres. During these outings, we emphasized the need to visit hospitals, did a number of tests, treated diseases and also carried out monitoring of pregnant women”, She explained adding that the drive saw a surge in the number of Batwa visiting health facilities after some time. With sensitization, Katto elaborates, the Batwa have improved on sanitation and personal hygiene though there is much to improve on.
In 2011, the CARE partnership came to an end and Sustain for Life- another NGO came on board. This organization foots the hospital bills and also pays for the food rations given to the patients and their care takers.
The hospital now receives about four Batwa pregnant women per month seeking antenatal services. As of today, 20 Batwa women are taking family planning services from St. Francis hospital. “Though the numbers are low, it’s a big step and an achievement- considering that we started from zero”, an enthusiastic Katto- an enrolled nurse by profession noted.
Outstanding Health Challenges Among the Batwa
As already highlighted, sanitation is still a huge health challenge among the Batwa. With poor sanitation, this community is not at all safe from diseases.
Due to the Batwa’s Landless nature, food is still a huge mountain to climb. Consequently, malnutrition cases among the Batwa children are high. The most affected are children. “Due to poor shelter and clothing, we get many cases of pneumonia among the Batwa children”, Katto elaborated but added that under the CCMB project, they are now giving mothers free baby clothing kits.
According to Katto, another huge health challenge is HIV and Positive living among the Batwa. Like any other community in Uganda, the Batwa are also affected by HIV/AIDS.
Some people are positive but very few know their HIV status. According Katto, the CCMB project encourages HIV testing during the community outreaches but very few test to know their status. Those who test positive, she adds are enrolled on treatment and closely monitored. However, she notes that positive living is a big challenge. “Adherence to treatment is a huge challenge because the Batwa are always on the move. Because of little food, taking medicine is difficult and positive living in now a huge challenge.
Traditions like sharing of women have increased the spread of HIV and other sexually transmitted diseases”, Katto further narrated to me during our detailed discussion in her office at St. Francis hospital- Mutorere.
Birth rate among the Batwa is high and uptake of family planning services is still very poor. According to Katto, after years of sensitization, they have registered 20 Batwa women who are using family planning. “This is a small number but a positive step”, she observes.
Despite all this, the Batwa are moving forward and the future looks brighter. Peninah Zaninka- the head of the Organization for Batwa Development in Uganda (OBDU) observes that the Batwa have come from far and despite the challenges, they hope for a better tomorrow. According to Zaninka, the key to making the lives of the Batwa better is solving the land question- in other words; getting the Batwa Land to stay on and do developmental projects.
Batwa Resettlement Efforts
For over the years, non- governmental organizations have tried to resettle the Batwa. Organizations like the Organization for Batwa Development in Uganda (OBDU), ADRA Uganda, CARE International, Bwindi Mugahinga Trust, the Adventist church and may others have bought land in several areas of Kisoro, Kanungu and Kabale districts where they have resettled some Batwa.
The Batwa in these areas are living in decent houses and have land for cultivation. As of December 2015, the Batwa had been resettled in Kabahenda, Butoobo, Kamugyemani all in Busanza Sub County- Kisoro district, Rubuguri, Nteko, and Nyakabande in Kisoro district.
In Kabale district, the Batwa have been resettled in Karengyere in Muko, Murambo, Ekinyarushengye and in Rubindi. In Kanungu, the Batwa have been resettled in Buhuma where they live today.
When I visited Kabahenda, Rubuguri, Nteko, Murambo, Karengyere and Buhuma communities where the Batwa have been resettled, I observed that the people here are living a more organized life, fully integrated into the community, sanitation levels are better, they are engaged in cultivation and they are more positive about life compared to those in communities like Kisoro Town, Ruceri village and other areas where the Batwa are living as squatters.
Voices of the People
Winnie Mukandinda- Land rights Officer at OBDU:
The Batwa are such an interesting group of people with potential to do a lot. They have come from far and the future looks bright for them. Government of Uganda ought to come out now and work with the non- governmental organizations to address challenges of the Batwa especially Land. They were evicted from the forests without compensation and this injustice ought to be corrected.
Milton Mutabazi Bazanye, Chairman Kisoro District (2011-2015); As a leader I wish to see all the Batwa settled. As a district we have plans to resettle them but this is a long term project. We salute organizations that have really helped to resettle the Batwa much as more are still squatting. If the Batwa get land like those who have been resettled, we will be able to see their productivity and poverty among them will be history.
Sam Byibesho- the Kisoro Municipality Mayor (2011-16); When you compare the Batwa living in Kisoro town with those living in rural areas especially those who have been resettled, you realize that we need to get these people where they can call home.
Addressing the Batwa land question is key but this needs all the stake holders to come on board. “ I propose that to get the Batwa on the same footing with the rest in development, after handling their land needs, we should come up with an affirmative action to economically empower them”, he notes.
Nyamihanda Alice- an Educated Mutwa: The Batwa have been marginalized for long.
“We deserve better than this”. Am glad many Batwa children are now accessing education, many people are now engaged in income generating projects, the Batwa now access quality health care and of course the support from the NGOs is good.
However, one worrying aspect is the sustainability for some of these projects like the Health project at Mutorere hospital. “As a Mutwa, I believe we need a representative in Parliament who can be our voice and articulate our issues”, the 27 year old who dreams of representing her area in Parliament notes.
Ronah Ritah Ninsiima- The Kabale District Woman Member of Parliament (2011-2016): As leaders we must consider the plight of the Batwa people and see how to help them settle in the community.
They must also benefit from government programs like Operation Wealth creation, NAADS, Youth Livelihood fund but if they are still landless, they might not and they will unfortunately stay poor.
Tibamanya William Kisoso- The Mbarara district speaker (2011-2015);
I have visited families of the Batwa living in Mbarara district (Nyakayojo Sub County). The truth is, these people need to be loved, treated well, welcomed and they must enjoy every public good like all other Ugandans. Because of the historical injustice they faced, an affirmative action is needed to improve the situation they are in today.
John Justice Tibesigwa- Senior Warden Bwindi Impenetrable National Park; 
Today, we enjoy a good relationship with the Batwa. Many of them operate as tour guides in the national park where they get income, the areas neighboring the park where some Batwa stay benefit from the revenue sharing program. We are working with the Batwa leader and the district leadership to identify their former worshipping and ancestral places so that we preserve these places and also allow Batwa access to these important places.
Abenaitwe Cliff 