World AIDS Day: South Sudan addresses concerns of HIV-affected refugees

KAJO KEJI, South Sudan, December 1 (UNHCR) - Mary Kiden wants to return to her home in South Sudan more than two decades after fleeing to north-west Uganda, but she's been dismissing the idea because she thought that she would not receive the health care she needs to stay alive and to support her family.

Forty-one-year-old Mary is living with HIV and she needs antiretroviral drugs to live a normal life and keep AIDS at bay. At Oliji in the West Nile region of Uganda, she receives the care that she needs, but the infrastructure in South Sudan is in tatters as the region struggles to emerge from years of civil war.

To help her make an informed decision about whether or not to return to southern Sudan, UNHCR recently invited Mary to join a "go-and-see" visit to Kajo Keji in Central Equatoria state. But on the long drive to her home region, she started finding reasons why she could not return.

She told her fellow refugees that, as the family's only breadwinner, she feared she would not be able to support her mother and children. What worried her most was getting access to antiretrovirals and becoming stigmatized by people in her village, which did not even have a health clinic when she left all those years ago.

Precise figures for the number of Sudanese refugees in West Nile living with HIV are not available, but a lot of them share Mary's reluctance to return home until they know more about the health facilities and access to treatment. They fear the worst after more than two decades of war between the Khartoum government and the rebel Sudan People's Liberation Army, and five years of fragile peace.

But when Mary finally reached her home region on the "go-and-see" visit, she was pleasantly surprised by what she saw. "It is really so developed," she said, pointing to newly painted buildings and busy restaurants and shops in Kajo Keji.

Her mood got even better when the group visited the town's sprawling health centre. And she kept on running into people from her past, including a former refugee leader in Oliji who now headed the neo-natal and family planning clinic, working directly on the prevention of mother-to-child transmission of the AIDS virus. They toured new buildings used for HIV/AIDS testing, education, counselling and drug distribution.

"I don't see any reason why refugees shouldn't return home," the hospital administrator, Felix Leju Tip, told Mary. "We need them to come home and help us reconstruct. We need their hearts and their brains."

As if reading Mary's mind, Dr Tip and other hospital staff informed her that the World Health Organization and the Ministry of Health have been supplying the hospital with antiretroviral drugs for the past year, and will continue doing so for the foreseeable future.

Buoyed by her visit to the hospital, Mary next met members of the "Loving Club Association," including a long-lost cousin. This support group, which has received seed funding for livelihood projects from UNHCR, gathers approximately 230 people who are living with HIV. Profits have been used to buy land that will be worked by the members to provide food for the most vulnerable among them.

The Loving Club Association members told Mary about the challenges they faced, while urging her to tell refugees in Uganda that things are slowly improving in Kajo Keji and they should return to help in the development.

"It is like building a home," one member told Mary, while trying to reassure her that refugees living with HIV would be warmly welcomed and supported by the association and others. "We do not feel frightened here, and we are able to live openly without stigma," one member claimed.

Mary rounded off her visit by spending some time in her village with her cousin, Elia, and his wife, who is also HIV positive. She was delighted when Elia offered her a plot of fertile land if she and her mother returned.

On the drive back to Uganda, Mary sounded like a different person from the anxious woman who had fretted so much on the journey out. She felt that her concerns about access to drugs, medical care, support and acceptance had been allayed and that she could return.

But while the situation in Kajo Keji has moved forward, such facilities and support systems found in the town remain absent in large parts of South Sudan and continuing help in developing infrastructure is urgently needed.

"I am really very happy," said Mary, who now hopes to return to Kajo Keji with her elderly mother and sons in 2012. In the meantime, she and millions of other southerners will be hoping that South Sudan remains peaceful and continues to develop after next month's referendum on its future.

By Page Buono in Kajo Keji, Sudan