Lessons from Family Medical Point’s work have proven that fishing communities, those doing business in lakeshores and lake landing sites across Lake Victoria face unique challenges in accessing sexual and reproductive health services than the average population in Uganda.
Whereas the Ugandan government has ramped up construction of all sorts of medical centers across the country, all aimed at taking the services closer to the people, fishing communities remain a forgotten lot due to challenges involved in acquisition of land around lakeshores and unwillingness of qualified medical professionals to live in these communities.
To an average Uganda the major challenges to accessing health services in Uganda generally and SRHR in particular are institutional, structural and individualchallenges. On overage a Ugandan will need to travel 5 km to access health center III and about 10-12 km to health center IV. Most essential drugs are not available in public health facilities, while in private facilities they are expensive. Women still have to grapple with decision to seek service without consent from their spouses and on the other hand they do not trust some services even if they wish to use it, because they do not have accurate information about the service.
There is still a huge gap between demand and supply of health services generally; and it continues to widen the need for SRH services. HIV is still a development challenge and it continues to burden the countries health and social sector (NDP 2010/15). The Uganda AIDS Indicator Survey (2011) showed a general rise in prevalence from 6.4% (2006) to 7.3% in 2014.New infections is particularly a challenge with new dynamics and continuing changes in the Most at Risk Populations (MARPs).
The health system is also a challenge: stigma and discrimination towards young girls is still common, especially in facility based care setting. At least 5.4% of young women had ever been denied health service on suspicion that they are HIV infected. Generally the unmet need for health services is still very high especially in rural communities and for particular populations including women and girls; populations living in fishing communities, migrant workers, Mines and special groups like sex workers, MSM and people living in humanitarian settings.
For the fishing communities these challenges that the general population are faced with are compounded by the nature of their lifestyle. The fisher men spend the night in the lake and arrive at the shire in the morning. The arrival of the fishermen means business for everyone else in the community as the main commodity- fish- is delivered and business lines are activated. The fisher folk do not have time for rest throughout the day as they are swallowed up in the perishability of the fish to ensure business is conducted as soon as possible. The later part of the day is hugely spent in alcohol drinking joints and commercial sex points.
The demanding schedule of many of the folks in the community means time to travel for medical services of any kind can only be created on emergency situations which SRHR services rarely become.
Family Medical Point is working with this communities to deliver services to them at their door steps and ensure they are served within the water where they work from or at the shores when the land for business.
Family Medical Point has engineered an idea that will deliver services to all fishing communities through a mobile boat clinic. This well thought intervention though remains unfunded and Family Medical point is now seeking partners to get this rolled out.