The Battle

Why don’t you end this battle now?

What are fighting for?

Every time when you pull out the trigger,

You light your gun loaded with bullets wrapped in papers,

Stop shooting your lungs,

Stop burning your life,

You have traded your life for a trash of ashes,

Don’t you see you are breaking down your system?


You think you are high,

But your grades are getting down,

You smoke to get stronger,

But your body is getting weaker every day,

Stop living in suicidal denial,

Open your eyes and be true to yourself,

Break the walls of deception,

Look to the reality,

Your future is bright with no ashes and smoke,

You don’t need to pick the lighter again,

You can see where you are going,


Before you leave this page,

Sit and listen not to the garbage everyone is saying,

But listen to the person inside your heart,

Don’t be afraid to stop now,

Make the right decision that you will be proud of years to come,

Put down the lighter, take off the paper from your mouth,

Say No to Drug and substance abuse,


Live, breath and make the right choice to live Again.


Sickle Cell Disease (SCD), a silent killer in Uganda


Sickle cell disease is one of the most common public health problems in the world today. It affects 25 percent of the world’s population, more than 1.6 billion people (Benoist et al. 2008). The Ministry of Health for the last two decades has focused on the prevention and treatment of diseases like malaria, HIV/AIDS and the provision of child immunization against measles and polio. Sickle cell disease in Uganda is not among the health conditions which have been prioritized in terms of resource allocation and it has remained a major silent killer.

Sickle cell is an inherited condition which changes the normal shape of the red blood cells. The red colour of blood is made up of a pigment called haemoglobin which carries oxygen with protein to the body tissues for normal function and removes carbon dioxide. The modified haemoglobin causes round blood cells to become stiff, sticky and sickle shaped. The deformed cells can block blood flow, causing severe pain, organ damage and stroke.

How many people suffer from Sickle Cell Disease?

In Uganda, the disease has been a major public health problem for many years, according to data from the 2001 Uganda Demographic and Health Survey (UDHS) 71% of children under five and 37% of women of reproductive age (WRA) were anemic. Five years later, these rates increased to 73% and 42%, respectively (Uganda Bureau of Statistics and ICF International, Inc. 2007). In 2015 the Uganda Sickle Cell surveillance study (US3) was conducted and it indicated that the country still has a big number of sickle cell patients.

The study revealed that districts from the northern region had the highest prevalence of sickle cell trait amounting to 18.6%.  The East-Central region was second at 16.7%, followed by Mid-Eastern Uganda with 16.5% and South-Western region had the lowest at 4.1%. During the study it was discovered that out of 23, 000, children who were tested from different regions, 2,800 tested positive for sickle cell  gene which amounts to 12% of the tested sample.  This implies that one in every ten babies born in Uganda carry the gene.

In infants signs of sickle cells start to emerge as early as six months, the common signs include swelling body parts especially the hands and feet during the first year of life. Patients with sickle cells have low blood levels or anemia, yellow eyes especially when dehydrated and experience episodes of pain when sickle cell block blood flow and decrease oxygen delivery.  In adults, many have ulcers and bone infections and in men they can experience uncontrolled painful erection.

Though the number of children born with sickle cell gene in the country is high, only 7,000 patients are registered with the Sickle Cell Clinic at Mulago National Referral Hospital. On average the clinic receives 200 patients over five days according to the information from the Sickle Cell Association of Uganda. Mulago Hospital has the only sickle cell clinic and it is a day care centre operating from Monday to Friday.

Malaria and Sickle Cell Disease

Malaria is widely considered to be one of the major causes of illness and death in patients living with sickle cell disease in Uganda. This has created a need to scale up malaria control, prevention and treatment interventions. Results from the Uganda Sickle Cell surveillance study revealed that the Northern region which had the highest prevalence of sickle cell also had the highest prevalence of malaria at 63% and the south western region which had the lowest prevalence of sickle cells also had the lowest prevalence of malaria at 13%. This implies that interventions to prevent and treat malaria can reduce and control the increasing number of children born with sickle cell genre and also improve the lives of sickle cell patients. The government needs to revise and improve strategies to fight malaria especially in the Northern and East-Central regions where prevalence of malaria is still high.

sickle cellTackling Sickle Cell Disease

Awareness about sickle cell disease is still low especially in rural areas where most of the patients live, there is need for government and non-government organizations to come up with countywide programs to create awareness on how sickle cells can be prevented, encourage couples to go for genetic testing, highlight the importance of newborn screening and available treatment options in case the baby is tested positive. This will reduce the number of children born with sickle cells and also increase the number of patients seeking for treatment.

Interventions that can help to reduce and control sickle cells are genetic counseling and new born screening services for early detection, prevention and provision of vaccines, clinical care for children and pregnant women and also capacity building of human resource to improve quality of life of sickle cell patients. These interventions should be made available in lower health centres which most Ugandans have access to.  Health centres should be equipped with enough pharmaceuticals and trained human resource to respond to the needs of sickle cell patients. For patients with sickle cell diseases to live a better life, interventions that improve survival, prevent complications, treat acute events, and reduce end organ damage must be made available at all times especially in lower health centres.

Prevention and control strategies including encouraging Ugandans to sleep in insecticide-treated mosquito bed nets should be scaled up since it has been established that there is a direct relationship between sickle cells and malaria. Also supplementation of women and children with iron and vitamin A, deworming, food fortification particularly vitamin A-fortified oil Comprehensive care programs for sickle cell patients especially infants should be introduced at lower health centres to prevent complications which negatively affect their survival and quality of life.

Finally, strong political commitment and continued investment in strategies to reduce the disease are needed to help patient/parent support groups and advocacy organizations scale up countrywide interventions and draw government’s attention to sickle cell disease as a public health priority. There is greater need for proactive measures and collaboration on the part of the government and its partners to effectively implement population screening and counseling programs as a prevention strategy is much more economical than spending on managing the burden of sickle cell disease in children.

By Ssekajoolo Mathew,

The writer is a social worker and advocate for health equity and social justice.


Twitter @Ssekajoolo

Taking a new challenge


It all started on 10th/02/2017 with a congratulations message from Marcel Koomson the Challenges Worldwide Programme Co-ordinator in Uganda telling me that I had been accepted on the programme as a Volunteer Team Leader. I would be responsible for supporting a group of volunteers from Uganda and the UK during a three-month period from February to May 2017.
Challenges Worldwide is a social enterprise based in Scotland. They support entrepreneurs and enterprises to strengthen their skills and abilities, helping them to grow business that generate income, sustainable economic growth and employment. Challenges Worldwide ICS is a development programme that brings together young people from the UK and developing countries and offers them the chance to play a key role in reducing poverty in some of the world’s poorest countries. Challenges Worldwide volunteers work with growing businesses across Africa and Challenges have been working here in Uganda for several years.
I was excited about joining a team of vibrant young people with diverse knowledge and cultural background from Uganda and the UK at the same time nervous about my position and responsibilities as a Team Leader. Filled with mixed feeling I knew it was the perfect opportunity for me to improve my knowledge on how social enterprises operate and how to improve their effectiveness in creating social and economic change. My first week in the programme was really a learning period, I learnt how to live with my fellow team leaders Patricia from Uganda, Anna and Chris from UK with support from Challenges staff members, especially the Programme Manager Nicola and Co-ordinator Marcel. I was able to adapt to the new cross cultural working environment. I am building my social capital and my network with people in business, volunteers and staff who I believe will be very essential in developing my career.
Before joining Challenges Worldwide I had worked with different organizations both government and non-governmental in different positions. I have been looking for an opportunity to get business experience and learn how it can be integrated into social projects to create lasting change in the Ugandan community. This programme has offered this unique opportunity and I am now learning the potential that businesses have in changing people`s livelihood and improving economies. Since I joined the programme, I have been able to interact with different social entrepreneurs in agriculture, ITC, Health, Education renewable energy. Through these interactions I have been able to understand how different businesses operate and are managed. This experience has already improved my understanding of business which I believe will be relevant in my future work.
Through the Chartered Management Institute (CMI) trainings, we are learning how different tools, theories, and approaches can be used in improving social enterprises and enable them make more impact in their communities. Being a Team Leader, one of my roles is to facilitate CMI sessions for the volunteers and ensure they are applying the knowledge and skills in their business. This has helped to improve my communication skills and also my knowledge about business consultancy and building an effective client relationship. This programme has offered me a unique opportunity of new learning. This experience gives myself and volunteers a chance to understand what methods work in a particular setting, which is not offered in the training institutions in Uganda.
I can confidently say, even just five weeks in, that this programme has not only contributed to my career development, but has provided a perfect opportunity to contribute to the development of my country through supporting businesses and enterprises in Uganda to operate more effectively and increase their social impact to create a sustainable and a more empowered community.

Those days

Those days have come, when society will isolate me,

When I will not be able to sit in the same room with my classmates,

The days when I can’t attend school anymore

Those days when I can’t sleep in the same house with my family,

When I will spend nights without bathing.

The days when I can’t eat good food even when it’s available

The days when I can’t play with my friends,

When I can’t go to the market or even to the hospital

Those days that make me feel like I’m dead while I am living.

The days have come, to be called unclean, untouchable, impure,

The days when a normal and natural process will become a secret

When I will have to suffer in silence.

Those days when I will not be allowed to sit and have a meal with my family,

When I can’t join the community in any function, not even in prayers

Those days that make some think a minor is ready for marriage,

The days when I can’t even touch a plant,

When I am not allowed to cook

The days which make me feel like I am nothing

No one prepared me for those days, even when they

knew they will come,

I’m afraid to ask my parents, the only person I can talk to is my friend,

Who also knows very little about those days

No one can understand that I need sanitary pads, menstrual cups, tampons or clean cotton cloths during those days.

They don’t know that I need to drink a lot of water and eat good food during those days

They don’t know at times I need medicines to relieve the pain during those days

They don’t know that I need to exercise and relax during those days

They don’t know that I need their support to make those days safer for me.

I am motivated by those women and men, who taught us all about menstruation.

Who can confidently talk about those days.

They represents a community that I want to see

The community in which I believe menstruation matters everyday, everywhere

It’s something which is normal and not a taboo

And no one should be afraid to talk about it.

Now I know menstruation is normal and it’s what make me special

I feel proud that I am growing into a young woman who will one day, change Africa.


Inspired by International Women`s Day

Be Bold For Change

Be bold to question, to challenge and fight the conscious and unconscious gender biases within yourself, Be a voice, a speech, an author, a poet, a writer for her story,
Be a fighter, a lawyer, an advocate, defender for her rights,
Be the courage, the motivation, the hope for her future,
Be a change, a catalyst, a leader for her community,
Be a keeper, a mentor, hope for her goals,
Be a teacher, a parent, a social worker, a friend who listens to her concern,
Be bold for change

Be bold to stand with her, nurture her into a future leader,
Let everyone understand being a feminist is not becoming a perfect human being but simply someone who understand her privileges and responsibilities,
Her rights and duties,
Give her the opportunity to be herself,
Let her learn and lead,
Let her start business, be a boss , a manager, a CEO
Be bold for change,

Take a challenge,
Broaden your knowledge about diversity and inclusion,
Challenge policies, laws and cultures that limit her participation,
Be a leader who listens to her voice,
Speak against the gender disparities,
Welcome different points of view and value different individuals as they are,
Support efforts to end Gender based violence,
Support her to get high quality education,
Give her skills and resources to manage her business,
Respect her decisions
Point out bias and highlight alternatives,
Applaud social, economic, cultural and political women role models,
Celebrate women’s journeys and the barriers overcome,
#BeBoldForChange this 2017 IWD and beyond.