A Champion for Youth
Muwonge Gerald Discusses the Struggles and Successes of the Foaster Foundation for Healthcare Uganda’s Efforts to Help Youth Affected by HIV/AIDS
by Chael Needle

In a Valentine’s Day video message posted on the Facebook page of the Kampala-based NGO they founded, the Foaster Foundation for Healthcare Uganda (FFFH-UG), Muwonge Gerald had this to say to other advocates:

“In the days of me growing up, I didn’t know what love is. But today I want to extend my sincere gratitude and love to my fellow community leaders, mainly the minority leaders, the LGBTQ community: You really deserve love. Because the work we are doing, the work you are doing is not easy. It is work that has trauma, insecurity, and all kinds of human rights abuse that we go through doing this work. But I really see that you guys we are doing a great work. So Happy Valentine’s to all the human rights defenders in Uganda. Happy Valentine’s to my community, the LGBTQ community in Uganda.” In closing, he waves with a smile and a cheery hello, as if to say, I see you, before blowing a kiss.

Gerald, who serves as the foundation’s executive director, is on a mission to help empower young people living with HIV/AIDS in Kampala and its outskirts. Since its launch in 2019, the Foaster Foundation for Healthcare Uganda, where he is also a team leader, advocates for equity in providing medical care for youth living with HIV/AIDS and to create sustainable and socially transformative programs for LGBTQ+ and women. The nonprofit is youth-led and, taking its cue from national and global health priorities and goals, focuses on sexual reproductive health and rights, HIV/AIDS, TB, and human rights for everyone regardless of gender, religious affiliation, cultural affiliation, and sexual orientation. FFFH-UG also actively promotes the “meaningful involvement and collective organizing of AGYW [adolescent girls and young women] living with HIV to strengthen a unified, vibrant, national, and sustainable youth led movement in Uganda.”

What prompted this twenty-seven year old queer Ugandan living with HIV/AIDS to become an advocate? Both reasons are close to home.

A family member had been paying Muwonge’s school fees when they were younger, but, after he died of AIDS-related causes and Muwonge had to leave school, they felt an inner turmoil. “[It] made me to straighten up and become a better person,” they say about becoming an advocate, first and foremost making sure “those who aren’t sick keep safe and those who are sick adhere to their medication.”

Muwonge Gerald raises awareness about PrEP with LGBTQ community members at Kasaganti Health Center III, as part Foaster Foundation for Healthcare Uganda’s services.

Their advocay was also prompted by their own seroconversion, which they relate touchingly in their bio: “2016 was the year [they] tested positive fell to rock bottom only to rise and float, not as a dead body but a swimmer braving the waves of self-unworthiness, stigma, poverty and so much. Therefore [they] made it a priority to be at the forefront to curb the scorch of HIV/AIDS within the youth of his community.” For others, they strive to be an example of “positive living”—”a true testimony of everything they advocate for.”

Gerald knows that examples of positive living are much needed. According to UNAIDS, the number of adults and children living with HIV in Uganda is 1,400,000. In terms of the HIV testing and treatment cascade: about 91% of people living with HIV know their status; about 90% of people living with HIV are taking antiretrovirals; and about 82% of people living with HIV have achieved viral suppression.

According to a Demographic and Health Surveys report (2016), quoted by UNAIDS, 45% of young people ages fifteen to twenty-four knew about HIV prevention.
Along with Gerald, the five all-volunteer staff members help implement the nonprofit’s holistic and wide-ranging programs to address the needs of people living with HIV/AIDS or at risk for acquiring HIV. One of its programs provides support services to people living with HIV/AIDS and other STIs, including education about living well with HIV, drug adherence, safer sex and their general wellbeing in the community.

Another program teaches people living with HIV/AIDS about nutrition and diets that will help them. FFFH-UG also provides some food to its clients, when available.
In addition, the foundation helps clients living with HIV/AIDS by promoting social-economic empowerment. In order to generate their own income, youth are provided practical vocational training in activities like carpentry, hairdressing, cake baking, tailoring, catering, and animal husbandry. Income leads to writing up business plans and setting up small businesses and planning for the future—that’s the idea behind helping youth become self-reliant.

Other programs include psychosocial support, partnership building and advocacy, legal support, and sexual reproductive rights services.

Although people living with HIV/AIDS in the U.S. may have greater access to this kind of support, people living with HIV/AIDS and what Gerald calls “vulnerable groups” like LGBTQ+ youth and young women often face perhaps steeper hurdles to health and wellbeing.

Although LGBTQ rights activists successfully blocked the implementation of Uganda’s now-annulled 2013 Anti-Homosexuality Bill, which in earlier versions allowed at one time allowed the death penalty for anyone convicted of engaging in homosexuality, a new bill that contains a clause that criminalizes same-sex sexual activity with the possibility of a ten-year jail sentence almost passed into law. While positive changes in attitudes toward people who are LGBTQ+ have occurred, homophobia is still pervasive and sex between men and between women remains criminalized.

Facts about intimate partner violence and reproductive health reveal how women are in need of support services, as well. According to UN Women: “In 2018, 26.1% of women aged 15-49 years reported that they had been subject to physical and/or sexual violence by a current or former intimate partner in the previous 12 months.” In addition, “women of reproductive age (15-49 years) often face barriers with respect to their sexual and reproductive health and rights: in 2018, 55.1% of women had their need for family planning satisfied with modern methods.”

When it comes to people living with HIV/AIDS, says Gerald, stigma and the perpetuation of negative stereotypes about this group persist as “big challenges.” Notes Gerald, people living with HIV/AIDS are regular targets of gossip and also shunned from workplaces and family homes because of others’ fears of acquiring HIV. People living with HIV/AIDS in this way become “aliens of their country,” states Gerald, who contrasts Uganda with the U.S., where they perceive people living with HIV/AIDS as ostensibly more empowered thanks to the country’s liberal aspects.

Asked about other obstacles some of the affected people face, they say, “The long distances to move to areas where they can access drugs. For example during the lockdown it was hard for our members to [travel] from places like Makindye, Entebbe Road, Nansana, among others, to Mulago and Namuwongo [on the other side of Kampala], where the most at-risk clinics and [HIV] medical centers are. So many of these got infections and, because of the fact that they couldn’t [travel] far, [compounded by] high transport fares, they failed to reach Mulago and resorted to keeping the STDs [untreated].”

Notes Gerald, healthcare workers also create treatment-access obstacles for clients, particularly those who are transgender, through inexperience, stigma, and discrimination.

A legal awareness session, with a focus on LGBTQ rights, in partnership with Human Rights Awareness and Promotion Forum (HRAPF)

Asked about the foundation’s greatest successes so far, Gerald responds: “We managed to train peers through evidence-based approaches…on the correct and consistent use of a condom for those who aren’t sick and adherence for those who are sick.” The foundation relied on evidence from established research but also gathered quantitative and qualitative data through one-on-one interviews.
Additionally, “[w]e managed to mobilize resources to reach out to our fellow members who don’t have support and those affected by the virus. For example, [during] the first lockdown, we managed to help some members in the shelters with food and HIV medication.” The third success Gerald notes is how the foundation managed to follow up on cases of fellow members who had been beaten and imprisoned based on false accusations by homophobes in the community. Gerald reminds: “Uganda is still a homophobic country driven by cultural and religious norms and values.”

The foundation needs more funding, and Gerald and the team have concrete ideas about how the nonprofit might expand if it had more income.

“First and foremost our goal here [is that] we want to have drop-in centers where our members can easily get treatment ,” says Gerald, who adds that the centers would provide much needed information and other HIV services. “So with the funding [I] am looking at having different drop-in centers in the entire country working to support the LGBTIAQ members who in most cases can’t move further but can be availed with the medication closer. And also we are looking at building safe havens for those who have lost hope to be rehabilitated from there.”

Part of the key to bridging gaps in awareness and access to health is the use of social media.

Notes Gerald: “[The] Internet and social media are so important given the fact the generation is changing and now all the youths and others are following the trend. So, with such platforms, it’s where we post all the important information, messages for young people to reach out and also follow. Many young people now have brand ambassadors for platforms and this creates visibility for so many things including but not limited to SRHR [sexual reproductive health and rights].”

In the meantime, Muwonge Gerald will continue to work to support youth impacted by HIV/AIDS as that exemplum they so pointedly described in a written social media post:

“But one thing I know for sure is that my coming out public will encourage people living with HIV, who r still fighting stigma,rejection and denial. My coming out public will help others queer people (LGBT) who think living with HIV limits you from having a healthy life.My coming out public will teach the world that HIV is not a death sentence and people will act human to people living with HIV. I believe that my coming out public will take away the beast in someone’s heart who has decided to spread the virus to others knowingly so we can end HIV in our society. I know HIV can end with us,only if we decide to be human n help n support people living with HIV .

Follow photographer Afram King on Instagram @Afram_king.

For more information, find the foundation on Facebook @foasterfoundationug and Twitter @foasterfoundati. To contact the foundation, e-mail them at: [email protected]

Chael Needle interviewed advocate Jeffrey Long for the February 2022 issue. Follow him on Twitter @ChaelNeedle.