Okotel Misaki, 25, is dedicating his life to improve the health resources of those living in refugee camps in Uganda.

JSI and World Education in Uganda JSI Research and Training Institute, Inc's and World Education's Integrated Model District Programme (AIM) is a USAID funded programme that is looking beyond prevention or clinical services toward a continuum of care model that meets a full range of needs. This approach enables men, women and children in selected districts in Uganda to access and utilise appropriate, available, affordable and quality HIV/AIDS prevention, care, and support services. Activities are community driven, ensuring a core set of services while building the capacity of local groups to plan, implement, and monitor activities which address current needs as well as the growing complexity of the epidemic.

Okotel Misaki decided in high school that he wanted to help improve people's lives. After one of Uganda's many civil insurrections, Misaki's family spent 10 months living in a refugee camp for internally displaced people (IDP). There he learned first hand the hardships IDPs live through after they've already had to leave their homes under duress-the lack of food, running water and sanitation. Luckily, Misaki was able to continue his schooling and ultimately attended college. Once out of school, he looked for work until he heard from a friend about a group that was working with IDPs and other people in need. He applied for a job and for three years has been the Program Officer for Monitoring and Evaluation at Healthneed, a non-governmental organization (NGO) based in Soroti District, Uganda.

Healthneed is a small organization dedicated to improving the health of the people it serves in Soroti and Katakwi districts. Healthneed was launched in 1993 by providing relief support to displaced populations and renovating of health units with the assistance of MSF Holland. In 1997, as MSF pulled out, they identified an NGO from the Netherlands (Healthneed) to continue to provide support their work in communities.

In the Magoro IDP Camp near Katakwi, Healthneed is working to improve camp sanitation and strengthen health services, in particular increasing the IDPs understanding of AIDS and how to prevent transmitting the disease. Misaki visits the camp about once a month, traveling by motorcycle over 45km, mostly along dirt roads. At the Magoro camp, he has trained peer counselors-people living in the camp-to provide information on a range of issues including HIV/AIDS and sanitation.

In the Magoro refugee camp, young men have given up hope and spend most of the day drinking. The poverty and drinking are directly related to the burgeoning rate of AIDS in Ugandan camps.

HIV is a large problem at the camps. Soldiers who guard the camps often take advantage of the women interned there, and the lack of work or schooling for older youths also promotes poverty and drinking, both of which encourage unsafe behaviors. While no one knows the HIV prevalence rate at the Magoro camp, AIDS is on the increase. There are no voluntary counseling and testing (VCT) services available at the camp or in the nearby town, Katakwi, though the NGO Action AIDS sets up a clinic a few days a week to treat opportunistic infections affiliated with HIV and AIDS. There is one ambulance to serve a broad area of 10 health clinics, but with no communications, it never gets to Magoro even when there is a need. There are no doctors-or even a midwife-at the camp, and women giving birth typically use a traditional birth attendant with rudimentary skills.

There is a local school the younger children can attend, but with little food and at times 200 children to a classroom, little learning actually takes place.

With all these concerns at Magoro — and the six other camps Healthneed serves — the organization is working in incremental steps. Community peer educators are one way. Improving sanitation is another. But it does not have nearly the capacity or resources to provide HIV testing and counseling, even though the community is crying out for this service. Healthneed has turned to the USAID and CDC-funded AIDS/HIV Integrated Model District Programme (AIM) for assistance. AIM is working with Healthneed on strategic planning, and once completed, will assist with setting up some of the systems they so desperately need. Along with VCT, Healthneed has identified issues such as assistance to orphans and education as critical to improving life in the camps and surrounding communities.

AIM will work with Healthneed — and other similar NGOs in Uganda — to build its systems and capacity to help in refugee camps as well as potentially expand their services in their districts.