Just to locate where I am, Uganda is part of East Africa, a land-locked country, that has been called 'the pearl of Africa' for good reason with its welcoming peoples and largely fertile lands. Lake Victoria, to the south of Uganda is the size of Wales, which puts its size in context.
It has the second highest rate of growth in population in the world at the moment (3.3%) with 50% of the population being under 15 years of age and the population doubling every 20 years. So it is no surprise that much of the forthcoming development money is going into family planning, maternal and child health, and alongside is a focus on agriculture; coffee, maize and beans being of key importance. Climate change is taking its toll with less predictability in the rainy seasons with its knock on effects on production and every step of the supply chain.
The prevalence of HIV/AIDS has reduced from about 30% in the early 1990's to between 6-7% due to President Museveni being willing early on to acknowledge the condition, seek international help, and develop an Emergency Plan to tackle the issues it has brought. Still, about 80,000 people die from AIDS each year and the ART is not accessible to all, and for those who can access it, there is not a consistent supply as yet.
As people live longer with HIV and AIDS here, HIV-related cancer rates are increasing, as are particular kinds of cancer in the general population. Due to the lower standards of health care here, people suffer greatly from the tumours and the open wounds that often develop when there is no treatment and of course, incredible levels of pain then are experienced. Uganda was the third African country to change legislation to allow oral morphine to be used which is the cornerstone of palliative care in Africa - attention to pain and symptom control allows holistic care into people's lives at a personal level as the levels of pain otherwise severely limits the ability to have any quality of life.
As you can imagine, and it may be coming over, I am in a steep learning curve about palliative care in Africa and in Uganda particularly. Uganda is seen as leading in mainstreaming palliative care and yet, even here, there is a long, long way to go.
The other key development is that Uganda has oil reserves, and a lot .. . 2.5 billion barrels. Exploration actually started in the 1920's. 55 wells have been drilled. 26 developed into exploratory wells with only 4 having no oil. Tullow Oil, originating as an Irish company has been exploring oil and it expecting to start bringing oil to the surface later this year but production on any scale is estimated to start in 2015. There is much excitment and almost as much concern in relation to the potential riches the oil may bring. The legal framework is poor and resources for Uganda will most likely come from the processing of crude oil. A baseline assessment of the environment is needed urgently.
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