At 2 p.m., we arrived at one of the local public Primary Health Care (PHC) facilities we support for our maternal health portfolio in the rural Kayunga District. Typically, by Tuesday afternoon, patient numbers are low, as most outpatients come on Mondays for treatments, checkups, or drug refills. To ensure better care, we’ve encouraged expectant mothers to attend antenatal care on Tuesdays when the facility is less crowded and health workers have a lighter workload.
However, today was different. Upon arrival, we found the facility in chaos. The crowd was much larger than expected. After inquiring, we learned that an HIV/AIDS partner organisation was winding down its operations. This partner, funded by the U.S. Government through an INGO Prime Partner, had been affected by President Trump’s announcement to freeze all USAID operations. They had received immediate instructions to cease all activities. The team was finalising tasks such as tallying ART clinic data, counting ARV stock, updating records, and providing final care to their clients. Even their community-level counterparts, including para-social workers who received stipends for outreach to orphans and vulnerable children affected by HIV/AIDS, were told to stop working.
Rumour had spread in the villages that ARV supplies would be cut off for the next 90 days. This caused panic, and many people living with HIV (PLHIV) rushed to the clinic to refill their ARVs, fearing they would run out. The PHC clinic in-charge was unaware of the project closure, and the District Health Office had not communicated any contingency plans. No one, including the affected CSO staff, knew what was happening. The CSO staff had been informed by their HR department that their contracts would be terminated by January 31, 2025, and they were to use their remaining days as annual leave.
Sarah, however, couldn’t simply walk away. As an HIV Linkage Officer for the past four years, she had built strong relationships with her 289 clients, many of whom are young women, including expectant mothers who rely on ART for their health and to protect their unborn babies. With tears in her eyes, she expressed her shock, disappointment, and pain over the situation. Her clinic’s ARV stock, which usually lasts two weeks or less, had just been replenished in the third week of January after delays during the Christmas break. Now, with the sudden closure, there was no plan for the next 90 days.
I spoke to one of Sarah’s clients, Rita, an 18-year-old who has been living with HIV for three years. When I asked if she had secured enough medication for the next 90 days, she shrugged pessimistically, looked down, and began to sob. The project had not only provided ARVs but also nutritional support to Rita and other PLHIV under the Orphans and Vulnerable Children (OVC) program. Now, all of that was gone. With no job, no husband, and no access to medication, Rita’s future looked bleak.
I couldn’t stop worrying about the 1.3 million Ugandans whose lives depend on this support. Questions flooded my mind: Do the American people know about this? If they do, do they care? Is this the “America First” foreign policy promised by the new president? Where is our government? Why haven’t they spoken up? Do they care? If so, why didn’t they anticipate this and prepare a contingency plan?
As I prepared to leave, I looked at Sarah—a dedicated young woman continuing to support her clients with a smile and words of hope, murmuring her faith in Jesus and His ability to perform miracles. I couldn’t help but hope that, indeed, divine intervention would come to save these innocent people, whose only mistake was being born in the wrong country—or perhaps with the wrong skin colour. This is the accident of birth.