We are making progress and staying on track. - Evarlyne Buregyeya Asiimwe

Everything has its pros and cons. From a practical standpoint, the military encourages open discussions about any issue. However, this approach can sometimes mean that deeper, personal matters are not fully addressed. People may downplay their true concerns and hesitate to share issues that deeply affect them. Despite this, we have well-established psychosocial services, including trained counselors and psychologists. The uptake of these services has been encouraging, with many soldiers actively seeking help. Today, almost every division has a psychologist. Initially, psychologists were brought in to address HIV-related issues, but their roles have since expanded to cover a broad range of psychosocial concerns, offering holistic and multidisciplinary support.

Yes, it is. One of our key achievements is the introduction of the mobile approach for Voluntary Medical Male Circumcision (VMMC). I believe the UPDF was the first to implement this model, and now it has been adopted widely. It’s not just about pioneering these initiatives, but also about responding to the unique needs of the situation. We realized that establishing a traditional health facility to serve our troops would be impractical—when would we ever complete a whole battalion? And with soldiers often deployed to remote locations, getting them to a fixed facility would be challenging. This is why our funding model is so distinctive. Current funding focuses on high-incidence areas, but often, these areas don’t have our troops. Instead, our soldiers may be stationed in regions where the HIV prevalence is lower, but they still require services. In some of the most remote locations, the prevalence might not be high, but access to healthcare is extremely difficult. It's not just about providing services to soldiers, but also to the surrounding communities who live in these hard-to-reach areas. We must ensure that people in these regions have access to care. It’s been valuable that PEPFAR has recognized the unique challenges of military health needs and routed funding through URC-DHAPP, an organization that understands military logistics and can effectively negotiate at that level. When mapping HIV distribution across Uganda, the scientific approach is logical, but it doesn’t account for the large group of people—soldiers and civilians alike—who still need care, whether it’s treatment or prevention services. Without a tailored approach, these individuals might be overlooked.

The DSDM model involves reaching out to communities directly, where we maintain contact with our clients. We find it more convenient to deliver medication to our clients rather than asking them to travel to health facilities, as many lack transportation or are too ill to make the journey. We identify key points where a large number of clients gather, and that’s where we deliver the medications. This model proved particularly effective during the COVID-19 outbreak. While it existed before COVID, the restrictions during the pandemic helped us organize and streamline the process. It was originally implemented by health workers in remote areas where our soldiers are stationed, and we would gather medical records for certain groups, refill prescriptions, and deliver the medication to those locations. The pandemic only amplified the scope of this initiative, and it continues to function effectively today. We’ve since expanded the model. Now, a multidisciplinary team goes to specific locations to offer a variety of services, rather than just delivering medications. In addition to dispensing drugs, the team conducts disease monitoring, TB contact tracing, and even viral load testing. Essentially, we’re bringing the entire healthcare facility to the community. People now know that on specific days, they can access healthcare services right in their own neighborhood, instead of having to travel long distances to find a clinic. As long as a battalion is stationed in a particular area, we will continue to offer services to both the soldiers and the surrounding communities.