'Umugore wanje atinya imibonano mpuzabitsina, nanje ntinya gupfa' - ingaruka zo guhagarika USAID

Ubuzima bwa Mike Elvis Tusubira, umushoferi wa moto agendana umugera wa Sida muri Uganda, bwarahindutse cane kuva Perezida wa Reta Zunze Ubumwe za Amerika Donald Trump ahagaritse imfashanyo ku bindi bihugu mu kwezi guheze.

Uretse ko uwo umugabo w'imyaka 35 afise ubwoba bwo kubaho kubera asanzwe afata imiti ipfupfahaza indwara ya Sida (ARV), avuga ko azotegerezwa kuvana n'umugore wiwe kubera ko batagishobora gukora imibonano mpuzabitsina ku bwoba bwo kwanduzanya indwara.

Umugore we nta mugera wa Sida afise kandi afata ibinini vya PrEP, umuti ugabanya ivyago vyo kwandura umugera wa Sida.

"Bivuze ko n'urugo rwanje rugiye gusambuka, kuko atagira ubwo buryo kwirinda, ntazoguma ngaha,'' niko yabwiye BBC.

"Nta dukikingirizo, nta mavuta yo kunyereza [lubricant] mu kwirinda kwandura umugera, nta PrEP, nta kintu na kimwe. Ntidushobora kuguma tubana ata mibonano [mpuzabitina dukora]. Bisigura ko ngiye gusubira kuba jenyene."

Imiti n'uburyo bwo kwirinda gusama inda uwo muryango wakoresha wayironka kubera imfashanyo Amerika yatanga ibicishije mw'ishami ryo gufasha ibindi bihugu USAID.

Kuva ayihagaritse giturumbuka, ibintu Tusubira yamenyeye ku mbuga hwaniro, ntibashoboye gusubira kuronka imiti yabo uko vyahora. Umugore wiwe ubu PrEP yaramuheranye yose, ubu bompi bakaba bafise ubwoba ko gukoresha udukingirizo gusa - two haracari udusigaye - atowovyizigira.

Trump yategetse ko imfashanyo ku bihugu vyo hanze ihagarikwa mu kiringo c'iminsi 90, ingingo yafashe ku munsi wa mbere yongera kwinjira amabanga y'umukuru w'igihugu, kuva ico gihe hakaba haciye hasohoka amategeko yo guhagarika akazi mu bigo vyose vyafashwa na USAID.

Mu nyuma imigambi yo gufasha abari mu kaga yaremerewe kubandanya ikora, ariko ico gihe umugambi wa Sida Tusubira yarimwo - wari mw'ivuriro rya Marpi mu buraruko bw'umurwa mukuru, Kampala - wari wamaze guhagarara.

Yahamagaye umujenama wiwe mu Kigo Nderabuzima ca Kiswa III mu gisagara kugira ngo amenye uko bimeze.

"Umujenama wanje yari yagiye ruguru. Yambwiye ko atagikora muri iryo vuriro."

Uwo mugabo w'umwana umwe, yamenye ko afise umugera wa SIDA mu 2022, kuva aho ntiyashoboye gukoresha ibipimo vyo kumenya ingene umugera ungana mu maraso n'inguvu z'ukwirwanira umubiri wiwe ufise.

"Ndiko ngendagenda mu mwijima. Sinzi ko umugera waheze mu mubiri wanje. Nahahamutse.''

Ntiyibaza ko akazi kiwe ko gutwara moto, kazwi muri Uganda nka "boda-boda," kazoshobora kumufasha gusimba ivyo bibazo bihanze umuryango.

"Bamwe bavuga ko imiti izoba iri mu bigo vy'ubucuruzi vy'abikorera ku giti cabo... nk'umushoferi wa boda-boda, sinzi ko nzoshobora gukorera amafaranga yo kugura imiti."

Avuga ko bagizweko ingaruka no kubura ivyo bahora baronka biciye mw'ishirahamwe ritegamiye reta (ONG) ryafashwa na USAID.

Umugore wiwe yaronka imiti ya PrEP biciye muri ONG yo muri Marpi, nawe umwana wiwe w'umuhungu w'imyaka itanu yafashwa n'iyarihira ishure n'ivyo kurya abana b'intege nke.

''Umwana wanje ubu ntakiri kw'ishuri," niko yavuze.

Igisata c'amagara muri Uganda kizera cane ku mfashanyo, izana 70% y'uburyo bukoreshwa mu migambi yo kurwanya Sida.

Ico gihugu co muri Afrika y'ubuseruko kiri mu bihugu 10 vya mbere vyaronka imfashanyo nyinshi ya USAID muri Afrika. Amakuru atangwa na reta ya Amerika avuga ko igihugu caronse miriyoni 295 z'amadolari mu mfashanyo y'amagara y'abantu gihawe na USAID mu 2023, kikaba kiri mu kibanza ca gatatu inyuma ya Nigeria yahawe miriyoni 368 z'amadorari na Tanzania yaronse miriyoni 337.

USAID yafasha kandi imigambi y'ico gihugu mu kurwanya indwara za malaria, igituntu n'imibembe - yanafasha kandi mu migambi y'amagara y'abana n'abavyeyi no mu bibazo vy'amagara vyihutirwa.

Abakozi ibihumbi bakora mu gisata c'amagara y'abantu baragizweko ingaruka n'ihagarikwa ry'iyo mfashanyo ya Amerika.

Muganga Shamirah Nakitto, akora muri Reach Out Mbuya (Rom), ishirahamwe ry'ikibano rishingiye ku kwemera ritanga ubuvuzi rikanashigikira mu nyifato abagenda umugera wa Sida muri Uganda - yakorera kw'ivuriro rya Kisenyi Health Centre IV, gifasha karitiye y'abakene baba ahantu hadatunganijwe ku mategeko i Kampala.

Muri rusangi, yakurikirana abarwayi 200 ba Sida n'igituntu buri munsi. Ariko nyuma y'itangazo ryo guhagarika imirimo, abakozi bose ba Rom barahagaritswe.

Igisata c'igituntu ubu nta gakoma, n'igisata c'impfuvyi n'abana b'intege nke naco carugaye i Kisenyi.

"Turindiriye iminsi 90. Iki kiruhuko twategetswe kujamwo ntaco nari niteguriye,'' niko yabwiye BBC.

''Kandi caje bukwi na bukwi. Gushikiriza akazi ntivyakozwe neza. Twarahagaritse gukora ubwo nyene.''

Ubushikiranganji bwa Uganda buvuga ko buriko buraraba uko ingaruka zitoba nyinshi cane.

Muganga Diana Atwine, umuyobozi mukuru mu bushikiranganji, yasavye abakozi ''bashaka kubandanya akazi ku gatima ko gukunda igihugu no kwitanga'' ko bobimkenyesha.

Mu bumanuko muri Malawi, ibikorwa vyakorwa ku mfashanyo ya USAID navyo vyahagaze.

Ico gihugu caronse miriyoni 154 z'amadolari zaturutse ku mafaranga agenewe amagara muri USAID mu 2023, bituma kiza mu kibanza ca cumi mu bironka imfashanyo nini muri Africa.

Mu gisagara ca mu Mzuzu kiri mu buraruko, inzugi zirugaye kw'i vuriro ryahora riri mu yakomeye mu gutanga ubufasha ku mugera wa Sida muri iyi ntara. Imodoka ziricaye; nta kimenyetso c'igikorwa na kimwe ubona kw'ivuriro rya Macro Mzuzu Clinic. Abakozi barugaye imyango, barazimya amatara baca barataha iwabo, haheze iminsi 18.

N'ubwo ubushikiranganji bwa Amerika bujejwe imigenderanire mu nyuma bwatanze uruhusha ku wa 28 Nzero rw'uko imiti nka ARV yotangwa, amavuriro menshi yari yarugaye kuko adafie abakozi batunganya ivyo bikorwa vya USAID, gutanga iyo miti bica bigorana.

Na hamwe ibikorwa vyokwemerwa gusubira kurangurwa, amasezerano menshi y'akazi (contrats) ntawuzi kazoza kayo. Abakozi bo mu gisata c'amagara ntibazi ivyo gukora n'ivyo kureka.

Reta ya Trump itegekanya kugabanya abakozi ba USAID ku rugero rurenga 90%.

Atul Gawande, yahoze ari icegera c'umuyobozi w'igisata c'amagara ca USAID kw'isi, yavuze ko abakozi bayo bazogabanywa kuva ku 14.000 gushika ku 294 - 12 bonyene akaba ari bo bagenewe Afrika.

Amerika yari imaze imyaka myinshi ari yo ya mbere mu gufasha Afrika mu bijanye n'amagara y'abantu.

Cane cane biciye ku mugambi watangujwe mu 2003 wo kurwanya ikwirakira ry'umugera. Uwo mugambi wari uzwi nka nka ''US President's Emergency Plan for Aids Relief (Pepfar)'', wararokoye ubuzima bw'abantu barenga miriyoni 25.

Ku bw'umukuru w'ikigo ca Afrika co kurwanya indwara Africa CDC, USAID mu mwaka uheze yahaye Afrika imfashanyo ingana na miriyaridi 8 z'ama dorari.

''73 kw'ijana yagiye mu gisata c'amagara'' niko Jean Kaseya yabwiye BBC Newsday mu kwezi guheze.

Abahinga bavuga ko kuronka amafaranga asubirira ahavuye ayo bizogorana cane.

Ibihugu vyo muri Afrika biramaze kugira akigoro mu kugabanya kuzera hanze. Kenya iririhira 60 kw'ijana yo kurwanya Sida. Afrika y'Epfo igeze ku 80%.

Ariko ku bihugu vyinshi vy'amikoro make, amadeni, ibiza bifatiye kw'ihindagurika ry'ibihe n'ibindi bibazo vy'ubutunzi bituma kwigwanako bidashoboka.

Amref Healtj Afrika, rimwe mu mashirahamwe ategamiye reta akomeye ku mugabane, igabisha ko ata cihuta gikozwe, umutekano w'amagara y'abantu kw'isi ushobora kubangamirwa.

''Ibi bisaba ibihugu vya Afrika na CDC kwongereza amafaranga yavyo, ivyo bikaba bisa n'ibidashoboka uravye uko ikibazo c'amadeni cifashe,'' nk'uko umuyobozi nshingwabikorwa wayo yabwiye BBC.

''Mu gihe ivyaduka biguma vyiyongera kubera ihindagurika ry'ibihe n'ingaruka z'ibikorwa vy'abantu ku bidukikije, ibi bizotuma isi igoyagoya kandi ntitekane - atari kuri Afrika gusa, kuri buri wese.''

Kw'isi yose mu 2023, hapfuye abantu 630.000 bahitanywe n'indwara zishamikiye kuri Sida hamwe n'abantu bashasha miriyoni 1,5 banduye umugera.

N'ubwo urugero rw'abandura rwari rwaragabanutse mu bihugu vyari bibangamiwe cane, ingaruka zo kwugara USAID zishobora gusubiza inyuma intambwe yari yarashitsweko.

Winnie Byanyima, umukuru wa UNAids yabwiye ikiganiro Africa Daily ca BBC muri iyi ndwi ko ''ufatiye kuri iyo ntererano nini ya Amerika, twiteze ko mu myaka itanu iri imbere, hazokwiyongera abantu miriyoni 6,3 bapfa bahitanywe n'indwara zifatiye kuri Sida''.

''Hazoba abandura bashasha bangana na miriyoni 8,7, abana bagizwe impfuvyi na Sida nabo hiyongereko miriyoni 3.4. Sinshaka kuba imburi y'umunsi mubi, ariko mfise inshingano zo kuvuga uko ibintu tubibona.''

Dusubiye muri Uganda, Tusubira ntabona kazoza.

Asigaranye imiti ya ARV izomumaza iminsi 30 - kandi ashobora gufata ingingo yo kuva Kampala agasubira kuba ku gatumba inyuma y'aho.

''Nibura ho bizokworoha gato. Mpfuye, baca bampamba aho nyene, hako ngora abanje ngaha i Kampala.

''Kuko nta buryo mfise bwo kuba ngaha ntagira ARV.''