This Friday, December 1st, is World Aids Day. Grania Willisreports from Uganda on efforts there to fight the disease
Berna Nakijjoba is an extraordinary woman. The 66-year-old widow lives in a slum development in the Ugandan capital of Kampala in a makeshift shack not much bigger than a garden shed.
But, even in a country where the average female life expectancy is 41, it isn't just her age that makes Berna different.
Her previous dwelling was washed away last year in the flash floods that frequently affect the 0.3sq km Kimwanyi zone, a desperately overcrowded settlement inhabited by 7,000 people, mostly Aids widows and children.
But although Berna has 15 children living with her in the tiny squalid shelter, she has never had a child of her own. The children in her care are all orphans or youngsters who have been abandoned by their mothers.
The single-room dwelling has just two beds, which Berna and three younger female companions share with the children. One of the adults, a strikingly beautiful woman in her early 20s, is trying to comfort a sickly baby.
The boy, less than a year old, is desperately underweight and, when his vest is removed, his distended belly shows evidence of both malnutrition and worms.
The sores on his back are not Aids related, however, they're caused by syphilis, a legacy from his mother who works in the sex industry and who abandoned her son into Berna's care.
Berna, her face etched with the lines of care as well as age, says that God told her to look after the children. She is a member of the Pentecostal church, whose members provide her with medical support, clothing and food.
With no earning capacity, she also receives assistance from the help of the Makere Women's Development Association, which works in partnership with ActionAid Ireland providing home-based care in the Kawempe division of Kampala.
Betty Namuddu, who lives a stone's throw away from Berna in the Kimwanyi shanty town, is 30 and has two children, the youngest just 11 months. As part of Uganda's mandatory HIV/Aids testing programme for pregnant women, Betty has already had two negative results, but is going for a third test in February.
Testing and counselling services are supposed to be free, but corruption within the system means that many hospitals are now charging 5,000 Ugandan shillings per test. It's only just over €2, but it's too much for many Ugandans and the uptake of testing services is low.
Betty's husband has two other wives and, in a country where a man's masculinity is measured by the number of sexual partners, her chances of remaining HIV negative are slim.
Her mother, 58-year-old Damali Nabagereka, is an Aids widow. Her husband died last year, leaving her with 11 children, including Betty, to raise on a minimal income scraped together by cooking and supplying food to local office workers. All 12 family members, plus two-year-old Futuma, who was abandoned by her mother, sleep in the two bunks and one single bed that are squeezed into a tiny bedroom.
Almost three-quarters (74 per cent) of the young people diagnosed with HIV in Uganda are female. Futuma has been diagnosed as HIV positive. Two other children also abandoned by their mothers into the care of Damali last year have since died.
With the help of the Makere Women's Development Association, Damali and Betty are able to eke out a living and provide some sort of future for little Futuma.
But Futuma's life, like so many others within the Kimwanyi zone, hangs by a thread.
Nutritional support is available from the association, but it is limited and many HIV/Aids sufferers are forced to abandon their antiretroviral drugs treatment because ARVs have to be taken as part of a balanced diet - a luxury that the majority of Kimwanyi dwellers cannot afford.
The suppressed immune systems of HIV/Aids patients leave them vulnerable to opportunistic infections, but sanitation is another massive problem in Kimwanyi, where three toilet blocks are supposed to cater for all 7,000 inhabitants. A 100 Ugandan shilling charge for use may be only just four cent, but it's too much for most families.
As a result, the gutters are running with raw sewage and, when the flash floods occur, like the one that took away Berna's house last year, cholera and dysentery sweep through the settlement, claiming the weakest.
Uganda has had considerable success stemming the tide of HIV/Aids, with its ABC policy of Abstinence, Be faithful and Condom use, cutting Aids numbers from 15 per cent to just 6 per cent of the population, but new research indicates an erosion of the advances made against the disease in the 1990s.
There are now around one million Ugandans living with HIV/Aids and corruption at the highest level means that only around 10 per cent of government funding for the HIV/Aids programme gets to its intended targets.
Although the World Bank multilateral debt-relief initiative slashed Uganda's external debt by almost 90 per cent in May of this year, the country is still dependent on external aid and, unless the G8 leaders uphold last year's pledge to provide Aids treatment for all those who need it by 2010, Futuma and so many of the Kimwanyi dwellers will become another of the sub-Saharan Africa statistics.