Margrethe Junker

In the AIDS-ravaged nation of Uganda, Margrethe Junker is bringing medical, social and emotional care to urban slum dwellers living with HIV/AIDS with no other access. As clients receive care and begin to recover, they become part of the program, working as nursing care providers, social workers, teachers and supporters for fellow clients.

Uganda is widely promoted in the international community as a “success story” in the fight against the spread of HIV/AIDS, but many people, particularly the urban poor, still have only limited access to care, support and treatment. When the immune system becomes compromised by HIV/AIDS, opportunistic infections take over; the most threatening to individuals and communities being tuberculosis. All too quickly, an HIV positive family member can be viewed as a burden and experience heartbreaking isolation.

To help bring medical care and support to the poor communities in Uganda’s cities, Margrethe has developed a community volunteer program called “Reach Out–Mbuya Parish HIV/AIDS Initiative” which trains and employs people with HIV to work as caretakers and supporters for one another. Her model includes counseling, testing, medical treatment and social support through microfinance and other income generating activities, giving people a chance to regain physical health and also become able to financially support themselves and their families. The clients are empowered to support themselves and others in all aspects of the program. As people receive early treatment for opportunistic infections and anti-retroviral drugs when needed, training and opportunities for self-help, they continuously get stronger and healthier.

Moreover, they gain confidence and strength and take leadership roles in the community and defy social isolation.Throughout the community of more than 60,000 slum dwellers, Margrethe has reached more than 3,000 people living with HIV/AIDS and their families by harnessing them into a self-help force that allows ordinary people to access information, improve their health, and run home care facilities for the bedridden, and support each other in income-generating activities.

Uganda was one of the first countries in the world to acknowledge the existence of AIDS. Since 1982, when the disease was first reported, 1.9 million Ugandans have been infected. At least 1 million people are living with HIV, and 100,000 are living with full-blown AIDS. People living with HIV/AIDS are at higher risk from infectious diseases because of their weakened immune systems, and even mild illnesses can be life-threatening. Close to a million HIV-infected people have died, primarily from opportunistic infections.

Because this disease can easily be transmitted from mothers to their unborn children, women and children are particularly at risk. As many as 6.5 percent of pregnant women in Uganda are infected with HIV. Women are sometimes denied the proper care for their condition because of the social stigma surrounding the disease.Although Uganda has made progress in stemming the spread of HIV/AIDS, most of the country’s intervention has failed to provide services for the urban slum communities. These cramped, impoverished areas breed crime, and HIV spreads here more quickly. AIDS is seen as a death sentence, and known carriers are treated as outcasts.

Early treatment allows HIV carriers to live longer, healthier lives despite their illness. However, the poor tend not to come forward for treatment because they cannot afford to pay the necessary fees to be tested for HIV. Of those that are tested, it is rare to receive treatment because the cost is too high.

Margrethe has created “Reach Out,” a network of volunteers who provide holistic care with medical, social, and emotional support to Uganda’s urban poor. Seventy percent of Margrethe’s volunteers are themselves HIV positive, and so know firsthand the stigma that is associated with the disease. By employing people who understand the unique problems of living with HIV/AIDS, Margrethe has cultivated a culture focusing on the “Joy of Giving” that encourages people to love and care for each other as if they were brothers and sisters. For many poor urban HIV/AIDS victims, this is their first time experiencing genuine tenderness from a health care provider.

Margrethe’s approach focuses on a particular geographic area, where her crew runs tests, treats infections, and gives information and training to clients. Some of her employees start as volunteers working for a small stipend, and later go on to higher paying jobs inside the program. She keeps costs low by using doctors and outside professionals as volunteer advisors instead of full-time employees. The clinic is run by nurses, activities are carried out inside the church area, and there are no cars or fancy offices. All services are provided for free, but clients are expected to participate actively in the program.

A major part of the program is devoted to catching opportunistic infections early, such as tuberculosis. Opportunistic infections are the gravest danger to a poor person living with HIV/AIDS and often highly visible. Watching AIDS patients’ health quickly decline when they catch such illnesses is frightening, and in large part responsible for the fear with which AIDS is viewed. When people see how much Margrethe’s patients visibly improve as they recover from these illnesses, it helps to attract new patients to the program. Two years ago treatment with anti-retroviral drugs were introduced, which has made the atmosphere of ‘Hope for Future’ very tangible for all.
Margrethe’s model is starting to spread to other parts of the country and the surrounding region. She has developed a ‘RepliKit” to help other community programs starting a similar model of holistic care. Reach Out is also running basic health care training courses and other training with other community HIV/AIDS programs.

Born in Denmark, Margrethe is the sixth of seven children. When she was eight years old, Margrethe read a book by Albert Schweitzer that inspired her to become a doctor and work in poor communities. She has been true to this early commitment and, throughout her professional life, has mainly worked with poor people in developing countries.

Among her other accomplishments, Margrethe has established a 12-bed hospice for adult HIV/AIDS clients dying in the streets without family; she has provided daily medical care at Maryknoll Seedling of Hope for HIV/AIDS and Tuberculosis in Phnom Penh, Cambodia, where she also started a very successful quilt-making program “Patches of Hope.” She has managed a medical screening program for repatriation of 23,000 Mozambican refugees living in Swaziland and South Africa; she started a youth vaccination program at the Mother Theresa Orphanage in Old Delhi, India; and she planned and implemented with her Sudanese counterpart the National Control of Diarrhea Disease Program in Sudan.

Margrethe lives in Kampala with her husband and five children.