Nassa Michelle Mich

Nassa Michelle Mich was only 13 years old when she was diagnosed with HIV. She was on a break from school in 2015, visiting family in northern Uganda. An aunt took her to get tested.

I had started getting very sickly, like in and out of the hospital. There was no cause. No malaria. There was no typhoid. My aunt just said, Let’s test. And when they tested, I turned out positive.

She was scared to confide in her father but needed his guidance on what to do next. Should she return to Kampala, where he lived and where she attended school? When she finally worked up the courage to call him, he hung up as soon as she told him about her diagnosis.

Then he called back and said I am no longer his problem. I should find somewhere to stay.

Mich returned to Kampala anyway.

He would just kind of abuse and throw insults. That you’re a prostitute and I’m not taking you back to school. But I did go back to school.

Eventually she decided to move to Gulu. She started receiving treatment at a specialized clinic tucked in the back of the city’s sprawling referral hospital.

It felt like a safe place for me. They had youth get togethers once a month, so we could the second Tuesday of the month. You have all the young people coming and they’re talking about their experiences. How they deal with keeping their meds when they’re in boarding school. How they deal with the stigma. Or just to talk about other issues.

One of the nurses, over time, said you really have good English. Would you mind talking about the issues teenagers face as they start [anti-retroviral therapy]? There is this meeting with the board of directors for the hospital.

I was like, Why not? For the first time, it felt like I was useful, and I was needed somewhere.

She started looking for more opportunities to help.

I wanted to give kind of a listening ear to the young people who don’t have a proper support system. Most of them don’t, when it comes to our region here. I became the peer counselor and peer educator. It felt easier, like the whole world knew, and I don’t have really a very big burden or secret so keep.

In 2021, I contested to become the Miss Y+. It’s like a pageant for positive young people, to become an ambassador for young people.

Mich ran on a platform that emphasized the importance of maintaining the kind of specialized services for young people that had helped her so much. She won the pageant on her second try, in 2022.

I don’t think I’ve wanted to turn back.

She is currently studying food science and agribusiness at a university in Gulu, but she would use any spare time to continue her work as a peer educator.

When you have peer supporters like us, when a young person comes in [to a health facility to get tested], they have a direct access. I’m going to come to them and be like, Hi, my name is Michelle. And you are? How can I help you? And then it’s direct to the youth friendly corner and they are getting their services.

The U.S. cuts to foreign aid in January eliminated those services.

Some of the other peer supporters who are there, they all stopped going to work. I think everything kind of just stopped. Whatever that was happening just stopped.

Instead, anyone who needs HIV services is being directed to the Gulu hospital’s outpatient, or OPD, ward. Mich worries about how young people will respond to this shift.

Our OPD is very crowded. The time I went there to get services, and I spent the whole day without really getting treatment. The people who work there are very, how can I say, not nice. They’re very angry all the time. So they’re unable to have the courtesy to deal with you as a patient, as a client.

And they really announce people’s results openly. So just imagine you’re there waiting for your ART and someone stands there, Ah, Michelle, come and get your ART. And everyone is looking. That would definitely kill me.

Particularly back in the days when she was a teenager, still ashamed of her HIV diagnosis.

The in-charge of the [specialized youth HIV] clinic was telling me that she’s worried that this is going to cause an increase in the number of unsuppressed clients. Even the ones already suppressed are going to become unsuppressed because of that shift to OPD.

If people are not suppressing, which happens when a patient stops taking the drugs to keep HIV in check, they can develop resistance to their previous treatment. Eventually, if they do not restart ART, they will die.

The young people are going to disappear into thin air.