An International network of DSS sites involved in demographic and health research in developing countries      

                                                    INDEPTH SECRETARIAT VISITS RAKAI DSS - NOVEMBER 14, 2007

Started in 1988 as the RAKAI project; a research project in the Makerere University, Uganda, the RAKAI Project has twenty years down the line increased and diversified its research activities, and has been fully transformed to the Rakai Health Sciences Program with support from the NIH, the Gates institute for Population and Reproductive Health at John Hopkins University, Bill and Melinda Gates Foundation, Doris Duke Charitable Foundation, Rockefeller foundation, Walter Reed Army Institute of Research, and many other generous donors.

Rakai DSS is situated in RAKAI district about 160km away from Kampala, in South West of Uganda, and close to the Tanzanian border). Rakai district, where "slim disease" and its association with HIV had been reported in the mid and late 1980s, was considered the epicenter of HIV/AIDS epidemic in Uganda. There was need to establish a population-based cohort to study the multi-facted epidemiology of HIV/AIDS. The Rakai Community Cohort Study (RCCS) was initiated to study the dynamics of the HIV disease. The population under surveillance is 12,000.

The RAKAI program has grown from strength to strength. From the small office premises that they started with, RAKAI Health sciences program today has an ultra-modern office complex, with spacious and well-furnished staff offices, a big computer laboratory, a theatre (where circumcision procedures are carried), a very well equipped laboratory including a P3 lab, where all lab procedures are carried out. It also has a nice meeting place where staff can sit for discussions, meetings, etc.

With regards to research work in HIV, RAKAI continues to provide Voluntary Counseling and Testing (VCT) to surrounding communities. It has moved from the house-to-house counseling approach that was initially adopted, to field-based counseling centers, in which counseling centers are set up at various locations, and people voluntarily troop to these centers to submit themselves to VCT. It should be mentioned that in addition to VCT, the RAKAI HIV program offers ARTs to infected cohort members. It also covers the transportation cost for those who make it to the counselling centers, and has a mobile clinic set up at counseling centers to provide first line attention to people who fall ill while waiting for their turn at VCT centers.

This holistic approach has endeared community members to the project. It is interesting listening to members of the community and field workers recount how families were so skeptical and resistant to the project when it started, and contrast it with the situation today, where the community members willingly troop to the VCT centers to participate in Voluntary counseling and testing programme. RAKAI DSS has expanded its research portfolio to include circumcision as a Preventive HIV measure.

With regards to human resource, RAKAI DSS has almost 400 employees, including clinicians, biostatisticians, Data Managers and supervisors, and a full complement of other disciplines.

Some pictures from RAKAI DSS