A Call for Mindset Change in How We Value Human Connection

Bonding as Medicine: Why Healthcare Must Stop Undervaluing Its Most Powerful Tool

The Missing Piece

Healthcare systems invest billions in technology, pharmaceuticals, and infrastructure. Yet the most powerful healing tool remains chronically underfunded and undervalued: people supporting people through shared experience.

For over a decade, I worked with more than 8,000 people living with HIV. I watched brilliant medical treatments fail—not because the science was wrong, but because patients faced their challenges alone. I saw people return to emergency rooms repeatedly, not because they needed more medicine, but because they needed someone who understood.

The gap isn’t clinical. It’s human connection.

Twenty years ago, I started as a young peer educator at Fort-Portal Regional Referral Hospital HIV Clinic in rural Uganda. I didn’t have fancy frameworks or big budgets. I had lived experience, compassion, and the belief that healing happens in relationship. Those Wednesday youth clinics—where we created safe spaces with snacks, peer support, and honest conversations—taught me something medical school doesn’t teach: people heal better together.

What Is Bonding in Healthcare?

Real bonding isn’t about feel-good activities or occasional support groups. It’s structured, sustained, and central to care delivery.

Bonding means:

People with lived experience becoming paid, valued members of care teams
Ongoing relationships that exist between appointments, during crises, and throughout recovery
Mutual healing, where supporting others strengthens your own journey
Cultural translation that makes medical information actually usable
Trust-building that creates the foundation for everything else to work

When someone who’s lived through your diagnosis says, “I understand, and here’s what helped me,” something shifts. Trust forms. Hope emerges. Adherence improves. Lives change.

Why This Works: Evidence From the Ground

Over 20 years building bonding-based programs in HIV care, tuberculosis, and antimicrobial resistance etc, here’s what I’ve seen:

COVID-19 Vaccination Campaign

95% uptake among healthcare workers
75% uptake among patients with HIV
Why it worked: Peer educators addressed specific fears through trusted relationships built over years.

Patient Safety Advocates Program

90+ advocates trained and deployed
System-wide improvement in safety reporting
Reduced adverse events through peer-to-peer safety conversations
Why it worked: People living with chronic conditions understood patient perspectives that professionals missed.

Young Adult Scholarship Program

100% graduation rate over multiple years
Zero dropouts across 100 young people living with HIV
Why it worked: Comprehensive peer support addressed not just medical needs, but life challenges.

These results didn’t come from expensive technology or new medications—they came from investing in human connection.

The Bridge Between Facility and Community: Where Peer Supporters Transform Care

Healthcare happens in homes, workplaces, markets, schools, and places of worship—not just in clinics. Peer supporters are the essential bridge extending care into the spaces where people live.

Inside the Facility

Peer supporters help patients navigate the clinic and make care meaningful:

Before appointments: Remind patients, clarify concerns, prepare emotionally
During appointments: Translate jargon, advocate for patient needs, explain instructions
After appointments: Clarify treatment plans, develop practical adherence strategies, link to resources
Within care teams: Provide patient perspective, identify systemic barriers, suggest culturally appropriate interventions

Beyond the Facility

The real work—and the real impact—happens in communities:

Home visits: Address real-world challenges like medication storage, food insecurity, family dynamics, and stigma
Community mobilization: Lead market talks, school programs, faith-based sessions, and cultural performances that educate and reduce stigma
Linkage to care: Accompany patients from community to clinic, building confidence and trust
Crisis response: Provide immediate emotional support, triage emergencies, and connect to clinical teams
Addressing social determinants: Connect patients to food, housing, employment, and legal resources
Family support: Educate and involve family members, turning households into support systems

The Continuum of Care That Actually Works

Peer supporters illuminate the “black box” between clinic and home, creating continuity:

Community outreach identifies people needing care
Peer accompaniment overcomes fear of first visits
Facility-based support navigates systems and treatment
Home visits tackle real-world barriers
Ongoing check-ins maintain connection and prevent crises
Community integration reduces isolation and builds belonging

The Multiplier Effect:
One peer supporter directly supports 30–40 patients. Each patient influences 5–10 family members. Community education can reach 200–500 people yearly. Total impact per peer supporter: 800–1,500 lives touched annually.

Why Facilities Alone Cannot Do This

Clinical staff face constraints: limited time, restricted to facility settings, professional boundaries, cultural barriers, and no capacity for after-hours support. Peer supporters complement clinicians—they do the essential relational, cultural, and social work that clinicians cannot.

The Mindset That Must Change

Current Mindset:

Peer supporters are “nice to have” volunteers
Lived experience is less valuable than professional credentials
Peer support is supplementary
Facility-focused care is enough

Needed Mindset:

Peer supporters are essential care team members with fair compensation
Lived experience is specialized expertise
Peer support is core healthcare delivery
Facility-to-community connection is essential
Investment in bonding is strategic, cost-saving, and outcome-enhancing

Stop Exploiting, Start Investing

The Exploitation Pattern:

Volunteers doing full-time work
Stipends insulting expertise
No benefits or career pathways
Expecting emotional labor without support
Community outreach without resources

What Investment Looks Like:

Competitive salaries and full benefits
Career advancement pathways
Training, supervision, and ongoing development
Resources for community work: transportation, phones, materials
Compensation for crisis response and after-hours availability

The Four Pillars of Effective Peer Support

Hire for Lived Experience, Train for Excellence: Peer support, community outreach, home visiting, family education.
Integrate, Don’t Isolate: Full inclusion in care teams, facility and community, decision-making authority.
Support the Supporters: Supervision, peer networks, mental health resources, resources for safe community engagement.
Measure What Matters: Treatment adherence, appointment attendance, patient trust, community reach, family engagement, crisis outcomes.

From Local Circles to Global Stages

Peer supporters are not just local assets—they inform global health systems. At TB-DASH in Nairobi, centering community voices led to contextually relevant, equitable, and sustainable solutions. My role as Co-Chair of the UC TB Community Advisory Board bridges grassroots expertise with global research—because bonding isn’t just individual, it should shape entire systems.

The Bottom Line

Healthcare’s most powerful intervention isn’t a drug, device, or procedure. It’s people supporting people—inside facilities and in communities. The evidence is clear, the methodology exists, and outcomes are transformative.

Stop exploiting peer supporters. Start integrating them as professionals. Build care bridges from facility to community. Stop asking, “Can we afford this?” Start asking, “Can we afford not to?”

Let’s build healthcare that actually heals—together.

Connect: Pitch Point or professional networks
Talk About: Mindset shifts, investment strategies, and sustainable facility-to-community implementation

The time for exploitation is over. The time for investment is now.

@mercykukundakwe
Bonding isn’t a luxury—it’s essential for wellbeing. Through shared experiences and peer support, trust grows, safe spaces form, and personal struggles become collective strength. Now, health systems must invest in bonding—peer-led programs, safe spaces, and community dialogue. When connection is valued alongside medical care, we build stronger, people-centered systems that save lives, reduce costs, and deliver real, human-focused solutions. @World Health Organization (WHO) #viral #trendingvideo #viraltiktok #Bonding
♬ Epic Music(863502) – Draganov89

01/02/2026

2026: A year of truth, courage, and collective impact

Dear Friends, Community, and Fellow Advocates,

As we step into 2026, I am filled with profound gratitude for every person who has walked this journey with me through Pitch Point. What began as a platform to share stories has become a community of voices united by hope, resilience, and the unwavering belief that our experiences matter.

The past year reminded me that advocacy isn’t just about speaking—it’s about listening, learning, and lifting each other up. From the villages of Uganda to global stages, from personal struggles to collective victories, we’ve proven that change starts when we dare to share our truth.

“This year, we don’t just tell stories, we create movements. We don’t just advocate, we transform systems. We don’t just survive, we thrive, together.”

2026 Manifesto

🌍 More authentic voices
Amplify stories that deserve to be heard especially voices from communities at the margins because lived experience is a powerful form of knowledge.

💬 Deeper conversations
Moving beyond surface-level discourse to engage with what truly matters in global health, justice, and human dignity.

🛠 Practical tools
Expect strategies, frameworks, and insights you can actually use — tools that empower you to create meaningful change within your own community.

🤝 Community collaboration
This blog belongs to all of us. Your stories, perspectives, and wisdom will help shape where this journey goes.

🌱 Unwavering hope
Even when systems fail us. Even when doors close. We will keep finding and creating windows.

Whether you’re here because you’re living with a chronic condition, fighting for health equity, navigating professional challenges, or simply seeking authentic connection—you belong here.

2026 is our year to be bold, vulnerable, strategic, and unapologetically human. It’s the year we refuse to accept “how things have always been” and instead ask, “What could things become?”

Thank you for being part of this journey. Thank you for your comments, your shares, your messages, and most importantly, for believing that our voices matter.

Let’s make this year count—not just in what we achieve, but in how we show up for each other along the way.

With hope, courage, and deep gratitude,
Mercy N. Kukundakwe
Lead Author & Global Health Advocate

Join the Movement Beyond the Blog

Pitch Point isn’t just where I write—it’s where we build community, share knowledge, and create change together. This year, I’m expanding our reach through multiple platforms to meet you wherever you are.

TikTok: Community Education & Advocacy

Quick, impactful health education on topics that matter—from HIV/AIDS, TB among other infectious disease awareness to antimicrobial resistance, mental health, patient safety, and civic literacy. Bite-sized knowledge that sparks real conversations.

Follow on TikTok

How You Can Engage in 2026

💬Comment & Share

Your voice matters—share your story, ask questions, challenge ideas

🔔Stay Connected

Follow on TikTok and subscribe to the blog for updates

🤝Collaborate

Have a story or topic to share? Let’s amplify it together

📢Spread the Word

Help us reach communities who need these conversations

Pitch Point | Voices, Visions, Victory

Together, we're not just learning—we're transforming communities, one story at a time.

12/25/202512/25/2025

Christmas Through the Lens of Care and Compassion

Christmas, to me, is a soft pause in the middle of demanding days, a moment to breathe deeply, reflect gently, and reconnect with purpose. In my work as a global health advocate, I walk alongside communities facing illness, stigma, loss, and uncertainty. This season reminds me that hope is healing  and compassion is just as powerful as any medicine.

Christmas means choosing empathy even when systems are strained, listening with an open heart to stories often left unheard, and showing up with kindness where it’s needed most ❤️. It reminds me that healing goes beyond clinics and policies — it lives in shared meals, warm conversations, laughter, and the reassurance that no one is alone.

This season fills me with gratitude— for resilient communities, tireless frontline health workers, and the privilege to advocate for equity, dignity, and humane health systems. Christmas renews my commitment to serve with love, speak with courage, and always center people at the heart of health.

As we celebrate, may we remember that the greatest gift we can give one another is care — care that heals, includes, and uplifts. Wishing you a Christmas filled with peace, gentle rest, renewed strength, and lasting hope ✨

12/01/202512/01/2025

My 2025 WAD Reflections:

This year has been a journey of learning, growth, and impact. From engaging with communities on health advocacy to pushing for patient-centered approaches in HIV, TB, and AMR programs, I’ve witnessed firsthand the power of voices, stories, and action.

2025 reminded me that progress is fragile without investment, yet resilient when real people and communities lead. Every conversation, every campaign, and every collaboration reaffirmed that meaningful change starts from the ground up.

As I look ahead, my focus remains clear: empower, educate, and advocate—because ending AIDS, fighting misinformation, and building healthier communities isn’t just a goal, it’s a responsibility.

Key Takeaways:

Community-led change matters: True progress comes when communities are at the center of health advocacy and engagement.
Patient-centered approaches save lives: From HIV, TB to AMR, prioritizing patients ensures programs work for the people they serve.
Investment is critical: Fragile progress can easily reverse without sustained funding and support.
Stories drive action: Amplifying voices from the ground creates real-world impact.

"My commitment remains: empower, educate, advocate". Together, we can end AIDS, fight misinformation, and build healthier communities.

11/18/2025

World Antimicrobial Awareness Week 2025 Begins: It’s Time to Act Against AMR

Today marks the official start of World Antimicrobial Awareness Week (WAAW 2025), a global campaign running from 18th to 24th November to raise awareness about antimicrobial resistance (AMR). AMR continues to threaten global health, food security, and development—including in our local communities.

This year, I am adding my voice to the global movement by highlighting simple but powerful actions we can take:
• Do not self-medicate
• Always complete your full dosage
• Never share leftover pills

Protecting antibiotics protects our future.
Let’s handle medicines with care and encourage others to do the same.

#WAAW2025 #AntimicrobialResistance #StopAMR #GlobalHealth #HealthLiteracy #AntibioticStewardship #PublicHealthAwareness

10/20/2025

TB-DASH Workshop – Africa

What an incredible honor to lead sessions bridging community voices, frontline health workers, and health systems at the TB-DASH Workshop organized by TB Dash project under UCSF Institute for Global Health Sciences in partnership with Johns Hopkins University, held from 14–15 October 2025 in Nairobi, Kenya.

This two-day convening brought together brilliant minds from 15 African countries—TB survivors, community advocates, health workers, researchers, policymakers, and national TB program leaders—to design a global framework aimed at strengthening demand, access, and care-seeking across the TB patient journey.

✨ Key takeaway: Centering the voices of people and communities affected by TB transforms solutions into contextually relevant, equitable, and sustainable interventions. Innovation is exciting, but impact is magnified when it addresses real-world, system-level barriers.

I left the workshop inspired, energized, and reminded that community-driven TB programs are not just effective—they are essential. 💡

A heartfelt thank you to Johnson & Johnson for funding this critical workshop and fostering collaboration toward ending TB, especially in Africa.

And of course, it was an absolute pleasure meeting, learning from, and laughing with you all!

#TBDASH #Tuberculosis #GlobalHealth #CommunityEngagement #HealthSystems #TBAdvocacy #UCSF #AfricaUnited #EndTB #CommunityDriven

WhatsApp Image 2025-10-17 at 17.07.19 Download

https://youtube.com/shorts/CrsijRUpxXs

09/23/202509/23/2025

Fighting AMR Through Lived Experience: My UNGA Experience

`"Same day last year, on September 23rd, in New York, I stood not just as a delegate, but as a living testament to the power of community, the strength of assumed vulnerability, and the urgent need for authentic voices in our fight against antimicrobial resistance."`

When Your Story Becomes the Principal Focus of Interest

I stood confidently at the podium of the United Nations General Assembly last year on this very date—September 23rd, in the heart of New York City. Weeks of preparation and resilience had steadied my voice, but nothing could have prepared me for the weight of the moment. I felt the vibrations of every drumbeat right from my village, every voice that had believed in me, trusted me with their story, and every life that antimicrobial resistance had touched in ways that statistics could never capture. Standing before world leaders during the UN General Assembly high-level meeting on AMR, alongside fellow advocates like Dr. Tasha Koch, I carried more than data points and policy frameworks. I carried the weight of my grandfather’s confusion when his usual remedies stopped working. I carried the rhythm of children’s laughter as they learned about medicine through song. I carried the tears of mothers who watched their babies fight infections that once-reliable antibiotics could no longer defeat. Most importantly, I carried the stories of my community—people living with chronic conditions who navigate a world where the medications that keep them alive are increasingly threatened by resistance.

Why it Came From Me

In the corridors of power, we often hear polished presentations from researchers, policymakers, and healthcare professionals. Their expertise is invaluable, but something happens to your soul when you watch your own community struggle with a crisis that feels both invisible and overwhelming. As someone who works closely with people living with chronic conditions, I don’t just study antimicrobial resistance—I witness daily how vulnerable communities face the terrifying reality that medications are losing their power to heal. I’ve held the hands of community members whose bodies rejected the very antibiotics that once saved them. I’ve witnessed firsthand drug reactions due to drug stock-outs, as well as watched mothers pace clinic floors, desperate for answers when their children’s infections wouldn’t respond to treatment. I’ve sat in peer support group circles and meetings, listening to whispered fears: “What if the medicines stop working completely?” This story couldn’t come from anyone else because it lives in my community’s bones, flows through our shared experiences, and beats with our collective heart. The global community needed to feel our pain, not just understand our statistics. They needed to see that behind every AMR projection is a human face, a family’s future, a community’s hope hanging in the balance.

The Power of Native Traditional Creative Solutions

In Uganda, health challenges are never confined to sterile meeting rooms. We give them colour and form—drawing our deepest emotions with pencil and paper, singing them into existence, dancing them into understanding, and performing them into our collective hearts.

Composing songs in our multilinguistic heritage—Ruganda, Runyankore, and other local languages—turned complex AMR concepts into what felt like ancient wisdom. When you hear your grandmother’s voice in a melody about finishing an antibiotic course, it doesn’t feel like a medical instruction—it feels like love. Like protection. Like community care wrapped in familiar rhythms.

Our HIV support group gatherings transformed into musical healing sessions, rich in education and awareness. We wrote ballads, poems, and skits about the courage it takes to stick to treatment regimens; hymns about the strength we find in each other; and lullabies mothers could sing to children taking their medication.

One Performance at a Time

Our dance circles became sacred spaces—where healing flowed through movement and drumbeats. We created choreography that told stories of resilience, of medications working in harmony with our bodies, and of communities supporting each other through illness and recovery.

I’ll never forget Nathan—a young patient struggling with adherence due to stigma. He first watched from the sidelines as we performed. Then, slowly, he asked to join the circle. Through drumming and movement, he rediscovered his strength, returned to consistent treatment, and emerged as one of our most powerful advocates for responsible antibiotic use.

Our community theatre performances carried the same transformative spirit. They made people laugh, cry, and ultimately rethink their choices. We staged the story of a mother who saved leftover antibiotics “just in case”—until she watched her neighbour’s child suffer complications from incomplete and self-medication treatment. These weren’t abstract educational tools; they were our neighbour’s stories, our own struggles, and our collective wisdom embodied on stage. Each skit was born from real experience, shaped by real tears, and performed with real hope for change.

A Human Story on the Global Stage

On September 23rd, I had the honour of sharing this approach with global leaders. I watched faces soften, perspectives shift. In that moment, antimicrobial resistance (AMR) ceased to be only a technical or policy challenge—it became a living, breathing human story. A story woven with melody, movement, and cultural expression.

Connection is as vital as science in driving global change. And sometimes, the most powerful medicine begins not in laboratories, but in the songs, dances, and stories of our people.

Behind the Scenes

Let me be honest with you: this work nearly broke me—emotionally, physically, and in resource-limited ways. It also weighed heavily on the theatre group I was leading at the time. Every message we curated—whether through poems, skits, or songs—was born from sleepless nights after exhausting days of routine advocacy. Each piece we choreographed meant choosing community service over rest, over family time, over the self-care that anyone working in high-stress health advocacy desperately needs.

But here’s what sustained me: love.
The fierce, uncompromising love for my community. The conviction that I was finally telling the story I had always wanted to tell. Love that made me willing to share our most vulnerable truths on the world’s biggest stage. Love that transformed pain into strength, and struggle into purpose.

Standing in New York on September 23rd, speaking before world leaders, I thought about the nights I spent with my team and patients navigating complex treatment regimens. I remembered the mornings filled with the quiet anxiety of people wondering if their medicines would continue working, and the afternoons teaching children that medicine is precious—not something to waste or share.

This work demanded everything—my time, my energy, my emotional reserves, my comfort, and most of all, my confidence. But it gave me something invaluable in return: the knowledge that our sacrifices and discomfort had purpose, our community’s struggle had meaning, and our stories could save lives around the world.

To global partners reading this: when you fund community health initiatives, you’re not just supporting programs—you’re supporting human beings who pour their hearts, lived experiences, and very souls into this fight. We are not simply implementing strategies; we are sharing our deepest truths on stages around the world.

Why Lived Experience Matters in Global Public Engagement

You can never truly tell a better story you have not lived. At the UN General Assembly, amid technical discussions of international funding mechanisms and lasting surveillance systems, I brought the human element. I could speak to:

The reality of medication decision-making in resource-limited settings
Community trust dynamics that shape treatment adherence
Cultural beliefs that intersect with modern medicine
Practical barriers that statistics alone cannot capture

Global leaders needed to hear that antimicrobial resistance (AMR) is not just a looming future threat—it is a present reality affecting communities where every antibiotic matters, where treatment interruptions have immediate consequences, and where health literacy is built through relationships, trust, and storytelling—not pamphlets.

The Ripple Effect of Authenticity in Advocacy

The response to our presentation revealed something profound: when you speak from lived experience, you give others permission to engage authentically as well. Delegates approached me afterward, sharing their own community challenges and asking not just about our methods, but about our motivation, resilience, and hope.

This is why certain stories must be told by certain people—not because others lack expertise or status, but because authenticity creates connection, and connection drives action.

A Partnership Across Borders

What made that September day even more powerful was sharing the stage with Dr. Tasha Koch, whose work with Eh!woza in Cape Town mirrors our community-driven approach in Uganda. While I spoke about our creative initiatives through the GIPA programme at the Infectious Diseases Institute, Tasha shared how art, science, and community engagement can transform health awareness, particularly around tuberculosis and other health challenges.

Our parallel journeys—mine through patient-led HIV advocacy and hers through innovative public engagement combining art and science—demonstrated to the global audience that community-driven solutions transcend borders. Whether in the townships of Cape Town or the villages of Uganda, authentic community engagement remains the key to meaningful health behaviour change.

Fleming Initiative and CAMO-Net: Global Stages for Community Voices

The impact of our presentation extended beyond that single moment. Through collaboration between the Fleming Initiative and CAMO-Net, funded by Wellcome Trust via Multi-sectoral One Health Networks, our work became a flagship example during multiple high-level events throughout the week.

At Carnegie Corporation Headquarters, key stakeholders from around the world gathered to learn about our innovative approaches and discuss global action on AMR through education and community involvement. Standing alongside CAMO-Net representatives—Professor Alison Holmes (Lead), Professor Anna Levin, Professor Senjuti Saha, Professor Marc Mendelson, and Dr. Tasha Koch—I felt the weight of representing not just Uganda, but a new model for global health collaboration.

Distinguished figures including Dame Louise Richardson, Professor the Lord Ara Darzi, Professor Hugh Brady, and Jeremy Knox emphasized the crucial importance of public engagement in addressing AMR.

A Plea to Global Partners: See Us, Fund Us, Trust Us

The week was a testament to what is possible when community voices are elevated to global platforms. From the emotional impact of “Lifeline: The Musical” to high-level discussions where CAMO-Net was repeatedly cited as a flagship example of equitable collaboration, our approach proved its worth on the world’s biggest stage.

We are not asking for charity—we are offering partnership. We bring to the table something no funding can buy: authentic connection with the communities most affected by AMR. Our music, dance, and drama are love letters from our community to yours, written in the language of hope and performed with the urgency of survival.

Investing in community-led initiatives like ours amplifies marginalized voices, supports overlooked leaders, and transforms shared struggles into solutions that can save lives. The global fight against AMR needs more than surveillance systems and policy frameworks—it needs human touch, cultural understanding, and community trust.

Your support doesn’t just fund our work—it validates our community’s pain, honors our shared journey, and transforms collective struggles into solutions.

From Local to Global

"From the stages of rural Uganda to the halls of the United Nations, from local support groups to global platforms like CAMO-Net,Fleming Initiative,Wellcome Trust... this fight belongs to all of us. But it starts with those who carry both the burden of disease and the wisdom of survival. On September 23rd in New York, I shared our story. Today, I’m asking you to join it by Acting Now to protect our present, secure our future.

Probably the perfect end to a meeting about engaging communities – a performance from the Scottish sell-out musical Life Line. Here’s a little snippet of their performance #AMR #publicengagement pic.twitter.com/RXi901ujsY
— CAMO-Net (@CAMO_Net1) September 23, 2024

09/16/202509/16/2025

From Community Peer Educator to Global Stage:

My ICASA 2025 Journey

Twenty years ago, I became a young peer educator and mentor- a journey that started from Fort-Portal Regional Referral Hospital HIV Clinic in rural southwestern Uganda. I spent my days sitting in health facility and community meetings with children and young people living with HIV, listening to their stories of stigma, hope, and resilience. This clinic, run by the Joint Clinical and Research Center as the implementing partner, served a diverse population ranging from infants to people in their nineties.

What made those days truly special was the Wednesday young people’s clinic. We created something beautiful — an interactive space where every attending child received snacks, peer support, and health education. An amazing team engaged young people through various activities, including community outreaches to support linkage to care. Those moments of walking with young people living with HIV, helping them understand their test results and what treatment adherence meant, and organizing group peer meetings to address stigma and improve treatment adherence — these experiences planted the seeds that would grow into my life’s work.

Today, I write this blog post with a deep smile after receiving incredible news: I have been awarded a full virtual scholarship to attend the 23rd International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA 2025). This marks my second time attending ICASA, having first experienced it physically in 2019 in Kigali, Rwanda. That experience left me deeply inspired, and now, stepping into ICASA 2025, I carry forward both the lessons of the past and the hope of what’s to come. When I opened that email from the ICASA Secretariat and saw my name, Mercy Kukundakwe, officially listed as a scholarship recipient, my mind immediately travelled back to those early days in Fort-Portal.

The journey from that young peer educator to where I stand today feels surreal. Over the past decade, I have served as a Programme Executive providing oversight to all non-medical Greater Involvement of Persons Living with HIV (GIPA) programs at the Adult Infectious Diseases Institute (IDI) — an ambulatory center of excellence in HIV prevention, care, and treatment serving over 8,000 people living with HIV. But the path didn’t stop there. Today, I am honoured to serve as Co-Chair of the University of California Tuberculosis Community Advisory Board (UC TB CAB), leading global community advisory capacity dedicated to increasing community involvement in TB research across San Francisco and Berkeley. The UC TB-CAB brings together diverse individuals from Uganda, Vietnam, and the San Francisco Bay Area — strong, research-literate community activists from TB-affected communities across Africa, Asia, and North America. We provide community-centered input on research priorities, study design, dissemination practices, and community-engagement strategies. It is a role that connects directly to those early days when I believed communities hold the keys to their own health transformation.

My decade at IDI was filled with transformative experiences that shaped my understanding of creative, patient- and community-led healthcare. I remember the pride I felt leading and empowering a patient-led advocacy group of over thirty people living with HIV, representing diverse care categories to enhance PLHIV leadership and advocacy. There was the joy of watching our Young Adult Scholarship Fund achieve a 100% graduation rate, supporting 100 young people living with HIV to build self-sufficient futures.

I guided various investigators in setting up public involvement and engagement projects, co-designing science into understandable translations for community awareness, especially in remote rural communities. I trained at least 90 patient safety advocates who were deployed to empower the broader healthcare system on safety identification, reporting, and mitigation to minimize harm during service delivery. I led inaugural quality improvement projects such as the 5S matrix, enhancing the workplace environment by 90%. There was the overwhelming responsibility of coordinating Uganda’s first Patient Safety Symposium, hosted at IDI in partnership with Community Health and Information Network (CHAIN), the Ministry of Health, and Nottingham University. For the first time, we brought together stakeholders who had never sat in the same room before. I will never forget leading the coordination of our COVID-19 vaccination program that achieved 95% uptake among health workers and 75% among people living with HIV attending our clinic — a true testament to the power of community trust and engagement.

Our peer support and health education work using music, dance, and drama to educate and raise awareness about HIV and emerging global health issues like antimicrobial resistance (AMR) eventually took me to high-level AMR events at the United Nations General Assembly in New York and the Global Strategy Lab workshop at Wellcome Trust Headquarters in London, where I shared our public engagement experiences from back home.

Throughout this journey, I have also served as a freelance community psychologist and mental health advocate on social media and through one-on-one interactions, always remembering those countless nights spent figuring out how to make healthcare more accessible for marginalized communities in Uganda.

Each experience taught me something profound about the intersection of policy, research, and grassroots reality. When I presented at the UN General Assembly AMR Side Event in New York, speaking to delegates about public engagement in Uganda, I carried with me the voices of every patient who had shared their medication challenges with me. When I delivered talks to more than 200 Fleming Fund Fellows globally, I wasn’t just sharing data — I was sharing stories of resilience, innovation, and community-led solutions.

But ICASA 2025 feels different from all my previous international conferences. While I have participated in AIDS conferences in Montreal, presented in London at Wellcome Trust events, and contributed to Lung Health conferences in Bali, this one is coming home to Africa. It is happening on a continent where we understand the unique challenges, resource constraints, and cultural nuances that shape how health interventions succeed or fail, especially in the current funding crisis.

The scholarship package reflects ICASA’s commitment to inclusivity — full virtual participation with translation services in over 50 languages, plus flexibility to attend in person if circumstances allow. For someone who has witnessed how creative arts campaigns like Music, Dance, and Drama helped overcome language barriers in rural Ugandan communities, this emphasis on breaking down communication barriers resonates deeply.

As I prepare for this conference, I think about the 8,000+ patients I have supported, mentored, and empowered through various GIPA programs I helped institutionalize — but also the 1,500,000 Ugandans and the larger 40 million global persons living with HIV. Their voices, experiences, and innovations will travel with me virtually to Ghana. The patient-led care supporters I have supervised over the years, the community advisory boards I co-chair, the quality improvement initiatives, and the general public I have educated — all these experiences have prepared me for this moment.

ICASA 2025’s theme, “Africa in Action: Catalysing Integrated Sustainable Responses to end AIDS, TB & Malaria,” could have been written about my current or previous work. Whether I am serving on Uganda’s National Quality Improvement Taskforce, training PLHIV as patient safety advocates, or developing incident reporting systems for adverse events, developing integrated public engagement frameworks for TB managment, I have witnessed firsthand how integrated approaches create lasting change.

This conference represents more than professional development. It is validation that community engagement specialists like me — those who bridge the gap between policy and practice, between research and reality — have essential perspectives for continental discussions. My Bachelor’s in Community Psychology from Makerere University, certifications from institutions like the University of Bath and Google, and membership in organizations like the WHO Global Patient Safety Network have all collectively prepared me for these conversations.

I am particularly excited to learn from peers across Africa tackling similar challenges in different contexts. How are communities in Ghana approaching HIV care integration? What patient safety innovations are emerging in Kenya? How are South African organizations addressing stigma and discrimination? These conversations will directly inform my work back home in Uganda.

But I am coming as a contributor, not just a learner. My experience developing COVID-19 vaccination tracking tools adopted by national health platforms, creating capacity-building opportunities for patients as change agents, and implementing the 5S matrix programs are solutions that might benefit other African contexts.

The virtual format offers unique advantages for someone managing active programs. I can engage with relevant sessions while maintaining responsibilities for social media engagement and education, where communities will depend on this conference experience. I can replay crucial presentations, access real-time translation, and truly absorb the wealth of knowledge being shared across the continent.

As I write this, I am already planning how to share these learnings. UC TB CAB meetings and other projects will become richer with continental perspectives. Social media health education and engagement sessions will incorporate new approaches and innovative models I discover from peers across Africa.

Receiving this ICASA 2025 scholarship feels like coming full circle. From that young peer educator in Fort-Portal who believed communities hold the keys to their own health transformation, to a professional who has presented on global stages while never losing sight of grassroots realities, this opportunity represents the perfect synthesis of my journey.

To the ICASA Secretariat and organizing committee, thank you for recognizing that those of us working directly with affected communities deserve seats at continental tables. This scholarship is an investment in community-led solutions, in the voices of people living with HIV, and in the kind of integrated responses that truly work in African contexts.

December 3rd–8th will be more than conference dates on my calendar. They will be days when a decade of community engagement experience meets continental innovation, when grassroots wisdom encounters cutting-edge research, and when the stories of 1,400,000+ Ugandans living with HIV contribute to Africa’s collective response to our health challenges.

The journey from village peer educator to ICASA 2025 scholarship recipient has been filled with learning, growth, and profound privilege. Now, it is time to take everything I have learned and experienced to the continental stage — ready to listen, contribute, and return to Uganda with innovations that will benefit the communities I am honoured to serve.

As I prepare to join thousands of advocates, policymakers, researchers, and changemakers, I am reminded that every story matters—and this year, I look forward to sharing mine while learning from others who, like me, are committed to transforming communities and lives. This is just the beginning of my ICASA 2025 story. Follow along as community engagement meets continental collaboration in Ghana this December.

Beyond my work in peer education and mentoring, I have a deep love for music. The song I’ve attached has been on my playlist since last week, and I hope that, as you read through my random yet remarkable experiences, you can feel the power of its lyrics and the resonance of its melodies alongside the story I share…

09/12/2025

The Presentation That Never Happened: When Organizations Need Resilience Most

There’s a particular irony in having a presentation on resilience cancelled due to organizational dysfunction. Yet that’s exactly what happened during what should have been a routine soft skills training session—a moment that taught me more about workplace resilience than any PowerPoint slide ever could.

The Perfect Storm: When Timing Reveals Everything

Picture this: a team under pressure, stress levels climbing, morale wavering. Changes rippling through the organization like aftershocks from an earthquake. If there was ever a moment when discussing resilience, adaptation, and thriving through challenges wasn’t just relevant but essential, this was it. I had been specifically asked by senior leadership to prepare a presentation on resilience for our general staff meeting’s soft skills segment. This wasn’t my idea—it was a recognized organizational need. I spent weeks crafting content that went beyond theory, drawing from organizational psychology research, practical mental fortitude strategies, and real-world examples of how resilient thinking transforms workplace challenges into growth opportunities. The presentation wasn’t just timely; it was desperately needed. Our team was experiencing exactly the kind of pressures that resilience training is designed to address. The content was ready, the audience needed it, and the timing couldn’t have been better. Then organizational dysfunction intervened.

When Personal Trumps Professional: The Plot Twist Nobody Ordered

Organizations, like life, rarely unfold according to carefully laid plans. The original meeting chair was suddenly called away—a common occurrence in busy workplaces. The responsibility fell to someone else. Someone who, I knew, had personal issues with me that had nothing whatsoever to do with the quality, relevance, or organizational value of the presentation I’d been asked to prepare. In that pivotal moment, what should have been a straightforward professional decision about staff development became entangled with personal dynamics. The presentation was quietly removed from the agenda. No discussion about its merit. No consideration of whether the content might benefit the team regardless of who delivered it. No attempt to reschedule or find an alternative presenter.

It simply… vanished.

This wasn’t a scheduling conflict or a content concern. This was personal preference overriding professional responsibility. It was exactly the kind of organizational dysfunction that makes resilience training necessary in the first place.

Living the Lesson: The Ultimate Irony

There I sat, holding a carefully prepared presentation about resilience while experiencing firsthand one of the most common threats to workplace resilience: when personal conflicts and organizational dysfunction prevent essential knowledge from reaching the people who desperately need it.

The situation became a perfect case study for every point I’d planned to make:

Resilience isn’t just individual—it’s systemic. A truly resilient organization has processes that prioritize valuable content and learning opportunities over personal grievances. When individual conflicts can derail team development, the entire organization’s adaptive capacity suffers. We weren’t just missing one presentation; we were witnessing how dysfunctional systems undermine collective growth.

Good ideas transcend their messengers. In resilient organizations, valuable insights are evaluated on merit, not on who presents them. When personal dynamics filter out potentially crucial knowledge, we rob our teams of tools they might desperately need. The irony was palpable: discussing resilience required us to demonstrate it.

Crisis moments demand resilience most. The presentation was scheduled during peak organizational stress—precisely when resilience training delivers maximum value and when dysfunction is most likely to interfere with it. It was like cancelling fire safety training during a drought.

The Content That Never Reached Its Audience

Since that presentation never happened, let me share what the team missed—insights that might have helped us navigate the turbulent period we were experiencing:

Resilience Is Learnable, Not Fixed

Many people believe resilience is an innate trait—you either have it or you don’t. Research consistently shows otherwise. Resilience is a skill set that can be developed through specific practices, mindset shifts, and behavioral changes. The team could have learned concrete techniques for building individual and collective resilience capacity.

Psychological Safety: The Foundation of Team Resilience

Teams become truly resilient only when people feel safe to voice concerns, admit mistakes, and suggest improvements without fear of retaliation or personal consequences. The fact that a presentation could be cancelled due to personal conflicts was itself evidence that our psychological safety needed serious attention.

Adversity as Organizational Strengthening

Instead of merely surviving difficult periods, resilient organizations use challenges as diagnostic tools to identify systemic weaknesses, build stronger processes, and develop more effective collaboration methods. Every crisis contains information about how to become stronger.

Communication: The Nervous System of Resilience

When people understand what’s happening, why changes are necessary, and how they can contribute to solutions, they adapt more positively to difficult circumstances. Unclear communication creates anxiety; transparent communication builds confidence and engagement.

The Power of Collective Sense-Making

Resilient teams don’t just react to challenges—they actively make sense of them together, creating shared narratives that help everyone understand their role in moving forward. This collaborative meaning-making transforms individual stress into collective problem-solving energy.

The Unintended Masterclass: Resilience in Real Time

Paradoxically, having the presentation cancelled became its own profound lesson in resilience. It forced me to grapple with questions that no amount of theoretical discussion could have addressed:

How do you respond when good intentions collide with organizational dysfunction? Do you become bitter and withdraw your contributions, or find alternative ways to add value despite systemic obstacles?

What happens when the very systems meant to support professional development become barriers instead? Do you abandon efforts to help, or develop creative workarounds that serve the original purpose?

How do you maintain your own resilience when facing workplace conflicts that prioritize personal comfort over organizational health? How do you model the very qualities you were hoping to teach?

Finding Alternative Channels: Resilience in Action

The presentation might have been cancelled, but the ideas refused to disappear. They found new life through different pathways: one-on-one conversations with struggling colleagues, informal discussions during coffee breaks, written communications that shared key concepts in accessible ways.

These alternative approaches proved unexpectedly powerful. Unlike a formal presentation that would have been delivered once to a passive audience, these organic conversations allowed for personalized application of resilience concepts. They created opportunities for deeper dialogue about how to apply these ideas within our specific context and challenges.

The cancelled presentation became a distributed learning experience that reached more people more meaningfully than the original format ever could have. Sometimes obstacles force us to discover better approaches.

The Hidden Costs: What Organizations Lose

This experience illuminated a troubling reality in many workplaces: how frequently valuable learning opportunities evaporate due to personal conflicts, inadequate delegation practices, or systems that prioritize individual comfort over collective growth.

When presentations like this don’t happen, organizations lose more than training time. They forfeit opportunities to:

Address brewing problems proactively rather than waiting for them to become crises
Build team cohesion around shared challenges and common solutions
Develop collective problem-solving capabilities that strengthen the entire organization
Create shared language and frameworks for navigating difficulties together
Demonstrate genuine commitment to employee wellbeing and professional development
Model the very resilience they claim to value

Most critically, they miss chances to build organizational cultures capable of thriving through uncertainty rather than merely surviving it.

Leadership Lessons: Preventing the Prevention

For leaders facing similar situations, this story offers crucial considerations:

Separate Personal from Professional

When delegating responsibility for essential functions like staff development, ensure that personal dynamics don’t interfere with professional judgment about team needs. Create clear protocols that prioritize organizational benefit over individual comfort.

Design Resilient Systems

Build backup processes for critical functions. If the original meeting facilitator can’t attend, have clear protocols that maintain agenda priorities rather than defaulting to whoever happens to be available, regardless of their capacity or potential conflicts.

Evaluate Content Independently

Develop mechanisms for assessing presentations and training opportunities based on potential organizational impact, not on interpersonal relationships or personal preferences. Good ideas deserve consideration regardless of their source.

Address Conflicts Directly

When personal issues between team members start affecting professional functions, address them explicitly and promptly. Allowing unresolved conflicts to undermine organizational effectiveness serves no one’s interests.

Create Multiple Pathways for Important Content

Don’t rely on single presentations or meetings to deliver crucial information. Build redundant systems that ensure essential knowledge reaches its intended audience through various channels.

The Resilience We Actually Developed

Looking back, the cancelled presentation may have taught the team more about practical resilience than the original session would have accomplished. We learned to:

Recognize organizational dysfunction when it interferes with our collective development
Create alternative pathways for sharing important ideas and supporting each other
Maintain focus on core purposes even when formal systems fail us
Build resilience through informal networks and authentic relationships
Question whether workplace systems actually support the outcomes they claim to prioritize
Transform setbacks into learning opportunities rather than sources of permanent frustration

These weren’t theoretical concepts we discussed—they were practical skills we developed through necessity.

The Broader Implications: A Mirror for Organizations

This experience reflects broader organizational patterns worth examining. How many other valuable initiatives get quietly cancelled due to personal dynamics? How often do interpersonal conflicts override professional judgment about what teams need? How frequently do organizations claim to value resilience while simultaneously demonstrating its opposite?

The cancelled presentation became a diagnostic tool, revealing:

Communication breakdowns between leadership levels
Unclear delegation processes that allow personal bias to influence professional decisions
Missing psychological safety that enables personal conflicts to affect team development
Inadequate systems for ensuring important content reaches its intended audience
Disconnect between stated values (resilience, professional development) and actual practices

Moving Forward: The Message That Endures

Every workplace encounters moments when personal conflicts, communication failures, or dysfunctional systems interfere with important work. How we respond to these moments—whether we let them derail us or transform them into opportunities for systemic improvement—becomes its own test of resilience.

The presentation that never happened taught us that resilience isn’t just about bouncing back from setbacks. It’s about finding ways to contribute positively even when the systems around us aren’t functioning optimally. It’s about maintaining focus on what truly matters when distractions and dysfunction threaten to derail important work.

Most importantly, it demonstrated that sometimes the most powerful lessons come not from what we plan to teach, but from how we respond when those plans are unexpectedly disrupted.

The Presentation Continues: New Formats, Same Mission

The cancelled presentation didn’t end the conversation—it transformed it. The content found new life through different channels, reaching people who needed it through more personal, meaningful interactions. The ideas evolved, adapted, and ultimately became more impactful than they would have been in their original format.

This experience reinforced a fundamental truth about resilience: it’s not about avoiding obstacles or ensuring everything goes according to plan. It’s about adapting creatively when obstacles appear, finding alternative pathways when original routes are blocked, and maintaining focus on core purposes even when circumstances force us to change our approach.

When Organizations Need Resilience Most

Sometimes the most important lessons emerge not from the presentations we deliver, but from the experiences that prevent us from delivering them. The cancelled presentation on resilience became its own powerful case study in organizational dynamics, workplace priorities, and the vital importance of finding alternative ways to share essential knowledge when formal channels fail.

For anyone who has watched good ideas blocked by dysfunctional systems, or seen personal conflicts interfere with professional growth, remember: the message matters more than the medium. The content is more important than the container. When one pathway closes, resilient people and organizations find others.

The presentation that never happened still has profound lessons to offer—not about the slides that were never shown, but about how we respond when obstacles appear. The greatest demonstration of resilience isn’t avoiding setbacks; it’s transforming them into opportunities for growth, learning, and positive contribution.

Perhaps that’s the most resilient response of all: turning a cancelled presentation into a more powerful story about what organizations truly need to thrive in challenging times. The lesson continues, just in a different classroom than anyone originally planned.

09/11/2025

Moving Through Fear: My First Drug Reaction

The last few weeks have been slow and heavy as I battled a lingering cold that seemed determined to overstay its welcome. I tried everything I could think of—traditional remedies passed down through generations, modern medicine from the pharmacy shelf, endless rest, and sheer persistence. Little by little, I started to feel myself again, like emerging from underwater and finally breaking the surface. Yesterday morning, I even woke up with a burst of energy, ready to dive into my routine with the kind of momentum that makes you believe your body is truly on your side again. But halfway through the day, my body betrayed me.

When Everything Changes in an Instant

A sudden wave of weakness and fatigue washed over me, swift and unforgiving. At first, I couldn’t understand what was happening. My mind scrambled for explanations—was the cold returning with a vengeance? Had I pushed myself too hard too soon? Then it hit me: this was my first reaction to a new medication. Recently, I was switched to a new treatment option because of drug stockouts—a reality that has become all too common in our healthcare system. It was not a change I expected, nor one I wanted. The decision was made for me by circumstances beyond anyone’s control, a reminder that sometimes our most intimate health decisions aren’t really decisions at all. The reality is that the looming funding shortages and inconsistent supply chains force countless people into similar situations every day. We hear about these issues in policy papers and news reports, but the consequences are deeply personal. People are not just statistics in a healthcare crisis—they are lives interrupted, health shaken, and stability stolen. Now, I find myself dealing with both the side effects of this new treatment and the stubborn remnants of a cold that refuses to let go.

The Spiral of Fear

The physical symptoms spread through my body like spilled water, seeping into every corner. The blurred vision made reading difficult, the joint pain made simple movements uncomfortable, and the swelling made my clothes feel tight and foreign. Even my blocked ears added to the sense of being disconnected from the world around me. The exhaustion was bone-deep, yet the inexplicable hunger kept driving me to the kitchen, creating a confusing cycle of eating without satisfaction. Until even the simplest tasks felt overwhelming, I turned to my phone and started scrolling through TikTok, though the blurry screen made focusing difficult. I hoped to distract myself with the endless stream of bite-sized content, but it didn’t work. The bright screen and quick videos felt hollow against the weight of what I was experiencing. Instead, fear crept in with the stealth of a shadow at dusk. My mind spiraled into frightening questions that felt both irrational and completely valid: What if this drug harms me more than it helps? What if I die young because of complications I can’t foresee? What if my health is worse than I realize, and I’m just now seeing the truth? It was a terrifying place to be. My body felt foreign, untrustworthy—like wearing clothes that no longer fit. My thoughts grew darker with every passing minute, each worry feeding the next until I was caught in a web of catastrophic thinking that felt impossible to escape. This is what health anxiety does: it takes a moment of physical discomfort and transforms it into an existential crisis. It whispers that every symptom is a harbinger of doom, every change in your body is evidence of your worst fears coming true.

Finding the Way Back

Eventually, I did the only thing I could: I allowed myself to rest. Not the frustrated, impatient kind of rest where you’re mentally fighting against the need to be still, but the surrendering kind. I let my body have what it was asking for without judgment or timeline.
Later, with a bit more strength returning, I managed to do some light work and cook a meal. These small acts of normalcy—typing on my laptop, chopping vegetables, stirring a pot—became anchors that tethered me back to myself. There’s something profoundly healing about completing simple tasks when your world feels chaotic. But the true turning point came in the evening when I caught up with a friend. Our conversation flowed effortlessly across the landscape of human experience—about work challenges and career dreams, the complexities of relationships, the stress and freedom that money brings, questions of purpose that keep us up at night, and the role of faith in navigating uncertainty. It was deep, honest, and life-giving in the way that only authentic connection can be. Slowly, the heaviness of the morning began to loosen its grip. I was reminded that while fear is real and valid, it doesn’t have to dictate the rhythm of my entire day, let alone my entire life.

The Bigger Picture

Living with a chronic condition means that moments like these—unexpected medication changes, new side effects, health scares—are not anomalies but part of the ongoing conversation between you and your body. It means learning to navigate a healthcare system that doesn’t always have your best interests as its top priority, where supply chain issues can disrupt your treatment plan and force you to adapt to medications you didn’t choose. It means becoming intimately familiar with the dance between hope and fear, between taking care of yourself and trusting that tomorrow will be better than today.
What I learned today is that moving through fear isn’t about conquering it or making it disappear. It’s about acknowledging its presence while continuing to live—resting when you need to rest, working when you can work, cooking when you’re hungry, and reaching out for connection when isolation feels too heavy to bear alone.

Moving Forward

Tonight, as I write this, I feel more like myself again. The weakness has largely passed, though I know it may return as my body adjusts to this new medication. The fear, too, has quieted, though I’m sure it will visit again when unexpected symptoms arise or when the weight of managing a chronic condition feels particularly heavy. But I also feel something else: a deeper appreciation for the resilience that lives within all of us, the way we can move through terrifying moments and find our way back to ourselves. I feel grateful for friends who create space for honest conversation, for the simple luxury of cooking a meal when I’m feeling better, and for the reminder that our bodies—even when they feel foreign—are still capable of healing and adapting to new treatments. Most of all, I feel thankful for the opportunity to share this story, because somewhere, someone else is probably scrolling through their phone, feeling weakness wash over them, wondering if they’re alone in their fear. You’re not alone. We move through these moments together, one breath, one conversation, one small act of self-care at a time.

If you’re dealing with medication changes or health challenges, remember that it’s okay to feel scared, okay to rest when you need to, and okay to reach out for support. Your feelings are valid, and you don’t have to navigate this alone.