Search
Close this search box.

Activists to Pursue Maternal Health Case Against Government

By Andrew Green

Kampala — A petition backed by over 50 NGOs and charging Uganda’s government with failing to prevent the deaths of expectant mothers was thrown out by the constitutional court on 5 June, but the petition’s supporters plan to appeal.

The constitutional court argued that upholding the petition, which urges the government to boost health services, would have forced judges to wade into a political issue that was outside their jurisdiction.

However, the petitioners said the court relied on outdated international law in making its decision and overlooked its constitutional obligation to protect Uganda’s mothers.

Principal State Attorney Patricia Mutesi, who argued the case for the government, said the petition “was asking the court to do the work of the parliament in reviewing the efficiency of the health sector”.

The petition, which centred around the deaths of two mothers (Sylvia Nalubowa in central Uganda and Jennifer Anguko in the north), got nationwide media coverage when it was filed in March 2011. It said the women’s deaths could have been prevented if the health centres where they died had had “basic indispensable health maternal commodities” and if health workers at the facilities had not neglected the two women.

In throwing out the case, the justices suggested the petitioners seek an order from the high court compelling a public officer, such as a government health worker, to carry out his or her duties, or to request compensation for individual deaths from the government.

On 14 June the petitioners filed a notice informing the Supreme Court and the Attorney General’s office of their plan to appeal against the constitutional court decision; they have 50 days to finalize and file the appeal.

Rights denied?

Moses Mulumba is the executive director of the Centre for Health, Human Rights & Development (CEHURD) – the group that originally pushed the petition forward. He said the court’s decision not to wade into a “political question” was based on antiquated law and failed to address the fact that women were being denied rights guaranteed under Uganda’s constitution.

“I think it was very wrong for the judiciary to rely on very old United States jurisprudence to inform their decisions on clear violations of human rights,” he said. The courts should focus on upholding the constitution, he said, instead of “hiding under old political doctrines.”

In a country where statistics show that 16 women die every day from childbirth complications, the activists generally charged the government with perpetuating a maternal death rate that is “unacceptably high”. Ultimately, they are looking for the government to invest more in the country’s health system, to improve care and make sure critical resources are always available.

Valente Inziku, Anguko’s husband and one of the petitioners, said he watched his wife bleed to death as he tried to get nurses at the hospital to attend to her. “When she started bleeding seriously, the only the thing [the staff] did was they came and they told me… to clean the blood,” he said.

“People are disappointed, but we are not stopping there,” said Sylveria Alwoch, of the Uganda National Health Consumers Organization, one of the groups that supported the petition. “We are encouraging people to always report those cases. They shouldn’t be demotivated… They should still have that courage, that vigilance to speak out and bring out those issues.”

Win or lose, CEHURD’s Mulumba said;

the petition had raised awareness of the country’s ongoing maternal deaths and helped rally people around the cause.


 

Luweero struggles to cope with safe births ahead of celebrations

As Luweero District authorities prepare to host the National Safe Motherhood Day on October 17, the health department in the area has been hampered by lack of facilities to handle complications during delivery.
The district deputy health officer and the in charge of Kasana Health Centre IV, Dr Agaba Byamukama, told Daily Monitor that while the national statistics on safe motherhood indicate 435 deaths out of 100,000 mothers in the country, Luweero has limited facilities which has encouraged more referral cases to distant health units.
“We refer about 30 cases with birth complications to other health centres due to limited facilities and inadequate supplies such as cotton wool and anaesthetic drugs for use in the theatre,” Dr Agaba said. The district in conjunction with the Ministry of Health is organising community outreaches to extend immunisation and health care services for both mothers and babies ahead of the celebrations.
According to Dr Agaba, a health fair and a convention on safe motherhood will be conducted to attract resource persons from health partners and international health bodies.
About 180 mothers deliver at Kasana Health Centre while a total of 350 mothers report for the Prevention of Mother-to-Child HIV/Aids Transmissions services at the antenatal clinic every month but the centre has only 15 beds for mothers in the wards.

Source: Daily Monitor
http://www.monitor.co.ug/News/National/-/688334/1248184/-/bikphbz/-/index.html

Maternal Deaths Against Constitutional Rights

When Valente Inziku’s wife, Jennifer Anguko, went into labour they had decided she would go to the local referral hospital just to ensure a safe delivery.
But Anguko bled to death because nurses and doctors could not be bothered to treat her. Her unborn child died as well.
“We attended antenatal clinics and each time they advised us to be near the health center when the delivery time comes. We did just as we were told and when we arrived the services were not provided,” Inziku said.
He had arrived at the hospital after his wife did and found her bleeding. “All the nurses were telling me was I had to clean the blood myself. I had my sister so we cleaned the blood,” said Inziku. “It was purely negligence of the nurses I kept calling them and they would tell us it is not yet the time for her to deliver the baby.”
So Inziku and his sister literally sat down holding his wife as she bled to death. “She died in my arms. She told me: ‘We have children, we have love but all this seems nothing if we have no help.’” Inziku said.
Inziku says the only doctor appeared 12 hours after his wife was admitted. “When the doctor finally arrived he told me it was too late and he asked why the nurses had called him,” Inziku said.
Inziku, a primary school teacher, is now left to look after their three children, all under the age of 10, alone.
Inziku is part of a group that has petitioned the Uganda Constitution Court to pronounce the escalating maternal deaths in Uganda violates the Constitutional rights of Ugandans.
The case was brought to court in March by the Centre for Health, Human Rights and Development together with three individuals: Professor Ben Twinomugisha, a lecturer at Makerere University; and two health activists, Rodah Kukkiriza and Inziku.
They want government to address maternal mortality and compensate the families that have lost mothers to negligence or poor services.
In the petition, the activists argue that by not providing the essential services for pregnant women, and many others, the government of Uganda is in violation of the fundamental obligation of the country to uphold the Constitution and defend, protect and promote the right to health and the right to life.
“I am here today because I want the court to know there’s an injustice going on. I have pain in my heart,” said Inziku.
The court was scheduled to hear the petition on Jul. 7 but the case was postponed because they did not have the required quorum of five judges.
Noor Nakibuuka Musisi, the programme coordinator at Centre for Health Human Rights and Development said securing a court declaration would be a great start in getting government to act.
“We want a declaration that the non-provision of essential services in the government facilities is a violation of the right to life,” she said. “The reason many women die is because there are no maternal kits, there’s no blood in hospitals and we have poorly paid health workers not behaving in the most ethical way.”
In June the Ugandan government announced an increase in the health budget for the 2011/12 financial year. It increased from 270 million dollars to 412 million this year.
However, Francis Runumi, the commissioner of health services and planning at the ministry of health said most of the budget was going to infrastructure and would not address the human resource crisis that has contributed to maternal mortality figures.
Still activists question the political commitment and health sector accountability. Recently government spent 760 million dollars on fighter jets and other defense equipment, which many question as a priority for Ugandans.
Robinah Kaitiritimba, the executive director of the Uganda National Health Consumers Organisation, part of the coalition that brought the case to court, said Ugandans must fight for their rights.
“There are no rights which are given on a silver platter, we must continue to fight and ensure our government responds to the cries of mothers and families.”
Maternal death in Uganda has remained high over years, every day at least 16 women die in childbirth. Uganda’s maternal mortality figures are at 435 deaths of every 100,000 live births, which translate to 6,000 deaths annually. Also child mortality remains high with infant mortality rate at 78 per 1000 births.
Most of the maternal deaths in Uganda are preventable and mainly caused by the massive shortage of trained and motivated professional health workers to attend births, lack of access to emergency obstetric care for responding to emergencies, lack of access to quality antenatal care, and lack of access to family planning services.
The gap in access to life-saving HIV treatment and malaria prevention and treatment are also major causes of maternal deaths.