The right to health through the lens of media practitioners

The Uganda Law Society (ULS) is an Association of all advocates in Uganda. It has different clusters and one of them is the health and the Law cluster chaired officially by Mr. Mulumba Moses the Executive Director, CEHURD. It was launched in December 2017 and has already been nominated as the best performing cluster in 2018. The mandate of the cluster is to inform the ULS on the trends and topical issues in health and the law as an area of practice and guide on the ULS intervention in this area.

On the 15thday of February 2019, the Health and the law cluster had an evening chat to discuss,as a topical issue, health and the law through the lens of media practitioners.The Health and the Law cluster members had a face to face interaction with journalists on challenges they face while investigating health and the law issues in Uganda and discussed how best the Uganda Law Society through the Health and the Law Cluster can support them even as they undertake investigations on controversial topics.

This meeting brought together media persons, medical practitioners and lawyers to discuss legal issues affecting health in Uganda especially looking at access to health goods and medicines in light of the current stock outs and theft of drugs. The journalists complained of police harassment and lack of capacity in terms of knowledge of the law when they are carrying out their work.

We were able to increase awareness on the health and the law issues among lawyers since this is a one of kind meeting with the health and the law cluster of the Uganda Law society which is a start of many more to come.The cluster committed to be available for providing legal aid to medical personnel and journalists promoting the right to health. This will in turn create synergies between the lawyers in the cluster and the medical professionals and journalists.

By Laker Gloria

When a national referral hospital ceases to be one: Reminding government of its duties

The news of Rebecca Kadaga, the speaker of Uganda’s parliament admission at Nakasero Hospital and later being transferred to Aga Khan hospital in Nairobi for medical treatment brought back a painful memory of my late aunt’s experience at the Uganda Cancer Institute.

I remember around 2017, my late aunt a cancer patient went to the cancer institute at around 6am in the morning and spent the whole day there. When she finally got to see the doctor at around 9pm it was too late, the doctor who was removing his hand gloves told her that she was to be seen the next day. The next day she still could not see the doctor and decided to go back to the village.

When her condition got worse while in Lira, I and other family members got into a debate on whether we should have our aunt brought back to the Cancer Institute or not because her past experience at the facility took the entire day and she was not attended to. That debate left me wondering why we have national referral hospitals just in names and not in functions.

History has it that the late president Amin, Lady Sarah Nalule Kisosonkole and Sir Tito Winyi IV (former Omukama of Bunyoro) were at one time admitted at Mulago National Referral Hospital to receive medical treatment. It was also reported at one time in the newspapers that the Rtd. Bishop of Busoga Diocese, the Rev. Cyprian Bamwoze, who had spent a week bedridden at Kamuli District Hospital, declined transfer to Mulago National Referral Hospital in order to show confidence in Kamuli district hospital.

Why should then a section of persons be given special treatment by government in the names of being ‘Very Important Persons’ (VIPs) and given privileges to access the best medical services in ‘uptown’ private medical facilities and abroad. What about others who are not ‘Very Important Persons’? The government should perform its core minimum obligation and ensure that its public health care facilities function by among others, providing it with enough human resources and tool of work.

This also brings in another question of how the proposed national health insurance scheme will function and how public health facilities will compete with the ‘uptown’ private health facilities. If government already prefers to take its VIPs to private facilities and abroad, how then will the beneficiaries of the scheme have confidence to access medical treatment from public health facilities?

In the words of Solomon Serwanja, a journalist with NBS TV “injustice in our society will continue as long as we all remain too afraid to lose the little privileges”. The VIPs should not be afraid to challenge government to do more for the public health facilities.

 

By Komakech Job

Promoting access to quality, affordable and timely HIV, TB in Uganda

The Center for Health, Human Rights and Development (CEHURD) is implementing the Uganda Country Programme on HIV, TB and Human Rights Training and Advocacy in partnership with Uganda ARASA partners including; International Community of Women living with HIV Eastern Africa (ICWEA), Uganda Network on Law, Ethics and HIV/AIDS (UGANET), Uganda Harm Reduction Network (UHRN), African Young Positives Network (AY+) and Tororo Forum for People Living with HIV Networks (TOFPHANET) with financial and technical support from the AIDS and Rights Alliance for Southern Africa (ARASA)

The Country Programme is aimed at promoting access to quality, affordable and timely HIV, TB, and SRH services and justice among communities of persons living with and those affected by HIV and TB and key populations in Uganda and this will be achieved through three major approaches: Research for evidence building; Capacity strengthening to increase demand and uptake of services; and Advocacy to influence policy development, change and or implementation.

Under the approach of evidence building, CEHURD in collaboration with Uganda Ministry of Health (MoH) and partners conducted a “Rapid assessment and mapping of the legal environment on the provision of HIV and TB services to key populations, persons living with HIV and those with tuberculosis: A Case of three districts in Uganda” a process that began in October, 2018.

A number of stakeholders including MoH technical team, Parliamentarians, district officials including; District Health Officers (DHOs), Secretaries for Health, HIV and TB Focal Persons from the five selected districts, Professional bodies, legal experts, CSOs, media were brought together on February, 21st 2019 to validate the study findings which were also presented to the Communicable Diseases Control (CDC) Technical Working Group (TWG) at MoH on February, 22nd 2019 for more comments and inputs that will inform the final report.

The research process has helped to strengthen our in country partnership as the ARASA partners but also the collaborations with Ministry of Health, Local Governments, Legislators, CSOs among other stakeholders. The draft report also already clearly highlighted the knowledge and capacity gaps on the linkage between HIV, TB and Human Rights and these will be addressed during the forthcoming trainings in the respective districts. Most importantly the final report will serve as an advocacy and resource mobilization tool for future intervention.

 

By Muhumuza Abdulkharim

Harnessing health innovations to build communities where girls and women thrive

Women’s day is commemorated every year to celebrate and reflect on the role of women in society. The rights of women and taking stock of how these rights have been protected or infringed upon. Wit the theme for this year’s Women’s Day is, “think equal, build smart and innovate for change,”this theme seeks to put innovation by women and girls, for women and girls at the heart of efforts to achieve gender equality.

What does this theme mean for Uganda’s women and girls that make up over 50% of the population? We need to continue to the real issues that affect the lives and women and girls in Uganda. Having closely followed the current discourse in Uganda about the issues that result in death, permanent complications and disease for this gender, it is becoming increasingly clear that we cannot let this women’s day commemoration go by without a reflection on whether our women and girls have benefitted from technological advancement in the field of health and more specifically Sexual Reproductive Health and Rights.

A 2017 UNAIDS study found hat young girls between the age of 15-24 are disproportionately affected by HIV infection, with the HIV prevalence among adolescent girls at 9.1% is higher a than the national prevalence rate that stands at 7.3%. Government statistics also indicate that 1 in 4 girls iseither pregnant or has already had a baby by their 19thbirthday. We cannot have a meaningful conversation about the state of Sexual Reproductive Health and Rights of women and girls in Uganda without reflecting on the  high numbers that die annually due to pregnancy related complications, this is very critical since adolescents have been noted to have an increased risk of death during pregnancy or childbirth compared with older women. Of women that die due to pregnancy related causes and therefore there is no surprise that 57,000 abortions took place amongst adolescents in Uganda in 2013.

Other female experiences like menstruation have had dire consequences on the well being of the female gender. The critical unavailability of sanitary products in Uganda like in all developing countries is a major barrier to education for girls of school-going age. The inability to effectively manage menstruation contributes to absences of up to 4-5 school days each month, equating to as much as 20% of the academic year intentionally skipped, simply due to menstruation. Eventually many of these girls drop out of school entirely, increasing their likelihood of early pregnancy health complications and early marriage, and further limiting their future career and economic opportunities.

All is not lost and I am sure that it is no coincidence that this year’s theme for women’s day celebrates the role of innovation in promoting gender equality. Innovations like methods of contraception that can delay and altogether prevent pregnancy, re-usable pads and the menstrual cup that can be utilized for 10 years. This is not to mention programs like Sexuality education and School Health Programs that seek to impart young people with knowledge and information to enable them make healthy life choices become critical. Above all, Sexual Reproductive Health innovations, programs and methods for delivery of the same that are tailored to the unique needs of women especially those still going through physical development are very critical.

As we commemorate the International Women’s day, we need to prioritize these innovations that cannot only improve the quality of lives of our women and girls, thisrequires putting in place enabling laws and policies, ensuring availability of funds to support such programs and above all protecting the rights of women and girls from derogation.

 

By Joy Asasira

How and why the general public should support implementation of the tobacco control law

Creating public awareness on tobacco control and encouraging the public to adhere to, comply with and support implementation of the public health and tobacco control laws in place will help reduce the morbidity and mortality of cancers caused by tobacco smoke.

In Uganda today, Tobacco use has remained a significant public health challenge and a leading cause of many non-communicable diseases including heart diseases and lung cancer.

According to the World Health Organization, tobacco kills more than 7 million people each year. More than 6 million of those deaths are the result of direct tobacco use while around 890,000 are the result of non-smokers being exposed to second-hand smoke. Current scientific evidence has established that tobacco consumption and exposure to tobacco smoke causes disease, disability and death (The Global Adult Tobacco Survey: Country Report 2013). These are preventable deaths we all can commit to end if only we raise awareness on tobacco control and adhere to public health policies.

Parliament as the Legislative body in Uganda exercised its mandate under Article 79 (1) of the Constitution and enacted the Tobacco Control Act 2015 with the objective to among others control the demand, supply, production and consumption of tobacco and its related products.

There has however been a lot of misconceptions and misguidance about the Tobacco Control Act 2015 by the general public but also a deliberate move by the tobacco industry to sabotage the smooth implementation of the law. For example some of the arguments that have been forwarded by the Tobacco industry is that the Act is against the rights of farmers in Uganda and their legitimate right to trade in tobacco and its related products. As such, we need to educate ourselves and others on the law through supporting the Tobacco Control cause and complying with the public health/tobacco control laws in place.

It is also important that the public supports implementation of the law because it is all our responsibility to monitor tobacco use and protect people from tobacco smoke, offer help to those who want to quit smoking, warn people about the dangers of smoking tobacco in public places, and promote a smoke free environment.

The public enjoys a number of rights under the Constitution of Uganda and Tobacco Control Act including the Right to a clean and healthy environment as well as the right to a tobacco smoke free environment, the right to health among others. The law inter alia prohibits smoking in public places, workplaces, any means of public transport, or any outdoor space that is within 50 meters of any public place, workplace, public transport terminal, a place that provides services primarily to children, or a place of service or consumption of food/drink.

It is important to note that an individual’s right to smoke is not prohibited by law as thought by the general public and the tobacco industry, rather the law places a limitation on smoking in public places. This helps to ensure that in the enjoyment of one’s rights and freedoms, the fundamental or other human rights and freedoms of others are not infringed or violated upon by individuals smoking in public. (Article 43 of the Constitution).

The public should henceforth support the implementation of the law by ensuring that owners of public places   display notices on premises prohibiting smoking in such places, ordering people found smoking in public places to cease smoking immediately, requiring such person to leave/disembark the place, causing arrests of such person, or contacting a law enforcement agent/authority.

The Act also regulates the Tobacco Industry (manufacturers, wholesale distributors, importers of tobacco products, persons/entities working on their behalf to further their interests) by placing a comprehensive ban on all forms, methods, and means of tobacco advertising, promotion and sponsorship, restricts the sale and display of tobacco and tobacco products, bans the importation, manufacture, distribution, processing for sale, offering for sale, or bringing into the country electronic nicotine delivery system/cartridges with nicotine, water pipe tobacco delivery system, and smokeless or flavored tobacco products. The public should ensure that such is complied with.

Just like all other businesses that are regulated by Government, the control of tobacco smoking in public places and regulation of its advertisement and promotion is not a unique thing. The public should therefore disregard the arguments by the Tobacco industry that the Tobacco control law bans them from conducting in a lawful trade. The public should instead join and support the government in promoting public health.

It should therefore be noted that the Act does not ban the Tobacco Industry from practicing their trade as provided under Article 40(2) of the Constitution of the Republic of Uganda 1995 but puts in place a regulation on the conduct of their trade. The public health issue comes into context where the public needs to be protected from the harmful effects of certain trades.

As such, we should all join hands to make healthy lifestyle choices and avoid using tobacco and related products and educate ourselves and others to support the Tobacco Control cause through complying with the tobacco control laws.

 

By Esther Dhafa and Komakech Job