August 14th, 2015
For immediate release
Nakaseke District Local Government Demonstrates Accountability for health rights violations in Nakaseke District Hospital
Kampala – Uganda -Today, Mr. Mugerwa David and his three children have received a cheque worth UGX 9, 400,000 from the Chief Administration Officer of Nakaseke District Local Government. This payment is partial compensation of the UGX 35,000,000 awarded to this family by the High Court of Uganda for violation of human and maternal health rights of Ms. Nanteza Irene who died in labour due to the negligent acts of employees of Nakaseke District Hospital.
In May 2012, The Center for Health, Human Rights and Development (CEHURD), Mugerwa David and his four Children dragged Nakaseke District Hospital to court over failure to provide basic Emergency obstetric Care to Ms. Nanteza Irene (Now deceased) while she was in labour at the Hospital. On the 5th of May, 2012 Nanteza was taken to Nakaseke hospital by her husband, Mugerwa David to deliver her baby. While at the hospital, a nurse detected that the deceased suffered an obstructed labour that required urgent intervention by a doctor. The doctor on duty only arrived at the hospital after over eight hours when it was already too late for any medical intervention to reverse the haemorrhage that had arisen due to a ruptured uterus. Ms. Nanteza Irene died.
On the 30th of April, 2015, Hon. Justice Benjamin Kabiito while delivering his judgment to the case concluded that Nanteza’s human and maternal health rights, right to basic medical care and the rights of her children and husband were violated. Nakaseke District Local government was found vicariously liable for the acts of the doctor and the hospital administrator who failed to ensure the provision of emergency obstetric care urgently required by Ms. Nanteza Irene. The Court then awarded general damages worth UGX 35,000,000 against Nakaseke District Local Government to Mr. Mugerwa and his children for the pain and loss of their loved one.
This case demonstrates to Ugandans that local governments can be held responsible for their inaction, or failure to protect human rights, as well as the infringements on human rights. As agents of central government, Local governments are supposed to take appropriate measures to prevent, punish, investigate, or redress harm caused by their employees that could lead to a violation of human rights as guaranteed by the 1995 constitution of Uganda.
“CEHURD applauds Nakaseke District Local Government for taking urgent steps to meet the orders issued by Court.” Notes Mr. Mulumba Moses, Executive Director of CEHURD. “We also take cognizance of the improvements in Nakaseke District Hospital after the determination of the case, we have received reports that Nakaseke district Hospital has now got a new outpatient department, two theaters, and three isolation wards and is putting in place measures to supervise health workers among others. This is good progress; NO MOTHER SHOULD DIE WHILE GIVING BIRTH.” Mulumba adds.
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As one of the program goals at Centre for Health Human Rights and Development to; document, influence and advocate for human rights and health law policies, plans and best practices that impact and improve the social justice in health, CEHURD is working closely with media to ensure this. Here the daily monitor shares a story on Plant Varieties. Find here full story
By: Margherita Cinà, Intern from McGill University
A few days ago I visited Kabarole District in Western Uganda and I was talked to a layman involved in projects for strengthening his community. Being a Canadian interested in development and finding myself in a new, and very different country, I asked him what the biggest challenge was with development initiatives in the area. He responded:
“In Uganda, we have a saying: ‘God gives meat to those who do not have teeth’. This means that many people are given things that they cannot use, and that’s a big problem with development initiatives because many organizations do exactly that. Organizations need to know the local community, their needs, culture, and governance structures before they come and try to help us. For there to be long-lasting success, organizations have to work with the community so that members can take ownership over the project and so that efforts are not wasted. Many organizations don’t do that.”
Since the beginning my internship at the Center for Health, Human Rights and Development (CEHURD) on 11 May 2015, I have witnessed the works of an organization that does not make that mistake. I have had the opportunity of being involved in all three of CEHURD’s programs (Research Documentation and Advocacy, Strategic Litigation, and Community Empowerment) and I have been able to witness the importance and the effectiveness of the approach of engaging community members and providing them with the knowledge to demand for their rights. Particularly, through the Community Empowerment Program, CEHURD works with local communities to identify specific health issues and work together to address them by creating knowledge and awareness.
At the beginning of June, I travelled with the CEHURD team to Manafwa District in Eastern Uganda and participated in implementing a project in partnership with the African Rural Development Initiative (ARDI), a Community Based Organization that works closely with CEHURD in that area. Together, the two organizations have been working to advance sexual reproductive health (SRH) in schools in this district. The organizations sensitize students on pertinent issues of SRH, such as access and barriers to modern family planning methods, and help them make informed decisions about their own reproductive health. The project also involved holding stakeholder dialogues with religious and cultural leaders, the police, and community members, all of whom play essential roles in the topic of SRH.
This particular community project is a direct response to a study conducted by CEHURD in 2014 entitled “Criminalization of Abortion and Access to Post-Abortion Care in Uganda: Community experiences and perceptions in Manafwa District”. This study revealed that unsafe abortions are particularly prevalent in Manafwa District. A local health care centre, Bugobero Health Centre IV, reported that they received approximately 25 patients per month who needed post-abortion care (PAC), while a total of 205 abortion cases were registered by public health facilities in the district over a period of 12 months. Given the illegal nature of abortions, it is likely that these numbers do not show the whole extent of the problem, as many cases remain unreported for fear of the legal and social consequences of this criminal act. Uganda has one of the highest rates of maternal mortality in Eastern Africa with a rate of 438:100,000 live births. Of the over 6,000 estimated maternal deaths that occur in the country every year, about 26% (more than one quarter!) are attributed to unsafe abortions.
I engaged students from four schools, including Lwakhakha Primary and Secondary, Bumbo Secondary, and Kisawayi Primary, to critically think about and discuss SRH issues and over 500 students were involved in debating the topic: “Should the use of contraceptives be encouraged in schools?”
This topic was chosen in order to open dialogue between school children about contraceptive use and the high rates of unsafe abortions that occur in their district. Students between the ages of 8 and 22 were selected ahead of time to debate both sides of the argument. At the end of the formal section of the debate, the floor was opened up to other students that wanted to contribute arguments either for or against the motion.
Overall, the level of debate was very good and the students were all enthusiastic and quite comfortable talking about issues of sex, contraceptives, pregnancy and sexually transmitted illnesses. There were however many misconceptions of the use of contraceptive that were found across all 4 schools. Among the most frequent mistakes were that contraception use damages reproductive organs, causes permanent infertility, produces deformed babies with big heads or the size of small rats, leads to diseases such as hypertension, and that girls will waste the family’s little financial capital on buying these pills, Injectaplans, or condoms.
Following the debate, a community health worker, a midwife at a Health Centre III, gave the students sexual education by explaining biological basics as well as addressing some of the myths and misconceptions about contraceptive use that arose during the course of the debates. Importantly, she also informed all the students that contraception, such as pills and condoms, are actually free of charge at health centres and therefore can be obtained by anyone. She told the students of the “youth-friendly services” are available in many health centres and that students should begin to start accessing them if they are engaging in sexual activities.
The nurse also brought in the issue of unsafe, self-induced abortions, an issue that had been raised by a few of the students arguing for the use of contraception to be encouraged in schools. Many early pregnancies by young girls who are still in school can lead to the girls seeking unsafe abortions in order to remain in school or avoid stigma by family or community members. In order to avoid these early pregnancies, it was highlighted that the two best options were abstinence and, if that is not possible, condom use.
The students remained engaged throughout the whole session. At the end of the midwife’s talk, students asked very relevant and interesting follow-up questions and, upon an informal evaluation at the end of the session, students clearly indicated that they had learnt new information about contraception use and were aware that some of their initial ideas were in fact wrong.
My visit to Manafwa District taught me many things and helped me reflect on some of my own conceptions of human rights and development initiatives. Firstly, I began to think deeper about what exact “the right to health means,” which is three obligations on the government: the obligations to respect, protect, and fulfill. Empowering community members through these dialogues and debates is the beginning of creating an environment where individuals take ownership of their rights and begin not only to understand them, but to also be able to hold appropriate people or institutions accountable. The government always has the three obligations however, when individuals are not aware of their rights, they are not able to demand those rights. By informing individuals on their sexual reproductive health rights, the government becomes accountable for its duty to respect and protect the communities.
Secondly, I had the opportunity to experience and to reflect on what it takes to begin to effect real change in a least developed country (LDC) like Uganda. My personal interests have always been in development issues, particularly around health issues, in low- middle-income countries and yet this is the first time that I have had the opportunity to work with an indigenous NGO and, more specifically, to interact with the community members that many international laws and policies I’ve read or studied are supposed to help.
This experience in Manafwa District with the CEHURD team has allowed me to better understand the challenges and barriers that individuals and communities face as well as their specific needs and stories.
When it comes to reducing the number of maternal deaths due to unsafe abortions, the road begins with educating children and youth on the facts of SRH and then including all key stakeholders in the discussion. Sustainable and effective change starts by addressing specific community needs and involving all those in the community in the change process.
By Margherita China
Intern-Centre for Health, Human Rights and Development (CEHURD)
To provide overall leadership and management of CEHURD’s research processes and the coordination of CEHURD’s Regional work on Health Equity. This is a dynamic position that requires the officer to provide leadership in designing and implementing research projects and evidence-based advocacy initiatives. Other responsibilities include fundraising, coordination of regional health equity initiatives with a strong contribution to CEHURD’s Strategic Plan.
Job Title : ADMINISTRATIVE ASSISTANT
Reports to: OPERATIONS MANAGER
To perform a range of administrative tasks for the effective and efficient operations of CEHURD. While the Administrative Assistant reports to the Operations Manager, she may often be required to perform administrative and office support activities for multiple supervisors.
The closing date for the receipt of applications is 31st July 2015 by 12:00noon; and only shortlisted applicants will be contacted.
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If you believe you are the ideal candidate for any of these posts, please submit your Application Letter, Curriculum Vitae, and copies of your academic documents in a sealed envelope, clearly indicating the position applied for on the “top left-hand side of the envelope” to:
The Executive Director
Center for Health, Human Rights and Development Plot 833, Old Kiira Road, Ntinda-Kiwatule
P.O. Box 16617 Wandegeya
Kampala – Uganda
OR Email your application & other supporting documents to: firstname.lastname@example.org clearly indicating the position applied for in the subject line of the email.
The Ministry of health launched the “Standards and Guidelines for the Reduction of Maternal Mortality and Morbidity Due to Unsafe abortion in Uganda on 4th April 2015.” According to the Uganda Demographic and Health Survey (UDHS) 2011, Uganda has a maternal mortality ration of 438 per 100,000 live births, 26 percent of these deaths are attributed to unsafe abortions.
As an intervention, in 2013 the Ministry of Health in collaboration with Development partners, implementing partners, and stakeholders including; the Center for health human rights and development (CEHURD), IPAS Reproductive health Uganda (RHU), Association of Obstetricians and Gynecologist of Uganda (AOGU), Makerere University department of Psychiatry, Ministry of Justice and Constitutional Affairs, Makerere University School of Laws PACE, Health GAP, Marie Stopes Uganda, and the Coalition to Stop Maternal Mortality Due to Unsafe abortion (CSMMUA) started a consultative process for the development of Standards and Guidelines to address the mortality and morbidity as caused by unsafe abortions in the country.
These guidelines will be implemented in all health facilities nationwide and will also be used by health professionals as well as policy makers to take steps in the area of service delivery, advocacy and capacity building all aimed at reducing maternal mortality and morbidity caused by unsafe abortion in Uganda.
The launch of the Standards and guidelines which has marked the end of the two years multi-stakeholder consultative journey has been officiated by the Director of Health services at the ministry of Health Professor Anthony Mbonye on behalf of the State Minister of Health (in charge of primary health care) Honourable Sarah Opendi. In his statement during the launch, the Professor noted that Uganda like any other country pledged to meet the obligation under the Maputo plan of Action, MDG 5 on reduction of maternal mortality as well as other Global initiatives in order to ensure that lives are not lost as a result of unsafe abortions. “This has therefore remained a key Government concern,” he added.
The chief executive officer of CEHURD, Mr. Mulumba Moses said that the standards and guidelines document is a step towards stopping women from turning to backstreet alleys. Mr. Mulumba added that it is encouraging to hear that the ministry is ready to tackle the problem head on by developing a policy structure that aims to deal with an issue that has been ignored for far too long.
In Uganda, termination of pregnancy is restricted and only permitted to preserve the life, mental and physical health of pregnant mothers. There have been challenges due to limited understanding of the legal environment by health providers, policy makers and patients hence formulating these guidelines which will help in solving this issue.
Dr. Charles Kigundu, president of the Association of Gynecologist and Obstetricians of Uganda noted that as health workers dealing with maternal health issues still find a lot of women coming to them with complications such as infections and punctured uteri. The guidelines will help solve the situation greatly since many health professionals believe that abortion is totally legal yet the guidelines provide a better picture on how, when, and in what circumstances a safe abortion can be performed.