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UCHD 2023
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Aggressive Measures Could Help Beat Cancer

Chances of survival from cancer are as high as 90% if a woman is tested regularly and the cancer is detected in the early stages. We have a saying where I come from, that a stone you can see, might prevent you from stumbling. Likewise, when cancer is caught early, the chances of treating it and healing are higher. It is important to strengthen the capacity of community health workers as a first point of contact.

Miriam kyomugisha

By Miriam Kyomugisha

According to the Uganda cancer institute, in a press statement released on 1st September 2022, an estimated 33,000 Ugandans are diagnosed with Cancer every year. Out of this, only about 7400 make it to hospital for treatment and care.

In Uganda, breast cancer is one of the most common types of cancer. Despite growing efforts to improve awareness, over 75% of breast cancer patients in East Africa present with late-stage disease, with Uganda registering over 80% of women presenting late-stage disease. This is attributable to a dysfunctional and lack of recognition of the early signs and symptoms among primary health care providers, and compounded poor infrastructure, delay in seeking support and an inadequate human capacity

As a person who has lost someone dear, to cancer, the experience caring for a patient right from detection to death is so heart breaking and I always look out for friends and family in this regard.  A couple of weeks ago, a friend told me she felt a lump in her breast. I cautioned her not to take it lightly and advised her to have an immediate medical checkup. Two weeks down the road, I call to check if she had done the medical check up and alas, she had not done any test. Her explanation was that, as a Christian, she was giving God a chance to take away the lump and that her and her community of Christians were engaged in 40 days fast as part of the healing process and would only check after the 40 days. Knowing the importance of early detection, in improving the prognosis, I was so disappointed. Don’t get me wrong, I believe in God and miracles. The person I lost trusted God for healing and I know well how it all ended. Knowing how hard it can be to face a test that might be life altering, I chose not to push her too hard. For me, the death of the loved one still haunts me to date, perhaps if we had acted intime and had her tested and cancer detected early, maybe we would have saved her life. Chances of survival from cancer are as high as 90% if a woman is tested regularly and the cancer is detected in the early stages.

Unfortunately, for many women in Uganda, access to cancer screening and testing is constrained. In most private facilities, a mammogram on average costs 150,000/= and this is way beyond the reach of many women. The situation is worsened by limited access to these mammograms. With the current state of affairs and as the old adage says, prevention is better than cure.  Emphasis on making healthier lifestyle choices and food choices is a good place to start. Secondly, early detection should be emphasized. We have a saying where I come from, that a stone you can see, might prevent you from stumbling. Likewise, when cancer is caught early, the chances of treating it and healing are higher. Even the cancer treatments are easier to withstand before the body is overwhelmed by cancer cells.

It is evident that the fight against cancer is not just for the medical professionals but all of us. Like the Prime Minister said in her recent visit to Uganda Cancer Institute, “We need to fight cancer like corona virus was fought by involving all stakeholders”. There is need for behavioral change through addressing cultural and religious beliefs that frustrate early detection and treatment of cancer. Early detection and treatment can be enhanced through community empowerment by building the capacity of critical mass community advocates. This can be through strengthening the ability to self-examination for symptoms of cancer. It is important to strengthen the capacity of community health workers as a first point of contact.

 A robust cancer awareness has to be created as a preventive measure against cancer. Furthermore, there’s a need for sensitization to the masses on the proper and effective treatment for cancer.  I got into a conversation with some colleagues and discovered that many patients had chosen herbal medicine as an alternative treatment because of the high cost of treating cancer and the disproportionate number of patients compared to medical professionals.

It is import for government to invest in the fight against cancer screening and treatment. To leave no one behind in cancer screening and treatment, it is imperative that government takes deliberate action to decentralize these services. The cost to travelling to Kampala for cancer treatment is prohibitive and this partly contributes to the high cancer mortality rates. Investment in breast cancer screening and treatment is an equity issue and must as such be prioritized.

The writer is a lawyer and a Programme Officer at the Center for Health, Human Rights and Development (CEHURD).

Posted on Categories Featured, General News 167 Comments on My Experience Litigating Sexual and Reproductive Health and Rights Related Cases

My Experience Litigating Sexual and Reproductive Health and Rights Related Cases

“Where, after all, do universal human rights begin? In small places, close to home – so close and so small that they cannot be seen on any maps of the world. Such are the places where every man, woman and child seeks equal justice, equal opportunity, and equal dignity without discrimination. Unless these rights have meaning there, they have little meaning anywhere.”

Eleanor Roosevelt

By Ruth Ajalo | Lawyer

Before joining the Center for Health, Human Rights and Development (CEHURD), I had basic information
about the right to health. This basic information was gained while pursuing the health and the law course
unit in my fourth year at Makerere University Law School. Learning the right to health was exciting and it
set a spark within me that I desired to carry forward in my career. This did not materialise immediately after Law School but when I eventually joined CEHURD, I was excited and looked forward to learning more about the right to health and this unique area of legal practice.


At CEHURD, I have learnt, unlearnt and I continue to learn each day about the right to health and the
intersectionality of health and human rights. I can confirm that there is a lot of knowledge and exposure that the right to health brings to light. CEHURD, among other things, provides legal support to victims and survivors of sexual violence and health rights violations. It also litigates strategic cases aimed at addressing systemic gaps and bottlenecks within the provision of health services in the country. 


CEHURD prepares, nurtures, and gives you a platform to shine and build your career. As a legal
practitioner, last year, I had the unique opportunity of litigating a landmark Sexual and Reproductive Health Rights case before a bench of five justices of the Constitutional Court. This is a dream come true for any young lawyer.


My experience in handling and litigating SRHR cases has been an emotional rollercoaster; it has been easy, hard, tasking, draining both physically and emotionally at times but above all, fulfilling. It is exciting to secure a win for a client and a win for the transformation in the provision of health services in the country.
Litigating SRHR cases is unique because this is not something you do without learning, unlearning,
understanding and preparing. Your mind is trained to creatively pick out the rights issues in the case and
articulate them sufficiently in a manner that reflects preparation and in-depth knowledge of the issues at
hand. Furthermore, the external lawyers we work with on some of our cases have to be oriented on the
unique aspects of the right to health and why it matters before they delve into the gist of the cases. This
calls for thorough research, preparation which continuously builds one’s mastery in the area of Health and Sexual and Reproductive health.


When a person calls the CEHURD toll-free line or walks into the office seeking help, that person is either
seeking information or is seeking for support. They are usually hurting or have suffered some form of loss
and need redress and or some form of support. Regardless of the circumstances and the facts of the case,
as lawyers we are expected to be non-judgmental, good listeners and provide the most appropriate
professional support. During the client-advocate meeting, when the client breaks down and starts to cry, the counsel must wear another hat of a counsellor and have to exercise empathy towards them. This requires that the lawyer for a moment, abandons the legal path and the knowledge acquired in Law School to concentrate on helping a client recompose through provision of Psychological first aid. This requires that for a moment, you abandon the legal package and knowledge you walked into the meeting with, and take on a new mantle of a counsellor.

We walk the journey with our clients, we counsel them, we exercise empathy, we hand-hold, we manage expectations and above all, we keep an open mind as we handle these cases. It is important to note this process also takes on an emotional toll on the lawyer and calls for selfcare. The emotional toll is largely because lawyers by training are not counsellors but in country with limited professional counsellors, any lawyer will by default provide; counselling to their clients especially when engaged in SRHR.


This type of work is not void of challenges such as the heart-breaking experiences of the clients, and being misunderstood by the public because of the nature of the work done, among others. Sexual and
Reproductive Health is a largely contested arena. Listening to clients’ experiences can get emotionally
draining because their experiences are in most cases very painful and nobody deserves to go through such grueling experiences. Furthermore, the clients are not conversant with the litigation progress and despite an effort to explain to them and manage expectations, they get burnt out and experience litigation fatigue.


Litigating human rights will certainly be difficult for any client especially if they are facing stigma,
discrimination, abuse, and isolation among others because of the delay in the disposal of their cases. 
To respond to these challenges, CEHURD has invested in the provision of psychosocial support to the
legal team that handles these cases, general staff wellness and welfare to enhance the continuity of
litigation. We also share and learn amongst ourselves in the Strategic Litigation Programme with the view
of bettering ourselves. We also hold annual clients’ meetings where clients are invited for interactions and
update meetings about their cases, clients share amongst themselves and learn from each other and we
also receive feedback which we find useful for improving our service delivery.


As mentioned, we are sometimes misunderstood by the public but choose top stick to our calling trudge on nonetheless, undeterred and ever so ready to defend and stand for our clients’ rights and for system
change. 
Justice for our clients comes in many forms; arrest of an accused person, sentencing (imprisonment) of an
accused person, an apology from the health worker, an explanation offered for what went wrong, an
admission of wrongdoing from the health facility or health worker among others. It is these small wins and seeing systemic changes in the provision of Health that is the power below my wings and that keeps me waking up every day to provide legal support.


Despite all the hurdles and challenges encountered, the work is fulfilling. Fulfilment is in the fact that you
helped a person and they didn’t pay you for that service; that you utilised your legal knowledge to address a human rights violation and get justice for your client. Fulfilment is the phone call from a grateful client highlighting his or her gratitude “mwebale nyo, tusimye byona bye mwakola” –” thank you very much, we appreciate everything you do for us”. Some clients call us to update us on the progress of their daughters who suffered violence to indicate that our interventions built the girl’s confidence, she returned to school and she passed her Primary Leaving Examinations (PLE). 


To all human rights defenders, your work is not in vain; a step-by-step effort, a multi-sectoral approach, and perseverance will go a long way in realising a just society; a society in which people are free from sexual violence, free from health rights violations and all other violations around us. Let us persevere and keep the flame burning because society and the world at large still need us. 


“Helping one person might not change the world, but it could change the world for one person” – Anonymous.

The writer is a Programme Officer in the Strategic Litigation Programme at the Center for Health, Human Rights and Development (CEHURD).
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End Gender Inequalities and End Aids by 2030

We have to agree that the epidemic will not be over until the cycle of new HIV infections is stopped and all people who need it are on lifelong treatment. Treatment alone is unlikely to end AIDS, prevention is also essential. Too many adolescents and young women are still falling between the cracks of the global response.
It is important to note that gender inequality such as gender-based violence leaves young women and girls more vulnerable to HIV. It also restricts the rights of women and adolescent girls, including their ability to refuse unwanted sex or negotiate safer sex, and access HIV and sexual and reproductive health services.

By Mary Nyaketcho

For over 40 years, the 1st of December has offered an opportunity to rally support for people living with and affected by HIV and also to honour those who have died from Aids-related illnesses across the world. Uganda and the world at large are still lagging behind in reaching the commitment to end Aids by 2030 not because of a lack of knowledge or materials to beat Aids, but because of various barriers that obstruct HIV prevention and treatment. Discrimination, gender inequality, poverty, and criminalisation are barriers that prevent people living with HIV/Aids from accessing healthcare. Therefore, World Aids Day raises awareness of the impact of HIV on people’s lives to advocate against stigma and discrimination against those living with HIV and also to highlight how far we have come.

The theme “ending inequalities among adolescent girls, young women and boys” is a call to action. It is a call to action for all of us to confront the inequities that drive AIDS and hinder access to essential HIV services, especially for adolescent girls and young women and boys. The high HIV prevalence among adolescent girls and young women and boys suggests that factors beyond behaviour may be contributing to the heightened vulnerability of this group. Without bold action against inequalities, the world is likely not to reach the target of ending AIDS by 2030. 

Regardless of the enormous advances made to eradicate AIDS globally, adolescent girls, young women and boys are disproportionately at risk of acquiring HIV, a fact that must change. Urgent action to reduce the risk of adolescent girls and young women to HIV is vital to end the epidemic. This won’t be achieved without addressing the entrenched gender inequalities that exist where these girls and young women live.

Globally, young people are among the populations most at risk of and affected by HIV and AIDS and Uganda’s population constitutes a significant percentage of young people. Young girls and boys rarely receive sexuality education and only rely on the wrong perceptions given by their fellow youth. This situation might continue unabated unless causes of vulnerability to infection among them are clearly identified and addressed within respective contexts.

Many adolescent girls and young women aged 15 to 24 years in Uganda are more susceptible to HIV infection than their male counterparts. Adolescent girls and young women are biologically more vulnerable to AIDS and twice as likely as men to become infected, according to the UNAIDS Global AIDS Update 2022. They are at a greater risk because they are physically and physiologically more vulnerable to the sexual transmission of HIV than men their own age. 

It is important to note that gender inequality such as gender-based violence leaves young women and girls more vulnerable to HIV. It also restricts the rights of women and adolescent girls, including their ability to refuse unwanted sex or negotiate safer sex, and access HIV and sexual and reproductive health services. Take for example the situation of early marriage. Gender inequality is at the heart of what drives these marriages. In poverty-stricken communities, most girls are married before the age of 18. Early marriage has profound consequences for the health and well-being of adolescent girls and young women. They are at a greater risk of sexual and gender-based violence and sexual violence is closely linked with an increased chance of acquiring HIV. The men they are married to are also often older and have already been sexually active, which also increases the risk. In addition, it is quite difficult for adolescent girls and young women to negotiate safe sex and condom use. 

Many cultural practices also impede efforts to tackle Aids-related issues. A girl is taught from an early age to be submissive and obey men. The girls have not been taught how to say no, how to say what they want and what they do not want. As a result, adolescent girls and women cannot say no to sex, and not request safe sex if a man does not want to use protection.

For that reason, tackling inequalities is a long-standing global need, whose urgency has only increased. However, ending inequalities requires a lot of transformative change. Economic, political, social, cultural and legal inequalities obstructing progress must be addressed. 

We should endeavour to look into laws and policies that address these inequalities and observe the need to protect the rights of everyone especially adolescent boys and girls and young women. By removing punitive laws, policies, practices, stigma and discrimination that block effective prevention and treatment of AIDS, inequalities will be struck out and with more advocacy on this, HIV/Aids shall subsequently end.

At the societal level, we should address the social and cultural norms and practices that perpetuate inequality. It is clear that addressing inequalities and inequity will require the motivation and engagement of the people who are most affected. Therefore, efforts should be made to empower and strengthen people. 

Staying in school reduces the likelihood that adolescents will be infected with HIV/Aids. Education helps individuals protect themselves against HIV infection. But education itself alone does not help, also, there is a need to integrate sexuality education into the curriculum to equip young people with knowledge about HIV/Aids and their rights.

It is time for the government to act with bold and accountable leadership and move from commitment to action. It must promote inclusive social and economic growth. The government ought to also realise that ending HIV/Aids requires ending all inequalities and driving multisectoral action across a range of sustainable development goals (SDGs) and targets and that promoting equal opportunity are fundamental issues for development and sustainable growth. 

We have to agree that the epidemic will not be over until the cycle of new HIV infections is stopped and all people who need it are on lifelong treatment. Treatment alone is unlikely to end AIDS, prevention is also essential. Too many adolescents and young women are still falling between the cracks of the global response.

Therefore, this year, let us be mindful of the inequalities that exacerbate the dangers for everyone, no matter our status, we are all affected by HIV/Aids in one way or another. So, let’s do all we can in order to help tackle the inequalities and end AIDS.

The writer is an intern in the Community Empowerment Programme at CEHURD

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Call for Expression of Interest to Conduct a Midterm Evaluation for the Joint Advocacy for Sexual and Reproductive Health and Rights (JAS) Programme in Uganda

The Center for Health, Human Rights and Development (CEHURD) with nineteen (19) partners are implementing a four-year programme (1st January 2020 – 31st December 2023), titled: The Joint Advocacy for Sexual and Reproductive Health and Rights in Uganda (JAS) Programme in Uganda. The JAS programme is due for midterm evaluation to assess the progress so far made in the implementation. CEHURD therefore, seeks to engage a consultant / firm to support in the external evaluation of the programme that will inform decision making for the remaining period of implementation.

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