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
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).

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

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.

My Work Summer Experience

The learning was deep and significant. The work was beautiful and challenging. Living was both fun and hard. It was exhausting, amazing, sad, intense, and so very many more adjectives. I am grateful, however, for the complexity. I don’t think that one can successfully seek simplicity in human rights.

By Rebecca Clayton

I wrote my first blog as five lessons from my early days in Uganda, so I figured I would conclude with five more lessons from the end of my internship (and in the space since returning home). I would be lying if I said that my reflections since returning to Canada have been easy – translating what I have been feeling into words has been a steep uphill battle. I’ve wrestled (probably for longer than I should have) with what to say on the tail end of an experience like this one. I think my reflections can best be summed up in the following five lessons:

Language is a key player in human rights work; An obvious (but perhaps underestimated) truth in human rights work. Even though English is common, in many of the circumstances where I assisted with client intake or mediation, Luganda was the language spoken. I appreciated being a part of this work but felt at times disappointed that I couldn’t offer more. It was an important reminder about the role of language, and how central it is to everything we do. The best of intentions and the most in-depth knowledge of the legal system don’t mean anything if you can’t communicate with someone – if you can’t learn about them and their experiences. I think this lesson is important to keep in mind as we navigate the world of human rights and public interest law.

There is magic in an organisation that creates space for its employees to connect with one another; In my second last week at the Center for Health, Human Rights and Development (CEHURD), the entire staff went on their bi-annual staff retreat. Twice a year, the staff spend a week somewhere in Uganda (in this case, it was the Ssese Islands) to report to one another, teach one another about new topics in their work, and receive feedback from management on their work over the past six months. Most significantly, though, I noticed that a key outcome of this retreat week is how it provides a space for CEHURD staff to connect with one another. Outside of work hours through meals, exploratory trips, and evenings filled with dancing (and maybe some alcohol), CEHURD staff get to unwind and enjoy each other’s company. All summer, though there was often not much overlap between teams as everyone was busy and focused on their own work, I noticed that staff members were well-connected with each other. After participating in a staff retreat, I think I figured out why. The work at CEHURD is serious, and expectations are high for their employees. It is challenging in more ways than one to work in the human rights field, but carving out space for their teams to feel connected to one another changes the entire workplace culture. I was impressed with much of what CEHURD does, but this was one of my favourite of those things. Having worked in the non-profit sector, I know that organisations need to choose their priorities, as time and funding are always limited. Prioritising this chance to invest in their work culture makes a huge difference in the work that they do, and I felt so fortunate to get to experience it firsthand.

Predictably, a lion lounging in a tree is pretty cool; When Somaya and I went on a safari trip on a long weekend in June, we were on a mission to see lions. Having come all the way to Western Uganda to Queen Elizabeth National Park (famous for tree-climbing lions), we were adamant that seeing lions was non-negotiable. After a disappointing morning game drive, we lucked out in the late afternoon and proceeded to spend the rest of the day passing binoculars between us to watch the sleeping lioness in a tree. And it was exactly as cool as we thought it would be.

Being a cultural outsider can hinder at times, rather than help; In June, CEHURD went to court to argue a seemingly “sensitive” case. A week before the court date, we had a legal expert meeting with the entire Strategic Litigation team, as well as other lawyers and community organizations to talk about our case and what it entails. We discussed strategy, anticipated counterarguments, asked questions and, importantly, discussed public messaging. The way that we wanted to appear in court was carefully weighed – do we pack the courtroom with lots of bodies, trying to control the energy and drawing the public’s attention? Or do we fly under the radar to minimize coverage, and as such, minimize the amount of pressure that the judiciary might feel? Ultimately, the decision was made to do the latter. Weighing out how the public would inevitably respond to a case about such a “sensitive” issue was a careful undertaking – not even our entire team went to watch the case be argued. When I asked my manager if I might go with those who were going to attend, she gently explained that my presence might hinder rather than help. My face in the courtroom might have sent a message, my manager feared, about “external cultural influence” guiding this case. Perhaps unlikely, but we weren’t taking any chances on such an important issue.

This decision, however, reminded me of a whole line of challenges against human rights work. Sometimes, the human rights structures that have originated in the West can cause more harm than benefit through their origin and rigidity. By imposing specific ideas about how rights manifest in all circumstances – these specific ideas being tied up in Western values and perceptions – there are groups that have dug in their heels to resist this imposition and some people have become more marginalised because of it. As with all human rights work, it is important to be aware of our impact in different circumstances, and this court case was a good reminder for me about this. Sometimes, it is best for everyone to sit back and hear about how things went the next day.

I am a super sensitive person – and I need to remember this in my work; Quite honestly, I was not expecting to find working in Uganda as challenging as I did. Having lived abroad, travelled extensively, and worked in the non-profit sector, I had enough related experiences that I thought I would transition rather seamlessly into my life there. I’m not sure whether it was a post-COVID mental health slump, the work itself, or (most likely) a mix of the two, but this summer was incredibly emotionally taxing for me, and I am still trying to figure out how I feel about the experience that I had. I have always known that I am a deeply sensitive person, but I was more exhausted than I ever anticipated at the end of every workday. Progressively throughout the summer, I retreated deeper into books and other sources of comfort in my downtime to avoid thinking too much about the human rights violations I was reading about all day. I missed my security networks – my partner, my family and my friends – in ways I had not expected. And, by the time I returned home, I felt entirely drained. This feeling was made all the more challenging by the fact that it was entirely unexpected for me, and I was wholly underprepared to respond to it. The lesson here for me is one that I am still unpacking but requires me to look seriously at what I need to do to better prepare myself for human rights work in the future, as well as what that work looks like for me to be able to partake in it without having it take over my entire capacity. This personal learning is hugely valuable as I navigate law school and try to figure out a prospective career path. The objective of this programme, I believe, is not just to learn about human rights practice, but to explore how you fit into it. I am grateful for this opportunity to have looked a bit deeper into my own strengths and weaknesses when it comes to human rights, to give me more reference points as I plan for my future.

All in all, there is no one way to sum up my experience in Uganda this summer. The learning was deep and significant. The work was beautiful and challenging. Living was both fun and hard. It was exhausting, amazing, sad, intense, and so very many more adjectives. I am grateful, however, for the complexity. I don’t think that one can successfully seek simplicity in human rights.

The writer was a fellow in the Strategic Litigation Programme at the Center for Health, Human Rights and Development.

A copy of this article was first published in the McGill Human Rights Interns blog