PRESS RELEASE

Kampala, Uganda

Today the Center for health human rights and Development filed a complaint jointly with Dr. Diana Stella Nasike with the Uganda Medical and Dental Practitioners Council (UMDPC) to challenge the poor working environments and conditions in which many of our health workers are subjected to.

Prior to November 6^th 2015, Dr. Diana Stella Nasike had raised concerns with the human resource department at the International Medical Centre Clinic in Kololo where she works in a poorly ventilated room where she had to attend to patients. This is Consultation Room 2 at the International Medical Center (IMC), Upper Kololo Terrace which has no window but just a small hatch sized opening. Dr. Diana works a 12 hour day shift and at least 180 hours a week! Her patients’ are mostly people with respiratory infections, coughs and colds. Being the health worker, she notified the administration and management of IMC that poor ventilation was a risk to her health as patients cough in her face from time to time. Indeed a few months later she was diagnosed with tuberculosis and had to continue work while undergoing treatment. As though that’s not enough, the treatment room at IMC Kololo provides no privacy at all for patients who are being attended to. Anyone can walk in, watch and or listen in while a health worker is attending to a patient.

The management of IMC Clinics –an affiliation of the International Medical Group has however made no effort to rectify the situation even after several letters from CEHURD were written to their office to desist from abusing their employees’ rights to work in a clean and healthy environment.

“TO DO NO HARM- that is a clause in the Hippocrates’ Oath that we take as doctors. That is a vital clause that should govern both our personal and institutional medical practice. A medical doctor or medical institution that does not uphold this becomes a danger to themselves and to the very people they serve.”Dr. Diana Stella Nasike notes in her statement to the Uganda Medical and Dental Practitioner’s Council.

All Ugandans have rights to privacy of information –this is re-echoed in our 1995 Constitution, the Ministry of Health Patients Charter, the Medical Code of Professional Ethics and a guaranteed right to a clean and healthy environment.  Uganda’s parliament has guaranteed that occupational health and safety is underscored in our domestic laws through enactment of the Occupational Safety and Health Act, of 2006. IMC’s deliberate disregard to employees’ rights and patients’ rights to privacy while they access services in their facilities is in utter violation of these obligations.

“It is our appeal to the Uganda Medical and Dental Practitioners’ Council to suspend all health services to patients at the International Medical Centre located on Plot 51A, Upper Kololo Terrace until these complaints are addressed by the management of IMC. All employers ought to understand that it is a constitutional obligation for all persons, health facilities, and government, to respect, uphold and promote human rights of individuals including patients and health workers in private practice.” notes Ms. Primah Kwagala –Program Manager Strategic Litigation at the Centre for Health, Human Rights & Development (CEHURD).

For details please contact: Info@cehurd.org.

kwagala@cehurd.org

or zeere@cehurd.org

or call +256414532283

Download the full  press release .

 

CEHURD within the HIV/AIDS coalition has joined other civil society organizations together with academics, professional associations, public health specialists and researchers to challenge the ‘vague and criminalizing’ sections of the HIV law by filling a petition in the constitution court of Uganda. These different actors believe that criminal punishment and discrimination on the basis of HIV infection is both a legal and human rights question.

 

The major grounds of this petition include S. 18(e) “Disclosure by the third party” which violates the right to privacy as per Article 27 of the Ugandan Constitution as well as S.41 “Attempted transmission” which also violates the right to equality and the right to dignity.

These sections go on to violate the rights of patients as stipulated under the patients’ charter – a document that was developed by the ministry of health with the sole purpose of raising the standard of health care by empowering patients to responsibly demand good quality health care. Specifically, these discriminatory sections of the act gravely contradict articles 2 and 15 of the patients’ charter which speak to a patient’s right to confidentiality and privacy as well as prohibition of discrimination.

Preceding the filing of the petition at the constitutional court, a bevy of human rights activists gathered at the Uganda Museum on the 14th of July 2016. Activists from all branches of human rights were ready to take to the streets and march in support of this cause. People living with HIV/AIDS, nurses, medical workers, students, mothers with their babies, persons with disabilities, lawyers, journalists and human rights activists, clad in their T-shirts and placards, were led by the Makerere University band to TWED towers where the constitutional court resides for the petition to be filed.

The major concern was that criminalizing HIV transmission and/or exposure seriously hinders public health approaches to preventing HIV transmission and also disrupts access to HIV testing, education and support services and erodes public health norms that support mutual responsibility for HIV prevention and further heightens HIV-related stigma.

With the filing of this petition, civil society and all human rights activists hope that the government can give Ugandans a law that is not only amended, but also respectful of the rights of its citizens – even those living with HIV/AIDS.

 

 

 

By James Zeere

Health rights activists in Uganda will always look to the 2015 as the year in which they cleared major barriers regarding the health rights of mothers in Uganda. The story of maternal health care in Uganda has always been a gloomy one. Three women, now deceased, have forever altered the future of Ugandan jurisprudence on maternal health rights. These women best illustrate the state of maternal health care in Uganda as it is.

On August 19, 2009 Sylvia Nalubowa needed emergency obstetric care. The nurses, who required Sylvia to pay for the necessary commodities for the operation, systematically extorted her. While all this extortion was proceeding, Nalubowa passed away before she could even see a Doctor at the Hospital.

Further to the North of Uganda in December 10, 2010, Jennifer Anguko was kept in the labour ward for up to nine hours without being attended to. She started bleeding profusely while the nurses at the Hospital were in a room close by, chatting. Anguko death could have been averted if the nurses gave her the necessary care and attention.

The Constitutional Court in the first instance rejected CEHURD’s claims for declaratory orders that the deaths of Sylvia Nalubowa and Jennifer Anguko violated maternal health rights and that the State needed to undertake measures to end preventable maternal deaths in Uganda. Questions of the provision for the health services of mothers were committed to the Executive and could not be heard by the Court in accordance with the doctrine of separation of powers. On appeal the Supreme Court decided that the question of whether the deaths were a consequence of the violation of the right to health was a legitimate question that required the interpretation of the Constitutional Court. The Constitutional Court was therefore directed to hear the case.

But before the Supreme Court passed the decision on Nalubowa and Anguko’s deaths, CEHURD brought another matter before the High Court of Uganda. In May 2011, Nanteza Irene accompanied by her husband went to Nakaseke Hospital to deliver a baby and it was detected that she had suffered an obstructed labour and required emergency obstetric care by a doctor who was nowhere to be found within the hospital. The doctor showed up after eight hours but it was too late. Nanteza had breathed her last having endured eight hours of excruciating pain due to an obstructed labour.

These two cases seem miles apart in terms of the issues they deal with, but they’re both concerned with key questions of accountability in the realization of health rights in Uganda. Primarily, the facts identified disclose that the problems in each of the cases were risen when a pregnant mother could not receive emergency obstetric care because the doctor who was supposed to be at the health facility was inexplicably absent.

The Committee on Social Economic and Cultural Rights (CESCR) under General Comment No. 14 on the right to health prescribes that that states have the obligation of making functioning public health care facilities, goods and services available in sufficient quantity. Very importantly, however, CESCR also notes that the precise nature of facilities, goods and services vary depending on numerous factors including trained professional personnel receiving domestically competitive salaries. In that regard, while it may be argued that the state exhausts its obligation under the right to health when it puts in place a health facility and hires qualified health workers that are competent to provide health services required by the public, as the three mothers learnt, it is never enough. In the cases of Jennifer Anguko, Slyvia Nalubowa and Irene Nanteza, qualified doctors to provide emergency obstetric care services had been hired and deployed at the respective hospitals. Yet when they were urgently needed, they were nowhere to be found.

Justice Kabiito in CEHURD Vs Nakaseke District Local Government HCCS 111 of 2012 faulted the hospital administration for not adequately supervising the hospital staff, which led to the failure of ensuring doctors remained at their duty stations to attend to the patients. This here is the first level of accountability. It is not enough to have qualified health workers and commodities at the health facility when at the end of the day the public will still remain unable to access quality treatment. The right to health requires that deliberate measures be undertaken to ensure that all resources, both human and pharmaceutical, that have been put in place for purposes of health care provision serve their purpose, however meager they may be. The failure to put in place measures to ensure that the resources deployed are performing their function makes their supply redundant and deviates from the envisaged goals under the right to health.

In the utopian scenario where human resources, essential medicines and health supplies have been adequately made available in a health facility and they are effectively performing their function of providing quality health care to the public, a second level of accountability arises. According to Justice Bart Katureebe in CEHURD & Ors V Attorney General SCCA No 1 of 2013, while it is the sole prerogative of the executive to make policies for the provision of health care, the Constitution of the Republic of Uganda envisages situations where an individual or the public may be aggrieved by the policy made by the Executive on the grounds that it infringes on the Constitution. In such instances, the Constitution has granted the Constitutional Court’s powers to entertain this grievance in the form of a constitutional petition. Constitutional petitions determine whether or not the policy contravenes the Constitution as alleged or not. Yet, the Constitutional Court had refused to exercise these powers when approached by CEHURD in the first instance to protect mothers in Uganda today.

The Constitutional Court and the High Court are two strong accountability mechanisms that were rightfully recalibrated by the Supreme Court. In addition to ensuring that health care services are available, the state is required under the normative framework of the right to health to ensure that the services acceptable, accessible and of quality.  Where the state has through its policies made health care services available but has fallen short on the quality, acceptability and accessibility components, the powers of the Constitutional Court can be invoked because the right to health though not expressly provided for is guaranteed by the Constitution of the Republic of Uganda. The Constitutional Court had divested itself of these powers and denied the public access to justice where policies and laws violated the right to health.

CEHURD Vs Nakaseke District Local Government HCCS 111 of 2012, the Court challenged the State to strengthen its own accountability mechanisms for the protection of the right to health, while in CEHURD & Ors V Attorney General SCCA No 1 of 2013 the Court placed in the hands of the public a formidable weapon to challenge policies or laws that violate the right to health. Jurisprudence on the right to health in Uganda has never been stronger and the fight to realize the right to health within Uganda’s health system has never raised so much hope for mothers. The struggle continues but for now every duty bearer in Uganda can be held accountable for any violation of the right to health in Uganda thanks to these landmark cases.