The Center for Health, Human Rights and Development (CEHURD) will be holding a 4-day health camp in the Buikwe District from Tuesday 19th August to Friday 22nd August 2014. Buikwe is a predominantly fishing community located in the central region of Uganda.

The health camp follows the community consultations conducted by CEHURD under the Go4Health (Goals and Governance for Global Health) process from which a number of issues arose as health concerns in this district: family planning services, antenatal care, postnatal care, post-abortion care, HIV services (particularly mother-to-child transmission of HIV), lack of testing and counseling services, malaria treatment, diarrhea, and non-communicable diseases (including diabetes, cancer, and hypertension).

As an intervention, CEHURD reacted with organizing a health camp where local health centers, service providers, and NGOs have collaborated to provide free services to the community members of Najja and Nyenga (sub-counties). This health camp will act as an opportunity for the community to engage in health education, obtain testing, screening and counseling services, and receive a variety of hygiene and nutrition tips.

The health camp will also create a platform for health service providers, agencies, and advocacy groups to learn immediate health concerns from community members in order to strategize how to build capacity.

The Health camp will be held in two shifts. It will be held in Nyenga Sub County on the 19th and 20th August 2014 at Allied teachers’ School playground and 21st to 22nd August 2014 at Sacred Heart Senior Secondary school playground.

By Matthias Heilke (Intern CEHURD, 2014)

A Chinese quarrying company, China Communications Construction Company (C.C.C.C), has deprived two villages in Mukono District, Bamutakudde and Kiryamuli of their right to health and right to a clean and healthy environment. The company, which operates a large quarry in Bamutakudde and Kiryamuli villages, has been uprooting trees and tearing apart earth, polluting the stream from which the two villages collect all their water. The company practices “dry quarrying”, which throws up stone dust that throttles the villagers’ plants and gets into their lungs. The explosions used for quarrying damage villagers’ homes and give them terrible stress.

The right to health means more than just getting care if you are sick. It also means living in an environment that is safe for your health and having access to safe water. CEHURD recognizes this fact, and we have brought a case to the High Court of Uganda to enforce those rights.

CEHURD visited Bamutakudde and Kiryamuli earlier in May to inspect the condition of the villages. By the time we became involved, the residents had petitioned Mukono District Local Government and held peaceful protests, to no avail. The district authorities in Mukono had rebuffed to intervene, and C.C.C.C. had promised better practices, only to break its word. Now, the torn-up earth nearly reached the stream. Much longer, and the stream would be permanently buried underneath a few tons of rock and dirt. We quickly filed a case against C.C.C.C. and the two government agencies that had ignored their duty to supervise them (Civil suit No. 172 of 2014).

The environmental focus of the claim makes it especially strong. The Constitution of Uganda only mentions the right to health in its National Objectives, which Ugandan courts often decline to enforce them. The Constitution is more blunt about environmental rights: “Every Ugandan has a right to a clean and healthy environment” (Article 39). There are more detailed articles that detail the government’s duties, as well. Anyone who sees the conditions in Bamutakudde and Kiryamuli would realize that the quarry is making their environment unclean and unhealthy, so the villagers have a strong case that their rights have been violated.

We also filed for an interlocutory injunction (Misc application No. 290 of 2014 (arising out of civil suit No. 172 of 2014), and an interim injunction (Misc Appln. No. 291 of 2014, arising out of Misc Application No. 290 of 2014). An interim injunction means that the registrar orders the defendant to stop doing whatever it is doing while the court considers the actual case. That way, the court’s final ruling doesn’t come too late to matter. For instance, if C.C.C.C. were to bulldoze the stream while the High Court was hearing the actual case, it might be impossible for anyone to restore the stream — so we want an injunction to make sure the stream is protected until the final ruling is made. The registrar plans to release her ruling on the interim injunction on 14th July.

Even though the court has not yet ruled on the interim injunction, much less the main case, we are starting to see practical results. C.C.C.C. has been digging a trench around the stream in hopes that dirty water will stop flowing into it. There is talk of repairing houses that have been damaged. We still need a court order, of course, to make sure that C.C.C.C. doesn’t revert to its damaging practices and to get the government to start supervising properly. Still, the practical results in the case show how litigation can advance human rights.

Today July 4, 2014, the High court of Uganda will give its ruling in the miscellaneous application filed by the Center for Health Human Rights and Development (CEHURD) against C.C.C.C, NEMA and Mukono District Local Government for violation of rights to health and right to clean and healthy environment. PRESS STATEMENT

By Joan Kabayambi:

A global report released this month (May 2014) reveals that maternal deaths have declined by 45% since 1990. There were 523,000 deaths that occurred from complications in pregnancy or childbirth in 1990; in 2013, that number was 289,000. This new data  published in “Trends in maternal mortality estimates 1990 to 2013” is under the collective authorship led by World Health Organization (WHO) and includes UNFPA, the United Nations Children’s Fund (UNICEF), the United Nations Population Division (UNPD) and the World Bank Group.

The figures were produced through an academic collaboration with the National University of Singapore and the University of California, Berkeley. The data, which come from dozens of studies and improved methods of estimating births and deaths, are considered more reliable than previous assessments.

Despite this global progress, most countries are not on track to meet the fifth Millennium Development Goal (MDG 5) target on maternal mortality, which is cutting maternal mortality ratio by 75 % by 2015. The report reveals that just 10 countries account for around 60 per cent of all maternal deaths: India (50,000), Nigeria (40,000), the Democratic Republic of the Congo (21,000), Ethiopia (13,000), Indonesia (8,800), Pakistan (7,900), the United Republic of Tanzania (7,900), Kenya (6,300), China (5,900) and Uganda (5,900).

According to 2011 Uganda Demographic Health Survey, Uganda’s maternal mortality rate was found to be 438 per 100,000 live births. However, this was within 95% confidence within the confidence interval of 368 – 507 per 100,000. Considering that in 1995 MMR was 505 per 100,000 and today it is said to be 438 per 100,000, this change is not statistically significant.

With a few months to the MDG year of 2015, it also shows that sub-Saharan Africa is still the riskiest region in the world for a woman to give birth. Although Chad and Somalia have the highest lifetime risk of maternal death, Uganda accounts for 2% of annual maternal deaths globally.

This translates into 492 maternal death per month and 16 deaths per day. This is a very high figure and yet we also know that most of the deaths are not captured by the health information management system which was the source of the maternal mortality estimates. One wonders how the mothers that died at home or on the way or never made it to a health facility are counted or estimated.

Although the new data reports Uganda as “making progress” on MDG 5, it is clear that Uganda will not be on track in the next 7 months to meet its MDG 5 target unless a miracle happens.  There is still a lot to be done to improve the national healthcare delivery systems and maternal health services in particular which continues to face serious challenges.

What is killing the women? New data says the worst place to be pregnant is sub- Saharan Africa where one (1) woman out of 40 die of maternal death compared to 1 out of 3300 women in Europe. The pattern of causes of maternal death has changed and now topped by pre-existing medical conditions accelerated by pregnancy like diabetes, malaria, HIV, and Obesity (28%), bleeding (27%), Eclampsia (14%), sepsis (11%), obstructed labour (9%), unsafe abortion (8%) and blood clots (3%) as opposed to the conventional known highest cause of death which has been bleeding.  Like it is today with general population, the disease burden profile in pregnancy is changing from communicable to non-communicable diseases.

What more can be done for Uganda?

Health systems must be strengthened, with quality facilities, personnel, equipment and medicine made accessible to all women. Comprehensive sexuality education and services for young people must also be made available. Supervised deliveries, improved antenatal services and increased use of contraception, access to emergency obstetric care, ensuring skilled medical attendance to mothers at birth, universal access to family planning and antenatal care.

Many efforts to improve maternal health care are currently underway. Ministry of Health and its partners are working on the ground to train health workers – particularly midwives – and to distribute life-saving supplies such as clean delivery kits (Mama kits) also supports voluntary family planning services, comprehensive sexuality education and emergency obstetric care.

But healthcare solutions are not enough. The human rights of women and girls must also be prioritized.
Improving roads to facilitate access to health units, provision of standby ambulance for referral, car and bicycle ambulances, telephone communication to health units and carrying out public sensitization campaigns.

As a country, we should purpose that for “every mother that is pregnant to term there must be a baby to go back with, and for each baby there must be a mother to go home with” But there is also a challenge of mothers not going to health facilities for delivery in preference for traditional birth attendants. The government and community should also purpose that each pregnant mother in the community should go to a health facility to deliver.

Most importantly, more accurate data is needed; it is believed that only one third of all deaths around the world are recorded. We need to document every one of these tragic events, determine their cause and initiate corrective actions urgently. When more is known about how many women are dying, and more is also known about the reasons behind their deaths. This will help policymakers and public health officials design better interventions.

Joan is MakSPH – CDC Fellow attached CEHURD