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Mother, Mulago in dispute over ‘missing’ baby

By SOLOMON ARINAITWE & ANGELLA NALWANGA
When Goretti Kajumba, 33, checked into a maternity suite at Mulago Hospital on December 3, 2012, she was full of optimism and joy, awaiting the birth of her first born.

However, the joy would soon be eroded by agony and frustration as her baby girl mysteriously went missing, minutes after birth.
The hospital insists the baby was born in “distress” and died soon after birth.

Ms Kajumba, on her part, says the baby was doing well and could have been sold by unscrupulous health workers. Her case becomes more baffling when she reveals that she was not shown the body of the baby, despite repeated requests to hospital staff.

“They [doctors] told me that the body was buried by KCCA but when I went to the mortuary, there was no such record. I have been asking doctors about my child but they kept on confusing me until I went to the director and told him that sir, you are a father, where is my baby?” a distressed Kajumba, weeping inconsolably, told journalists yesterday at Mulago hospital.

An Inpatient Discharge Form (IDF) signed by Dr Lubega shows that Ms Kajumba gave birth to a baby girl of 3kgs, with a rating of 9/10, on December 3, 2012 and was discharged on December 7, four days later.

However, Dr Baterena Byarugaba, the executive director Mulago hospital, who has been handling the case, says there “was a mix-up in documentation and that is why the baby was not recorded as dead” on the form.

“She underwent a Caesarian Section and gave birth at around midnight but the baby was taken to the special care unit and the mother to the High Dependence Unit because they both had breathing problems,” Dr Byarugaba explains.

He adds that the baby died in the SCU while the mother recuperated after a dose of intravenous fluids and blood injections.

Dr Byarugaba notes that the mother was admitted without a helper who could have assisted the hospital in indentifying the dead child.

After failing to make headway, the mother reported the case to Inspector General of Police Kale Kayihura, who in turn directed the Commander Kampala Metropolitan police Felix Kaweesi, to take up the matter.

Mr Kaweesi yesterday met the directors of the hospital and the latter agreed to co-operate in the investigations.
Source: http://www.monitor.co.ug/News/National/Mother–Mulago-in-dispute-over–missing–baby/-/688334/1725002/-/t5uw7r/-/index.html

Uganda: The Law – Abortion’s Biggest Hurdle

By Patience Akumu,
When the woman entered Kiggundu’s office and requested an abortion, he felt his hands were tied: abortion is essentially illegal in Uganda. Kiggundu, a law-abiding citizen, told her that while he appreciated her predicament, he could only refer her for proper antenatal care so that she could deliver safely.

Three days later, he was called to the emergency gynaecology ward. And there, on the verge of death, was the same woman. “She was now a sick-looking, dirty young woman,” Kiggudu recalls. “Her intestines were out of her vagina and she was bleeding profusely.” The doctor asked the woman what happened.

“You are asking me what happened?” she answered. “I was here three days ago and you refused to help me; I did what I had to do.”

Kiggundu had to perform an operation to remove her uterus to save her life. She spent four weeks in the hospital recovering. Yet it could have been worse for Kiggundu’s patient. In 2008, the ministry of Health estimated that abortion-related causes accounted for 26% of all maternal mortalities in Uganda.

Uganda’s maternal mortality rate from abortion is 8% higher than that of East Africa which stands at 18%. The restrictive legal and ethical regime means that many women continue to die as a result of unsafe abortions both in and outside the hospital setting. The Constitution forbids abortion except as authorised by law, while the penal code criminalises abortion except where it is necessary to save the mother’s life.

Prof Ben Twinomugisha, a health law expert and lecturer at Makerere University, says that at the end of the day it is not really about statistics and legal provisions but, rather, about the woman who should be placed at the centre of the abortion debate.

“There is law and there is ethics. But what does the woman say?” he argues. “Whenever Kiggundu thinks of the woman without a uterus, he has regrets.”

According to Twinomugisha, the law is only restrictive and not prohibitive, and in fact he recognises that there can be lawful abortions. He points out that health workers are not utilising the law to provide abortions to women for whom having babies would mean adverse effects on their psychological and physical health. The 2006 National Policy Guidelines and Service Standards for Sexual and Reproductive Health and Rights provide for circumstances where a woman should be able to terminate her pregnancy.
Resource: http://allafrica.com/stories/201303110138.html

Experts want pact extended

By JOSEPH OLANYO

Trade experts, legislators and civil society organisations have called for an indefinite extension of the World Trade Organisation (WTO) Trade Related Aspects of Intellectual Property Rights (TRIPS) agreement until poor countries like Uganda develop.

The TRIPS agreement requires East African countries and all other WTO member countries to protect and enforce all kinds of Intellectual Property (IP) – a legal concept that refers to creations of the mind for which exclusive rights like copyrights, trademarks and patents are reserved. The extension period is critical for EAC owing to the state of the affected sectors such as health and agriculture. But even then, the partner states have not developed positions yet on approaching the important process.

On the basis of their economic and financial constraints, the extension was given on the assumption that by 2013, Least Developed Countries (LDCs) like Uganda would have developed their technical capacities and industrial base. The extension period granted to LDCs expires in July 2013. But LDCs contend that they need extra time to build their capacities to produce drugs, ensure food security and review and modify their laws to ensure they provide for public welfare through flexibilities.

At a recent meeting organized by the Open Society Institute in conjunction with SEATINI Uganda, participants called for the period to be extended.

“It is absurd that we were not able to create capacity at the time we were given. However, we have no choice but to get the extension unless they want to suffocate us,” said Bernard Mulengani, a Member of the East African Legislative Assembly (EALA).

“Capacity may be available but funding is a challenge. So, we need a very informed technical team that can negotiate. Otherwise, without an extension, the population will suffer,” he added.

Private Sector and CSO officials from East Africa note that if the transition period is not extended, LDCs face the specter of failure to avail affordable goods like scholastic materials, seeds and medicines to impoverished citizens. SEATINI Country Director Jane Nalunga said it was important that “we as actors in this process speak the same language on critical processes that affect our development”

Elizabeth Tamale, the Assistant Commissioner External Trade, ministry of Trade, Industry and Cooperatives, said there was need for a national framework that brings different agencies together and harmonises positions on trade discussions.

“We need to think of what provisions are there in the law, study them and develop a framework as we seek for the extension. It should avoid compromising issues either for developing countries or LDCs,” she said.

Source: http://www.observer.ug/index.php?option=com_content&view=article&id=24021:experts-want-pact-extended&catid=38:business&Itemid=68

Contraceptives can reduce the number of unsafe abortions

By Henry Zakumumpa

More than half of all pregnancies in Uganda are unintended and nearly a third of them end in abortion, according to survey results unveiled by Dr Charles Kiggundu, a consultant gynaecologist at Mulago hospital.

“Probably half of all of you seated in front of me today were not intended by your parents,’’ Dr Kiggundu told a fully- packed Palm conference room at Kabira Country Club in the outskirts of Kampala.

The study results released by the US-based, Guttmacher Institute and the Centre of Health, Human Rights and Development, also reveal that Ugandan women on average wished they had at least two children less, a phenomenon also called excess fertility.

On average, each woman in Uganda gives birth to 6.7 children which is high even by Sub-Saharan African standards. The study results are based on analysis of Uganda’s 2011 Demographic and Health Survey.

At the centre of the millions of unintended pregnancies in Uganda, is non-use of contraception.

Only an estimated 25 per cent of women in Uganda have access to modern contraception methods pointing to a staggering lack of access to modern and safe contraception.

One in three married women in Uganda had an unmet need for contraception according to the survey results.

“It is also a question of having less options of contraception,’’ added Dr Frederick Mugisha, a health economist, who maintained that Ugandan women do not have many choices when it comes to contraception.

Clearly, investments targeted at increasing access to family planning and contraception for women of reproductive age in Uganda would save the country phenomenal sums of monies spent on treating post abortion complications and having fewer mouths to feed, educate and would be kinder to the environment. If all Ugandan women had met their wish of having two children less than they currently have, the population of Uganda would have been undoubtedly impacted by gains in per capita income and a better quality of life achieved for millions of Ugandans.

It emerged at the meeting that myths and misconceptions about modern contraception methods causing cancer and fibroids is widespread and is a barrier to contraception utilisation by Ugandan women.

The traditional medicinemen have hijacked contraception education. There are several programmes on local radio and television stations that are misinforming many women on safe contraception in preference for crude and riskier methods.

Dr Zainab Akol of the Ministry of Health regretted that the medical profession in Uganda has ceded the ground for offering scientific and evidence-based contraception information to misinformed “medicine men” on whose inaccurate advice many rural and uneducated women depend for decisions on birth control and family planning.

Unsafe abortion and contraception is a human rights, public health, legal and moral issue in Uganda that must be addressed,’’ emphasised Moses Mulumba, head of the Centre for Health, Human Rights and Development, who revealed that 26 per cent of all maternal deaths are attributed to unsafe abortion.

Prof Ben Twinomugisha, dean of the School of Law at Makerere University, emphasised that human beings have a right to enjoy sex and then when debating issues surrounding abortion, “the woman should be at the centre” of the debate.

Studies done by the Guttmacher institute show that there is a co-relation between restrictive laws on birth control and increased abortion. Countries, especially in Europe, which have a liberal stance on birth control have fewer deaths from unsafe abortions and spend less on post abortion complications.

Source: http://www.monitor.co.ug/artsculture/Reviews/Contraceptives-can-reduce-the-number-of-unsafe-abortions/-/691232/1712464/-/13kqg7lz/-/index.html

CEHURD holds Regional Meeting on Community Participation

 

    Members attending the regional meeting in Kiboga
Members attending the regional meeting in Kiboga

Center for Health, Human Rights and Development CEHURD, Uganda with its partners the Learning Network for Health and Human Rights from South Africa with support from the International Development Research Center (IDRC), hosted a regional meeting that brought together various institutions and individuals who are taking part in the on-going project titled Health System Governance: Community Participation as a key strategy for realizing the Right to Health. The project is an ongoing pilot study implemented in two sites – Cape Town South Africa and Kiboga/Kyankwanzi district in central Uganda.

The project is aimed at developing models for community participation in health that advance health equity and strengthen governance systems for health by testing approaches and sharing experience gained in the two sites using a rights-based approach to health and build the agency of community structures to articulate more strongly claims for health rights, with a view to proposing models for best practice.

Before the meeting, CEHURD together with members from Civil Society organizations in Uganda and delegates from South Africa, Zimbabwe, Zambia, Kenya, Malawi, and Canada visited different sub counties, hospitals, and district headquarters in the communities of Kiboga and Kyankwanzi Districts.

They met L.C 5 chairperson Kiboga, the Medical superintendent   Kiboga District hospital, Chief executive office  Kyankwanzi District, and Chief health officer Health center IV Ntwetwe in Kyanwanzi district.
This was aimed at meeting community leaders and other senior health officials to hear their experiences, challenges and to understand the decentralized health system in these communities.

It was established that the health system in these two districts is purely decentralized, starting from village level to the District level. This includes Village health teams at village level, Health center II at parish level, Health center III at sub county level and Health center IV at county level and a District hospital at the district level.  However, the major challenge faced with the health sector in these communities is poor funding.
In the meeting, participants from countries across the region made presentations about practices of community participation in their countries.

Community voices were also heard from Uganda and South Africa where Uganda was represented by a village health team coordinator who elaborated more on the roles of village health teams which among others included, sensitizing the public about preventable diseases, referring patients to higher health facilities, encouraging mothers to go for antenatal care and handling minor illnesses like dysentery in children under five years.

On the other hand a participant from South Africa also presented her role in promoting community participation in her country which included among others linking community members with health officials, holding government accountable for deliverance of essential health services.

The meeting that aimed at sharing best practices in community participation from different parts of East and Southern Africa in regards health and human rights, identifying strengths and weaknesses and identifying opportunities for networking was concluded successfully as members learnt different lessons regarding community participation.

Among the practices that were learnt in regards community participation as a key strategy for realizing the right to health include, capacity building, strengthening systems, sensitization, creation of awareness, advocacy, resource mobilization, material development, support strategies like litigation services, monitoring and evaluation, and finally dissemination of different publication which are all aimed at promoting and protecting the right to health.

CEHURD will therefore concentrate on the best practices identified to make sure community participation is improved. It will build on the already existing practices and those borrowed from other countries as presented in the meeting.