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Bringing Healthcare to the Margins through Reaching Other Vulnerable Populations (OVPs) in Kaberamaido, Soroti, Serere, Dokolo, Apac, and Amolatar Uganda

– Prepared by Jemimmah Adipa | CEHURD

In the quest for universal health coverage, addressing the distinct health needs of vulnerable and underserved populations remains essential. In Uganda, groups such as fisherfolk, truck drivers, and persons with disabilities (PWDs) face significant health challenges, particularly related to HIV, tuberculosis (TB), and malaria. These communities often experience barriers to accessing vital health services due to their mobility, geographical isolation, social stigma, and limited awareness. 

Recognizing these challenges, CEHURD with support from The AIDS Support Organization (TASO-Ugnda), spearheaded a series of targeted hotspot mapping and community outreach initiatives across six districts—Kaberamaido, Soroti, Serere, Dokolo, Apac, and Amolatar. These efforts aimed to bring much-needed health services directly to these vulnerable populations. 

A central element of the initiative was hotspot mapping, supported by local health facilities and community leaders. This strategy was crucial to ensuring that health services reached the right people at the right time. For mobile populations like fisherfolk and truck drivers, traditional, fixed-location health services often fall short of meeting their needs. By identifying high-risk areas—such as landing sites, truck stopovers, and PWD communities—the outreach teams could focus on the locations most in need. This data-driven, targeted approach helped maximize the impact of limited resources. 

The outreach activities had a profound effect on the vulnerable populations in these districts. Hundreds of fisherfolk, truck drivers, PWDs, and others received integrated health services, including HIV testing, TB screening, malaria diagnosis, antenatal care (ANC), and health education. Those who tested positive for HIV were quickly linked to care, while individuals diagnosed with TB or malaria received immediate treatment or were referred to local health facilities. Additional services, such as family planning, immunizations, and STI screenings, were also integrated into the outreach depending on community needs and the availability of resources at health centers. 

These outreach efforts not only improved health outcomes but also increased access to essential services and raised health awareness among these vulnerable communities. However, the long-term success of this initiative hinges on the sustainability of such efforts. Regular outreaches will be critical to ensuring that key populations—like fisherfolk, truck drivers, and PWDs—continue to receive the care they need. 

Sustaining these efforts will require ongoing investment to ensure services remain responsive to the evolving needs of these communities. Effective collaboration between government health systems, local health facilities, and community-based organizations will be essential to streamlining service delivery and ensuring that resources are allocated efficiently and effectively. 

One of the standout successes of these outreach initiatives was the integration of various health services using the test and treat approach, offering HIV, TB, malaria, family planning, antenatal care, sexual and reproductive health (SRH), and immunization as a single package. This holistic approach maximized service uptake, addressed multiple health needs simultaneously, and strengthened the relationship between communities and formal healthcare systems. This is a vital step toward reducing the burden of disease and achieving universal health coverage. 

The writer is a Community Led Monitoring Officer in the Community Empowerment programme at CEHURD 

A Triumph of Justice and Support in Kaliro District, Uganda

– Compiled by Johnson Komagum and Matthew Mwidu – CEHURD

Case file Reference Number: KLIRO059/07/2024. A 50-year-old woman and grandmother residing with her three young grandchildren in Buwologoma LCI, Nansololo Sub-County, Kaliro District. She separated from her husband’s family due to stigma and domestic violence. 

In a compelling case of resilience and hope, the Center for Health, Human Rights and Development (CEHURD) Legal Aid Clinic, with support from The AIDS Support Organization (TASO-Uganda), has significantly transformed the life of a woman in distress who was previously marginalized and struggled to support her young grandchildren following her failure to access her inheritance from her late father’s estate.  

 This denial and violation of her rights was perpetrated by her uncle (a brother to her late father). Despite the fact that she had hope that her own brothers and family would support her, they discriminated and sidelined her causing her untold pain and distress. Her plight was further exacerbated by the lack of support from the local area leaders and law enforcement agencies, leaving her in a seemingly hopeless situation. 

 Upon turning to CEHURD for assistance, her case was met with empathy and determination. CEHURD’s Legal Aid Clinic conducted in July 2024 provided crucial support, helping her navigate the legal system and push for justice. After persistent efforts, including follow-ups with police and family elders, her late father’s estate was divided among his three children, ensuring that she received her rightful share. Despite this progress, her plight still continued upon discovering that part of her inheritance had been leased to a sugarcane farmer. CEHURD continued to support by advising her on eviction procedures and facilitating a resolution.  

 Additionally, CEHURD’s engagement extended to addressing her health concerns. The client, who is HIV positive, had previously hesitated to seek treatment due to stigma. With CEHURD’s intervention, she was connected with local health workers (Village Health Team members) for counseling and support, facilitating her access to necessary medical care. This case highlights not only the challenges faced by women in similar situations but also the profound impact of targeted legal and health support. CEHURD’s comprehensive approach not only restored her access to her late father’s estate but also ensured her health and well-being were addressed, marking a significant victory in her journey towards justice and social stability. 

Restoring Hope: How CEHURD’s paralegal Helped Cherotich Reclaim Her Land and Secure Her Family’s Future in Bukwo District, Uganda

– Compiled by Johnson Komagum and Matthew Mwidu – CEHURD

Case file Reference Number: Bukwo 048/06/2024. A 38-year-old widow living with HIV, residing with her four daughters in Riwo Sub-county, Bukwo District, was evicted from her one acre of land due to her HIV status and ridiculed for having only daughters. This left her devastated, helpless and burdened by stigma. 

Cherotich Lilian, a 38-year-old widow living with HIV, faced immense hardships after her husband’s death. She had shared her marriage with her late husband and his other wife, with Cherotich allocated one acre of land and the other wife receiving two acres. After her husband’s death, clan members and relatives accused Cherotich of infecting him with HIV, leading to his death, and mocked her for having only daughters. As a result, they unlawfully took possession of her one acre of land, leaving Cherotich devastated and without a means to provide for herself and her four daughters. 

With her land taken away, Cherotich struggled to care for her family. She started a small retail alcohol business to make ends meet, but it was not enough to sustain them. The emotional and financial strain became overwhelming, leaving her feeling isolated and powerless against the injustices inflicted by her husband’s family. 

 Upon hearing about the mobile legal aid camp organized by the Center for Health, Human Rights, and Development (CEHURD) with support from The AIDS Support Organization (TASO-Ugnda) in June 2024, Cherotich attended and received much-needed support. Understanding the gravity of her situation, the CEHURD team worked closely with her to engage local leaders, including the LC1, LC2 and LC3, to address her land dispute. A community paralegal, trained by CEHURD, tirelessly followed up on her case to ensure Cherotich would see justice. The paralegal also organized meetings with local leaders to support her, leading to three meetings between the leaders, clan members and the family who had wrongfully seized her land. 

 Following the persistent follow-up and negotiations led by the community paralegal, the clan leaders eventually agreed to return the one acre of land to Cherotich. This significant victory restored her hope and provided her with the land she needed to support her family. Cherotich is now back on her land, where she grows crops to ensure food security for her daughters. She continues to receive HIV treatment at Riwo Health Center III in Bukwo district, enabling her to maintain her health while supporting her family. CEHURD’s intervention not only resolved her land dispute but also empowered Cherotich with knowledge and ongoing support, fostering justice within her community. 

Voices Silenced: Battling Inheritance Injustice for Women and PLHIV in Otuke District, Northern Uganda

Compiled by Nakalembe Judith Suzan | CEHURD

In the heart of Northern Uganda’s Lango sub-region, Otuke District’s predominantly rural communities are grappling with severe challenges surrounding cultural practices, land inheritance, and access to justice. This is particularly true for women, elderly widows, and persons living with HIV (PLHIV), who face escalating violence and exclusion as their rights to inherit family property are systematically denied. 

Despite Uganda’s Constitution and Succession Law guaranteeing equal inheritance rights, deeply entrenched cultural norms in Otuke continue to marginalize these vulnerable groups. Widows, especially those whose husbands died from HIV-related illnesses, are often unjustly accused of infecting their spouses, leading to eviction from their homes and denial of inheritance. Jannifer, a widow in Orum Subcounty, recounts, “When my husband died of HIV, they said I was the one who killed him and threw me out of our home,” highlighting the cruel intersection of stigma and property rights violations. 

Women who have only daughters face similar injustices. Once their daughters are married, these women and their children are frequently disinherited. Juliet from Agwete Subcounty, forced off her land by a brother who claimed sole ownership, laments, “They tell us we no longer belong here,” emphasizing the systemic denial of property rights. 

Elderly widows suffer additional brutality. Grandsons often resort to violence, including rape and arson, to seize control of property, while childless elderly women are accused of witchcraft to justify their eviction. These inheritance violations targeting especially women, girls and persons living with HIV, stand in stark contrast to Uganda’s legal protections, which affirm that all children, regardless of gender, and widows are entitled to inheritance. 

The failure to enforce these laws has intensified the plight of women and PLHIV in Otuke District, perpetuating a cycle of marginalization and injustice. Access to justice is further complicated by the district’s limited judicial infrastructure. Otuke has only a Grade One Magistrate’s Court, which presents significant jurisdictions barriers for victims seeking legal redress  

CEHURD, supported by TASO and the Global Fund, is spearheading efforts to combat these injustices. By implementing robust legal education programs, raising community awareness, providing free legal aid, and advocating for effective law enforcement, CEHURD is challenging harmful cultural practices and striving to bridge gaps in legal protections. They are also addressing the challenge of court accessibility, helping victims navigate the complex legal system and overcome barriers to justice. 

These initiatives are crucial in empowering vulnerable groups to claim their rights and promote a more just and equitable society. However, without enhanced enforcement of existing laws and improved access to judicial services, women, girls, and PLHIV in Otuke District will continue to face severe discrimination and injustice, remaining at the mercy of discriminatory cultural practices that deny them their rightful place in society. 

Compiled by Nakalembe Judith Suzan, Center for Health, Human Rights, and Development, Community Empowerment Programme. 

Information session for Persons Living with HIV and sex workers in Buikwe district

The fishing communities of Kiyindi Landing site in Buikwe District had the opportunity to have an information session on prevention, treatment mechanisms of HIV/AIDS and TB and reduction of stigma and discrimination at the community level organised by CEHURD. The targeted groups included Persons Living with HIV, sex works, Community Health Advocates in the areas of Najja and Nyenga.

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Dr. Grace Mugabi an HIV / TB specialist at the session said that Buikwe district has a high HIV prevalence than other parts of the country and advised that individuals should test for HIV every after three months because of the widal period where the virus may not be detected in the human body.

He talked to participants about the treatment target to help end the AIDS epidemic called the 90%-90%-90%, that sets out to ensure that by 2020, 90% of all people living with HIV will know their HIV status. By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy and that by 2020, 90% of all people receiving antiretroviral therapy will have viral suppression.

He further stated that to achieve the 90%, 90%,90% plan there should be no stigma against the people with HIV increased involvement of mothers should be paramount and so should of male involvement.

On the concern of stigma and discrimination of PLHIV, participants said that in their communities name calling is seen as a common practise names like “kasilimu” have been used by community members to refer to some of the PLHIVs. This they say they have become used to but agreed is wrong and something needs to be done about it.

Recommendations made by Persons Living with HIV and the sex workers included;

  • An anti-stigma and discrimination policy should be put in place to protect those with HIV from any form of unfair treatment in society.
  • HIV positive children in schools should be given an opportunity to take their ARVs at the right time.
  • Prisoners should also be given an opportunity to take their ARVs at the right time.
  • More community outreaches are needed to ensure that people are taught how to welcome those with HIV back in the community and ensure that they are supported and looked after.

At the end of the information session participants who included PLHIV, sex workers, and community health advocates who said they had acquired information about stigma and discrimination, the session also taught them to keep a close watch to their children and talk to them about HIV and lastly it gave them strength to openly talk about HIV and their statuses.

Cissy Nagita one of the beneficiaries from the information session said, ” the training has given me strength to do more outreaches to get more people in my community on board in the fight against HIV, stigma and discrimination.”