World No Tobacco Day 2017: The Health Cost of Tobacco Use in Uganda

Today, as the world commemorates World No Tobacco Day 2017 under the theme Tobacco- a threat to development, Hon. Chris Balyomunsi, Hon. Dr. Aceng Jane Ruth and Prof. William Bazeyo and WHO Country Representative Dr. Abdulaei D. Jack have launched “The Health Cost of Tobacco Use in Uganda – February 2017”.

The report was compiled by Makerere University’s College of Health Sciences – School of Public Health in collaboration with the Uganda Cancer Institute, American Cancer Society, The Centre for Tobacco Control in Africa and Ministry of Health.

According to the report, 21% of the patients had a history of tobacco use (8% were currently using tobacco products and 14% had ever used tobacco). The proportion of patients who were current users or had ever used tobacco products was 32% for men and 9% for women. The total direct healthcare cost to all patients was about UGX 1.2 billion, of which the highest proportion 44% was on nursing and medical procedures and 24 % was on medicines.

Furthermore, the report indicates an annual average medical cost of UGX 3,697255 on a current or former smoker suffering from a tobacco- attributable disease, which is 2.28 times the annual average medical cost of a non-smoker, that is UGX 1,619,309 . The direct cost of treating tobacco -attributed illnesses in Uganda is estimated to be at UGX 108.05 billion.

At the launch, Center for Health, Human Rights and Development (CEHURD), was commended for issuing a legal opinion to the Ministry of Trade on issuing sponsorship licences to support tobacco farmers which contravenes with the law; sensitizing government ministries including; Office of the Prime Minister, Uganda National Bureau of Standards (UNBS), National Environment Management Authority (NEMA )and Ministry of Gender Labour and Social Development.

CEHURD was also applauded for the well-fought battle together with the Attorney General’s office in response to the BAT petition in court and was encouraged to take to court all institutions that will defy the Tobacco Control Law.

The launch follows the Constitutional Court in Kampala’s decision on 17th May 2017 denying an application by the British American Tobacco Limited for a temporary injunction to stay the implementation of some provisions of the Tobacco Control Act. The court stated that it found that the Applicants (BAT) did not make a case to warrant the grant of a temporary injunction.

Introduced by the World Health Organization (WHO), The World No Tobacco Day is intended to promote awareness of the environmental effects and health complications resultant from chewing or smoking tobacco.

Let’s all join the fight against tobacco use because a tobacco-free Uganda is everyone’s responsibility.

A Court Judgement Offers a Ray Of Hope to a Family in Nakaseke District.

By Primah Kwagala.

A team from Center for Health, Human Rights and Development ( CEHURD) alongside officials from Nakaseke District and OSIEA visited Nakaseke district to monitor the implementation and impact of the judgement, for the case: CEHURD and others verses Nakaseke District Local Government Civil Suit No 111 of 2012.

The implementation is as a result of the 2015 the High Court of Uganda judgement in a suit brought by CEHURD against Nakaseke district local government, related to a death of an expectant mother.

First the team visited the deceased’s husband at his new home in Mifunya for a briefing of the circumstance that led to the case. The Meeting was attended by among others the Mifunya LC1 chairperson, representatives of the sub-county council, his elder brother and an elderly lady that introduced herself as a neighbour.

The local leadership was by and large grateful for CEHURD’s intervention. They shared that prior to that case, Nakaseke Health workers were untouchable, they were negligent and careless in the way they attended to patients.

A gentleman shared an experience to the effect that he took his wife to give birth, she laboured and eventually gave birth on the veranda while health workers looked on. He sadly reported that they subsequently lost that baby that very day. This was however prior to the case against Nakaseke District Hospital for the death of the expectant mother. They reported that ever since Nakaseke District Hospital was sued, the health workers are diligent, careful, wear nametags and the community members have been told that if a health worker mishandles you or fails to attend to them , then they should read his or her name from the nametags on their uniforms and report to the hospital administration immediately.

The community leaders reported that they have not heard of any maternal death since the CEHURD and others verses Nakaseke District Local Government Civil Suit No 111 of 2012 case. However, they believe that in the event that such a case occurs, the hospital is diligent and will not report it as such since the lesson the case gave to them was indeed harsh.
They however appealed to CEHURD to sensitize the health workers. They reported that some stubborn ones were transferred and the doctor that was not at the station at the time the mother needed attention in this case forced to resigned.

They also requested CEHURD to take on some community interventions in Nakaseke -This is because they believe Mifunya, villagemates are sensitised and learned a lot from the case but this is not the case for other villages in Nakaseke.

They claimed that they are treated as priority when they visit Nakaseke Hospital – because the health workers fear people from that village that sued.

We then heard from the deceased’s husband , he shared his story and indeed emphasised that the community had been very instrumental in pushing him to speak out on the vices in Nakaseke Hospital. He said his family is indeed very grateful to CEHURD – for the wise counsel in how he should spend his money, and support throughout the litigation.

He confessed that his eldest daughter is in boarding school, he wishes she turns out right like the ladies he worked with at CEHURD!, The younger two children are still in day school and hoped to push them through school too. He took us through his business, he is now a proud owner of a barber’s shop in Nakaseke Town, he has music systems, he has bought two pieces of land, one is half an acre and has some coffee plants and he hopes to annually harvest and make some money, the other he constructed a commercial building, it was partially occupied by a tenant, its close to a school and has electricity. He hoped to furnish the construction with the final cheque that was handed to him.

We then moved to Nakaseke Hospital where we met with Mr. Ssemakula (the Hospital Administrator). He told us that as a result of the case, there was alot to learn. He said the case was both good and bad. It was good because no fingers were pointed at individuals – that way everyone in the district leadership felt concerned and as the hospital administration they had to account and put their house in order. He said it was however bad because it caused them a lot of embarrassment – He prayed that it would have been good to first dialogue before rushing to court. He however said they conceded defeat and were made to pay as the hospital. “IN EVERY DARK CLOUD -THERE IS A SILVER LINING” -He said. Today he said it is possible to go a whole quarter without a maternal death in the hospital. They religiously audit themselves. He noted that in the past they’d record 2-3 maternal deaths a quarter. But today, they treat and God heals. If a maternal related death occurs, they sit as the hospital administration committee within no less than 7days from the date that the death occurred and thoroughly study the circumstances to ensure they avoid such recurrences.

He was happy that we had sought dialogue and feedback on the issue. He also prayed that we work together to achieve universal access to these maternal child health services. As a hospital, they are always ready and willing to learn from NGOs.

Engaging Law Enforcement Institutions on Access to Safe and Legal Abortion services in Uganda

By Denis Juuko

In collaboration with Ipas- Africa Alliance, CEHURD held a workshop for law enforcement institutions on the legal and policy environment for access to safe abortion services in Uganda.

The workshop built synergies between law enforcement officers and health workers in dealing with the unwarranted arrests, detention, and prosecution of women, girls, and healthcare providers for offering abortion related services.

At the workshop, participants shared their experiences of how they deal with issues related abortion in the communities they serve.

It was noted that post abortion care is not restricted but police is not aware about the position of the law hence resulting to unwarranted arrests, embarrassments and harassment of health practitioners who offer post-abortion care, which leads to stigma in the communities where they operate.

Health workers during the discussions brought to the attention of law enforcement officers that some women and girls come with inevitable abortions and therefore the law enforcement officers need to understand the situations the women are in. They equally emphasized the need to respect their professions since they take oaths of saving lives at all costs.

As a take home for the participants, it was agreed that law enforcement officers and health workers need to have a good working relationship to save the lives of women who suffer complications and death as a result of clandestine unsafe abortions.

CEHURD Court Case nominated for the Gender Justice Uncovered Awards: VOTE!

The Center for Health, Human Rights and Development (CEHURD), Mubangizi Michael and Musimenta Jennifer Vs the Executive Director of Mulago National Referral Hospital and Attorney General of Uganda ( Civil Suit No 212 of 2013), “Mulago case” and Justice Lydia Mugambe’s judgement have been nominated for the Gender Justice Uncovered Awards.

CLICK HERE TO VOTE FOR CEHURD!

The case resulted from the failure of Mulago hospital to account for the whereabouts of the baby of Musimenta Jennifer who gave birth to twins at the hospital but was only given one baby.   Later, the hospital gave her the body of a deceased baby whom after the DNA test was found not compatible with Mubangizi Michael and Musimenta Jennifer (parents of the lost baby).

In her judgement, Justice Lydia Mugambe ordered police to conclusively investigate the disappearance of the baby, the midwife who handled the baby at birth be held accountable, for Mulago hospital to take steps to ensure and enhance the respect, movement and safety of babies in the facility, dead or alive. The 1st Defendant was also ordered to make written reports every four months regarding steps taken.

The ruling also stated that the 1st Plaintiff shall have free access to the hospital to oversee implementation measures, 1st Plaintiff shall also ensure that the 2nd and 3rd Plaintiffs access psychosocial care, and lastly the 2nd and 3rd Plaintiffs were awarded a cost of Ugx 85,000,000/=.

The Gender Justice Uncovered Awards is an initiative by Women’s Link Worldwide to award decisions or statements which mainstream gender relations in the various aspects of life including the right to health.

You are invited to vote for the case each day between now and May 31st 2017. Vote here: http://www.womenslinkworldwide.org/en/awards/cases/missing-baby.

CEHURD added as an interested party in Tobacco Control Case – Petition 46 of 2016

The Constitutional Court of Uganda responded in affirmative to CEHURD’s Constitutional Application No.15 of 2017 arising from Petition No. 46 of 2016 filed by British American Tobacco (BAT) in a court session heard by five Justices including Kavuma, Cheborion, Kasule, Butera and Obura.

British American Tobacco (BAT) Limited was represented by Mr. James Mukasa Sebugenyi, Mr. Patson Arinaitwe and Paul Mbuga while the State was represented by State Attorney Mr. Gerald Batanda as well as CEHURD represented by Mr. David Kabanda and Mr. James Zeere.

Last year 2016 BAT dragged the Government of Uganda to court challenging several sections of the Tobacco control Act of 2015 claiming that they are in contravention of and/ or inconsistent with the constitution of the republic of Uganda. Upon this, they filled a petition challenging the constitutionality of the Act, and in the interim sought an injunction staying the application of the Tobacco Control Act.

Court will hear the application on 17th May 2017, and a ruling on the injunction application will be given on notice.

The constitution court ruled that CEHURD be added as an interested party after the Applicants conceded to the application. Parties to the case were given one week to file and serve necessary documents.
The next hearing will be on 17th May 2017.