A Human Rights body has lodged a complaint against the government, power distribution company UMEME, and the Electricity Regulatory Authority (ERA) over indiscriminate load shedding in public hospitals, which has led to many avoidable deaths of patients.
Center for Health, Human Rights and Development (CEHURD) lodged the complaint before the Human Rights Commission (HRC) in Kampala recently.
The complaint follows a story which ran in Daily Monitor on January 12 about how doctors in Jinja Referral Hospital were grappling with the challenge of keeping patients alive against constant power cuts. It was reported that over 150 patients had died in a space of six months due to unstable power supply and load shedding.
The complaint also highlights the temporary closure of Entebbe hospital recently due to rampant load shedding, which action they say violates the right to life and is discriminatory.
“This complaint is about the indiscriminate load shedding, including public hospitals, which has denied the citizens of their right to access to health care and in some cases either directly or indirectly led to the death of patients,” reads the complaint in part.
CEHURD faults the government for failing in its obligation to protect its citizens from third parties (ERA and UMEME).
The rights body furthers states that load shedding public health facilities which already have electricity supply is retrogression on the part of the government.
“Indeed the delegation of the government’s responsibilities of providing these essentials such as electricity (even to health facilities) to entities such as the ERA and UMEME does not mean delegation of the government obligation,” the complaint further read.
The complaint comes at a time when 24hr load shedding is set to continue until May this year.
CEHURD now wants the HRC to declare that electricity load-shedding in public hospitals is a violation of the right to health and the right to life.
They also want a permanent injunction restraining Umeme from load-shedding health centers and hospitals.
Background
The complaint is brought under Articles 51, 52, 53, 45 of the constitution and Section 7 of the Uganda Human Rights Commission Act Cap 24. Under Article 53 of the constitution, the commission has the mandate to investigate complaints of human rights violations before it from a person and or a group of persons.
In so doing, the Commission is independent and is endowed with powers to commit anyone for contempt of its orders and order for any legal remedies, redress and other redresses.
Public health activists have dragged government to the Constitutional Court demanding that it changes its reference to mentally ill people as idiots and imbeciles in the Penal Code Act and the Trial on Indictment Act.
The petitioners: the Centre for Health, Human Rights and Development and Yiga Daniel through their lawyers Kabanda and Co. Advocates, said both laws are “too abusive, archaic” and do not conform to the Constitution and the United Nations Convention.
The petitioners are also aggrieved with laws that deem persons with mental disabilities, who are not proven guilty, by referring to them as criminal lunatics.
They said detaining them in prisons for years awaiting a minister’s order on whether they are able or unable to stand trial violates their rights guaranteed under the Constitution.
The petition was filed in December 2011 and scheduling interparties on February 21 adjourned it to March 22 after the State Attorney, Mr Kasibayo Kosia, in a letter said he misplaced his scheduling notes and asked for adjournment.
A February 20 petition letter reads in part: “It is unfortunate that the State plays with very important issues that need quick response.”
FROM the Bugiri-Malaba highway, Bugiri hospital appears to be a deserted facility. The tin roofs hovering over the facility are rusted, its doors broken down and the infrastructure is dilapidated. But coming closer to the facility, you see a number of patients are lining up for different services.
This is around 9:00am in the morning. However, a keen look around the facility reveals absence of the senior workers — the medical superintendent, the administrator and junior cadres, are yet to show up. I am told to wait. Within half an hour, the administrator shows up but she tells me to wait as she attends to the Resident District Commissioner of Bugiri, who had also showed up to check on the facility.
The hospital is in dire need of equipment ranging from beds to drugs. A fresh coat of paint would also be nice
After almost three hours, the administrator, Sarah Nabulime, a short talkative woman, invites me to her office. Nabulime starts by lamenting that as much as sick people fl ock the facility for treatment, the centre itself is “like a patient on drip.” Nabulime laments that the hospital has failed to retain its staff who vanish after training.
On the day I visited, the medical superintendent was away. He went for further studies but, unfortunately, after the course that was sponsored by the Government, he vanished.
TWO DOCTORS
The facility is also supposed to have three doctors but only two are available — the third went to Nairobi, Kenya for further studies. However, Nabulime fears that when he completes his studies, he is also likely to look for greener pastures elsewhere. Nabulime has lost count of the number of doctors from Bugiri hospital who enroll for further studies but never return. “Every year, we lose about three doctors who go for further studies and do not come back. According to Dr. Stephen Kirya, the Bugiri district director of health services, the staff of the facility stands at 52% against the 65% recommended by the Ministry of Health. “This seems like a good percentage but it’s the core staff who are missing,” he said. Kirya explains that while the facility is supposed to have about 12 doctors, they have only two. Out of the five specialists they should have, there is none. Because there are no specialist gynaecologists and obstetricians, every month, two babies and a mother die at the facility due to this shortage. Thankfully the facility has an x-ray and c-scan machine but no expert to operate it.
The infrastructure can best be described as sick. The beds in each ward are broken, mattresses torn or missing and the few available ones are dirty. The beds are also few forcing some of the patients to sleep on the floor.
The ceiling needs to be replaced
Yet deep in the toilets and bathrooms, a sanitation problem that is likely to cause disease is going on. The toilets are all broken down; sewerage leaks inside the wards and into the consultancy. The floor, walls and the entire infrastructure is dirty, dilapidated and unsuitable for human use. The facility uses water from an electric pump. However, power cuts have forced the facility to go without water for weeks. The maternity ward has become so filthy – a powerful stench that is indescribable threatens lives there. “Life is tough in this hospital. We have talked to the district to give us more money to buy fuel for the generator to power the whole hospital but the district is also broke,” adds an health worker, who preferred anonymity.
SHOE STRING BUDGET
Bugiri district prepares an annual budget of sh20b but they get only sh50m. However, at the end of each month, they use over sh20m to run the hospital. The facility budgets for sh1m per month to buy fuel for the generator but their annual budget for running the generator is about sh15m. “This clearly shows you the shortage we face,” adds Dr. Kirya.
Dr. Kirya explains that when there is no power or generator, they are always forced not to carry out any surgeries refering the cases to Iganga or Jinja hospital. However, by the time they cover a distance of about 30km to Iganga or 60km to Jinja, the patients are dead. No wonder, at the facility, 600 people – including children, women and men die annually. While the facility, like any other in the country receives its drugs, medicines and supplies from the National Medical stores, the supplies are often inadequate. Essential drugs like malaria, anti-biotics are often out of stock. And simple supplies like gloves, gauze, cotton, syringes and intravenous fluids are often out of supply. But she is also frustrated that they have promised each year in and out but nothing has so far come. Patients like Alice Nantume who has just given birth without the help of a doctor but a nurse, are desperate.
“I came here to get better care but life is instead tough. At least in the village, a traditional birth attendant will give you some herbs but here there is nothing.” Nantume explains that she did not fi nd any gloves, so she was advised to buy some. She also brought her own soup since the facility did not have any. “We request the government to help us,” she pleaded.
WAY FORWARD
Dr. Kirya calls upon the Government to help them recruit human resource and pay them well, “because the districts do not have capacity to attract and retain health workers. It is a pity but we need help.” Nabulime calls on the government to speed up the plan to rehabilitate the facility to give it a new facelift. Bugiri district chairman Malijani Azamwa Balubireire called upon the Government to increase funding to local governments and also stop creating more districts so that they are able to pay health workers well.
Over one hundred human rights NGOs, including some from Uganda, have petitioned the US government to stop a three-day Intellectual property summit set to take place in Cape Town, South Africa in April 2012.
The summit has been called to discuss intellectual property enforcement on the continent and could be a critical meeting.
Campaigners say enforcing trade related intellectual property rights (TRIPS) translates into banning Indian generic AIDS drugs by enforcing patents for Western pharmaceutical giants, outlawing extensive photocopying of educational materials published by Western multinationals, limiting access to newly developed disease-resistant agricultural seeds for poor farmers and cracking down on counterfeit Microsoft computer programmes, meaning millions of poor Africans will miss out.
TRIPS refers to the exclusive rights held by inventors and innovators of items such as new drugs, books, plant seeds, software developers. These rights are enforced by international law and unlawful access to them attracts penalties. The majority of intellectual property rights are owned by western countries.
The Cape Town summit, Africa Intellectual Property Forum: Intellectual Property, Regional Integration and Economic Growth in Africa is organised by the US Department of Commerce.
It has been billed as the first Africa-wide ministerial-level event of its kind. The summit is jointly organized by World Intellectual Property Organisation (WIPO) and several US multinational companies including PfIzer, Dolby,Caterpillar and Microsoft.
The summit has drawn the ire of human rights NGOs in Africa. This is partly due to the disturbing conflict of interesting which the summit’s sponsors – namely US multinationals, in collaboration with Western governments such as the US, France and Japan – are the organizations that own the majority of intellectual property and thereby have a vested interest in enforcing intellectual property rights in African countries despite the fact that the majority of Africans live on less than a dollar a day.
Mulumba Moses of the Center for Health, Human Rights and Development, a Ugandan human rights NGO, said: ”It’s a shame that the Africa IP Forum is putting emphasis on IP enforcement agenda. One would expect the continent to be discussing the development agenda in light of its social economic challenges in the areas of health, education and agriculture. Over emphasis on IP enforcement is iniquitous of the continent’s population that still badly needs to utilise the policy space provided for by the TRIPS Agreement.”
The summit is being castigated by human rights activists because it appears to reverse gains made by African governments in securing exemptions from enforcing the intellectual property rights of multinationals in poor countries. One such gain was the 2006 TRIPS agreement in Doha, which granted poor countries a grace period until 2016 to consume cheap generic AIDS drugs manufactured in India.
It is feared that the summit may trigger new intellectual property legislation in African countries in a compliance move that may curtail access to products, in some cases life-saving drugs such as AIDS or tuberculosis medication.
The irony of the South African government playing host to a summit on African soil which is seeking to perpetuate Western multinational interests by curtailing access to life-saving drugs or educational materials to poor African students is not lost on African and global human rights NGOs.
The sentiments of the petitioning African NGOs are aptly captured by Sangeeta Shasikant, Legal Advisor of the Third World Network: “The US is well known for pressuring developing countries to adopt TRIPS plus standards. The Africa IP Summit is another attempt by the US to advance its aggressive agenda on IP protection and enforcement such as Anti-Counterfeit Agreement (ACTA), which favours the interests of certain powerful multinational companies.
“The US concept paper and programme totally disregards the numerous developmental and socio-economic challenges facing Africa. Issues of access to affordable medicines, access to knowledge, misappropriation of genetic resources and associated traditional knowledge and farmers’ rights are totally disregarded.”
Pregnant women in Pallisa district in Eastern Uganda are reported to be delivering under trees due to the collapse of a building at the local health facility.
Due to inadequate space in Ngwere Health Centre III in Petete Sub County, health workers have created a makeshift shelter under trees near the centre for women to deliver in.
Reports indicate that Ngwere Health Centre III, which serves the entire sub county of more than 15,000 people plus its neighbors, has only two rooms after one of the centre’s buildings collapsed due to strong wind and heavy rain last year.
The facility, which is located about 15km from Pallisa town, is over crowded meaning patients are at risk of contracting infectious diseases during labor.
A health worker at the government aided facility described as “inhuman” the situation in which staff are forced to handle labors in the makeshift shelter due to a lack of space, adding that a quick intervention is required to rectify the situation.
“We have no alternative but to perform our duty in order to save the lives of these mothers as we wait for government response so as to rehabilitate the facility fully,” another medical worker said on condition of anonymity.
In Uganda it’s only the chief administrative officer or the medical superintendant who has the mandate to speak to the press about health matters but they are not always available. However, one nursing officers Ahmed Mpande agreed to be named as he said the collapsed building had become a major problem facing maternal health in Pallisa district. He added that the building’s collapse had been reported to the authorities but they had declined to respond.
Mpande says that other services including antenatal care, deliveries, laboratory and drug storage are all handled in the two rooms. Mpande also notes that, due to the poor working environment, the health facility is due to temporarily close until it is renovated.
Community resource person, Kulu Nalongo, says the centre serves a radius of 6km but regardless of its sorry state, the community still has hope over it though it’s not renovated.
When contacted, CAO Pallisa district Mbooge Isa confirms receipt of a letter sent in July last year (2011) drawing attention to the fact that the health unit requires immediate renovation.
Mbooge said Pallisa district has received funds from the poverty reduction program (PRDP) and expects to use part of the money to rehabilitate the health unit this financial year (2012/2013). But he did not mention when the work would begin.
However, Chairman of LC 5 Pallisa says that the district has no capacity to renovate the structure because it has no emergency funds.
“It is true this health unit is damaged but we have to budget for it next financial year since the district is in a planning cycle,” he added.
Nagwere health centre was run by NGO the Christian Children Fund in 1980 before the government took over in 2009.
has lodged a complaint against the government, power distribution company UMEME, and the Electricity Regulatory Authority (ERA) over indiscriminate load shedding in public hospitals, which has led to many avoidable deaths of patients.
