I have been in Uganda for a little over a month now and have already learned so much, both from my work as an intern at the Center for Health, Human Rights and Development (CEHURD) and from my daily life in Uganda. I have visited Ugandan courts, taken countless boda rides and visited the source of the Nile. My first challenges were mostly activities that usually seemed simple to me, such as getting to work. My colleague’s kindness and patience in showing me the way around allowed me to feel much more comfortable in Kampala and to focus on my work as a legal intern.

CEHURD was created to advance the right to health for vulnerable populations such as people living with HIV/AIDS, women, and children. It is divided in three complementary programs (1) the Research, Documentation and Advocacy (2) Community Empowerment and (3) Strategic Litigation. As a second year law student, I was assigned to the Strategic Litigation program. Their objective is to provide legal support to persons whose rights have been infringed upon in Uganda and to litigate issues with the potential to redress systematic problems in the country’s health system. I have supported their work by drafting legal opinions on incoming cases and federal bills, completing research papers, and putting together grant proposals. This experience has allowed me to witness the use of the law as not only a tool to solve a single fact pattern but as a tool with the potential to create population shifts and improve health conditions on a national scale.

Most of the cases move for the implementation of the right to health. However, the Constitution of Uganda lacks an express provision on the right to health, which makes the conceptualization of each case particularly demanding. The right is implied from other constitutional clauses, the national objectives and the directive principles of state policy, each with health-related facets such as the right to life, human dignity and women’s rights. Furthermore, the implicit nature of the right to health in Uganda makes it so that its realization largely depends on political goodwill, judicial interpretation and the treatment of the other rights from which it derives. This particular situation highlights the importance of advocacy and community engagement in the respect of human rights and the delivery of safe and acceptable health services.

As much as one may put together a case supported by persuasive evidence demonstrating a human rights violation in the delivery or lack of health services, the societal attitudes towards specific issues and vulnerable populations are often the last and most difficult barriers to overcome in obtaining justice. For example, CEHURD & Kabale Benon v Attorney General is a recent case that demonstrates the prevailing stigma surrounding claims made by individuals who have suffered from periods of mental distress. In addition to silencing the plaintiff based on his identity as an individual with a mental health disorder, the court also disturbingly put all medical decisions above the scrutiny of the law.

This message discourages Ugandans from taking initiatives towards ensuring the respect of their rights and towards keeping the government accountable in its actions. CEHURD has recently filed an appeal for this case.

Overall, I am very motivated by CEHURD’s work as they put forward that the right to health extends itself to the causal determinants of health such as adequate sanitation facilities, health infrastructure, trained workers and essential drugs. I hope to contribute to my team’s work as much as I can in the following weeks and am excited to learn more about the right to health in Uganda.

Catherine Labasi-Sammartino
Summer Intern – McGill University Ontario Canada

Grabbing by the purse strings: Global gag rule and International Funding
19:00-19:30 CET

Follow the link to watch the live broadcast: http://www.aids2018.org/Live

Panelists:

• Latanya Mapp Frett
  Planned Parenthood Global
  @ppglobe
• Joy Asasira @jasasira
  Center for Health, Human Rights and Development
  @CEHURDUganda
• Chloe Cooney
  Planned Parenthood Federation of America
  @PPFA

By Fahad Musisi and Mariana Kayaga

The international day of the African Child attracts our attention to the cries and tribulations, without exempting health, of children especially in Sub-Saharan Africa, including Uganda, that remain unprioritized and unattended to yet children make a significant demography in this part of the world. In Uganda for instance, the 1995 Constitution of the Republic of Uganda describes a child as someone below the age of consent, which is 18 years. This day that is celebrated annually also reminds us of the 1976 student uprising in Soweto South Africa who marched in protest of the quality of education they accessed, and demanding to be taught in their language.

This day is critical to raising awareness on the continuous need for improving the nature of education provided to children in Africa especially regarding access to information about their sexuality for informed choices. Children are inclined to making wrong decisions because education in Uganda has not fulfilled its mandate of streamlining access to sexuality information. It is not surprising that teenage pregnancies now stand at 25% according to the 2016 UDHS, neither is it by coincidence that discussions around access to contraception are highly polarised, yet national surveys (UDHS) indicate that Ugandan girls are having sex at the age of 15.7 on average and boys at an average age of 16.

The central question is then, does the education system which is not tolerant of sexuality education for children responsive to children’s needs given the statistics as presented above? Is the theme for this year’s commemoration (leave no child behind in development) a reality or a fiction?

Children are more vulnerable than adults and are classified as unable to make serious decisions whose consent must legally be under the care of a responsible adult or custodian. However, custodianship has also not saved children from early marriages below the age of consent. It is one of the commonest social and human rights issue in Uganda, with the 2016 UDHS indicating a 46 percent of girls marrying before they reach the age of 18, yet children are not equipped with enough information. This exposes them to early pregnancies which sometimes culminate into stillbirth, and sometimes unsafe births leading to preeclampsia and sometimes fistula that makes them lose their dignity in society due to the stigma and discrimination it is associated with.

Child marriages are considered illegal in Uganda. Article 34 of the Constitution provides that a child is entitled to basic education which shall be the responsibility of the state and the parents. Since the same constitution puts the age of consent at 18, the implication is it is unconstitutional to marry off any child who is not yet that age.
However, Uganda can still do something to stop child marriages. Empowerment programs for girls, such as the Legal Empowerment and Social Accountability mechanisms utilized by CEHURD in Mukono and Gomba Districts under the DREAMS innovation Challenge Project; Integrating Legal Empowerment and social accountability for Quality HIV Health services for AGYW, are key to providing an opportunity to build skills and knowledge, understand and exercise their rights and develop support networks. Access to information on sexuality must therefore be a central tenet of education since it guides on making right choices, respect for the rights and dignity of children and their peers. The Uganda Strategy to End Child Marriage and Teenage Pregnancy which was launched on 27th October 2015 is therefore an important precursor to protecting the girl-child and ensuring access to their education.

Lawmakers and enforcement institutions need to ensure that laws around early marriages are effectively implemented. Community participation on this must therefore be a pillar in acquisition of first-hand information from the people falling victim of early marriage with a conviction that community prosperity is mainly dependent on the guaranteed future of children, especially the girl-child. The local leadership, cultural and religious leaders must therefore use all the available platforms within their reach to communicate against early marriages and the health hazards this poses.

This will guarantee adequate protection for children with specific focus on the girl-child because their lives also matter and must be an integral part of development.

By: Ngasirwa Patrick

Ester Nagudi is a 13 years old girl from Manafwa District; she is tricked into having unprotected sex and ends up getting pregnant. Ester has no option but to try out an abortion since she cannot imagine herself facing her parents. A friend she trusted recommended an elderly woman who asked her to find a cassava stick. The woman peeled off the outer layer of the stick and told Ester to lie on her back and raise her legs. She pushed the stick inside and pulled it out, only blood spurted out but nothing else came with it.

Ester’s life has never been the same again from that day! This is a story of a girl whose life is taken on a garden path, takes a complete turn for the worst and is made to pay for just one mistake that she made (or was made to make). There are many more horrendous stories that talk about cases of insertion of objects into the uterus, dilation and curettage performed incorrectly, ingestion of harmful circumstances, application of external form and various other methods of unsafe abortion.

I didn’t think that abortion was a conversation we needed to have until my eyes stumbled on that harrowing story, I was taken aback by the facts and figures. For a long time I had always thought that the feminists and their great movement were simply advancing an agenda that only they knew about, I actually thought they were acting up but for the past few days and weeks reality has stared me in the face. It simply never occurred to me that such horrors exist, I had it all wrong!

Two weeks ago, I had the opportunity of starting my internship program. This was with a prestigious organisation called Center for Health, Human Rights and Development (CEHURD), one that has for a long time championed the realization of health rights in our country. Its impeccable record in litigating health related cases is second to none. Sometime last year CEHURD brought a case before the Constitutional Court, asking them to interpret Article 22 (2) of the Ugandan Constitution on whether there is a violation in the failure by the legislature to enact a law that regulates the termination of pregnancies. The fact is that we have no law in place on abortion but is our society ready to have the law? It is this abortion file that I have been poring over for the past fortnight and reality is beginning to check in.

There is a very critical question we need to start by answering. As a country, do we need to follow in the footsteps of our next door neighbors Kenya and Rwanda to enact a law on abortion? If that is answered in the affirmative then we also need to know whether we are ready to accept it. I have been a keen follower of the debate on abortion albeit making little contribution and for every single person who has claimed that it is not a law that we need, religion has been their basis. They have argued that God doesn’t allow killing.

They have also argued that in case abortion is made ‘legal’ then there will be an upsurge in promiscuity. I don’t intend to delve into the spiritual realm because it is one that is complicated to fathom but let us look at the argument of promiscuity because that is what we all understand. The law that should be in place first of all is not one of legalizing abortion; it is one of regulating the termination of pregnancies. The two are not the same, in fact they are completely distinct. The English meaning of regulation is “controlling a conduct.” That in and of itself defeats the promiscuity argument form the onset because if you think women will become loose simply because abortion has been legalized, you have it wrong.

The law will be seeking to put down the various conditions under which one can undertake a safe abortion. So their being loose will not be because the law has been enacted. If anything, it will make them more responsible! The Ministry of Health has itself realised that abortions ought to be carried out, they are something that you cannot dispense with and this is why they have come up with guidelines on the carrying out of abortions. The question then should be, if guidelines can be issued then why not a concrete law?

Many have also attempted to argue that a child (born and unborn) is a gift from God and therefore no one should take their life. That is a given and it is not in dispute. But if a child is a gift from God, then should we also presume that one that is as a result of rape is also from God? Doesn’t the argument become self defeating because then it would mean that rape is no longer a sin itself because a product of a sin cannot be a gift. I have also heard others argue that you could probably be killing a future leader or someone very important. I find this argument very shallow for these reasons.

If one is a victim of incest, would you rather have the shame and embarrassment of an abomination in a family live with you for generations than do away with? Secondly, would you rather save the life of a baby that you are unsure of than ensure the safety of the mother you are very sure of, one who is giving the life and is expected to sustain it until a certain age? These are all choices that we need to have a conversation about because they are about the lives of our people; they are about the lives of our children and the children of our children and for a fact they matter.

At the end of the day, one disturbing fact remains, there is no regulation on abortion and the unsafe abortions will continue. Another Ester will become wasted and the chain will go on. I think it is about time we had this conversation on abortion.