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

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

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.