Activists to Uganda: Don’t let Covid-19 destroy access to health care

LGBT and human rights defenders in Uganda have issued an open letter to President Yoweri Museveni, urging him to put the right to health and human rights at the centre of the country’s response to the Covid-19 pandemic.


From the African Human Rights Media Network


To enforce the countrywide Covid-19 lockdown, a member of Uganda's security forces beats women selling fruit in Kampala on March 26. (Photo courtesy of The East African)
To enforce the countrywide Covid-19 lockdown, a member of Uganda’s security forces beats women selling fruit in Kampala on March 26. (Photo courtesy of The East African)

By Kikonyogo Kivumbi

In a letter dated April 03, activists urged  President Yoweri Museveni to issue guidelines and/or a formal decree to enable people living with HIV/AIDS and other vulnerable groups to access health care.

The petitioners were led by the International Community of Women Living with HIV/Aids in Eastern Africa (ICWEA).

They fear that without such institutionalised guidance, some people may be “left out” — without food or medicines.

Jane Aceng‎, Ugandas health minister
Jane Aceng‎, Ugandas health minister

“Groups that may miss out [during the lockdown] are people living with HIV, yet nutritional support is critical for adherence to treatment and prevention of further HIV infections and Covid-19,” the statement read in part.

While commending the efforts by the Ugandan government to curb the spread of Covid-19, the activists want the power to issue  emergency access permits to be more decentralised. They want that responsibility to rest with local government councils 1, the smallest unit of government, which are close to the people. Currently, emergency permits to pass through security roadblocks can only be issued by resident district commissioners (RDCs), who are answerable to the president.

But the RDCs are sometimes too busy or overwhelmed by calls to attend to individual casea. Some of the RDCs are unreachable because they oversee areas with a radius of more than 10 kilometres.

In a separate call to the Ugandan government, Human Rights Watch echoed similar appeals by local activists and the African Commission on Human and People’s Rights that Uganda should protect the right to life and human dignity in the Covid-19 era.

Police have apologized for beating people during the Covid-19 crackdown, but incidents of violence by security forces have continued.

Ms Dorah Kiconco, the executive director the Uganda Network on HIV, Law and Ethics (second from left) and Ms Lilian Mworeko, the executive director of ICWEA, discuss health rights issues during the international AIDS summit in Durban 2017. (UhspaUganda photo
Ms Dorah Kiconco, the executive director the Uganda Network on HIV, Law and Ethics (second from left) and Ms Lilian Mworeko, the executive director of ICWEA, discuss health rights issues during the international AIDS summit in Durban 2017. (UhspaUganda photo

The activists’ letter is reproduced here verbatim:

OPEN LETTER TO THE PRESIDENT OF THE REPUBLIC OF UGANDA

3rd April 2020

H.E. General Yoweri Kaguta Museveni (Rtd) President of the Republic of Uganda

Office of the President P.O. Box 7168 Kampala, Uganda

Your Excellency

Ugandan President Yoweri Museveni

ACCESS TO HEALTHCARE SERVICES MUST BE AT THE CENTER OF COVID19 RESPONSE

Your Excellency, we commend you for the efforts that you are undertaking to ensure that Ugandans remain safe from Covid-19.

We also thank you for providing the leadership at the highest level, together with the Prime Minister’s Office, the Ministry of Health, all the Security Organs, Uganda AIDS Commission and all Development partners who are spending tireless nights to make sure Ugandans remain free from Covid-19 and those who are infected are treated.

The Uganda HIV Civil Society Organizations have taken seriously your guidance and are working with our communities to ensure compliance. We have also come up with our own structure to deliver on our mandate, contributing to the government efforts.

These include but are not limited to community mobilization, messaging on prevention and control of Covid-19 and providing emergency services possible. On behalf of our communities, we hereby write to you to express our deep dismay at the alarming difficult situations that women and children are finding themselves in as they try to access health care services during this period of the lock-down.

A member of Uganda's security forces beats a man in Kampala to enforce a Covid-19 lockdown issued by Ugandan President Yoweri Museveni. (Photo couresy of the Daily Monitor)
A member of Uganda’s security forces beats a man in Kampala to enforce a Covid-19 lockdown issued by Ugandan President Yoweri Museveni. (Photo couresy of the Daily Monitor)

This has led to the several deaths of pregnant mothers and their babies that have been reported in several parts of Uganda. We continue to receive daily outcries from several people especially people living with HIV and other non- communicable diseases who are unwell and not able to travel to access medical services.

Your excellency, your people may survive Covid-19 but unfortunately many may not survive other emergencies. Pregnancy for example may not allow the pregnant women to even remember the emergency numbers provided. Labour pains may come in the middle of the night when even the RDCs are not available in their offices.

A sickly child for example with a temperature would need immediate attention by a health worker and for any mother, they would need to rush with whatever means available to save the life of the child and also prevent the child from long term effects on his/her health. This again cannot wait for permission to be secured. With due respect to your directive on 30th March 2020 calling on the public to seek permission from the RDCs in case of any emergencies and on 2nd April 2020, where the Ministry of Transport emphasized that Police Officers should allow pregnant women to travel to hospitals, without clearance to move, this remains challenging.

Also interpretation at implementation level hasn’t followed logic and therefore even when a vehicle is carrying a person who is in a critical condition, some security officers have gone ahead to impound the vehicle, further risking the life of the occupant. We therefore propose that:

1) Power is decentralized to the Local Council Chairpersons to handle any emergency cases of sick people, pregnant women and children that need immediate attention to hospitals as opposed to RDCs and RCCs who might not be readily available and within reach.

The structure of LC1 systems works so well to the extent that almost all LC Chairpersons know their residents and when it comes to emergencies, they should be the first to be approached and we trust they will do a good job of prevention of Covid-19 and addressing preventable deaths.The RDCs should be left to handle situations that are non-emergency in nature;

2) Ambulances and cars are readily available at the community level and, where such is not possible, through the LC Chairperson’s authorization, personal vehicles by well-wishers should be allowed including boda bodas as long as they have a letter of authority from the LC1 Chairperson, who in case of doubt can be called;

3) We are happy that the medical personnel have been cleared for permits to travel without restrictions.

We request that the process of issuing permits is fast tracked.

4) Access to food and other essential commodities is critical during this period of the lockdown.

We commend the government for efforts towards this. We however are asking your excellence that guidelines and or a statutory instrument be issued in this process, otherwise the intended people may be left out. Groups that may miss out of this exercise are people living with HIV, yet nutritional support is critical for adherence to treatment and prevention of further HIV infections and Covid-19.

Sincerely,

Lillian Mworeko – International Community of Women living with HIV Eastern Africa (ICWEA) +256703975192 (Human Rights & Legal Environment Working Group)

Dora Kiconco – Uganda Network on Law, Ethics and HIV/AIDS (UGANET) +256774199374 (Human Rights & Legal Environment Working Group)

Mwehonge Kenneth – Coalition for Health Promotion and Social Development (HEPS Uganda) +256782 182 809 (Human Rights & Legal Environment Working Group)

Stella Kentutsi – National Forum of PLHIV Networks in Uganda (NAFOPHANU)+256701444440 (Social Protection and Social Support Working Group)

Nicholas Niwagaba – Uganda Network of Young People Living with HIV (UNYPA) +256 777 236 744 ( Communication and Media Working Group)

Dr Lydia Mungherera – Mamas Club 0772448102 (Medical Working Group)

Richard Lusimbo – SMUG Uganda +256782612972 (Resource Mobilization and Finance Working Group) for and on behalf of Uganda HIV Civil Society Organizations

Written by Kikonyogo Kivumbi

Kikonyogo Kivumbi is the executive director of the Uganda Health and Science Press Association. Contact him at [email protected]

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