Uganda

The situation in Uganda

Tackling homophobia in Uganda: oppression of LGBTinfo-icon people

 

In Uganda, lesbian, gay, bisexual and transgender (LGBTinfo-iconpeople experience oppression, assaults and imprisonment. In this country where religion is very strong, Médecins du Monde provides healthcare interventions to improve the everyday lives of these communities.

Homophobia is a harsh reality for LGBTinfo-icon people in Uganda. Since 2009, the country has made several attempts to toughen its legislation against homosexuality and to introduce the concept of ‘aggravated homosexuality’ where being HIV positive is considered as an aggravating circumstance. A draft law even contained provisions for life imprisonment for homosexuals and the death penalty for carriers of HIV. This is the context in which Médecins du Monde decided to act. We believe it is intolerable to criminalise someone because they have a particular disease. 

 

Sexual risk prevention is essential for LGBTinfo-icon people

Owing to real or perceived homophobia on the part of healthcare workers, LGBTinfo-icon people are often afraid to use health services, especially for sexual and reproductive healthcare. The impact on their health is significant, particularly for men who have sex with men (MSM) ) and transgender people. As a result, the prevalence of HIV is close to 14% among homosexuals in the capital city, Kampala.

 

Hosting South Sudanese, Congolese and Burundian refugees

 

Since 2013, Uganda has been a place of refuge for thousands of South Sudanese, Congolese and Burundian people fleeing from the violence (including torture, rape and murder) that is widespread in their home countries. In this context the Ugandan government opened six new camps, among them the Bidibidi camp in the north-west of the country. Today it is believed to be the largest camp in Uganda, with over 220,000 refugees from South Sudan recorded in 2018.

Uganda has a pioneering refugee policy which allows refugees to move freely, cultivate land provided for them, engage in commercial activities and access social services free of charge. However, the poverty resulting from scarce vital resources (especially during periods of drought), as well as the trauma of war and the violence experienced by refugees in their countries of origin and in the camps means that the healthcare needs are enormous.

En 2009, un projet de loi prévoyait la peine de mort pour les homosexuels séropositifs. ©Neamoscou
En 2009, un projet de loi prévoyait la peine de mort pour les homosexuels séropositifs. ©Neamoscou

Our activities in Uganda

At-risk population

Caring for victims of homophobia in Africa

In Kampala, Médecins du Monde decided to join forces with the Most At-Risk Populations Initiative (MARPI), an organisation which works at the hospital in Mulago providing sexual and reproductive health services to key groups (including gay and transgender people and sex workers). These services are tailored to their needs and the restrictions they face, and cover awareness-raising about STIs, contraception and gender-based violence.

This Ugandan organisation, set up to support sexual minorities in the country, has succeeded in forging an alliance with the Ministry of Health. It now runs an LGBTinfo-icon-friendly clinic right in the heart of the capital. Although many gay and lesbian people are afraid of going to the doctor for fear of being stigmatised or reported, the clinic ensures that they receive a minimum level of care. It represents ‘a small oasis’, known through word of mouth and by small LGBTinfo-icon organisations also spreading the word.

 

Supporting organisations that tackle homophobia

Through the provision of training Médecins du Monde is also supporting MARPI as it expands its activities to regional referral hospitals, including the one in Mbarara in the south-west of the country.

In addition to improving the services provided by the clinic (especially in the treatment of anal warts, a common STI among gay people in Uganda), the partnership is also training LGBTinfo-icon organisations in project design and fundraising.

 

Migrants and displaced persons

Working with refugees from south Sudan

In July 2018, Médecins du Monde took on the provision of outpatient consultations for Bolomoni Health Centre Level III, which was set up as an emergency response by Médecins Sans Frontières. The health centre provides local people and refugees from South Sudan with primary healthcare and sexual and reproductive health interventions, including integrated care for survivors of gender-based violence, mental healthcare and psychosocial support.

Since 1 January 2019, Médecins du Monde has also taken over the health centre’s 60-bed inpatient unit. The unit provides paediatric services, a maternity ward and services for adults. It also refers more serious cases to the public hospitals.

A reduction in the provision of services is planned for 2020 in preparation for the Ugandan health authorities taking on the management of the health centre.

 

IN 2019

Every month we provided:

  • 17,729 outpatient consultations
  • 3,382 hospital admissions
  • 1,020 antenatal consultations
  • 718 postnatal consultations
  • 829 safe deliveries
  • 965 family planning consultations
  • 686 consultations for survivors of gender-based violence (including 226 rape cases)
  • 4,491 mental health consultations

 

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