Kampala — Uganda's government currently finds itself the subject of unwanted attention following the decision of more than 50 civil society groups to seek legal recourse that could fundamentally call into question the state of the country's maternal healthcare.
The coalition, led by the Kampala-based Centre for Health, Human Rights and Development, want the Supreme Court to declare that the high rate of maternal deaths - said to be 16 deaths daily - are a breach of basic rights. The groups hope that an authoritative pronouncement could shame the government into taking positive action, and the case comes at a time of mounting pressure by international voices for Uganda to reduce its reliance on foreign aid and allocate its resources more equitably.
Mum's the word
The recent death of 24-year-old Hajara Katushabe, which has resonated around the country, encapsulates many of the issues at stake. Katushabe, an expectant mother and resident of Isunga, Kibaale, in the Western part of the country, faced an arduous journey to reach her local healthcare centre. Yet even after overcoming painstaking difficulties to reach the clinic, her medical safety was not assured. As she entered labour, the midwife on duty refused to attend to her claiming she was too exhausted due to being over-worked. Katushabe and her child died. When the news broke out, locals stormed the building, demanding accountability.
Katushabe's story, however, is not an isolated incident. Many pregnant women are dying from preventable problems: basic access to hospitals and healthcare centres is not only lacking, but tend to be under-staffed and ill-equipped.
Furthermore, this problem looks more likely to worsen in the near future than be resolved. The last few months have seen the repeated threats of strikes from medical workers against poor conditions and low salaries.
Nour Musisi, one of the lead petitioners working with the NGO Centre for Health, Human Rights and Development, told Think Africa Press that they would pursue the case of Katushabe and are lobbying for police involvement. "We get many cases of neglect every day and we demand that the government intervenes and finds why Katushabe was neglected," she said.
Sylvia Namabidde, who works with the legislature and is also the chairperson of a group of women parliamentarians advocating for increased funding of the health sector, says government has got its budget priorities "upside down". The 2012/13 national budget, unveiled in June, suggests health is given low priority. Despite disrepair and calls for the health sector to command 15% of the budget, it was given just 7%.
In the face of these challenges, activists are more determined than ever. "We will not give up because this is not acceptable. If we lose this case, we will petition the African court," Noor Musisi stressed. With the case having already been dismissed by the lower courts, the groups' chances of success remain uncertain. In May, the High Court of Uganda came to the decision that the case was unacceptable based on the 'separation of powers' doctrine.
Ostensibly at least, power in the country is shared between the legislature, the executive and the judiciary. Each one should provide a series of checks and balances on the others, and their strict separation is said to prevent one arm becoming too powerful. The court ruled that it would be unduly interfering with the role of the legislature if it interfered in its policies.
"They said this was a political question and therefore must be answered by politicians. The ruling was based on the doctrine of separation of powers in government. But if the Supreme Court rules against us we shall seek redress from the continental court," Noor Musisi said, referring to the African Court on Human and People's Rights.
Erias Kisawuzi, a spokesperson for the judiciary, told Think Africa Press that commenting on the case is prejudicial but that the groups are free to seek redress in any courts of law: "It's their right and if the Supreme Court decides in their favour, good for them," he said. "I don't know when the case would be decided but I think it will be soon."
Risdel Kasasira is a Ugandan journalist with seven years of experience in journalism. He has reported widely on politics, security and wars in East and Central Africa. He has been in Somalia many times covering the conflict in the Horn of Africa. He has also been in South Sudan, Central Africa Republic and DR Congo many times to report on the Ugandan army operations against Lord's Resistance Army rebels and its elusive leader Joseph Kony. He has also reported from the Ugandan Parliament for two years.