LGBTIQ+ people in Rwenzori sub region, Uganda are pleading for a non-discriminative environment at health facilities to ensure equitable and quality access to Sexual Reproductive Health (SRH) and HIV services.
LGBTIQ+ people in rural areas of Rwenzori sub region, says access to these services has drastically become more erratic and inadequate since the introduction of the Anti-homosexuality act 2023 which came into force last year.
The Act harms the lives of not only LGBTIQ+ persons, but also all other Ugandan citizens outside of the LGBTIQ+ community. By creating new crimes like “promotion of homosexuality” and “premises” liability, the Act requires citizens to report suspected violations, under threat of criminal punishment if they fail to do so.
The act criminalizes the work of local NGOs that offer support to the LGBTIQ+ community accusing them of “promoting homosexuality”. This has restricted the operation of NGOs especially those in the rural setting.
There’s a need for affirmative action in supporting grassroots rural communities. Donors need to understand the environment we’re operating in
The act has drawn widespread condemnation from the international community, with some countries, such as United Kingdom, United States of America cutting funding to critical sectors and placing sanctions on officials they claim are involving in serious human rights abuses.
On April 2024, the Constitutional Court, while upholding most provisions of the Anti-homosexuality Act 2023, struck down sections that restricted healthcare access for LGBTIQ people. Despite the ruling, queer people say access to these services at health facilities, especially in rural districts, is still a big challenge.
Grassroots rural organizations like We for All Rwenzori (WEFORI), Twilight Support Initiative (TSI), Blessed Rwenzori Uganda (BRU) among others have been trying to provide reasonable access to screening and testing, lubricants and condoms, PrEP, PEP services for LGBTIQ+ people. Despite their best efforts, these services remain largely limited due to lack of resources and hostile homophobic communities .
According to local NGOs, LGBTIQ+ persons in rural areas of Uganda like the Rwenzori sub-region do not get equal access to these services and even some of them have no idea about their existence. There is a need for sex education among the LGBTIQ community particularly on SRH issues since most of them have ended up neglecting their health due to discrimination, bullying and stigmatization.
There is a need for an enabling environment such as having health workers that understand the needs of LGBTIQ+ persons to create a friendly environment at health facilities that enables expression of health concerns.
In regards to SRH services that are available to LGBTIQ+ persons, some SRH services are particularly available to a specific group within the LGBTIQ community while some are generally available to all persons.
Its often difficult for grassroots rural organizations to compete for funding opportunities because most of them, especially in Uganda, operate in an informal setting that enable them manoeuvre in the homophobic environment. This makes it difficult for them to meet some funding eligibility criteria.
Peter Masereka, a paralegal worker from We for All Rwenzori-WEFORI, a community organization that supports LGBTIQ’s access to SRH services in Rwenzori sub-region, said connections with some public and private health facilities, drop-in centres and referrals have insufficient services.
“These people sometimes have special health needs; consumables like Female condoms; lubricants, douching machines, HIV Testing Services, HIV prevention services including PrEP and PEP, ART for HIV positive LGBTIQ+ persons, Hormonal therapy among others. Information on the use of female condoms and most of these services helps them to live a health life free from STD’s including HIV/AIDS”, Masereka said.
He added that his work of offering services to a vulnerable community is risky because some people believe he is promoting homosexuality. Many of the people he treats suffer from addiction or have mental health challenges that make providing care very difficult.
A trans woman from Kasese district who preferred being identified as Baseme, said most health workers in rural health facilities does not understand the unique SRH needs for LGBTIQ+ people and also have wrong perceptions about them.
These rural NGOs in Uganda that sacrifice to provide support to LGBTIQ+ people in remote areas amidst the homophobic situation that has been fueled by the homosexuality act 2023, need special attention.
“I explained to the health worker that I needed lubricants. She asked if I was a man or a woman because she could not tell by looking at me. Then she asked why I needed the lubricants. I demanded to know why she was interrogating me like this, in the end, I received the lubricants but only after the other nurses laughed at me”, says Baseme
She added that,“ visiting a health facility can put you at risk of being reported to the police. Most health workers in rural facilities do not understand the unique needs of Queer people. They think we are not humans. Yes, we have local people who help us access some of these services but that is mostly in the urban areas”.
Call to donors
Masereka from WEFORI said it is often difficult for grassroots rural organizations to compete for funding opportunities because most of them, especially in Uganda, operate in an informal setting that enable them manoeuvre in the homophobic environment. This makes it difficult for them to meet some funding eligibility criteria.
“There’s a need for affirmative action in supporting grassroots rural communities. Donors need to understand the environment we’re operating in”, Masereka said
“The situation in rural areas is worse than in urban areas. There’s a need for unrestricted funding opportunities for rural grassroots organizations to enable them to reach out and support these LGBTIQ+ persons”.
The key SRH needs include; condoms, lubricants, HIV services (including prevention and treatment such as screening and testing), PrEP and PEP. Most of existing services are inadequate and the current environment makes it complicated for some LGBTIQ+ people to get access to these medicines and commodities.
In August last year, the director of General health services at the Ministry of Health Dr.Henery Mwebesa, spoke to the Daily Monitor and reaffirmed that access to health services is a fundamental right guaranteed by the constitution of Uganda. Therefore, blocking anyone from receiving health services is against the supreme laws of the land.
“The ministry of health is mandated to provide preventive, promotive, curative and rehabilitative health services to all people in Uganda in their diversity without any form of discrimination,” Dr.Mwebesa said
However, the Kasese district Health Officer, Dr. Stephen Bagonza, said there has not been any reported incident of discrimination and stigmatization against LGBTIQ+ people at any health facility in the district and affirmed that they are willing to equally serve every person.
“I have not received any reported incidents of discrimination or stigmatization against gay people. These people access condoms, HIV supplies, testing kits, and other services. I think some of them just fear to seek services because they lack self-esteem”, he commented
Matyasi Bwambale, from Bundibugyo Hospital ART clinic which provides HIV/AIDs prevention, treatment, care and support services, said the clinic has offered services to all people irrespective of their gender identity and sexual orientation.
“We receive these people (LGBTIQ+) and offer them services, however, some of them are easily emotional when we try to ask for some information for record keeping. Someone thinks you’re trying to do an interrogation about his or her sexuality”, said Bwambale
Oscar Ayebale (not her real Name) , acknowledged receiving services from health facilities but said she was bullied by a health worker and other patients who were in the outpatient department at a certain undisclosed hospital.
“The health workers laughed at me. Even patients in the outpatient department ridiculed me because I identify as a woman. Health workers become homophobic once they realize that you do not fit their narrow standards”, Ayebale said
These rural NGOs in Uganda that sacrifice to provide support to LGBTIQ+ people in remote areas amidst the homophobic situation that has been fueled by the homosexuality act 2023, need special attention.
Funders need to get interest in finding them and offer them unrestricted support since most of them operate in hiding and cannot easily meet the eligibility criteria in competitive calls for proposals for funding.
Longino Mo is a freelance reporter and human rights activist in Uganda, affiliated to We for All Rwenzori-WEFORI , a rural grassroots community.
Comments (1)
Great advocacy In Solidarity 🌈