ISINGIRO – Annet (not real name), a young woman from Isingiro, Uganda, found herself in a precarious situation last December. Despite being unprepared for motherhood, she became pregnant. Feeling uncertain and scared, she hid the news from her partner and turned to abortion tablets recommended by a friend.
“A friend recommended abortion tablets, which I used. I bled that night and assumed the pregnancy had terminated.”
Determined to prevent future unwanted pregnancies, Annet got a three-month family planning injection. Unfortunately, her struggles didn’t end there. She began experiencing severe stomach complications and later discovered she was still pregnant. With the help of a friend, Annet obtained additional abortion tablets, but they only led to more health issues.
Annet revealed that she is now struggling to conceive, and fears those experiences may have affected her fertility.
“A medical professional suggested the previous family planning injection might still be active, but I’m skeptical since it was only meant for three months.”
Not alone. Brenda (not realname), another young woman, faced a similar ordeal. After becoming pregnant by a boyfriend who refused to take responsibility, Brenda turned to traditional herbs and abortion tablets. However, these methods failed, leading to severe complications and a hospital visit. Despite receiving post-abortion care, Brenda became pregnant again and resorted to unsafe abortion methods due to lack of access to affordable services.
“The medical team informed me that the abortion was incomplete and provided post-abortion care. Tragically, I became pregnant again and, desperate and uninformed, I used herbs to abort for the second time. Now, I’m experiencing persistent stomach pains, but I lack the funds to go to the hospital for screening and proper care. My experiences have left me scarred, physically and emotionally.”
Annet and Brenda’s experiences underscore the urgent need for safe and accessible abortion services in Uganda. The country’s abortion rate is higher than the East African average, with 34 abortions per 1,000 women between 2010 and 2014. This is largely due to restrictive abortion laws and limited access to post-abortion care.
Uganda’s abortion laws are complex and scattered across various legal and policy instruments. The Constitution is the supreme law, but it doesn’t explicitly address abortion. However, the common law health exception allows for abortions in cases where the mother’s health is at risk. Despite this, the law remains ambiguous, leading to inconsistent application and limited access to safe abortion services.
The consequences of these restrictive laws are devastating. Uganda’s maternal mortality rate is alarming, with abortion-related complications being a significant contributor. In 2016, the maternal mortality ratio was 336 deaths per 100,000 live births. This is partly due to the lack of access to safe abortion services, forcing women to resort to unsafe methods.
The stories of Annet and Brenda underscore the importance of initiatives like the health and legal camp organized by the Interim Advisory Committee on Abortion Movement in East Africa. The Committee comprises of; Alliance for Women Advocating for Change – AWAC Uganda, Human Rights Awareness and Promotion Forum – HRAPF, and Dynamic Doctors. This groundbreaking camp, held in Kikagate Border, Isingiro District, aimed to provide comprehensive healthcare services to marginalized women and educate them on their fundamental health rights.
Led by Dr. Muhoozi Kabagambe Oscar of Dynamic Doctors, the camp addressed pressing health issues such as sexually transmitted infections, surgical cancer, HIV, malaria, and ulcers. By bridging the gap between local health workers and marginalized women, the camp empowered women to take control of their health and well-being.
He noted that the primary objective of the camp was to provide comprehensive healthcare services to marginalized groups, particularly women, and educate them on their fundamental health rights and gender-based issues. By engaging with local women and leaders, the team gained valuable insights into the community’s specific health challenges.
“Unfortunately, many are unaware of the available services or struggle to access them due to lack of information or resources.”
To address these challenges, the camp brought together local health workers and marginalized women, fostering a sense of familiarity and trust. This connection aims to facilitate easier access to healthcare services in the future.
“By bridging this gap, we empower these women to take control of their health and well-being,” Dr. Muhoozi emphasized. “Our approach ensures that they receive personalized care from health workers they know and trust.”
He exlained that Uganda’s healthcare system faces significant challenges, including an alarmingly high patient-doctor ratio. The World Health Organization recommends a ratio of one doctor to 1,000 patients, but in Uganda, it’s approximately one doctor to 11,000 patients.
“This staggering disparity underscores the need for innovative solutions like our medical and legal camp,” Dr. Muhoozi noted. “We’re committed to addressing the unique health needs of marginalized communities and promoting health equity in Uganda.”
Natukunda Jennifer from Alliance for Women Advocating for Change (AWAC) emphasized the need to bridge the gap in access to Sexual and Reproductive Health Rights (SRHR) services for marginalized women.
“We’re committed to raising awareness and improving access to contraception, reducing unwanted pregnancies and unsafe abortions, and promoting stigma-free health services.”
The camp targeted over 200 marginalized women, providing them with:
- Comprehensive health screenings
- HIV testing and counseling
- STI treatment and prevention
- Cancer screening and education
- Malaria prevention and treatment
- Ulcer management
- Family planning services
- Legal guidance on health rights and gender-based issues
Although Uganda has made significant progress in combating HIV/AIDS, there’s still work to be done. As of 2022, the country saw 52,000 new HIV infections and 17,000 deaths related to the disease. This represents a 40% decline in new infections since 2010, which is a step in the right direction.
Interestingly, HIV prevalence varies across regions in Uganda. The South Western region has the highest prevalence, at 82.8%, while the Mid Eastern region has the lowest, at 60.3%.
One area where Uganda has made notable progress is in reducing mother-to-child transmission of HIV. Between 2010 and 2020, this type of transmission decreased by 77%, from 23,000 to 5,300 cases.
As of 2023, 90% of people living with HIV in Uganda know their status, 94% of those are on antiretroviral therapy (ART), and 94% of those on ART are virally suppressed.
To end AIDS as a public health threat by 2030, the global target is to reduce new HIV infections and deaths by 90% compared to 2010 levels.
Through this initiative, AWAC, Dynamic Doctors and other partners demonstrated their dedication to improving healthcare outcomes for vulnerable populations and promoting health equity in Uganda.
To address these challenges, organizations are working to improve access to family planning services, reduce unwanted pregnancies and unsafe abortions, promote stigma-free health services, and empower marginalized women to seek health services without fear of judgment.
Uganda needs a multifaceted approach to address the complex issues surrounding abortion, reproductive health, and maternal mortality. This includes advocating for policy changes, increasing access to safe abortion services, and promoting education and awareness about reproductive health rights.
By supporting marginalized women, organizations like Dynamic Doctors and AWAC are working towards a future where every individual can exercise their right to quality healthcare, dignity, and well-being.
