Uganda: GCWA calls for Justice in Scapegoating of Ugandan Medical Professionals Living with HIV
On 19 May 2014, a 64 year-old nurse, Rosemary Namubiru, was convicted of criminal negligence and sentenced to three years in prison. She was initially accused of attempted murder. Nurse Namiburu, who pleaded not guilty, was accused of giving a distraught two-year-old boy an injection after having accidentally pricked her finger, though the facts had not been established robustly. The Ugandan healthcare system handled the case appropriately, by immediately treating the boy with post-exposure prophylaxis. So far, no sero-conversion could be established. While the nurse was forced to disclose her HIV status, she was arrested and denied bail when the authorities learned that she was living with HIV, on the charge of being a danger to the public. Since the incident on 7 January 2014, to date, nurse Namubiru has been held in custody. The GCWA calls for social and legal justice for everybody, independent of their HIV status.
According to WHO, healthcare workers incur 2 million needle-stick injuries per year and 90% of these injuries occur in developing countries because of poor working conditions and control measures, putting both the practitioner and the patient at risk. Risks can be mitigated through the use of technologies designed to prevent needle-stick injury, and recommended by WHO as effective. Accountability in ensuring safe injections within healthcare facilities is shared between (1) the government, responsible for providing proper equipment and reasonable working conditions for practitioners; (2) the healthcare professionals themselves who must ensure sterility of tools and injection sites; and (3) patients and caregivers to be cooperative and facilitate the tasks of nurses and doctors.
In the early days of the HIV epidemic, Uganda was the very first country in Africa to break the silence on HIV and AIDS, under the leadership of the President Of Uganda, His Excellency Yoweri Kaguta Museveni. Together with the extraordinary community response, the country was a model of best public health practice, with efforts grounded in compassion, social justice, and access for all. Uganda continued showing its commitment to an effective HIV response, being one of the first resource-constrained countries to introduce antiretroviral treatment (ART), and more recently, making lifelong ART available to all pregnant and breastfeeding women; benefiting from global progress on AIDS treatment.
With an overall growing HIV epidemic, Uganda has understood the urgency of accelerating HIV prevention, and has proposed actions to curb the new HIV infections, including deliberate legal steps to criminalize HIV transmission. These appraches are evaluated by the international HIV and public health communities as least helpful, as experience have shown that criminalization fuels silence fuels HIV.
While intentional and malicious negligence deserves to be punished according to the national legal framework, a fair legal system equally has the duty to protect the rights of the person charged of such negligence and to establish the facts for not considering the case a medical misconduct, to be dealt with through the professional association. This would also require an assessment of the precautionary procedures in place, and the working conditions allowing medical staff to follow such procedures. Furthermore, a fair legal system should ensure that a “westernized” media hype is not instigated by unjustified legal claims and procedures, further damaging the reputation of the nurse.
Being a medical professional for 30 years, it is against the odds to believe that Nurse Namubiru would suddenly pursue intentially malicious outcomes of her service provision. Unambiguous facts on the event as well as the cicumstances and conditions are required to support this claim as being the truth. Moreover, even if this basis was estabished, one would have expected a more just and mature treatment of Nurse Namubiru, as she currently appears to be made an example, to put pressure on His Excellency the President to sign the 2014 HIV/AIDS Prevention and Control Act into law.
The Global Coalition on Women and AIDS calls on Nurse Namubiru to pursue a fair process and to appeal to the decision. The Global Coalition on Women and AIDS urges the legal system in Uganda to reconsider the decision, when the appeal is made. With no further justice put in place, the Global Coalition on Women and AIDS is gravely concerned that Nurse Namubiru will not receive the care that she needs in prison, and that her health will be affected. The GCWA therefore calls on its members and partners to assist Nurse Namubiru in receiving the best possible legal assistance, should she choose to appeal her sentence.
The Global Coalition on Women and AIDS will support the leadership of the International Community of Women living with HIV, at national, regional and global level, in designing social campaigns to support Nurse Namubiru throughout. The Global Coalition on Women and AIDS will continue to call for social and legal justice, irrespective of one’s HIV status.