Access to Justice and Health Services for Women in Rural Uganda

by Jillian Ohayon

I came to Uganda this summer to work as an intern for the Center for Health, Human Rights, and Development in the city of Kampala. I want to use this post to focus mostly on one aspect if the work that I have done here, and will likely use the next to write more generally about life in Kampala (which, spoiler alert, has been pretty amazing and an incredible experience of self-growth).

The Center for Health, Human Rights, and Development is an organization comprising about thirty employees. Most of them are lawyers, although vital members of the organization also include administrators, research officers, communications officers, and accountants. CEHURD has three programs which generally function separately from one another, though they are intentionally and intrinsically interlinked. They are Community Empowerment; Research, Documentation, & Advocacy; and Strategic Litigation. In Ugandan NGO terms, I have come to understand that CEHURD is a rather well-known name, despite it being a young organization of only about seven years.

I began my time at CEHURD by attending a court session regarding Ugandan tobacco laws with the Strategic Litigation team, but was soon after incorporated into a project with the Community Empowerment program. This will be a two-year long project supported by The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). CEHURD’s project is under a PEPFAR partnership with the DREAMS project, which stands for “Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe Women.” The DREAMS goal is to create country-owned and country-driven sustainable programs to address the prevalence of HIV/AIDS among adolescent girls and young women in sub-Saharan Africa. The vision is to combine evidence-based approaches with regards to the structural drivers that directly affect adolescent girls and young women in their risk of contracting HIV. This is where CEHURD comes in. CEHURD’s fieldwork on the DREAMS project involves going into villages to interview adolescent girls and young women as well as a variety of stakeholders. The work is focused predominantly on access to HIV services and the legal and societal context surrounding sexual assault. Due to the societal framework and corresponding views prevalent in rural Uganda, young women who are village dwellers are heavily susceptible to sexual assault. This, in turn, drastically heightens their risk of contracting HIV.

My work on this project began in the Kampala office, where I wrote a literature review for the Community Empowerment team. I researched past work that had been done on this topic, and noted the successes, failures, and recommendations that came out of those studies. This helped to shape and inform the fieldwork. I was also involved in editing and writing many of the research tools for the interviews we conducted in the field. Once the surveys were completed and the stakeholders had been mobilized, I joined the team to spend a week in the district of Gomba, about three and a half hours outside of Kampala. We visited three villages where we interviewed adolescent girls and young women, as well as various stakeholders, including police officers, parole officers, healthcare providers, NGO officers, and various members of local government. I had the opportunity to engage both with the stakeholders and women alike.

Village of Kanoni, District of Gomba

sitions in local government. In relative terms, these interviews were relatively encouraging experiences. Most spoke English very well, and they were all quite highly educated. They were also all quite familiar with the prevalence of HIV among adolescent girls and young women in their district, and seemed to have been very aware the structural drivers that perpetuate the problem. They shared with me their plans and programs that are being developed to address the problem, and all of them seemed serious and committed to the work. I am confident that CEHURD will be able to work with them toward the implementation of programs that will improve upon this situation in a significant way.

Health Facility Assessment

On my last day, I conducted a facility assessment, which took the form of an interview with the in-charge at a health facility in the village of Mamba. Luckily, I had been given a detailed assessment tool, because if I had been told to assess this facility according to my own standards, I’m not sure how I would have proceeded. The health facility does not have a doctor. From what I understood, the in-charge is trained in nursing, and, occasionally, they have a midwife come by. The facility has no electricity, no bathrooms, no running water, and had run out of stock on about half of its medication. Unfortunately, CEHURD’s area of expertise does not lie directly in facility improvement. From what I understand, it is the government that is responsible for that.

Interviews with Adolescent Girls and Young Women

In total, I surveyed 17 girls. 15 of them were transactional sex workers, all of whom were in relationships, some of whom were married, and all of whom had been tested and were HIV negative. I asked them questions about their experiences with gender-based violence, ranging from verbal abuse to being violently forced into sex using a weapon. Only one of the 17 told me she had never experienced any abuse, and the translator seemed to think that she wasn’t telling the truth. One of the girls, after I asked her whether her husband insults her and humiliates her in public, looked deeply confused, and then replied, “Of course.” Others laughed when I asked whether or not their partners had ever slammed them against the wall as if to say, “What kind of a question is that? Doesn’t that happen to everyone?”
To say the least, it was a lot to process.

One main issue that revealed itself from the interview responses we received is the lack of access to justice and the necessary HIV services in cases of sexual assault. The problems that amount to this issue are extensive and interlinked. Girls are very often married off at a young age in order to bring money to their families. If a girl has been sexually assaulted, she may be considered impure and possibly not suitable for marriage. Therein lies the first problem. Next, there is a 72-hour window in which a person can visit a clinic after sex in order to get the medication that would prevent HIV had they contracted it. However, since many girls are too afraid to tell anybody when they have been assaulted, and are also unaware of the 72-hour window, many do not receive the proper preventative care. Furthermore, most of the women with whom I spoke told me that they were too afraid to tell police officers about their experiences with sexual assault. They fear not being believed, being stigmatized, and having to face the anger of their perpetrator and/or their families. Furthermore, often, private negotiations will take place between the victim’s family and the perpetrator, and so the perpetrator is rarely formally punished. Beyond this, even if a victim does go through with the process of successfully filing a police report, there are two related access to justice problems that lie beyond that. The first is that the only court that hears those cases is quite a significant distance away from the village, and transport is both inconvenient and costly. The second is that the law states that the health worker who examines the victim after the assault took place must testify at the hearing. However, there exists no means of compensation for the worker’s time or transportation. Therefore, the large majority of the time, the health worker simply does not show up. When this happens, the case is thrown out.

***

On a more personal note, I have to say that as emotionally challenging as it was, speaking with these girls and women was a humbling privilege. Despite the hardships they shared with me, I sensed nothing but kindness and positivity radiating from them.


I sincerely hope that the empowerment programs that CEHURD implements will effect real change in the lives of these girls and women. Given the passion, focus, and dedication of the Community Empowerment team, I have faith that they just might.

Sunset over Lake Walamo in the village of Mamba

Kenyan Courthouses: Handwriting, Missing Witnesses and Wrong Numbers

2014-ODell-AnnieAnnie O’Dell

This is my fourth week in Kenya for my internship with the Equality Effect. I am working in Meru, with a student from the University of Toronto. We have been placed with a partner organization, who does almost everything. It has an orphanage, a health clinic, it provides micro-loans, there’s a school, and most importantly, a rescue centre. The rescue centre currently houses about 25 children, most of whom have been defiled (sexual assault of a minor). They offer them counselling, legal support, medical support, and aid during the transition into motherhood for the girls who become pregnant. Only those girls who either have nowhere to go or are in danger within the community are admitted, others are treated at home.

 Our job is to comb through the files since the 160 Girls decision was made last year to document how police treatment has changed, if at all. The decision clearly stated that the police must diligently fulfil their obligations to all children who bring a complaint of defilement to them. The belief is that, as Meru was ground zero for 160 Girls, the police here are the most likely to be compliant (the decision was binding across the country).

The most interesting part of our job is going to court. We’ve so far seen been to two trials… sort of. The Kenyan legal system is slow and delays happen regularly, mostly for reasons that would not fly in Canada.

Our first court date was at the courthouse in the city. Most of the Courthouse is outdoors, while the courtrooms are indoors. We checked a typed list posted on a notice board to see in what order our case would come. It was supposed to be a mention for an elderly man who had allegedly defiled a girl of 14. (I’m still not entirely certain what a mention is, but in this case, it meant the accused had a chance to accept or deny the evidence placed against him). We waited outdoors, on three long benches under a corrugated roof, for the accused’s name to be called. We sat at one end of the bench with the social worker and the mother of the victim. At the other end of the bench, probably no more than 20 metres away, awaited the accused who was out on bail. While I am not so familiar with Canadian courthouses, I was upset by the casual nearness the accused and the victim were expected to endure. Particularly in such a sensitive case.

Eventually, the accused’s name was called and we followed him into a magistrate’s chambers. The Courts are undergoing a transition, and the magistrates are currently hearing cases in their chambers. The room was barely big enough for the magistrate’s large desk, a desk for a bailiff/secretary, a bench crowded with the accused and his lawyer, and us four standing partially out in the hallway. Kenyans are very soft-spoken people, so I unfortunately did not hear anything. But we were in out and out of that room within a few minutes.

Apparently, a new magistrate was assigned to the case. When this happens, the accused is asked if he wished to re-start the trial or continue. I am unsure what the accused chose, but I believe he did choose to continue. The mention never came though, because the case notes were not typed. The magistrate then adjourned for another month or so, even though the case has been on-going for over a year already. This sort of delay is a frequent occurrence.

Another, even more frequent type of delay, is the absence of witnesses at trial. The second day we spent at a different courthouse. Once again, we checked for our accused’s name on a bulletin board and saw that it would take place in Courtroom 1. We waited for the courtroom to open (about an hour later than it was supposed to) and entered. We, and many others, squeezed into a tiny courtroom on three very uncomfortable wooden benches. A female magistrate eventually walked in. They called one accused at a time to begin their mention or hearing. While it took place in Kiswahili, it was easy to understand that many witnesses and some accused were missing. It was finally our accused’s turn. He was accused of defiling his tutee, his defence was that he thought she was over 18. He stood up. Some questions were asked in Kiswahili. One name was called. Silence. Another name called. More silence. Neither the doctor nor the police appeared to testify. Case adjourned for another month.

We then headed to the police station to enquire why the officer never showed up. We waited on the compound for over an hour to get an answer. The officer was back in the city (about 90 minutes away). But the officer who was helping us went above and beyond. He dug through handwritten files to discover we had with us the wrong court file number. He found us the right one (one digit off). That case has been closed for several months. The accused had been sentenced to 15 years imprisonment! Great news! Though we still have no idea whose trial we witnessed…

Injustice in the Malawian justice system and the objectification of victims

2013 Silvia Neagu 100x150By Silvia Neagu

While I’ve spent a substantial portion of my time so far doing legal research at the university, I also attended court to watch the proceedings of defilement cases. The difference between the Canadian justice system and the Malawian system was shocking at first.

Firstly, the magistrate met with us in his chambers before the hearing, discussed the case openly and made no effort to at least appear impartial. He commented that “you can tell a guilty conscience” because the defendant was not asking a lot of questions. During the proceedings, you could hear the magistrate’s phone vibrating and he also once interrupted a sentencing (before revealing the sentence) to have a  5-minute phone conversation. During the same sentencing, the magistrate wanted to make a point of how lenient he was being, so he passed around bits of paper to everyone in the room and asked us to write down what we thought the sentence should be. Although Alison and I tried to say everything to get out of it, he insisted we take part in the exercise and assured us this would not change the sentence.

The most shocking fact was that the accused was unrepresented and was expected to lead his own defence, despite a lack of basic education. The defendant’s questions to the prosecution’s witness were completely off-target and made the whole process feel like watching a train wreck in slow motion. Because the accused leads his own defence, this also means that he or she is expected to cross-examine the victim when he/she testifies, which is understandably hugely traumatizing for victims. However, in this particular case, the three-year old victim had testified at an earlier date and the accused had not asked any questions. The defendant’s complete lack of understanding of the justice system also meant that the magistrate further compromised his appearance of impartiality. At one point the magistrate was suggesting possible issues that the defendant could raise.

The court room at the Magistrate Court in Zomba, Malawi.

The court room at the Magistrate Court in Zomba, Malawi.

Our meeting with the magistrate and some police prosecutors was also revealing of some of the subversive attitudes towards sexual assault victims and women in general. When discussing the issue of consent, the magistrate explained that they would expect a woman to show evidence of her lack of consent, depending on the relative sizes of the accused and the victim. To illustrate this point, the magistrate then began suggesting that I, for example, would not necessarily be able to accuse one of the thinner police officers in the room of assault. When I looked incredulously at him, he then took the female prosecutor in the room as an example and someone joked about her “huge” size. The magistrate and some of the prosecutors’ attitudes toward victims of defilement also varied with the victim’s age: the older the victim, the less sympathetic they appeared to be.

When discussing the case that day, everyone repeatedly praised how clever the 3-year old victim was and what a shame it was that we had not been present during her testimony. The magistrate and police repeatedly offered to have us meet the girl, which we declined, explaining that we did not wish to trouble her further, even more so because she did not speak English. Despite our refusal, the next time Alison and I were in court, they brought the victim to meet us. It was very awkward and extremely uncomfortable to watch the magistrate question the victim for our benefit – and it was frustrating to realize that there was nothing we could do to stop it. The child was confused as to why two “azungus” (term for white people/foreigners) were there and apparently thought we were adopting her.  When we told this story to our director, Fiona Sampson, she commented that this was an “objectification of the victim”, which is a fitting description.

Another issue that was troubling us was the influence of our physical presence in the court room. When we tried to sit at the back of the court, the magistrate immediately motioned for us to come to the front. In fact, when the magistrate was reading out his judgement at the end of the trial, his judgment included a reference to “our guests from abroad.”

On another occasion, we had informed the prosecutor the particular day that we would be attending court. When we arrived, a clerk told us that the cases were cancelled that day because the President was in Zomba and all the police officers and vehicles were therefore busy. As we walked back to our hostel, we ran into the police prosecutors on the road, who were bringing the accused to the court house specifically because they knew we would be there that day. So Alison and I walked with three accused, two police officers (and the dog from our hostel that was following us around) back to the court house. We were quite the sight !

Blog authors are solely responsible for the content of the blogs listed in the directory. Neither the content of these blogs, nor the links to other web sites, are screened, approved, reviewed or endorsed by McGill University. The text and other material on these blogs are the opinion of the specific author and are not statements of advice, opinion, or information of McGill.