Abortion Laws and Blue Tape

By Catherine Labasi-Sammartino


During my last month interning at the Center for Health, Human Rights, and Development (CEHURD), I focused on access to safe abortions in Uganda. I am grateful for having been given opportunities to explore this topic in depth, as it was my biggest interest at the beginning of my internship. I engaged with Ugandan abortion laws in my work, including legal research, a community visit to the district of Mukono, and a staff presentation on the Harm Reduction Model as a legal defence for health care providers. Through these experiences I acquired an understanding of the current constitutional and legislative provisions framing access to safe abortions in Uganda as well as the associated social and cultural barriers.

Uganda addresses the issue of abortion under Article 22 of the Uganda Constitution 1995, which protects the right to life of all individuals. Article 22(2) provides that no person has the right to terminate the life of an unborn child except as may be authorized by law passed by Parliament. However, the duty to legislate and legitimize abortion under justifiable circumstances has yet to be fulfilled. Access to abortion is currently dictated by the Penal Code Act under Sections 141, 142, 143 and 212, which criminalizes abortion and penalizes any person, including mothers and health workers, who enables the termination of a pregnancy. Consequently, women risk undertaking clandestine and unsafe abortions without any professional health care out of fear of being prosecuted for murder.

On the other hand, the Uganda National Policy Guidelines and Service Standards for Sexual and Reproductive Health and Rights 2012 recognizes justifiable circumstances for the completion of safe abortions. It states that when a pregnancy threatens a woman’s life and requires the use of a safe abortion, it is admissible. Since the Penal Code Act has yet to be amended to decriminalize justified abortions, it remains inconsistent with the new policy and the intention set in the Constitution. This uncertainty in the law makes it so that women continue to die while conducting clandestine and unsafe abortions and that health workers risk being prosecuted when providing care. Hence, CEHURD advocates for Parliament to amend the Penal Code in order to align it with the Constitution by clearly stating the conditions under which women can legally obtain safe abortions services and under which health professionals can treat them without risking prosecution or stigmatization.

One of the most interesting discussions I participated in regarding access to safe abortions in Uganda was in the context of a Value Clarification and Attitude Transformation exercise (VCAT) led by CEHURD staff as part of a one day sensitization conference with police officers. The exercise was simple and yet effectively created a safe environment for each participant to discuss their perspectives on a variety of questions touching on abortion. Blue tape was placed on the floor to divide the conference room in two equal parts. As the participants all stood on one side of the room, CEHURD staff members explained that they would read a statement out loud and that each individual should move towards the blue line proportionally to their agreement with the statement. Those that fully identified themselves with the given statement were to cross the blue line. Statements included “I have kept someone’s abortion a secret” and “I believe that all women should have access to safe abortions.”

After everyone positioned themselves according to their feelings towards each statement, CEHURD staff gave an opportunity to individuals on both sides of the line to explain their position. Personal stories, political ideas, and religious references were shared and no judgmental or aggressive responses followed. It was a simple mediated conversation that left me surprisingly content and seemingly hopeful. This does not imply that all interventions were ones I agreed with. On the contrary, ideas I consider as distressing, such as that giving all women access to safe abortions would be dangerous because women would surely use this new right to threaten men, were many. I was satisfied by the exercise because of its effectiveness in creating a dialogue where I felt that both sides were actually listening to each other in a way that I had not witnessed in several years. Overall, Uganda’s alarming maternal mortality rate and CEHURD’s incoming cases on women maltreatment have left me impatient to see change in Uganda’s health and legal system. However, I have learned that processes that bring immediate and tangible change in both these systems are practically obsolete. Small and effective exercises that require only an open mind and blue tape, such as the VCATs organized by CEHURD, ought not to be overlooked in the process of changing social mindsets and reducing the maternal mortality rate in Uganda.

The Right to Health in Uganda

I have been in Uganda for a little over a month now and have already learned so much, both from my work as an intern at the Center for Health, Human Rights and Development (CEHURD) and from my daily life in Uganda. I have visited Ugandan courts, taken countless boda rides and visited the source of the Nile. My first challenges were mostly activities that usually seemed simple to me, such as getting to work. My colleague’s kindness and patience in showing me the way around allowed me to feel much more comfortable in Kampala and to focus on my work as a legal intern.

CEHURD was created to advance the right to health for vulnerable populations such as people living with HIV/AIDS, women, and children. It is divided in three complementary programs (1) the Research, Documentation and Advocacy (2) Community Empowerment and (3) Strategic Litigation. As a second year law student, I was assigned to the Strategic Litigation program. Their objective is to provide legal support to persons whose rights have been infringed upon in Uganda and to litigate issues with the potential to redress systematic problems in the country’s health system. I have supported their work by drafting legal opinions on incoming cases and federal bills, completing research papers, and putting together grant proposals. This experience has allowed me to witness the use of the law as not only a tool to solve a single fact pattern but as a tool with the potential to create population shifts and improve health conditions on a national scale.

Most of the cases move for the implementation of the right to health. However, the Constitution of Uganda lacks an express provision on the right to health, which makes the conceptualization of each case particularly demanding. The right is implied from other constitutional clauses, the national objectives and the directive principles of state policy, each with health-related facets such as the right to life, human dignity and women’s rights. Furthermore, the implicit nature of the right to health in Uganda makes it so that its realization largely depends on political goodwill, judicial interpretation and the treatment of the other rights from which it derives. This particular situation highlights the importance of advocacy and community engagement in the respect of human rights and the delivery of safe and acceptable health services. As much as one may put together a case supported by persuasive evidence demonstrating a human rights violation in the delivery or lack of health services, the societal attitudes towards specific issues and vulnerable populations are often the last and most difficult barriers to overcome in obtaining justice. For example, CEHURD & Kabale Benon v Attorney General is a recent case that demonstrates the prevailing stigma surrounding claims made by individuals who have suffered from periods of mental distress. In addition to silencing the plaintiff based on his identity as an individual with a mental health disorder, the court also disturbingly put all medical decisions above the scrutiny of the law. This message discourages Ugandans from taking initiatives towards ensuring the respect of their rights and towards keeping the government accountable in its actions. CEHURD has recently filed an appeal for this case.

Overall, I am very motivated by CEHURD’s work as they put forward that the right to health extends itself to the causal determinants of health such as adequate sanitation facilities, health infrastructure, trained workers and essential drugs. I hope to contribute to my team’s work as much as I can in the following weeks and am excited to learn more about the right to health in Uganda.

Catherine Labasi-Sammartino

CEHURD’s office in Nakwero, Kampala

View from the National Mosque

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