Experts task government to prioritize reproductive health needs for teenage girls

On the International Day of the Girl Child, a network of Ugandan society groups, health workers, young people, and other concerned citizens harshly criticized a decision by Ministry of Health executive leadership to halt the release of the Sexual and Reproductive Health and Rights Guidelines and Service Standards.

Last month, the state minister for primary health Joyce Moriku at the closing ceremony of family planning conference declined to launch the national guidelines and service standards for sexual and reproductive health and rights noting that stakeholders had been involved in the compilation of the guidelines.

Now the civil society have tasked the ministry to release the guidelines in a bid to reduce the teenage pregnancies.

According to the 2016 Uganda Demographic Health Survey 25% of adolescent girls and young women aged 15-19 in Uganda is pregnant or a mother, one of the highest teenage pregnancy rates in sub-Saharan Africa. Shockingly, this statistic has remained unchanged since 2006, despite massive funding by donor governments in reproductive health services.

Denis JJuuko the program officer for CEHURD,  notes that there is a big In Uganda, teenage pregnancy has drastic and far-reaching health, development, and economic affects at the individual, family, community and national levels. These include preventable death in childbirth, high risk of unsafe abortion, lack of access to education, poverty, lost economic growth, and more. Despite the catastrophic consequences of teen pregnancy, Ministry of Health has not only failed to invest in interventions that work, but also is fixated on thwarting actions that drive life saving services even further out of the hands of young women.

“Upon rejecting the guidelines, which are designed to focus attention on the services delivery needs of young women and girls agenda 15-19, Ministry of Health officials made inaccurate claims, for example that they “had not been consulted” and that the Guidelines intended to distribute contraceptives to 10 year olds.” said Patrick Mwesigye, the team leader for Uganda outh and Adolescent Health Forum

Experts pointed out that sexual activity among Ugandan teenage girls is an issue that the Ministry of Health has refused to address with evidence-based responses.

“Instead of ensuring a robust policy environment based on human rights and community needs, there is a policy desert. This must stop. We have to address the reality Ugandan girls are facing. These actions are making life for Ugandans more dangerous, by tying the hands of our policy makers and health workers. We need access to services based on science and evidence, and that includes sexual and reproductive health services such as Pre Exposure Prophylaxis for HIV prevention, contraception, and more for young people who are sexually active,” Jjuuko noted

Uganda’s rate of maternal mortality and morbidity due to unsafe abortion is higher than the regional average, and teenagers are at particularly high risk of complications from unsafe abortion—due to stigma, fear, isolation and criminalization.

This abrupt reversal is not the first of its type—Coalition members pointed to the ban on Comprehensive Sexuality Education announced in 2016, as well as the withdraw in 2015 of the Standards and Guidelines on Prevention of Maternal Mortality Due to Unsafe Abortion as part of an alarming trend in top Ministry of Health management sabotaging evidence based policies and approaches to prevent unnecessary suffering and death. Infighting and attacks among Executive Management has also created distraction from core work and demoralization among staff.

 

Advertisements

Empowering Girls in Emergencies is Crucial to their Survival- Save the Children

Press Release

On October 11, we celebrate girls, a source of joy, energy and inspiration. Every one of us can point to a girl that has made a remarkable difference in our lives. They are our daughters, grand-daughters, sisters, cousins and friends.

As we commemorate the day of the girl child, we are reminded of the millions of girls caught up in crises all over the world. The theme this year, ‘EmPOWER girls: Before, during and after crises’ is cognisant of the need to ensure that girls are able to survive in a rapidly changing world that grapples with conflict, climate change, violent extremism and forced displacement.

In Uganda, we continue to host over one million refugees from neighbouring countries such as South Sudan and the Democratic Republic of Congo. Women and children are the majority of those affected by this displacement. We are seeing young girls separated from their parents, having limited access to education and having to take care of younger siblings at a time when they can barely take care of themselves.

The United Nations Girls Education Initiative highlights that women and girls are uniquely and disproportionately affected by conflict. Insecurity, displacement and breakdown of social support systems coupled with limited access to financial resources, social capital and legal support leave girls at risk of discrimination and exploitation on many fronts.

Research has shown that girls are almost two and a half times more likely to be out of primary school if they live in conflict-affected countries, and nearly 90 percent more likely to be out of secondary school than their counterparts in countries not affected by conflict. In Northern Uganda, data indicates that violent conflict has had little effect on the education of boys from the wealthiest one-fifth of households. However, the poorest girls from the same area are twice as likely to face risk of extreme education poverty.

We must work together to ensure that girls are protected before, during and after crises. We need to strengthen our engagement with local authorities and communities to ensure that social support systems necessary to ensure that girls are safe and protected continue to function even when communities experience political, economic and social shocks as is common during emergencies. We need to ensure that there are strong policies on protection of women and girls in conflict and that these are implemented effectively.

Through our work in Northern Uganda, responding to the needs of the displaced we have found that protection, education and access to basic services continue to be among the greatest needs for girls in the refugee settlements. We are also helping children recover from emotional and psychological trauma caused by conflict and hunger, which has left them scarred by the past, wondering about today and hoping for a better future.

We continue to work with the government and partners to help children recover and survive. Save the Children is running an Accelerated Learning Programme that follows an approved fast-tracked curriculum to assist conflict and poverty affected children with opportunities to join, re-join and complete their formal education or access relevant vocational skills and livelihood trainings. A good number of girl mothers have enrolled too, and some come to class with their babies. They have a thirst to learn, because they know what education can accomplish for them as individuals, their children and their future.

 

Despite these great efforts, dropout rates among girls remain high, especially in the higher levels, further underpinning the challenges that girls face when attending school.  These include early marriage, household chores, responsibility over siblings, poor menstrual management and for many, the need to sacrifice their own education so that their younger brothers and sisters can go to school. No single girl should have to make this sacrifice – every child, girl or boy, has a right to an education and should enjoy this right.

We need to invest in education systems as a sustainable means to ensure access for all girls and boys and improve its quality. This should include system strengthening, school building, and training and remuneration for teachers. We also need to scale up funding and support for quality complementary and catch-up programmes to provide educational opportunities to children for whom the formal system is inaccessible.

To get all children back into school, particularly girls, we ask the international community to increase funding to help refugee host countries like Uganda provide children with a quality education. Currently refugee education gets only a fraction of the funding it needs. We also call on the Ugandan Government to develop and implement policies that ensure refugee children can attend school and learn from a quality education.

At Save the Children, we are committed to doing whatever it takes to ensure that all children learn, survive and are protected by 2030. We continue to work towards achieving significant breakthroughs in the way the world treats children and girls are no exception. We believe that working together with children and their communities, partners, donors and government can result in real transformation.

Nelson Mandela said that there can be no keener revelation of a society’s soul than the way in which it treats its children. We owe it to our girls to ensure that they have equal access to opportunities, are protected from harm and have hope for the future. Indeed, they are our future.

Brechtje van Lith

Country Director

Save the Children

 

Eye patients appeal to government to train more specialists

By Beatrice Nyangoma

 

On  27th June,2017, Gilbert Onegi 43 a resident of Oduk village, Abira West Parish in Zombo district trekked a distance of over 50 kilometers to Nebbi hospital to have his 3 year old Jonathan Rwot Omiyo treated of an eye complication.

Onegi’s travel to Nebbi hospital followed radio announcements that the hospital would be hosting a medical camp where several eye specialists would provide eye screening and treatment services at no cost.

To Onegi, this was a life time opportunity to have his son who had suffered for three years of an eye complication treated and have a new life free of pain.  Onegi ensured that he was at the hospital by 8am so that he is among the first people to be attended to. However, by the time he arrived, he found over 50 other patients lined up for the same service.

Because of the severity of the condition of Rwot’s eye, the doctors made Onegi jump the line and he was seen among the first patients.

Rwot’s left eye is protruded from the ball, red in color and it is teary. His father says that the eye started swelling when he was four months. He says that efforts to get treatment from different medical facilities were futile as all the medicines prescribed were not helpful while the swelling continued.

“This boy has been staying with his mother who left me for another man. For almost a year, I have been sending some money to her mother for treatment but things never changed. But at the start of this year, I decided to pick him and I have since been looking after him. But he cries every night because of pain. When I heard about this camp I borrowed money to bring him.’ he said

But according to Dr. Ben Watmon an eye specialist from Gulu Referral hospital said  the boy’s eye condition is one known as Retinoblastoma cancer which is in its advanced stages and may be difficult to reverse. He said that from the clinical observations, the tumor is already grown and is visible.

“This type of eye infection starts in babies as early as one month. During the night, the eyes close as that of a cat. This eye is now a burden to the child and therefore we have to remove it to reduce the pain but also prevent the suspected cancer cells from spreading into the body and then he will start on chemotherapy.

Ideally, chemotherapy should have been the first thing to do then the eye is removed but since it’s too late we shall remove the eye and then refer him to  Ruharo hospital in Mbarara district which is the only facility in Uganda that gives chemotherapy services. This boy could have maintained the eye but because we have few eye specialists in the region, he could not get early screening.’ He said

Uganda is a signatory to the World Health Organization strategy for elimination of avoidable blindness by the year 2020. Figures from the Health Management Information System indicate that eye diseases are among the top ten causes of morbidity in Uganda. It is estimated that between 300,000 to 350,000 people in Uganda are blind and over 1.2 million have visual impairment.

However, despite the commitment, Uganda is faced with acute shortage of ophthalmologists (eye specialists). According to a 2012 report by Sightsavers International, a charity organization dealing in eye related illness in Uganda, there are only 41 eye specialists, of which 26 of them are in Kampala while only 15 are shared by the rest of the country.

Dr. Charles Keneddy Kissa the Nebbi Hospital Medical Superintendent says that the hospital has a fully equipped eye clinic but it is non- operational because it lacks a specialist. He says that  patients with eye related complication are referred to Arua Regional Referral hospital which is over 70 kilometers away. He however adds that the hospital operates an outpatient eye  clinic that manages minor eye diseases such as allergies.

The burden of eye diseases at Nebbi hospital

 

Dr. Kissa says that the hospital registers a big number of people with eye problems. He say in the financial year 2015/2016, the hospital recorded 1,180 eye patients out of the total 49,809 patients which is about 2.3 percent.

“This is a big number of people most of whom end up losing sight which could be reversed if we had an eye specialist. We now depend on well -wishers who offer to treat our patients through medical camps.” he says

During such camps like the one that started on 26th June Monday and ended on Friday 30th July, very many people turn up because there is a service delivery gap.

The camp was organized by Ministry of Health with support from Amref Health Africa, attracted a total of 106 patients of which 42 underwent corrective surgery. “We had planned for round 80 patients from Nebbi district. However, we got more patients coming from as far as Zombo, Pakwatch, Arua while others come from as far as Democratic Republic of Congo.” He said

He adds that due to logistical challenges, many of the patients go unattended to nd instead priority is given to those who have higher chances of recovery.

Information obtained from the Health Management Information System indicates that between 300, 000 to 350, 000 people in Uganda are blind and over 1.2 million others have visual impairment.

Dr. Wotmon noted that of these, 170, 000 are blind due to cataract and that the number increases annually by 20% representing 34, 000 new cases every year.

Cataract is the clouding of the eyes. The clouds change the lens of the eyes leading to sight loss or reduction. Cataracts are common among the elderly but children and other age groups can also succumb to this condition. Patients suffering from cataracts can regain their vision only if they undergo a minor surgery. However, Watmon notes that many of the patients resort to using traditional herbs instead of seeking medical attention.

In order to deal with this, Dr. Wotmon said, the country needs to carry out at least 34, 000 cataract operations annually. But he said that unfortunately government is currently able to conduct only 10, 000 cataract operations annually, leaving the lives of the eye patients at big risk.

However some of the causes are preventable. The preventable causes of blindness and visual impairment include cataracts, trachoma, Onchocerciasis (River Blindness), vitamin A deficiency, measles, and injuries on the eyes, bacteria, viruses and fungus among others.

Dr. Kissa however appeals to the government to train more eye specialists such that the hospital can attend to patient on a daily basis.

“Whereas the medical camps are very important in service delivery to eye patients, they are not sustainable and they are expensive. For example the hospital has to feed the specialists that come to treat during the camp period and also provide some of the consumables. By the time the camp ends, we find the medical supplies are out of stock.” he said

He also adds that in cases where partners support medical camps, the health ministry should also support more by providing consumables that are very expensive such as the artificial lenses that cost round 1,000 dollars each which is about Shs.3, 500,000.

The Ministry of Health notes that vision impairment is the leading cause of disability. Worldwide about 45 million people are blind while 135 million others have visual impairment.

beatricenyangoma@gmail.com