Civil society petitions Kadaga over low budgets for palliative care

By Deo Wasswa

Eight leading civil society organizations working on Palliative Care, Health Rights and Budget Advocacy petitioned the Deputy Speaker of Parliament of Uganda on the low budgetary allocation for palliative care services in Uganda.

The organizations led by the Palliative Care Association of Uganda (PCAU) presented a joint statement at the Chambers of the Deputy Speaker.

While presenting the petition, Rose Kiwanuka the Country Director of PCAU who led the delegation said that Palliative Care is recognized as an essential service by the government of Uganda. She added that Palliative care is a component of the definition of Universal Health Coverage (UHC), which has a central place in achieving the Sustainable Development Goals (SDGs) by 2030.

Ms Kiwanuka noted that the World Health Organization (WHO) had defined Palliative as an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and thorough assessment and treatment of pain and other problems, physical, psychosocial and spiritual. She noted that this unique service provides relief from pain and other distressing symptoms among patients but also affirms life and regards dying as a normal process.

On who needs palliative care, Ms. Kiwanuka mentioned that the World Health Organization had identified the diseases that require palliative care for adults and children to include; cancer, cardiovascular/heart, HIV/AIDS and liver, and kidney diseases, among others. The majority of adults in need of palliative care have chronic diseases such as cardiovascular diseases (38.5%), cancer (34%), chronic respiratory diseases (10.3%), AIDS (5.7%) and diabetes (4.6%).

Ms. Kiwanuka pointed out that the provision of palliative care in Uganda began in with the establishment of Hospice Africa Uganda (HAU) in 1993 and that Uganda was viewed by the world as one of the countries with the best models of palliative care provision in Africa. Ms Kiwanuka thanked the government of Uganda for integrating Palliative Care in Uganda’s Health Sector Strategic Plans since 2004. She also thanked the Ministry of Health for establishing a Public Private Partnership (PPP) with Hospice Africa for the production of oral liquid morphine which is available for patients in need free of charge. Uganda was the first country in the world to allow specially trained nurses to prescribe morphine for pain control.

On access to Palliative Care Services, Ms. Kiwanuka noted that currently, only 11% of those who need pain control and palliative care access it in Uganda. She said that the country’s Health Sector Development Plan 2015/16 – 2019/20, showed that palliative care services were being offered in only 4.8% of the public hospitals in the country. She added that the 2017 Annual Report of the Uganda Human Rights Commission pointed out various gaps in the provision of palliative care services which included the following:

Uganda lacked a standalone palliative care policy to guide the implementation of palliative care services.

The public health structure emphasizes institutionalized care as opposed to home care which is the most suitable model for palliative care provision in countries like Uganda.

There was inadequate training of palliative care providers which was coupled with the fact that the public civil service structure did not recognize the few qualified health workers in the field of palliative care.

One of the petitioners Dr. Emmanuel Luyirika the Executive Director of The Palliative Care Association (APCA) informed the Deputy Speaker that whereas Uganda was the first country to start Palliative Care in Eastern Africa, the neighboring countries are making great strides. He mentioned that Rwanda and Tanzania passed their National Palliative Care Policies. He reminded the speaker that Uganda is a party to key international legal frameworks which called for superior investment in Palliative Care. He mentioned the frameworks to include:

The 2014 World Health Assembly Resolution on strengthening palliative care as a component of comprehensive care throughout the life course.

The 2017 World Health Assembly Resolution on cancer which commits Governments to provide pain relief and palliative care to their citizens.

The African Union (AU) Common Position on Controlled Substances and Access to Pain Medications which speaks to the availability of narcotic drugs and psychotropic substances to provide relief from pain and suffering associated with serious chronic illnesses.

One of the petitioners from the Initiative for Social and Economic Rights (ISER) Ms. Allana Kembabazi noted that Palliative care had not realized direct funding or vote in Uganda’s national budget. She said that in the Budget Framework Paper for the 2019/20 financial year, there were significant budget cuts that touch the provision of palliative care. She pointed out that the proposed Uganda Cancer Institute (UCI) budget for the FY 2019/20 was projected to decrease by UGX 30.561 billion (33.513%) from UGX91.192 billion in FY 2018/19 to UGX 60.631 billion. Ms. Allan implored the government to increase investment in health care which is a fundamental right to citizens.

At the same meeting Ms. Fatia Kiyange from the African Palliative Care Association (APCA) stated that in order to improve palliative care service provision in Uganda the civil society organizations recommend that:

Government fast tracks the development, approval and ensures funding for the implementation of the National Palliative Care Policy.

Government initiates steps to progressively realize direct funding for palliative care services in Uganda. There should be a vote for palliative care in the future national budgets of Uganda.

Government considers investing in human resources for palliative care by training palliative care providers at all levels.

The Health Service Commission and other relevant bodies should recognize palliative care as a medical, nursing and allied health workers specialty and therefore recruit and retain palliative care specialists in service at least up to Health Centre IV level.

While considering passing the National Health Insurance Scheme (NHIS) Government should ensure that the scheme covers all conditions that require palliative care.

Government considers deliberate funding to Private Not for Profit t Standalone Hospices to strengthen home and community care among palliative care patients and their families.

On his part, the Deputy Speaker of Parliament thanked members of the civil society for their thoughtfulness about such a pertinent issue; Palliative Care. He noted that he was glad that a team of committed palliative care practitioners chosen to bring this to the issue to parliament for attention. He said that parliament is committed to discussing such real-life issues which touch the core of humanity. He informed the members present that the role of allocating resources in the national budget rested with the President and that Parliament discusses the proposals made. He advised the Palliative Care Fraternity to prepare to engage with the process of budgeting for the next financial year. He pledged that his office would be fully supportive of the processes to ensure that Palliative Care services are funded by the government.

Civil society advocates for better payments for agriculture extension workers

By Daudi Zirimala
The civil society organization, Share an Opportunity Uganda SAO has implored members of parliament to increase on the budget for Agricultural extension workers to enable them efficiently improve service delivery in the agricultural sector.

Speaking during the dialogue with members of parliament on agriculture committee and stakeholders the National Director of SAO Florence Suubi noted that the civil engagement alliance commends the Uganda government for making a provision to recruit 5000 extension workers country wide within financial year 2019/2020 but since the districts increased to 128, the government will have to recruit 12,000 extension staff to fill the gap.

She says that once the budgetary allocation for extension workers is improved, the productivity of agricultural sector will be empowered in terms mobilizing, capacity building of staff and farmers to bridge the current gap between the Extension workers and farmers in the village model.

However, Nakaseke South legislator Paulsen Luttamaguzi Kasana said that government has no interest in investing money in agriculture but instead in politics since its aim is to cling on power rather than improving the welfare of farmers.

The Uganda’s economy is in intensive care therefore there is o way Members of Parliament can help allocate more money to the agriculture ministry because of too much borrowing for other priority sectors than agriculture says Hon Luttamaguzi

Similarly in the same dialogue organised by SAO,it was noted the ministry of Agriculture animal industry and Fisheries MAAIF is in a process of drafting the national agriculture Extension services Bill intended to come with policy that will guide and improve on the services of the extension workers.

This was revealed by the commissioner for agricultural extension and skills management Dr. Patience Rwamigisa saying that currently the agriculture sector contributes 50% to the national economy but in return its gets only 3% of the national budget which challenges the sector says Rwamugisa.

This bill they would specify the worker of extension workers at district and sub county level as well enabling farmers to engage in agribusiness by prioritizing certain commodities per district.

Rwamigisa has revealed that government has come up with a new model where a district identifies two commodities in which they can specialize in so that the government can invest money in the specified commodities that the district can manage.

Civil society seeks interpretation of cases of MPs charged with treason

By Robert Segawa

The constitutional court is hearing a petition filed by human rights and civil society seeking an interpretation of actions of the state that denied Ugandans their political will.

The case challenges charging political figures with treason and terrorism.

This comes after Kyadondo East Member of parliament Robert Kyagulanyi and 35 others were charged with treason and terrorism after they expressed their independent political opinions in the Arua by election.

The executive director foundation for human right initiative Livingston Sewanyana says Ugandans have freedom to express their political opinion should not be violated hence the need for court to pronounce it’s in the legality of the action.

Civil society backs government on merging commissions and agencies

By Daudi Zirimala

The Civil society organizations in the country have welcomed government decision to merge agencies and commissions saying this will save 2.2 trillion shilling meant to facilitate these agencies.

According to the executive director of civil society budget advocacy Group (CSBAG) Julius Mukunda, government should provide a strong road map on how restructuring is to be implemented, timelines detailing the activities to be undertaken in rationalizing the agencies, commissions and Authorities.

Mukunda says that a task force should be put in place to oversee the implementation on this rationalization process with clear terms of references and educate the public about the importance of merging these agencies.

He  worries that government has not provided any anticipated consequences and their management to reduce the risks involved in the process for example unemployment levels to be caused, variations in performances expected to stem from the rationalization.

Civil society urged to strengthen digital departments

By Edwin Muhumuza

Civil Society Organizations are rooting for the strengthening of cyber security in a bid to safe guard them- selves from attackers.

Executive Director, Defenders Protection Initiative, Yona Wanjala, said that non-governmental organizations around the world have been a target by state agencies accusing them of terrorism and money laundering a move they say has been as a result of cyber -attacks.

His remarks came during a digital security conference, at the Kampala Serena Hotel ,that brought together several organizations with aim of ensuring digital safety as they run their operations in the country.

NGO Forum Executive Director Richard Ssewakiryanga says work done by non-governmental organizations is too sensitive and therefore the need for digital security to safe guard it.

He adds that there has been break-ins where computers have been stolen leaving the fate of some organizations uncertain, and therefore the need for them(CSO’s) to increase budgets to prioritize Information Communication Technology.

Over the past five years there has been a wave of break-ins into the premises of non-governmental organizations, mostly those specializing in protecting human rights.

Despite the Uganda Police Force saying it has commissioned investigations into most of the incidents, the leaders of the affected organizations say there has hardly been any progress on this front, and not a single report detailing the progress of investigations has been issued.

They accuse the police and the government of being insensitive to the plight of civil society organizations at best, and at worst they say the State could be complicit in the break-ins. The police deny the accusations and say they are actively working to remedy the situation.

Civil society organizations vow to block scraping of the age limit discussion

By Wasswa Deo

Members of Civil society say they  will do whatever it takes to block President Museveni and some NRM members of parliament  from  passing  the bill that intends to scrape away the presidential Age limit.

Crispy Kaheru, the national coordinator of Citizens coalition on electoral democracy Uganda, says once this article is scraped, the country’s constitution will remain useless.

He says the civil society is set to begin a citywide mobilization to ensure Ugandans put pressure to members of parliament to confirm that this move does not see light on the floor of parliament.

Sources reveal that the 2017 bill that seeks to amend the constitution to remove the Article 102, shall be published in the Uganda gazette in a few weeks’ time before it can come to parliament for debate.

Civil society organizations deman that legislators investigate Nalufenya incident

By Wasswa Deo

Uganda Coalition Against Torture   has come out to demands that Uganda prisons services reject all suspects tortured prior to remand.

According to the  statement released in reaction to the inhumane torture of 13 men formally detained at Nalufenya police station. The 13 suspects were  implicated in the murder of AIGP Andrew Felix Kawesi, and his driver Godfrey Wambewo and body guard Kenneth Erau.

According to Muhammad Ndifuna the executive director of human rights network, Ugandans are losing hope in the ability by their government to protect them from acts of torture by security operatives.

Among others demands mentioned in the statement,  the Human rights committee of the parliament should conduct an investigation into the allegations of torture and specifically at Nalufenya,  Uganda government  should ratify the optional protocol; to the convention against Torture (OPCAT 2006) to allow free and unlimited access to all detention facilities in the country for inspection by Human rights bodies.

Government and civil society launch tax campaign.

By Wasswa Deo

In an effort to increase the country’s tax base, government and civil society organizations have embarked on a campaign to educate local communities about the importance of paying taxes.

The campaign spearhead by Action Aid Uganda and SEATINI has kick-started in West Nile district of Nebbi owning to the fact they realize low tax revenue.

According to Okumu Robert district chairperson in Nebbi district, local revenue target has reduced because disposal assets have not been included as source of revenue.

In last financial year, in Nebbi district local revenue contributed only 0.05% due to poor collection.

Figures in Nebbi show that in the next financial year, the district expects to receive 28.254 billion Uganda shillings of which local revenue shall contribute 2.6%, discretionary transfer will contribute 23%, conditional grant transfers shall contribute 69%, other government transfers is expected to contribute 3.5% and donor contribution is 1.5%.


Government hid behind National security to violate freedom of expression- Activist

Civil society activists want government to apply for a judicial review before ordering a social media shutdown. Uganda Communications Commission-UCC ordered a social media shutdown during the February 18th polls and during the swearing in of president, Yoweri Museveni on May 12th.

However, Sarah Kihika, a Human Rights Activists wants government to seek a judicial review before ordering the social media shut down. According to Kihika, court should be able to weigh in the evidence of the eminent threat to national security and need to shut down any form of media before violating the rights to freedom of expression and information.

Nicholas Opiyo, a Human Rights lawyer accuses Government of hiding behind national security to violate the rights to freedom of expression and information. He says the arbitrary closure of the media is unfair to millions of social media users across the country.
Speaking at the meeting convened by Chapter Four at its offices in Kololo on Monday, Michael Niyitegeka, an IT consultant said Government should come up with better ways to regulate social media other than blocking the entire platform and cut out Uganda from the rest of the world.

He says there are software applications that can enable Government truck individual users and restrict the activities of those deemed to be a threat. Timothy Kalyegira, a media practitioner called for self-regulation by social media users, adding that many people post irrational issues.

Fred Otunnu, the Director Corporate Affairs Uganda Communications Commissions, which mandated to regulate and control communications, says although the right to use media is essential, there is need for regulation. He defended the recent social media shut down, saying they acted on security warnings.

Christine Nanding, the Deputy Director Human Rights and Legal Services in Uganda Police, advised those offended by Governments actions to seek legal redress instead of inciting violence.