The aisles of a clinic for HIV patients in the Kampala suburbs are almost deserted. But staff are keeping an eye on CCTV footage, looking for suspicious individuals, reflecting fear among health workers after Uganda passed one of the most repressive laws criminalizing homosexuality.
“People have to trust their healthcare workers, healthcare workers have to trust their patients, but in the current circumstances it has created a situation where everyone is afraid of each other,” emphasizes Brian, the founder of the clinic, who preferred to withhold his last name, citing security concerns. During the three hours the AFP spent in the clinic, not a single patient came in – a sign of the law’s impact on HIV efforts, Brian says.
President Yoweri Museveni, who has ruled Uganda with an iron fist since 1986, promulgated a text in May providing for heavy penalties for people having homosexual relations. This law sparked a wave of indignation from human rights organizations and many Western countries. It also made patients and health workers fear being reported to the police, with anyone found guilty of vaguely “promoting” homosexuality facing up to twenty years in prison. A ten-year ban on activities is also provided for organizations found guilty of encouraging homosexual activities.
When the law came before Parliament, the debates were peppered with homophobic insults. “We have received many calls from former patients asking us to remove them from our systems,” Brian laments. And since then, attendance at the clinic has continued to fall. About 35% of people accessing HIV prevention services no longer go to his facility, while 10% of those who needed antiretrovirals have also stopped all contact, he says.
“We lost three employees who said they couldn’t work in this climate for their own safety, careers and families,” reducing the workforce by more than a quarter, Brian adds. And some patients who stop taking treatment see their viral load increase, which increases the risk of transmitting AIDS. The health ministry has ordered health centers to ensure that no one is discriminated against or denied medical services. But this has failed to reassure those working on the ground.
“Paranoia”
“We have seen people being arrested for possession of lubricant or condoms,” says Richard Lusimbo, executive director of the Uganda Key Populations Consortium, a human rights group. During parliamentary debates in March, police arrested six men in Jinja, in the east of the country, after finding in their possession 192 tubes of lubricant, a rainbow flag and brochures on the LGBT community . They spent more than three months in prison before being released on bail and being prosecuted in particular for “recruitment of adult males in homosexual acts”.
This new law has created “a lot of fear and paranoia”, argues Richard Lusimbo: “If nothing is done to cancel it, we will see an increase in infections. » UNAIDS and the Global Fund to Fight AIDS, Tuberculosis and Malaria have warned in particular that Uganda’s progress in the fight against AIDS is “seriously threatened” by this new legislation. But the director general of Uganda’s health services, Henry Mwebesa, assures AFP that the country is “on track to end AIDS as a public health challenge by 2030.” “Contrary to some exaggerated claims, services are provided without discrimination,” he maintains.
On the third floor of the clinic, Brian and his team are looking for ways to treat patients without putting them in danger. “We opened a WhatsApp line” in order to be able to reach customers directly, he says, also referring to the use of telemedicine. The packages are not labeled to avoid any risk of identification and targeting of recipients. But these measures are not enough to appease Brian and his colleagues. “When we come to work, we expect the worst,” he says.
Even if the law is repealed, the damage is done, according to Brian, who says Ugandans “have become radicalized” and the legislation has “reinforced homophobia.” “It will take us many years to repair the damage. It will take a long time to rebuild trust. »
