Uganda’s HIV Bill more complex than it appears

I read a bit of Human Rights Watch report on Uganda’s bill on HIV.

There’s are many issues but for now I will focus on the part of the Bill concerning mandatory HIV testing for expecting parents.

I was  looking through the AFP report that had an interview with the executive director of The AIDS Support Organisation (TASO) Robert Ochai and here is what he said.

If you make testing compulsory, the individual doesn’t buy into the result. For them to take action, like getting treatment for example, they have to accept to outcome of the test.

What are we going to do with all these people we forcibly test? We don’t have the resources to support them. People could run away from their doctors, or their homes. You could have suicides.

For many years now, mothers in Uganda have had to be tested because of the need to reduce the high rates of Mother-to -child HIV transmission. I have seen friends who had never thought of taking an HIV test until they were expecting and when faced with that they go ahead and lay thier fears aside and test. They indeed have not seen the mandatory testing as violation but as measure to prevent this deadly disease from getting to their precious children. So the Bill is not introducing something new. The practice has been going on and though there haven’t been any study or attention to it, I more inclined on the fact that it has helped people come to terms with their status and brought them the joy of knowing even if they are positive their child can be negative.

Uganda’s most new infections are high among married couples and about 80 percent of those with the virus don’t know they have it. And if any Ugandan tried to sample among their married friends they have had to take the test for the sake of their children.  The Bill says something important for those interested who have an eye for women’s rights and equal treatment. It also calls for mandatory  testing for men with expecting wives.

It’s been almost only women who undergo HIV testing during pregnancy which can be  unproductive if men are not tested. I pay attention to this becuase we live in a country where about 50 percent of married women who are infected with HIV have had one sexual partner. I have read stories of men forcing only their wives to take the test and sometimes if the woman takes the test on her own is abused and  accused of being the one who brought the HIV.

These stories of women suffering for their children to be HIV free cannot be missed in our newspapers. A journalist from West Nile once told of a story of how many were ashamed to take tests and when women get tested and confirm their status to positive men force them to share their prescribed ARVs.

Sometimes you hear husbands relieved after their wives have taken HIV tests which in itself is not a relief for there’s something called discordant couples. The practice of mandatory testing of parents has been going on and we must carry the burden of protecting our children from the scourge.

Uganda now has thousands of young people below 25 years who contracted the disease from their parents. Has anyone talked to them to see what their thoughts are? I am sure many Ugandans know how traumatizing it is to reveal to a 6 or 8 old child that he/she has HIV and the hopelessness that comes with this revelation. How can we talk about intentional transmission if parents can be free to decide whether to infect their children at birth or not. And in the end the resources that people like Ochai are worried about will not be available for all these young infected people.

Such a law is complex and indeed some people can opt to stay away but suggesting mass suicides is a bit exaggeration. Have we wieghed the otherside .  Organisations like HRW must be challenged that sometimes issues are not a matter of individual rights .There must be a balance between anyone’s rights and responsibilities. I will not comment much on Uganda’s own AIDS organisations for now because they are a business venture for most part.

The presentation of our country’s issues as black and white will not help. There’s also an obsession with criticisms rather than critical analysis in regard to this mandatory testing in the bill.  I may not support the people in power in my country but I am always worried about oversimplification of problems we face and interventions that are needed.

The issue of prevention of Mother-to-child transmission doesn’t stop at parents and their child but the poor Ugandan health workers in our poorly equiped hospitals are at risk of catching the disease while delivering babies. No body ever seems to think about them. So if we are to talk about rights what should such health worker do.

To approach this issue as matter of violating confidentiality and  individual rights  of parents is not enough.  We have lives at stake and few analysis have really gone indepth.  I will be picking on another aspect of the bill soon.