Battling on Behalf of Gay, Lesbians and Other Sexual Minorities: A Frontline Experience from Uganda

by Anonymous (an IRMA member from Uganda)

Are you aware you are abetting “homosexuality” in Uganda?

Our grass-root takes us among “most at risk populations”-MARPs. The day dawned normally as a carry-over from the previous weekend spent visiting 7 scheduled gay men living with HIV.

Come 8th March 2012 and another anonymous phone call. This time a lady claiming she sells insurance policy calling to meet over a policy I need to have! This was the 17th anonymous phone call I had received since 1st March 2012. Others were of people calling from different parts of Uganda. One ominous one intimated on why am helping people who don’t deserve aiding. This one was at night. I dismissed it as a hoax.

But, on 8th March 2012 I get the call that changed the way I do my grass-root work. I was asked to report to CID (Criminal Investigation Directorate) headquarters for matters concerning our organisation.

I left Uganda and went to a next door country where I stayed up to end of April 2012. How I survived while there is another story too.

My argument is that we need to show the good in all. And this is the mission we pursue. I don’t deny being vocal and instrumental in bringing about visibility of issues of: MSM, Sexual minorities, Long Distance Truckers, substance users, Fisher folk, discordant couples, persons in long term relations and mobile populations. I have helped document this kind of work and it has been the basis of my presentations during consultative meetings on MARPs. This kind of work was first done privately and goes back to 2004. I took up positions with the Ministry of Health-Uganda and have been involved in planning programmes targeting MARPs. After applying and waiting for 4 years our NGO was finally registered in 2011 and have since mobilized grass-root groups to focus on vigilance/ resilience plans.

There has been so much talk on prevention but less on what works among/for MARPs. The Rights agenda has done so much to lay bear action points. With these groups it has been possible to show that MARPs face disproportionate treatment and access. We have improved on their competence and overall sensitivity to issues. They are trained to address issues and overcome them using small steps and participatory planning. It has been possible to disaggregate efforts according to various categories MARPs (MSM, other sexual minorities Sex-workers, Substance users, Fisher-folk, Truckers, PLHIV and couples).

 This is what I have written about consistently for past 3 years. And all this is shared on: www.marpsinuganda.org.

MEETING CID PEOPLE:

I wish to share with you my story as I gave it during the 2 sessions I had with the CID guys. I hope this case which is given as a narrative and retrospectively will help show what activists experience in Uganda. It is about my work and how much I endeavoured to posit the angle of health programming. It is not easy to provide services to those who need especially if they are labeled as undesirables. But, this is a calling that if unanswered may lead to further injustices. I fear for being outed as a “chief recruiter” as I go about my work of treating and doing anti-HIV programmes among at risk populations. There is this battle of egos. I see myself as a public health activist and yet my interrogators and officials from government see me as a “recruiter” climaxing into closure of meetings, denial of safe spaces, fear of de-licensing NGOs, arbitrary detentions and summons to police.

The experience of being hounded by security operatives is un-nerving, un-settling and demotivating. I was asked to go to the CID to report myself because am known to work with MARPs. I at first was scared and had to call two friends for advice: one is part of the high powered state security team and another is our organisation lawyer. These two told me to go and meet the CID but before doing that I first called the person who called me (a one Byakagaba). I told Byakagaba about the security person. This softened my landing immensely. I called him to ask to be given an orientation on what we had to meet about. We negotiated a safer neutral place and he obliged. We later met a bigger team of interrogators at 3 pm up to around 9.30 pm. I think I saw a face of one person we met in two meetings at Protea and during the Uganda Human Rights Commission public hearing on the Anti-Gay Bill.

I remember this person could be the face I recall of one who followed me to the Protea washrooms and asked me why I take time to “help” the homosexuals. I was asked so many questions and many of them repeatedly. I want to share them.

Below are some of the questions that were asked. I want to present to you the questions I recall being asked of me and perhaps that will also give you a perspective of things:

Are you aware you are abetting “homosexuality” in Uganda?

1. Why do you recruit?

2. Who do you recruit? ( In the car to check offices/ resource center)

3. Why do you help?

4. Is everything on these 2 desk tops?

5. Who provides money for all the equipments in your office?

6. Why is your office/resource center in a walled off perimeter?

7. Why did you pay rent, electricity, water bills for a full year? (After going through all filed reports in our filing cabinets)

8. Who else is helping you?

9. How come you have a website?

10. Why is there even any work done among the “homosexuals”?

11. How large are those networks?

12. Why do you help them organize?

13. How much commission do you get from facilitating them (actually said helping)?

14. Why do you treat them?

15. What age group is commonly seen?

16. Where do most meet for recreation?

17. Your neighbours complain of loud noise. Why?

18. Who pays for all the activities?

19. Who come to your resource center?

20. Are there some who spend nights?

21. How many weddings have you conducted here?

22. Why are your phone numbers always busy?

23. Who pays for your airtime?

24. Why do you make it a point to bring out issues of “homosexuals”?

25. Who are MARPs?

26. Why do you sacrifice so much for “them”? ( Towards end of first session at around 8.30 pm)

27. How many have you helped? ( This was another burly faced individual who was looking at me with a very mean and intimidating look).

28. Do you use your position to recruit?

I noticed the desire to label, I noticed the conclusions made around serving the marginalised and noticed the lackadaisical tendencies of the security personnel that already deny one due diligence and attendance even as one who is thought/perceived to be a ‘homosexual’.

In order to get out of this quandary, I asked to be let off with what I was told as we were in the car being driven back for interrogations from our organization offices. Our organisation has consistently been run using our own money. We have come so far and we do not want to stop this work. I did negotiate my temporary freedom and the next day had to leave Uganda. I still wonder at the fate of what they took from our offices. I believe they are now using our two new desk tops for their cafes or have sold them off. I did manage to talk to my captors. I was told to move somewhere for quite some time until issues cool off.

They had suggested 6 months and beyond as opposed to being exiled to a far away off place away from Kampala and my work. I left Uganda with only have a shirt, pair of trousers, a data USB with all sensitive information and my travel bag.

In all this I learnt one big lesson and that is: we need to have the argument of HIV broken down as resilience activities.

These are what we need to document further and share with panels be they the CID! We need to document vigilance and how we, in our efforts actually mobilise, trace, follow up people and that way we are able to identify those with HIV! HIV at grass-root means: being in position to conduct anti-HIV activities; identifying those suffering; remedying the suffering by talking to them to know their needs; integrating psyche-social, sexual health, mental health; preventing abuses, violations, discrimination and stigma and; economic empowerment of those in need.

The individuals, clubs, groups and organisations are an asset and not a liability. I risked lecturing my interrogators but I cannot know where that courage came from and talking reason humbles even the gun-strapping-hand-cuff swinging arms! The use of the word “recruitment” is so common among criminal systems it is also used to relate to the Al-Shabbab issues. People are imagining penetrating “cells” of recruitment with all connotations attached. There should be a clear action point on bringing out health, human rights and development matters of marginalized based on evidence. This is possible.

Let us discourage actions or events that are lacking in integration of health, human rights and development.

 

I FLEE UGANDA:

I approached a human rights defenders’ support organisation and was extended USD 1,000 and a return air ticket to a country of temporary refuge. I had a government salaried job which I had to to leave, home and organization built out of sweat. While in refuge I tried the refuge and asylum seeking procedures. I went to organisations which in turn referred me to other organisations. We had to wait for outcomes. I understand there were so much back and forth consultations and in the long run no support was provided for my further stay during refuge.

I LOOK FOR WORK TO SURVIVE:

After two weeks I run out of money. I decided to do some work pro-bono around treating “marginalized” or training them in health/vigilance/resilience planning integration skills. A friend introduced me to another friend who runs a chronic care center and there I did some volunteer work. I would stay in a nurses’ station and use the washrooms. This place is near the capital city of the country I had taken refuge in. I enrolled for volunteer work during weekends and was fortunate that there were health camps scheduled in the various peoples’ spaces. I was given short contracts in health counselling at the various stations and other activities. I would in turn get a meal and continued social interactions. However, on 27th April 2012, I developed severe malaria which I treated and with some little money I had saved decided to leave for Uganda. I stayed around a border town up to 25th May 2012. I later left under the cover of darkness for our organisation address. I met with friends who lived nearby and managed to get first had intelligence about the affairs of our organisation and the fate awaiting us.

LANDLORD EVICTS US:

Our offices were in a double house turned office and our landlord had got wind of the CID house search in May 2012. He immediately asked us to leave his premises because we were promoting homosexuality according to word going around. In order to get safe passage, I went to police and got two escorts to guard us as we were moving property. We had to get another place where it was safer.

COMMENTS FROM THE NEIGBOURHOOD:

We located our offices in a suburb where most Kampala population has their homes. The various families and residents ganged together and complained to local leaders to have us evicted. There was so much pressure towards our landlord to have us out of the place. We even had graffiti written all over our perimeter wall. We left the premises at night and managed to avoid media.

WHAT WE ARE DOING NOW:

This is July 2012 and we have a smaller place, have managed to attach 170 people living with HIV to Uganda government ARV-accredited facilities. We have approached 112 CBOs and referred all our clients to them for chronic care support. We have managed to conduct a major training for the leaders of 52 groups under our society to take on more organisational roles to avoid so much exposure as people drop into our resource center. We have closed down the transitory home where we would give refuge to evicted marginalised persons. We have had this since 2008. We have joined the bigger networks and have paid membership dues. Such bigger networks include: Uganda National AIDS network; Uganda Health Sciences Association; Uganda National Academy of Science and; Microbicide Trial Network under the Makerere-Johns Hopkins Collaboration. The idea is to engage more with policy. Programmes have been left with the groups which we shall monitor progressively. Another crucial issue is to mobilise resources to enable our organisation move on. We have established a resource mobilisation desk which I head.

APPEAL:

Friends, allies and well-wishers should realize that Africa has a vast number of activists, many of whom have not been exposed through meetings at local or international levels. There are activists bound by professional ethics not to disclose so much information about their work especially if it concerns health conditions. There are activists using music, dance and drama to convey messages of tolerance and interventions. Many have not been thanked nor are they supported by funds from external sources. These activists deserve our appreciation.

It is my hope that the Global North will one day reach out to these un-sung activists who are using all resources to make the life of many marginalised bearable.

-------------------

*Join IRMA's robust, highly-active. moderated, global listserv addressing rectal microbicide research and advocacy as well as other interesting new HIV prevention technologies by contacting us at rectalmicro@gmail.com. Joining our listserv automatically makes you a member of IRMA - a network of more than 1,100 advocates, scientists, policy makers and funders from all over the world.

*Please look for us on Facebook: www.facebook.com/InternationalRectalMicrobicideAdvocates, and you can follow us on Twitter: @rectalmicro.

*Also, please note that shared news items from other sources posted on this blog do not necessarily mean IRMA has taken any position on the article's content.

-------------------

Appropriate Health Services Needed for Men Who Have Sex With Men in South Africa

via sahivsoc.org, by Rebe K, De Swardt G, Struthers H, McIntyre JA

Until fairly recently, the healthcare needs of men who have sex with men (MSM) have been under-researched and under-resourced in South Africa.1 This has occurred despite emerging local evidence confirming high rates of HIV among this most at risk or key population (MARP). Notwithstanding inclusion in the country’s previous National Strategic Plan for HIV and AIDS, STIs and TB (2007 – 2011), services for MSM were not scaled up nationally although impressive strides have been made in some provinces such as the Western Cape and Gauteng. Evidence shows that in settings where concentrated HIV epidemics exist among MARPS in countries with generalised heterosexual epidemics, failure to provide targeted and tailored HIV prevention and treatment programs to MARPS negatively impacts on that country’s HIV rates among the general population. 

MSM in South Africa comprise a diverse group of men who share only one behavioural commonality: they have sex with other men. 3 Many South African MSM do not identify with gay culture which may be viewed as a Eurocentric cultural construct which is often considered foreign and un-African.4 The behaviour of men having sex with men has however occurred across all cultures and all times, including South Africa, and is therefore well described in African oral histories. Colonial oppressors were largely responsible for the criminalisation of sodomy on the continent.5 Homosexual activity in South Africa therefore often remains clandestine with MSM identifying as heterosexual and dismissive of Westernised gay culture.3 This has implications for health messaging as non-gay-identifying MSM are not targeted in either mainstream heterosexual or gay media platforms and remain invisible in health settings.

MSM are at particular risk for HIV acquisition and transmission for multi-factorial reasons.6 Biologically, unprotected receptive anal sex is about sixteen times more likely to transmit HIV than unprotected vaginal sex.7 This is due to the friable nature of the rectal mucosa which does not contain mucous-producing cells as compared to the thicker, self-lubricating lining of the vagina.

The vulnerability of MSM is further increased by structural factors such as a lack of funding for MSM-appropriate services, lack of specific skills training of health providers and institutionalised stigma within the public health sector. MSM patients generally avoid being identified as MSM, culminating in their elevated risk of HIV acquisition or transmission being overlooked and no counselling about the risks associated with unprotected anal sex.

Organisations such as the Anova Health Institute, through it's innovative Health4Men project, and the Desmond Tutu HIV Foundation have been active in addressing these concerns in South Africa. In 2009 the Anova Health Institute, with support from PEPFAR/USAID, launched the first state sector clinic dedicated to MSM in the country. A further six sites have subsequently become operational across multiple provinces. Invaluable lessons have been learned through this process which will undoubtedly serve as a template for ongoing expansion of such services
Read the rest.


-------------------
*Join IRMA's robust, highly-active. moderated, global listserv addressing rectal microbicide research and advocacy as well as other interesting new HIV prevention technologies by contacting us at rectalmicro@gmail.com. Joining our listserv automatically makes you a member of IRMA - a network of more than 1,100 advocates, scientists, policy makers and funders from all over the world.

*Please look for us on Facebook: www.facebook.com/InternationalRectalMicrobicideAdvocates, and you can follow us on Twitter: @rectalmicro.

*Also, please note that shared news items from other sources posted on this blog do not necessarily mean IRMA has taken any position on the article's content.
-------------------

USAID Technical Brief: Human Rights Considerations in Addressing HIV Among MSM

via USAID, by AIDSTAR-One Project

Just as I was very proud to say the obvious more than 15 years ago in Beijing—that human rights are women’s rights and women’s rights are human rights—let me say today that human rights are gay rights and gay rights are human rights.

 

–Hillary Clinton, U.S. Secretary of State (U.S. Department of State 2010)

Introduction
Men who have sex with men (MSM) face a disproportionate share of the HIV epidemic throughout the world (Baral et al. 2007; Cáceres et al. 2008), and in low- and middle-income countries bear a greater burden of the epidemic relative to the general population. In many countries, the HIV risk to MSM is exacerbated by social, cultural, and political factors. These include cultural biases against MSM, limited access to information and services, low national investments in health, and legal, institutional, or social barriers, including negative bias among providers, that make it difficult for MSM to negotiate safe sex or obtain adequate services for preventing and treating HIV and other sexually transmitted infections (STIs). This situation is compounded by adverse human rights environments— for example, in settings where same-gender sexual relationships are illegal—where MSM may fail to seek treatment because doing so may lead to harassment, refusal of services, arrest, or violence.

Yet international consensus and recommendations— including the 2011 United Nations (UN) Political Declaration on HIV/AIDS, to which the United States was a signatory—recognize the vulnerability of MSM to HIV and endorse national and international efforts to include MSM in HIV programming and address discriminatory laws and practices that keep this group from obtaining services. In keeping with this consensus,the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has issued guidance on developing comprehensive programming to reduce HIV among MSM.
 
This AIDSTAR-One technical brief provides a systematic global review and synthesis of practical approaches, program examples, and resources to support human rights as a core element of HIV programming for MSM. The brief complements and is aligned with other global and regional publications that have relevance to human rights, health programming, HIV, and MSM.(1) This document gives an overview of U.S. policies on and commitments to MSM and human rights, and outlines recommended approaches, including program examples in various countries, for linking health and human rights to address HIV among MSM. It also offers a synthesis of questions for developing and monitoring HIV programs for MSM, and a list of program resources.

Read the rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Meet Thomas Muyunga: Another New Friendly Rectal Microbicide Advocate!

“When one goes to fish, they go to the water body for fish. With the net one catches all sorts of fish and other debris. Sorting out the fish from debris is part of fishing. Same applies to HIV work. Talk about HIV, engage in activities around mobilising beneficiaries and challenge them to participate fully- make it enjoyable. Show the whole list of HIV fuels. Show how stigma, discrimination and abuse fuel HIV in communities.”

Thomas Muyunga is an IRMA Advocate from Kampala, Uganda. There he is CEO of MARPS (Most At Risk Populations’ Society) In Uganda, an umbrella organization committed to “lasting, enduring, and durable solutions against poverty.” Their work focuses on “PLEASE” - Protection, Lasting sexual-reproductive health practices, Empowerment, Attitude change, Social integration and Education. Thomas loves to mobilize communities and prepare and empower them to fight poverty, discrimination, and HIV.

Thomas has worked in HIV Services Provision since 1993 when he was a student volunteer at Rotary International. He first became aware of microbicides at an STD/STI Clinic at the National Referral Hospital in Uganda. He has since dedicated much time and effort to learning about and advocating for the development of successful microbicides. He will join IRMA as a Project ARM (Africa for Rectal Microbicides) scholarship grantee in Addis Ababa, Ethiopia prior to ICASA 2011 to be part of a working meeting to develop an African rectal microbicide agenda!

He believes rectal microbicides are very important because they bring more attention to anal intercourse and help to create conversation about it. He hopes this will also stimulate talk about the power dynamics of anal intercourse.

His advice for others wanting to become IRMA advocates is to first focus on learning as much as possible about HIV prevention, care and treatment so that you can teach others about these issues. Education will also prepare you to inform planning, programming and policy. We can only move forward if we are educated.

Read more Friendly Rectal Microbicide Advocate bios.



[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Launch of online MSM sensitivity training for Africa

Today marks the launch of the launch of the MARPS Africa website

This facility provides online training for health care workers, advocates and researchers in Africa around issues affecting key populations.

Currently, a MSM sensitivity training course is available. This course was developed by the Desmond Tutu HIV Foundation in collaboration with Wellcome-KEMRI Kilifi and other international contributors.

In the future this site will provide online tools and trainings for around topics relevant to the needs of MSM, transgender, IDU Sex Workers and other key populations in Africa.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]