ugandahealthcom@yahoo.com
Vol. 1, No.7
December 2008
Announcements: In this issue: The HIV Prevention and Control Bill As you may already know, a Bill on prevention and control of HIV/AIDS is being drafted by the parliamentary HIV/AIDS committee. It has mostly been criticized for criminalizing the intentional transmission of HIV but it turns out that it contains a lot more than that. See our brief on its various clauses and sections.
Should Ugandan journalists specialise? Journalists are often criticized for being superficial. It’s said they don’t understand the complexities of subjects they cover, and ignore the underlying forces that shape our lives until there’s a crisis, and then they rush in with sensational coverage that makes things worse rather than better. What’s to be done? One answer is for journalists to concentrate in certain fields. That way, they can get to know their subjects better, and through experience develop better sources and greater sophistication. But specialisation is the exception rather than the rule in Uganda journalism. In this issue, Raymond Baguma, a general news reporter for The New Vision, argues is it time for that to change.
What next for DDT? “If we do not win the case (for spraying DDT), I will quit my job,” Dr. Myers Lugemwa of the Ministry of Healthvowed last month at UHCA sponsored debate on the issue. We bring you a summary of this debate between this is public health expert and Dr. Steven Nyanzi, a chemistry professor at Makerere University who is against the use of DDT.
School of Public Health Fellowships Journalists have an opportunity to join the fellowship programme at the Makerere University School of Public Health. The fellowship, supported by the US Centers for Disease Control and Prevention (CDC), enables professionals from diverse fields to gain expertise on HIV/AIDS. Journalists who join the fellowship receive training as well as financial and infrastructure support to enable them specialise in reporting about HIV for two years. It enables them to establish themselves as leaders in that field. For inquiries contact 014533958 or fp@iphcdc.co.ug
A virtual resource centre in the offing UHCA is designing a website that is aimed at being a fully functional and comprehensive resource point for health communicators. We invite you to participate in the process by guiding the team the kind of information you find most important. Send your suggestions to ugandahealthcom@yahoo.com
Guidelines for Reporting on Violence Against Women To mark the International day for the elimination of violence against women - November 25 - the International Federation of Journalists (IFJ) released guidelines for improving media coverage of the issue. To view the guidelines, go to: http://www.ifj.org/assets/docs/185/063/c3093b98c8e63f.pdf.
The HIV Prevention and Control Bill at a Glance This Bill has become synonymous with criminalizing HIV, yet as stressed several times during his presentation at the last UHCA workshop on December 10, there is a lot more to this proposed law. The Bill has seven parts each of which addresses a different aspect in the spectrum of issues to do with HIV: •
Part I is the preamble.
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Part II is a single section requiring every Ugandan to take reasonable care to avoid transmission of HIV, including using condoms. HIVpositive individuals would be required to disclose their HIV status to partners.
MP Chris Baryomunsi with Stella Kentutsi, programme manager for National Forum for People Living with HIV/AIDS Networks in Uganda
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Part III deals with HIV and AIDS counseling and testing. It sets guidelines and standards for counseling and testing. Mostly it would legalize practices that health workers are already doing, but articles that set circumstances when one might be compelled to test (article 13) and when the confidentiality of the test results may be ignored (article 19) may be especially noteworthy.
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Part IV establishes the state’s responsibilities concerning provision of HIV/AIDS health services.
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Part V is of special interest to medical researchers. It sets the terms and conditions for carrying out HIV-related human biomedical research, including the nature of consent researchers must obtain from persons whose blood or other body tissue they wish to use.
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Part VI is designed to protect HIV infected people from the various kinds of discrimination. For instance, it would prohibit insurance companies from denying their services to HIV-positive people.
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Part VII already has attracted the interest of many journalists. It declares what is an offence under this law and the attendant penalties.
In describing the Bill during the UHCA workshop, Baryomunsi said: “You need to access a copy of this Bill, tear it apart and generate public debate so that parliament can be guided to make a law that will add value to the gain we have made in fighting HIV.” Take heed, journalists and health communicators. You have your work cut out for you. For a copy of the Bill, send us a request at ugandahealthcom@yahoo.com.
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Media houses ought to let journalists specialise By Raymond Baguma Next February, I will count five years of newsroom experience: a memorable half decade spent hunting for information. I have been an all-round journalist, covering motor accidents, court trials of treason and murder suspects, product launches by manufacturers, political rallies, medical breakthroughs – everything from golf tournaments to latenight musical concerts. In my journalism career so far, I have lacked a specific area of professional journalism specialisation because I belong to the “general news” section in my media house.The closest I ever got to journalism specialisation was during the four years I was correspondent from western Uganda until 2007. My “beat” was the western region itself. In journalistic discourse, the word “beat” stems from a time when crime reporters literally followed police officers on their “beat.” Separate “beats” later developed for political news, culture, business and others. Ugandan newsrooms have a few journalism beats, including crime, legal affairs, business, sports, and environment. But these are the exception, rather than the rule. And that’s too bad. Beats give journalists a base for building their capacity for critical inquiry and in-depth analysis. They help us develop the tools not simply to churn out ‘news,’ or compilations of facts, but instead to produce ‘stories,’ which present those facts so that people can understand their significance. What’s more, beat reporters get inside the field they report. They learn its rhythm and pace. Instead of merely catching a few highlights, they connect events to each other in ways that deepen understanding. Many of our sources wish we could do that. A number of times, sources have told me, “We should keep in touch Raymond; because anytime I may have vital information to share with you. I wish I could work more closely with them. But I can’t. I am an everywhere-but-nowhere-journalist. Ultimately, readers pay. Lacking a beat, journalists can’t build a database of sources to give us up-to-the-minute information, they can’t ask critical questions and they aren’t good forecasting story events. They also can’t mentor cub reporters. Take for instance last February, when newspapers were awash with breaking news of how scientists had stopped further trials of a gel meant to protect women from HIV. This was after some women got infected with HIV. This was undoubtedly good news from a journalist’s perspective, but heartrending for the women who participated in the trials. Yet little was done for pursue what happened to the women. What a missed opportunity to get the stories behind the news! Questions remain unanswered today on how these women are coping. Did they sue in courts of law? Does Ugandan law protect people who take part in botched clinical trials? Is it the need for money that drove the women to participate in such trials because they need a little money? Would they have participated if they were wealthy? There’s one other advantage to beats: they create a natural structure for young reporters to learn from their seniors. If I were a cub reporter accompanying a senior writer on some assignments, I would receive truckloads of inspiration. And maybe the result would be more award-winning stories.
Raymond Baguma is a general assignment reporter for The New Vision.
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DDT and Malaria: The Debate Continues Although the government’s program to conduct indoor spraying of DDT to kill malaria-bearing mosquitoes is stalled in the courts, the controversy is still raging, as demonstrated when UHCA organized a discussion on the politically heated issue during the International Students’ Conference on Malaria in the Tropics on November 20. The discussion was supposed to pit Dr. Myers Lugemwa, an international health specialist with the Minister of Health’s Malaria Control Programme, against Dr. Steven Nyanzi, a chemist with the Makerere University Faculty of Science. Dr. Nyanzi was unable to attend, but his paper, “The Case Against Spraying with DDT as a Strategy Against Malaria,” which was published by the Forum on Health & Nutrition of the Uganda National Academy of Sciences, was presented on his behalf.
The “Debate” Dr. Lugemwa’s arguments for the use of DDT boil down to this: it works better than other strategies and at a fraction of the cost. What’s more, he said there is precious little scientific evidence to support claims that the pesticide is harmful to humans; the opposition to use of the pesticide is based on “political inclinations” rather than science, and on narrow economic interests (especially cotton growers who seek to participate in international markets for organic cotton) rather than the health needs of the wananchi. Dr. Nyanzi’s paper didn’t tackle these issues head-on. He made essentially four arguments in building the case against DDT: •
First, DDT spraying does not address the “root cause” of the malaria problem, which he said is inadequate environmental management – especially that stagnant water from man-made sources like polythene bags, broken bottles, clogged drainage channels and abandoned excavation pits, create abundant breeding grounds for mosquitoes.
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Second, indoor spraying – a strategy designed to attack malaria-bearing mosquitoes while minimizing the environmental impact of DDT – doesn’t attack mosquitoes during their vulnerable egg, larvae and pupa stages.
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Third, most Ugandans are small-scale farmers who often store their crops and animals in their homes, making these food sources especially vulnerable to indoor spraying.
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Fourth, Uganda has abundant natural plant life that could serve as a natural source of malaria drugs, insecticides and repellents.
A Sour Note We were dismayed by reports we got from the organizers of the International Students Conference on Malaria in the Tropics. Supposed journalists approached these student organizers asking for money to write about the event. We don’t know who these individuals are or if they truly were journalists. Certain con men attend conferences pretending to be journalists in order to get free meals and to trick organizers to give them money in return for bogus offers of favorable coverage. That, of course, is outrageous. If the individuals were journalists, the shamefulness of their behaviour barely requires comment: demanding – or accepting – money in return for coverage violates the Uganda (and international) code of journalism ethics. Journalists should serve their audiences without a taint of self interest. In any case, how could anyone expect to successfully extort money from a STUDENT organization? To workshop and conference sponsors, we offer these words of advice: 1) Never pay a reporter in return for coverage of your event; 2) if approached by someone claiming to be a journalist and demanding such payment, ask for his or her identification; and 3) report unethical behaviour such as shown during the malaria conference to the reporter’s employer.
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Dr. Lugemwa’s response: •
First, environmental management is already the law of the land, but it hasn’t worked to curb malaria. It probably never could. Mosquitoes can breed in even the smallest amounts of water; even a rainfilled depression created by a cow’s hoof is ample breeding ground.
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Second, the best place to attack the particular mosquitoes that carry malaria is inside residential houses because that is where those particular species live.
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Third, it is illegal for anybody to store cash crops or animals inside their residences.
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Fourth, while natural substances can be used to fight malaria, they are not as effective as DDT.
What’s Next?
UHCA General Assembly Meeting
On December 2nd, members of the UHCA met at the Kampala offices of the World Health Organisation for the Alliance’s Annual General Assembly. One of the key discussions at the assembly was UHCA membership. The assembly agreed on; • Only practicing journalists and health communicators will be eligible for membership • Sh10,000 membership fee and sh20,000 subscription for next year. This is subject to change as the assembly may was agree from time to time. • Only subscribed members will constitute the next general assembly but non members will still access UHCA workshops and newsletters. • More members will be mobilised from the electronic media • Constitution is to be amended and the amendments will be considered at the next general assembly early next year.
While the government’s DDT program currently is stalled, both professors agreed on one point: the fight against malaria requires massive mobilization of the public and stakeholders. The problem is simply too big to be addressed any other way. That doesn’t mean there’s a sudden consensus on the spraying program, however. Dr. Lugemwa said the government remains committed to indoor spraying of DDT, and he said the court proceedings over the current injunction are proceeding well. And then, the respected doctor and public health leader closed the debate with a statement that seemed to combine defiance and confidence. “If we lose the case,” he said, “I will resign my job.”
Health insurance may not heal ailing health systems A study by Oxfam casts a skeptical look at health insurance as a solution to the lack of adequate health financing in the developing world. It notes that after 25 years of private health insurance, less than 10% of the population in poor countries benefits from it. Government-run Social Health Insurance schemes generally leave out some of the people most in need – informal sector workers and the unemployed. Even with community-based health insurance, participants still rely on out-ofpocket expenditures to cover about 40% of their health costs, and very few people benefit: in Africa, such schemes cover only two million people out of a population of 900 million (0.2%). Oxfam argues that governments cannot for the foreseeable future see health insurance as a substitute for direct public financing of health care, which it says is “the only proven method for achieving universal coverage and access in the short term.” These are sobering words for Uganda, which hopes to launch its first national health insurance program next year – one that, at least initially, will be limited to the tiny fraction of the population employed in the civil service. Full report: http://www.oxfam.org.uk/resources/policy/health/downloads/bp112_health_insurance.pdf
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