By Fredrick Mugira
When Uganda’s President Yoweri Museveni extended the nationwide lockdown to halt the spread of the coronavirus for the next 21 days in April, Birungi Joyce, a housewife in Kacerere, Bisya, in Uganda’s hilly district of Buhweju, felt a boom of uncertainty.
The birth control pills she takes by mouth every day to prevent pregnancy were finished. Birungi thought after the initial 14-day lockdown she would travel; almost 30 kilometers from her home, on a commercial motorcycle, to purchase more pills at her usual pharmacy, but alas, the lockdown was extended for the next 21 days.
The only alternative she was left with was to abstain. But her husband was unwilling.
“He would sometimes beat me for denying him sex,” narrates Birungi further noting that, “but I persevered. This was better than conceiving and giving birth to our sixth child.”
Birungi, aged 35, says they have been struggling to fend for their five children and could not afford to add-on another.
Indeterminate of what else to do, Birungi sought advice from some women in her village who advised her to call officials of EPHWOR, a women-led non-governmental Organization, for help.
The women had watched officials of this organisation speaking on a local television. Fortunately, they noted down their telephone contacts.
Eventually, Birungi called the organisation. A day after her call, officials from this organisation drove to her village and gave her birth control pills to last her two months.
Deliveries of birth control to prevent seven million unwanted pregnancies
If Birungi had not received this help, she would probably be carrying an unintended pregnancy, putting her among the, “7 million unintended pregnancies,” that the UN population agency UNFPA, “expects to occur,” if the current, “lockdown continues for 6 months and there are major service disruptions due to COVID-19.”
But now, she is part of the 300 women from eight districts in southwestern Uganda that EPHWOR, also known as Enforcement of Patients and Health Workers’ Rights Uganda, has saved from unintended pregnancies during the COVID-19 lockdown.
The women are from the districts of Mbarara, Ibanda, Buhweju, Sheema, Isingiro, Rwampara, Kiruhura and Kazo.
EPHWOR started in 2017. It has been implementing programs aimed at enforcement of rights and advocacy of women, sexual and reproductive health and rights, and patients’ rights in rural and urban areas of Uganda.
Dr. Aruho Amon Kategaya, the Medical and Reproductive Health Consultant at EPHWOR says, this initiative, “will prevent women from conceiving children by chance as Uganda makes important strides in the contraceptive prevalence rate.”
Uganda’s 2020 fertility rate stands at 4.78 births per woman.
Women and adolescent girls enrolled on family planning methods in Uganda and several developing countries are finding it hard to access contraceptives following the COVID-19 lockdown. This was worsened by the ban on local transport means, leaving many of them unable to walk dozens of kilometers to health centers, clinics, and pharmacies to get contraceptives.
The situation was worsened by the countrywide closure of family planning outreaches that Reproductive Health Uganda (RHU) has been providing following the outbreak of COVID-19
Dr. Kenneth Buyinza Clinic services manager for RHU told New vision recently that they had to suspend all outreaches because they could not, “observe the four-meter social distancing with the large clientele,” they had.
Mbarara Regional Referral Hospital Director Dr. Therestine Barigye, says although some mothers still come to his hospital to access family planning services, lack of transport means to access health centers and hospital could be affecting, “several women and girls,” putting them at risk of getting, “extra children.”
“You can call it a baby boom,” narrates Dr Barigye, further noting that, “because now, people (couples) are at home. You can imagine what happens as they live together.”
Dr. Barigye predicts a spike in the number of babies born in the southwestern region nine months from now following the COVID-19 lockdown.
Last month, the archbishop of the church of Uganda, Stephen Kazimba Mugalu, cautioned women that they could get pregnant in the lockdown and tipped them not to forget using contraceptives.
“These guys are there; they are eating and doing things. Be careful,” noted Archbishop Dr. Kazimba as he preached on national Television from his home in Kampala.
The 45.7 million Uganda’s population is projected to reach 103.5 million by 2060 in the just 241,037 km² country.
A burden on the few resources families have
An additional child to a family, especially born by chance, strains the family’s resources just like how population increase leads to negative impacts on national resources.
Wilson Twamuhabwa Kadidi, the economic advisor to the minister of finance planning and economic development says, the increase in especially unproductive population is a “burden on few resources that governments or families have,”
“Population increase puts a lot of strain on resources because governments or families have to plan for those people who have been added on the population,” he notes.
The condition is even worse in rural Uganda, where most women rely on family planning to mitigate the effects of poverty when faced with a big family.
Enabling women living with HIV to access drugs
EPHWOR is not only offering free family planning services to the women. According to Dr. Aruho, it is also engaged in, “monthly refills for ARVs, cancer drugs and other medications to vulnerable women and girls in these eight districts.”
Working in partnership with government health facilities such as Mbarara Regional Hospital, Mbarara municipal council health center; Ruhooko Health center four, and Nsika Health center four among others, EPHWOR has been able to access free drugs and records of patients for follow up and delivery.
For other drugs hard to get in public health centers and hospitals, EPHWOR buys them using its own money and ensures timely delivery to women in need.
Dr. Aruho laments that people with chronic diseases including cancer, HIV/AIDS, diabetes, and others that need periodic refills for drugs have been neglected in the country during this COVID-19 lockdown.
During the now two-month lockdown, the organisation has helped 40 women access free HIV/AIDS drugs. 100 other women have been helped to access free diabetic and hypertension drugs. They have also offered over 1500 kilograms of maize flour to some women who are not able to find what to eat. Over 10 million shillings (2700 USD) has been spent on this initiative by the organisation.
Dr. Aruho says there can never be an opportune moment to help these rural women like this time.
This reporting project overseen by InfoNile was made possible through the generous support of the Pulitzer Center on Crisis Reporting and the National Geographic Society.