LGBTQ Health Equity in Uganda

By Anonymous Author | 17 Mar, 2014

Hello Everyone,

I want to start a discussion about the horrific situation occurring in Uganda as we speak. For those of you who don't know, the government of Uganda passed legislation in December 2013 making homosexuality an offense punishable by life imprisonment. The bill further goes on to state that even those 'associated with or supporters of homosexuality' will be punished by imprisonment.

Newspapers have published front page articles with pictures, addresses, and phone numbers of known gay people and violence in escalating. Hate crimes are building momentum and many LGBT (lesbian, gay, bisexual, & transgender) folks are seeking asylum in other countries. In addition to the human rights violations and inequity, the health of the entire country is at risk.

Aid is being cut by some European countries, including Norway, Denmark and the Netherlands, and others like Austria and Sweden, are similarly reviewing their aid commitments. U.S. policymakers are discussing halting aid to Uganda for the coming fiscal year in protest. The foreseeable consequences of these cuts are terrifying and will likely affect the majority of Ugandans.

Additionally, one of my greatest concerns is the care and treatment for LGBT Ugandans, including those living with HIV. With a long history of cultural stigma and hatred toward them, these marginalized individuals are no longer protected by the law, now they are hiding. We know that marginalized groups are more at-risk for HIV transmission, decreased access to care, and life-saving ARVs. Without appropriate treatment and support, the HIV epidemic has the potential to skyrocket, especially among MSM.

As leaders in global health delivery, as nurses- we need to act.

I am wondering if anyone knows of any organizations that are either openly or discreetly providing care to LGBT individuals in Uganda. Do any of our fellow nurses with policy experience think we could have some clout if we push the US government on this issue? Is anyone affiliated with the International Council of Nurses or a similar international organization that could help give us a voice? I personally am committed to taking action on my end, including returning to East Africa to provide direct care and educational support to nurses.

Any suggestions/comments anyone has are greatly appreciated.

In solidarity.

(I have chosen to create an anonymous profile because if opportunities arise for me (or others) to go to Uganda for support, I don't want to risk prosecution. It may seem overprotective, but according to friends (both African and expats) the situation is ACTUALLY that serious. Thank You.



Janet Stewart Replied at 6:50 AM, 18 Mar 2014

Thank you for this compelling report. I have no solutions or connections to help you, but I am grateful for your bringing this issue to this forum. I think that the international nursing community needs to take political action - maybe through ICN? - if for no other purpose than to shame the Uganda government and misguided community members for this human rights outrage. I am sure there are others who have more concrete ideas and better formulated plans than myself, but count me in on raising my voice.

Danny Gotto Replied at 9:07 AM, 18 Mar 2014

Hello Anonymous,

I appreciate your concerns about the situation in Uganda especially about
the consequences of LGBTI enactment in Uganda. I must say, I live and work
in Uganda as a medical officer and I see whatever you've said in our
country every day of my work. I must say some of us including my peers
where I work, we have silently continued to support (LGBTi) people in our
care especially those with HIV. My biggest disappointment is the pulling
out of fund by development partners. I don't think this was a genuine
approach to cut AID. It's not the guys in leadership who will feel the
pinch, its the common poor person. I feel this is irresponsible diplomacy
by the International community. Lets continue to engage, talk, educate,
etc. Lets reach out to every person in every corner of our country to
empower them to understand issues of LGBTi. This is the only way we will
move together as a country and as a global community.

Nevertheless, we will continue to support our people without any
discrimination of any sort. The LGBTi war is one we will have to continue
fighting. We are continuing our sensitization of the public though
clandestinely to make them appreciate. People can't countries are not at
the same level of development, especially understanding issues like those
concerning LGBTI.

To all the people of the world, we can't despair neither should we spend
all our time procrastinating and engaging recrimination of those who have
suppressed others. Let face forward one step at a time. It is humanity's
battle, lets face it together as human being as Ugandans. With the support
of the international community, I am so sure the future is good. Because I
know even in those countries which have good legislation this debate has
kept of the public discourse for year.

I encourage all LGBTi persons not to run away from us, lets remain focused
and fight together to defeat these inhuman laws. This is our country to
make better. No one is gonna do it for us apart from us. The other people
of the world can continue morale support and encouragement.

To all the health workers in Uganda, we can't discriminate people, our role
is to serve whoever comes with needs.

Anonymous Author Replied at 3:47 PM, 20 Mar 2014

Thank You Danny!

I'm so grateful to know that you and others are supporting the LGBTi community. Often times in these situations I feel powerless, as many do, and I'm not sure what to do. I am really hoping that others in this discussion forum will have some suggestions about how to reach out to the larger international community. I know if we ban together as nurses, we can at least have some sort of voice.

Again, anyone with any suggestions about how to do this- please share!

Elizabeth Glaser Moderator Emeritus Replied at 5:25 PM, 20 Mar 2014

You are not powerless. Give yourself credit for taking charge of your life and control of your voice by posting here.
Writing letters is a fine thing and I am happy to do so but I also want to act to can increase your agency in the short term, too. What specific thing can we do now that will help increase quality of life for you and our LGBTi colleagues?

Does ICN have the political will and power to put forth a letter of support for our LGBTi colleagues - can we get support from other professional groups as well? Can we petition WHO, World Bank, GFATM, PEPFAR, or other donors to negotiate change in exchange for aid ? Maybe. If we are going to write letters, let's make them count.

We can use this as a safe space to work out the best plan - please invite your colleagues to participate.


Anonymous Author Replied at 9:52 AM, 21 Mar 2014

Thanks for the suggestions Elizabeth!

A few thoughts/questions:

1. Is there another way to connect with people on this forum to see who may be interested in helping draft a letter and reaching out to other organizations? Is anyone on this forum connected to any professional organizations that would potentially be in support of this idea? How does one petition WHO, World Bank etc?

2. We need to think about what will make the UG government pay attention and care about what we are saying. I've reached out to some global health policy colleagues but I'm thinking about the angle of the worsening health outcomes, especially with the aid funding cuts from so many countries. Please reach out to your global health policy colleagues & friends for more suggestions.

3. Ultimately this has the potential to affect numerous people, not just the LGBTQI community. With these funding cuts who knows what could happen to maternal/child health, HIV/AIDS care, malnutrition etc... I think we as nurses need to raise these concerns because others may just be honing in the anti-homosexuality perspective.

Once we get a group of people who are interested- let's start tackling this issue, drafting letters, and reaching out.
I'm in. Are you?

in solidarity.

Elizabeth Glaser Moderator Emeritus Replied at 10:33 AM, 21 Mar 2014

Yes, you take the lead on this.


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