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Photo via New African

 

When the Ugandan government closed schools in March 2020, soon after the first case of Covid-19 was cited in the country, no one imagined at the time that the virus would further escalate the rising rate of child and teenage pregnancy rates in the country. 

According to Makerere University School of Public Health, the number of teenage pregnancies rose by 28% during the first Covid lockdown last year. Overall, Uganda has fallen short of her pledge at the East, Central and Southern Africa Health Community (ESAC-HC) conference in Lusaka, February 2020 to reduce teenage pregnancies from 25% to 13% by next year. Instead, the rate is on the rise.

Covid-19 has created new and bigger challenges in reducing child and teenage pregnancies in the country. The Education ministry says pregnancies among schoolgirls have risen by 30% since the outbreak of Covid-19.

The figure is higher in the poorer rural districts of the north and east. Unlike girls in urban areas, rural teenagers are naive and vulnerable to sexual exploitation and abuse, says Margaret Aciro, a teacher at Kalongo Primary School in the northern district of Gulu.

The coronavirus threatens to reverse the gains in rebuilding northern Uganda’s social infrastructure – including education and moral values – ravaged by two decades of insurgencies led by the priestess Alice Lakwena’s Holy Spirit Movement of 1986-87, and Joseph Kony’s Lord’s Resistance Movement between 1987-2009.

During that period, a high percentage of girls in the region were raped and made sex slaves. In contrast to the central and western regions of the country which have prospered economically, primitive 18th-century grass-roofed huts of mud and reeds, dirty spring water sources shared by humans and livestock, footpaths for roads and abject poverty are a sore reminder of the northern region’s continuing lack of progress.

According to the Comboni Missionaries Samaritans, a Catholic charity working in the region, over 17,000 girls were made pregnant, some of them as young as 12 years old, by both teenage boys and adult men in the eight districts of northern Uganda during the first two months of the 2020 Covid-19 lockdown. Comboni Missionaries Samaritans estimate the number of pregnant girls in the eight districts to have risen threefold after the first lockdown 18 months ago.

The northern region is not the only one facing the problem. The health ministry says the eastern Busoga sub-region has the highest rate of teenage pregnancies in the country. It says 45% of deliveries in the region are for girls below 17 years of age. In Kamuli, one of the districts, over 7,000 teenage girls became pregnant last year.

In the eastern Mount Elgon region, teenage pregnancies have been exacerbated by circumcision festivities, the Imbalu, a tradition treasured by the Bagisu ethnic mountain community. Circumcision is a rite of passage to adulthood for boys.

During circumcision festivities, girls and boys are allowed free involvement, usually overnight, in the run-up to circumcision itself. Promiscuity is believed to be largely tolerated. Health officials in Namisindwa, another district in the region, say there is usually an upsurge of teenage pregnancies during and soon after the circumcision season. District health officials say this reflects the endeavour by the newly initiated adults to prove their adulthood through sex.

Law has no impact

Although Parliament passed a law in 1990 which criminalised sexual intercourse between men and girls below 18 years as an offence of defilement and imposed a maximum penalty of life imprisonment for the culprits, there is no evidence of it having an impact on teenage pregnancy rates.

Since the law was passed, few have been indicted, an indication that the economic, social and cultural realities have rendered the law inapplicable. Some cultures in Uganda allow teenage girls to be married.

In Uganda, there is a perception that once a girl develops breasts and begins menstrual periods, she is considered an adult ready to be married. This why the majority of girls who drop out of school are married before they are 18 years old.

Besides, parents of pregnant girls have openly opposed the jailing of the culprits as that denies the victims and their children vital financial and material support from them. Instead, families of pregnant girls prefer negotiating for financial compensation or bride price. At the time the law was passed, Parliament did not consider the need for funds to cater for the children and mothers in the event that the culprits were jailed. As it stands now, that law is a white elephant.

Although the country has made some economic progress in the past three decades, extreme income inequalities exist, with some households living in abject poverty. Testimonies by some girls give grim accounts of how they were lured into sex in return for money, food and sanitary pads their parents or guardians could not afford to buy them.

The Ugandan government has no contingency programmes to feed and support economically vulnerable sections of the population.

Covid-19 has expanded and deepened the plight of vulnerable teenage girls. Some of their parents, who depend on daily wages or incomes from the informal sector for survival, cannot afford to buy food and other essentials of life for their families. In order to survive, some parents have allowed their adolescent children to hawk fruits, vegetables and manufactured goods to earn the badly needed income.

It is thought that these activities have increased the girls’ vulnerability to sexual exploitation and abuse, says Ms Stella Zziwa, a professional counsellor in Kampala.

Some experts blame rising pregnancies on the poor parental care or lack of it, and the erosion of moral, cultural and social values. The traditional role of the parents has vanished, with men abandoning children with their mothers, says Zziwa.

A recent survey of urban areas indicates that six out of 10 women are single mothers, most of them engaged in shady activities, including prostitution to feed and educate their children.

Social values have been eroded to the extent that some victims blame close relatives, including uncles, brothers, cousins and even fathers for making them pregnant. “Cases of incest are on the rise,” says Joan Naiga, a local leader in Kamuli town.

Resistance to contraception

The government has not made any headway in putting in place an appropriate policy to deal with teenage pregnancies. In 2018 it announced a policy on sexual education, which emphasised abstinence from sex and the use of contraception and condoms.

The policy was opposed by the Catholic and Anglican churches, which between them founded over 80% of government-aided schools in the country. The churches say contraception is ungodly and an affront on procreation. They argue that allowing teenagers access to sexual information, including contraception could corrupt their morals and encourage uncontrolled sexual activities to the detriment of their health and education.

Rev. Ronald Okello, the Education Secretary at the Uganda Catholic Secretariat, wants sexual information to be tailored to children’s age groups without compromising church values. His colleague, Rev. Richard Rukundo, the Children’s Ministry Co-ordinator at the Anglican Church of Uganda, says inculcating moral values in teenagers, and not giving them contraceptives and condoms, should take centre
stage.

Ms. Monica Amoding, a Member of Parliament and the Chairperson of the Uganda Women’s Parliamentary Association, says teenage pregnancies are a result of the information gap between parents and their daughters. She urges parents to get closer to their children to discuss sexuality. - Epajjar Ojulu, New African

A health worker counts antiretroviral drug tablets for a patient at The AIDS Support Organization (TASO) in the capital Kampala, Uganda, July 12, 2012. Photo AP

 

Uganda has kickstarted a trial for the injectable HIV drugs cabotegravir and rilpivirine. Researchers and those living with HIV say the trial will likely end pill fatigue, fight stigma, improve adherence and ensure patients get the right dosage.

The two drugs have been in use as tablets. The World Health Organization last year licensed their use as injectables.

While the two injectables already went through trials in Europe and North America, this will be the first time they are tested in an African population for efficacy and safety in an African health care system.

Uganda is one of three African countries, along with Kenya and South Africa, which got approval from the WHO to carry out the trials. However, Kenya and South Africa have yet to acquire approvals to start their trials, expected by the end of the year.

Uganda and Kenya will both have three trial sites and there will be two in South Africa, with a total of 512 participants -- 202 from Uganda, 160 from Kenya and 150 from South Africa.

Dr. Ivan Mambule, the lead project researcher at the Joint Clinical Research Center, says participants will need one injection every two months.

“We are going to choose participants who are already on ART [anti-retroviral treatment] and are stable on ART. And we will randomize them to either continue on their normal treatment, which is the pill that they’ve been taking, or to switch them to this injectable. The injection is on the buttock,” he expressed.

Uganda has 1.4 million people living with HIV/AIDS. Barbara Kemigisa who is living with HIV and founded the Pill Power Foundation working with rural women, says the injectable drugs will increase adherence to treatment and ensure people get the right dosage.

“One of the things that affects adherence is the fact that people have to hide medicine. In the village, people are hiding medicine in the kitchen roof, in trees, in bushes, in a baby’s shoe…If someone is wrapping the medicine in like five plastic bags and digs a hole in the garden and keeps the medicine there, by the time someone is taking that medicine, it’s no longer medicine, it's poison,” Kemigisa points out.

Nicholas Niwagaba, who has worked with young people living with HIV welcomes the trial, saying it will reduce the pill burden and fight stigma.

“Young people feel like, this is a lot of pills to take. Those who are on the first line, they will have to take one tablet a day. There are those who are on second line and they have to take more than one pill and they have to take it in the morning and in the evening. And of course, this requires you to have actually a balanced diet which is really a challenge for most of young people especially those from vulnerable communities,” he says.

According to the WHO, there are 25.7 million people living with HIV in Africa. With only the pill currently available to manage the scourge, this injectable may come as a relief for people living with HIV/AIDS. - Halima Athumani, Voice of America

Burundi's Minister of Health Dr Thaddee Ndikumana, centre, Minister of Interior Gervais Ndirakobuca, right, and China's ambassador to Burundi Zhao Jiangping, left, mark the arrival of the first Covid-19 vaccines to the country. Photo Berthier Mugiraneza /AP

 

Burundi has started to roll out its first Covid-19 jabs, leaving just Eritrea and North Korea as the only countries on Earth not to begin a vaccination drive.

The news comes after a year and a half of tentative coronavirus policies in the East Africa nation of 11.5m people.

The East African nation recently received half a million Sinopharm doses from China as a donation. The vaccination campaign started on Monday in the commercial capital of Bujumbura. 

No government officials were reportedly present at the opening, and dozens of people queued quietly at a vaccination site, saying they heard about the drive only through word of mouth.

“I rushed to take the vaccine because I have a trip very soon and, of course, I also want to protect myself,” 30-year-old Blaise told Reuters. “People's fears are groundless. I am reassured by the fact that I was with a doctor when I got it.”

Pierre Nkurunziza, Burundi's former strongman president, downplayed the severity of the virus at the beginning of the pandemic and did not take significant measures to curb its spread. 

In June 2020, The Telegraph quoted opposition sources saying that Mr Nkurunziza may have become the world's first leader to die of the disease. 

The news comes as confirmed cases across sub-Saharan Africa fall to their lowest rate since the beginning stages of the pandemic.

On October 18, Africa recorded its lowest level of new cases – just 1,844 cases – since March 16, 2020, according to the World Health Organization (WHO).

Earlier this week, Kenya reported a positivity rate of 0.9 per cent, with only 33 people testing positive for the virus. South Africa reported that its rate has dropped to 1.4 per cent, with only 210 new cases on Monday. These are some of the lowest rates since the pandemic began. 

These testing figures only show a warped version of reality, however. Last week, the WHO's Africa Director, Dr Matshidiso Moeti, said that an estimated six out of seven coronavirus cases go undetected in the region. 

Dr Moeti said that while some eight million cases of coronavirus had been detected in Africa since the beginning of the pandemic, more than 50 million cases are estimated to have gone undetected.

Despite the fall in cases, however, the vaccine rollout remains slow across the continent. Less than five per cent of Africans are full vaccinated, according to Africa Union (AU) data, compared with more than 60 per cent in the European Union.

This shortfall is primarily due to supply issues. Most African countries have been highly effective at distributing Covid-19 shots. Africa had used more than 70 per cent of the vaccines it had received, according to the UN. - , The Telegraph

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