Patients’ rights must not be ignored- Kaitiritimba

A banker by training, Robinah Kaitiritimba Karungi was attracted to advocating for health rights by a team of public conscious Ugandans headed by Brig Dr Samuel Lwanga (RIP) together with whom, they founded the Uganda National Health Consumers’ Organisation (UNHCO).
Nineteen years later, on March 8, 2018, UNHCO, was awarded the Bloomberg MPOWER E award for enforcing bans on Tobacco Advertising, Promotion and Sponsorship (TAPS) by Michael Rubens Bloomberg, a WHO Global Ambassador for Non communicable Diseases and Injuries.
UNHCO’s advocacy that led to the enactment and eventual compliance promotion of the Tobacco Control Act No. 22 of 2015 brought Kaitiritimba unprecedented international recognition.
The activist is happy that the successful legislative security for persons below 21 years and the entire Ugandan populace from public exposure to tobacco in the middle of big tobacco lobby groups leaves the public safer.
“We want to bring these pictures to the table rather than talk about things without evidence to show for them. We went the extra mile to show their living conditions and poverty shackles that tobacco chained unsuspecting homesteads to in Uganda,” she explains.
Kaitiritimba appreciates public resentment to tobacco exposure that she attributes to the relocation of the British American Tobacco Uganda factory and Tobacco Leaf factory from public places, Kampala and Kireka respectively.

Success
Kaitiritimba’s spirited fight saw her mobilise and organise the Kireka community in whose residence was a tobacco factory, coalesce with the like-minded CSOs, reach out to Dr Sheila Ndyanabangi (RIP) of the Ministry of Health, and Members of Parliament for Kinkizi County East Dr Chris Baryomunsi, and of Ndorwa West, David Bahati respectively.
This networking led to the enactment of bans against tobacco adverts, selling shisha in Uganda, involving persons below 21 years in all forms of tobacco activities, smoking in public places to mention but a few.
UNHCO, through the bill banned advertising of any form by cigarette producing companies, “We also banned it in shops because it was such that enticed children to smoke. In our report, “Big Tobacco Tiny Targets, we pointed out that cigarettes were mixed with toys, books sweets and other children friendly things which would make them believe that smoking was okay.

All this is what we called misguiding and harmful,” she notes.
They are now on a campaign to increase taxes on tobacco, “We learned that for every Shs1 collected from tobacco, we spend $3 (Shs11,400) to treat tobacco related cancer. We are doing this in partnership with the School of Public Health Makerere,” Kaitiritimba reveals.
While the tobacco industry is in court contesting some bits of the law such as age and displays of tobacco products in shops, UNHCO is impressed that Parliament and the President signed off the law.

Challenge
One of the hindrances for most bills is the Certificate of Financial Implementation, something that government looks at critically before adopting the Bill. However, for the tobacco Bill, its implementation is within Police work and other arms of government such as Kampala City Council Authority, and National Environmental Management Authroity.
“But it remains a challenge because the Police needs to understand the law and we need to build capacity of the legal arms such as state attorneys who need to know what to do when culprits are arraigned. Police also needs to know how to collect evidence,” Kaitiritimba shares.
The first group that police arrested was released owing to failure to prosecute them. Therefore, they are now working backwards to see how to patch the gaps “We now have a lawyer who helps us understand the law, trains the community as well as state attorneys. We are also designating smoking areas that are 50 metres from people,” she says.
She wonders that if people can sit on planes for as long as they have to without smoking, why do they behave like they cannot wait until they are really far from people to smoke?
In like manner, as a patients’ safety champion for World Health Organisation (WHO), health consumer’s representative on the Health Policy committee (HPAC) of the Ministry of Health, another breakthrough was when the Ministry of Health agreed on adopting the patients’ charter of 2009. The lobby, started in 2002, involved several key players to ensure integrating patient rights in health sector practice.
According to Kaitiritimba Beyond the charter, UNHCO team has reached out to the Speaker of Parliament, Rebecca Kadaga so that a comprehensive legislative tool that entrenches patients’ rights is fast-tracked. This gave birth to the patient rights and responsibilities Bill championed by MP Paul Akamba (Busika County), seconded by MPs Andrew Kaluya (Kigulu County South) and David Abala (Ngora).
The bill aims at restoring patient confidence, protecting health practitioners, there by reducing the cost of treatment and improving human capital for development at large. The right to health bill – patients’ rights and responsibilities bill is going to have its second hearing in Parliament.
She notes, “We are also fighting for our health workers for better service. For example, if one works in the rural areas, they should not be there for so long. Their pay should also be revised for better”.

The journey
Kaitiritimba has been in the health sector for more than 20 years and recalls one commissioner promising to close UNHCO offices but the then Commissioner General Prof Francis Omaswa cheered her on saying, “We have been looking for such help for so long.” The activist notes that such encouragement her realise a lot still had to be done.
“This fight calls for the understanding of communities and their satisfaction with the health sector, building relations between health workers and patients so that stereotypes are changed,” she reveals.