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UGANDA: “God Should Be So Kind That I Can Have Contraceptives”

Kwamboka Oyaro

NAIROBI, Apr 10 2008 (IPS) - For many of Africa’s women, getting access to family planning services is difficult at the best of times. When war intervenes they can find themselves without any services at all, even as they become more vulnerable to sexual violence – the situation in northern Uganda being a case in point.

A long-running conflict in this region has pitted the Lord’s Resistance Army (LRA) against government forces. The rebels, led by Joseph Kony, claim to be fighting for a government based on the Biblical Ten Commandments, but have become notorious for rights abuses that include the use of children as soldiers, sex slaves and porters.

While an initial ceasefire in the 20-year war was reached in 2006, a final peace agreement remains elusive. Kony was scheduled to sign the deal Thursday at a location along the border between Sudan and the Democratic Republic of Congo, but has reportedly asked for further discussions on the agreement. Negotiations have been complicated by the International Criminal Court’s (ICC) efforts to try the LRA leader and other high-ranking rebels for war crimes: the LRA has demanded that the ICC warrants against its members be lifted ahead of laying down arms.

In the course of the conflict, nearly two million people have been forced from their homes. Figures from the Geneva-based Internal Displacement Monitoring Centre indicate that about 1.23 million persons are currently displaced, living in camps and transit sites.

In the camps, “…the women have no access to economic activities so they are sexually exploited. Even husbands encourage their wives to get money from soldiers, especially on pay day,” said Rosemary Nyakikongoro, programme director at the Forum for Women in Democracy, a civic group headquartered in Kampala. She made the comments during a recent workshop on reproductive health that took place in the Ugandan capital under the auspices of the Washington-based Population Reference Bureau, a non-governmental organisation.

Girls as young as eight are forced into having sex, often for food. “Soldiers and non-school going boys initiate the girls to sex, usually through rape,” said Primo Madras, national programme officer for the United Nations Population Fund (UNFPA).

His words were echoed by Wilson Jaga, chief executive director of the Child Care and Rescue Programme, a local charitable organisation. “In northern Uganda, rape, defilement and coercion are the norm. Women are forced to sleep with soldiers in their huts for security. These soldiers are mobile…Once they move on, others take over.”

A 2007 study by the UNFPA showed that whatever contraception is available in the camps is snapped up: it quoted a health worker who had assisted in the settlements as saying that “When commodities are available the uptake is overwhelming, even for tubal ligation, and providers have to work around the clock to satisfy demand.” (The study was a follow-up to research about the situation in four camps for internally displaced persons – IDPs – in 1994.)

All too often, however, contraceptives are not on offer, or are out of reach. “Sometimes condoms are given free to the IDPs in northern Uganda for a month, and during the second month they are on sale. Where will the refugees get money to buy (them)?” asked Jaga.

Furthermore, “During war women are abducted for sexual exploitation and trafficking. In such situations they have no say regarding anything, including contraception,” explained Nyakikongoro.

Women in camps may also find themselves coming under pressure to have children from men who claim that community members who have died as a result of the conflict need to be replaced.

A constant sense of mortality adds to this pressure. “The ongoing conflict in northern Uganda makes it difficult to get men to embrace family planning. In a war situation, they feel that they must urgently get as many children as possible before they die,” said Deborah Mulumba, a senior lecturer in the women and gender studies department at Makerere University in Kampala.

The result is a fertility rate that exceeds the national average. According to the Uganda Bureau of Statistics, women in the camps have 7.4 children, compared to 6.7 for the rest of the country. However, Madras believes these figures understate the problem, and that displaced women may be having as many as nine children each.

Nationally, 25 percent girls under 18 become mothers; in the camps, it is more than 40 percent. “It is common to see many child mothers…even 12-year-olds…in camps of internally displaced persons in northern Uganda,” Mulumba told the workshop.

The UNFPA’s research into the state of affairs in four camps in 1994 showed many women resorting to abortion in the face of sexual exploitation and the uncertain provision of contraceptives. And, last year’s study indicated that little had changed in the intervening decade – the desperation this engenders encapsulated in a comment made by one of the women interviewed for the study: “God should be so kind that I can have contraceptives.”

Needless to say, sexually-transmitted diseases are often spread more readily among IDPs than elsewhere. According to Mulumba, HIV prevalence in the camps stands at 12 percent; the Joint United Nations Programme on HIV/AIDS puts general adult prevalence in Uganda at 6.5 percent.

Many soldiers refuse to use condoms because they claim it makes sex less pleasurable, and on the assumption that even if they do contract HIV they will die in battle before developing full-blown AIDS.

Add to this a climate of impunity concerning sexual crimes – in the camps, the perpetrators of rape and sexual exploitation almost always escape justice – and a chilling picture emerges concerning the plight of women living in IDP settlements.