Bridging the Digital Divide for Universal Health Coverage innovation in Africa

Bridging the Digital Divide for Universal Health Coverage innovation in Africa

Can Africa achieve Universal Health Coverage? There are mountains to climb  when it comes to achieving Universal Health Coverage (UHC) in Africa – poverty, inadequate infrastructure, lack of political will among others. Yet, technology has proved that Africa can leapfrog into the future. The mobile money innovation, has for instance, made it possible for the previously unbanked to receive and send money from their phones.

In this digital era, using digital technology to ensure access to quality healthcare is no longer an option; it is the way to go. In South Africa, the WatIF health portal was designed as a health work force multiplier that up-skills nurses to perform tasks previously reserved for doctors and specialists. Medtronics labs on the other hand, designs healthcare delivery models with and for communities using digital technologies across a range of healthcare services. It also collaborates with various partners to ensure sustainability and to amplify impact.

During the first multi-stakeholder meeting that took place in Kampala on March 20, convened by Novartis to discuss sustaining the momentum toward UHC in Africa, one of the key discussions was about leveraging digital technology. The stakeholders emphasised that technology is an enabler for the attainment of UHC. They also highlighted that any such technology towards UHC should be built on centralised systems and the innovation solutions scalable. However, low internet connectivity in Africa was pointed as a barrier for effective innovation for advancement of UHC on the continent.

While only about 35% of Africa’s population are connected to the internet, majority of the continent leaders look at digital technology as a threat to political power rather than an enabler for economic and social growth. So far, African governments that have interrupted the internet include Algeria, Burundi, the Central African Republic , Cameroon, Chad, Democratic Republic of  Congo, Congo (Brazzaville), Egypt, Equatorial Guinea, Gabon, Ethiopia, Libya, Niger, Togo, and Zimbabwe, Uganda, Mali, Morocco, the Gambia and Sierra Leone. In fact, within the first three months of 2019, internet disruptions were registered in five countries – Chad, Democratic Republic of Congo, Gabon, Sudan and Zimbabwe.

In Uganda, it is now 10 months since government introduced social media tax for Over the Top (OTT) services such as Facebook, Twitter, LinkedIn, Instagram and Skype. Subscribers are charged a daily fee of Shs 200 to access OTT services while 0.5 percent is charged on every mobile money withdraw. General outcry and protests that characterised the tax introduction fell on deaf ears. A recent research by Pollicy in partnership with Access Now, shows that prior to the social media tax, 33% of respondents would access social media platforms more than 10 times a day. This number dropped to 6.6% after the tax was introduced and 86% of respondents feel that the social media tax should be abolished.

For Universal Health Coverage to be achieved, the efforts of leveraging digital technology have to be supported by deliberate efforts from African governments to create an enabling environment for innovations. The first step is to connect people to the Internet and to desist from deliberate disruptions or shutdowns.

As Dr. Githinji Gitahi, the CEO Amref Health Africa Group said at the first multi-stakeholder meeting in Kampala in March, no country prospers without investing in its people and health is central to development.

My attendance at the Dialogue  was sponsored by Novartis Social Business. 

Sexism Is Not Just Words, It Poisons Society

Sexism Is Not Just Words, It Poisons Society

Sexism |ˈsɛksɪz(ə)m| 

by dictionary definition is prejudice, stereotyping, or discrimination, typically against women, on the basis of sex.

The State Minister of tourism Kiwanda launching the ludicrous Miss Curvy Contest in Uganda  said, “We have naturally endowed nice looking women that are amazing to look at. Why don’t we use these people as a strategy to promote our tourism?”

Good lord! This kind of sexism is a bad stench that reminds us Ugandan women of the male chauvinism and patriarchy that our society has been fed on for generations through culture and religion. You know like smell that comes from a trash bin when it hangs around the house longer than it should?

Uganda’s source of tourism is animals, nature and to add to list Kiwanda suggests curvy women. Because in Kiwanda’s mind, women are no less than the list of things that have been attracting tourists.

I watch the twitter timeline and Facebook feed painfully as Ugandan men young and old chuckle and make jokes about this absurdity. Sadder, that some girls think that skinny girls are just being plainly jealous when they speak out against this sexism.

On the surface, sometimes sexist comments sound like compliments and that is why socially unconscious people like Kiwanda struggle to see what is wrong with their thinking.

But this is what you do to women and girls that read this stuff in headlines of major news papers-   that women are second class citizens, that all girls should aim at is being delicate flowery attractions, that they shouldn’t aim for the highest positions in society. It is subtly passing on a message to the males on how they should view the females around them- no less than cheap objects that attract tourists.

The media is not helping the situation, in their quest for relevance and sales though sensationalism, you can read the undertone of the news-reporter that they are not just reporting the news but rather eagerly passing on a toxic piece of information.

But to understand sexism, these men should look at it as racism, being in a place and the way people look at you, talk to you – even the most mediocre of the race that claims superiority makes you suddenly question your humanity.  The principles of the evils are basically the same.

The Kiwanda’s don’t know that the rape issues, defilement of girls, female genital mutilation, cat-calling on the streets, sexual harassment at work, in schools and at the universities is find root in this culture of thinking that women are less because they are women.

“Why do you think sexism persists?” I asked a friend I was hanging out with recently.  “it is like how you programme a computer.” she said, “you will programme a computer according to how you want the computer to function, tell women that they are objects and it will be inked in their subconscious minds and men will dominate in workplaces, in positions of power and their egos will be boosted in their homes, they will control their women, get women to slave for them in their homes.” She said and I couldn’t agree more.

No wonder Ugandan women continue to suffer because of bad policies and poor management of the country, there is no maternal health care, women are struggling to feed their kids because of a bad economy; no decent jobs, insurance is a dream for many, unpaid care work, they toil in the fields, they feed the nation while being ripped off by middle men, inheritance and property rights are still a huge challenge, there is no proper housing, no proper roads, the phenomenon of absentee fathers is here because men have abandoned their basic duties. There is one thing that these misogynistic people don’t know is that Patriarchy works against an entire system that takes both men and women down.

Look at countries that respect their women- Scandinavian countries dominated the 2019 list of the best countries for women, they are far ahead than countries that seek to subdue and make fun of the agency of the woman.

Did the Spanking in School Make Us better Ugandan Citizens?

Did the Spanking in School Make Us better Ugandan Citizens?

Screenshot from the Survey on Violence Against Children in Uganda 2018

I run a poll on Twitter, my question was, “were you beaten at school?” Only 92% of the 73 people that responded had been beaten at school for all sorts of reason, they shared their experiences;

Evelyn tweeted;

Shanine said;

Omara added;

Did the beating make us better people or did it birth angry people or were we subdued to a culture of silence that makes us crouch down in fear in the presence of those that hold authority.

A study from Michael Mackenzie of Columbia University indicated that spanking at age 5 was associated with greater aggression.

Studies show that the use of corporal punishment is associated with increased mental health problems in children including increased psychological distress, which may lead to anxiety, depression, alcohol and drug use, and general psychological maladjustment in those to whom it is applied.

A recent survey conducted by the Ministry of Gender Labour and social development indicates that,

94% of Ugandan children who were subjected to physical violence by an adult, their first experience was nearly
always committed by a teacher. The study further indicates that 1 in 2 boys who experience physical violence experienced greater mental distress than boys who were not exposed to violence.

Unfortunately, this vice has been normalised. There was a common saying when we were in school, that an African Child’s ears are in the buttocks. What is the origin of this saying? I wonder.

Evelyn Masaba breaks it down for me;

I agree with this assertion in many ways; the school system we are attending, was by colonialists so the relationship between the teachers and the learners was a master- subject relationship. 50 years on, most teachers don’t seem to know any other way to discipline kids.

My mind is connecting dots right now – currently, there are high cases of Violence against women in Uganda- is this violence a byproduct of the violence that Ugandan kids faced while growing up?

Could this be a case of displaced aggression? According to Bushman a Psychologist, displaced aggression can occur when someone cannot aggress towards the source of incitement or provocation, so instead takes it out on something else and behaves aggressively towards another individual that had nothing to do with the initial conflict. Most of the victims are those whom the aggressor considers weak- women, children or pets.

I guess the time to take action is now – The Ministry of Education after this survey has to roll up its sleeves to train teachers in better ways to discipline children- because what is called disciplining right now is partly to blame for creating angry and subdued citizens.

Social Media Taxes Vs. Corruption – Ugandans Choose VPNs

Social Media Taxes Vs. Corruption – Ugandans Choose VPNs

When the president mentioned that he and his government were planning to tax social media for too much gossip, we laughed, funny memes made rounds on social media because we thought that this move was simply ridiculous. Who taxes end users of social media in 2018? The Civil society met the finance committee of parliament to convince them to drop this unreasonable tax, the committee after listening to the submissions mentioned in their report that the tax was unfair to Ugandan taxpayers. But somehow, out of the 400 members of parliament, only 3 objected to the tax proposal. The tax proposal was passed.

Why? In my opinion, the Members of parliament are self-seeking leeches that suck the blood of Ugandan taxpayers. Members of parliament are most vibrant when fighting to remove taxes from their allowances, and tampering with the constitution. Lately, the MPs are asking for army bodyguards following the assassination of Hon: Abiriga a member of parliament a few weeks ago. The social media tax is here, there is a social media blackout, the only way in is if you pay a tax. This stuff hurts. Do these MPs know that the internet should be open, safe, accessible and affordable and that the internet is no longer a luxury but rather a basic human need?

The president of Uganda is desperate, the song that has been on his lips since being elected for his fifth or is it sixth term- I have lost count, is to usher Uganda into a middle-income status by 2020. Tick-tock the clock is ticking but there no signs of a middle-income status. But I sort of understand where the president is coming from especially that as human beings, we inherently desire to leave a lasting legacy. For 32 years, this damn middle-income status has been elusive, in fact, the economy gets worse every single day; the shilling is struggling, the unemployment rates have skyrocketed, fuel prices have gone gaga, crime rates have risen, poor housing, government schools and health facilities are dilapidated.

When the president and his men took over power in 1986, they found the country in shambles; total breakdown in the rule of law, poverty, disease, bloodstained streets – a reign of terror. They were the much-needed liberators – the country rejoiced, behold a new era of peace and tranquillity. Our dear president I think sometimes feels like a musician who takes centre stage, sings a song, the crowd goes wild chanting “encore encore”, later, the song becomes tasteless and a loud silence follows. The musician tries to make a comeback but no one is chanting for an encore. Some musicians take to drugs; presidents get high on power. And take Nicolo Machiavelli’s advice seriously; “it is better to be feared than to be loved.”

It is seven days now since social media was blacked out. Many Ugandans have refused to pay the tax; they have resolved to use Virtual Private Networks (VPNs). Can you blame them? Experience proves that the taxes will end up in the pockets of a few government officials. These leeches will build large houses with high walls and big cars to push all of us out of traffic during rush hour. Since the year 2000, Uganda has lost over twenty-four trillion shillings to corruption scandals involving high profile Ugandans. Scandal after scandal; In 2007, 247 billion shillings meant for the Common Wealth Heads of States Government meeting disappeared into thin air. In 2008, 25 billion shillings went missing – the money was intended for malaria and tuberculosis drugs programmes. In 2010, the Ugandan government entered a deal illegally with Muhlbauer, a German firm to supply national IDs without the required open bidding – 25 billion shillings was lost in the process. In 2011, Amman industrial Tool and Equipment Ltd was contracted to supply bicycles, not even half a bicycle was delivered, 4 billion shilling was lost as a result. Still, in 2011, 60 billion shillings vanished from the Microfinance Support Centre in a period of three months. In 2012, Shilling 169 billion meant that outstanding claims of East African community workers disappeared. 2015, 18 billion Uganda shillings meant for the construction of the Kanoni-Sembabule road vanished, every year, the Auditor Generals report is full of squander and more squander.

Some sardines have been arrested whereas the whales are roaming free enjoying the proceeds of their corruption while Ugandans continue to wallow in poverty.

The Social Media Tax in Uganda will Widen the Gender Digital Divide    

The Social Media Tax in Uganda will Widen the Gender Digital Divide    

Undeniably, the newly introduced social media tax in Uganda will widen the digital gap.  But let me focus on women  because the barriers Ugandan women face in accessing and using the internet are still massive. 1 in 9 women in Africa have access to the internet. Only about 37 percent of women surveyed in ten selected cities in the world, Kampala inclusive were found to be using the internet compared to 59 percent males.

The sustainable Development goals demand  governments to achieve universal, affordable internet by 2020 but high costs are keeping majority women offline.

According to a score card by the Web Foundation, in Uganda, 1GB data priced at 22% of average monthly income. Countries that have expensive internet such as Uganda and Mozambique have the lowest numbers of women on the internet.

A research conducted by the Women of Uganda Network and the Web Foundation indicates that as a result of feminised poverty, many women who are dependent on subsistence Agriculture cannot afford to buy a smart phone and data bundles and those who can afford have problems of language barrier since most of them are illiterate and thus lack of knowledge and limited skills for expressing themselves using ICTs.

Considering that women’s general income status in Uganda is low, internet is expensive to purchase and maintain  The traditional setting of the Ugandan society  creates the negative thinking towards women’s participation and engagement in accessing public spaces like cafes and telecentres also affects women’s access and use of internet.Patterns of gender inequality, as reflected in political participation and representation in decision- making structures; differences in economic opportunities, access to resources, and division of labour within the economy; women’s over-representation among the poor; women’s higher levels of illiteracy. The persistence of stereotypical attitudes about women’s roles and of discriminatory laws and practices, are among the factors that also shape women’s capacity of access to and use of ICT.

The study further reveals that teacher educators hardly apply technology in their classroom practices; scanty institutional practices that facilitate or impede the use of digital resources as pedagogical tools. The greatest challenge reported by all the teacher educators was the problem of having limited access to ICT facilities, especially the Internet. The only Internet access point at the college that was readily available to both students and staff was the one at the computer lab. The Internet connection at the college had been cut off due to non-payment of the connection fee, which the college was expecting to receive from the Ministry of Education, but to no avail; and lack of Internet connection is very frustrating.

I am convinced that the newly introduced social media tax is frustrating all the efforts that have been put in place to bridge the digital divide but instead, the gap will grow wider and wider. Listening to President Museveni saying that social media is a luxury good, and that people have a choice  to use it or leave it if they don’t want to pay the tax, really hurts. This is 2018, the rest of the world has moved towards artificial intelligence, innovation around internet of things and free internet access in public places. Uganda has made a terrible mistake of switching off over-the-top services that can only accessed after paying a repetitive daily direct tax of 200 shillings and large number of women who live on less than a dollar per day will not afford this tax.

By the way, when talking to the women in Bwaise a slum in Kampala before the tax was passed, to them, the internet is WhatsApp, Facebook and for a few google. That means that they have been cut off.

The digital revolution gave Ugandan women a voice online to politically engage, to speak truth to power, to dismantle the patriarchy, to seek counsel from their friends, to access information, to connect with clients, to market their products,  to start charities, psychosocial support groups, coordinating savings groups, neighborhood watches for kids when they are away. It is clear that President Museveni is missing a point when he says that social media is for gossip. But even if it was, communication is a basic human need.

If only the Members of parliament, the president’s many advisers, the ministry of ICT stopped for just a second to listen to the outcry of the Ugandan people that we have seen on social media since 1st July when the tax came into effect then they would repeal the tax. If only the government of Uganda adhered to Article 19 of the UN Human Rights council on the promotion, protection and enjoyment of human rights on the Internet, they would know that the internet should be open. Article 19  seeks to “bridge the gender digital divide and enhance the use of enabling technology, in particular information and communications technology, to promote the empowerment of all women and girls and to reaffirm the human rights and fundamental freedoms enshrined in the Universal Declaration of Human Rights.”

By switching off the internet which is a public good the state disregards Article19 that is “deeply concerned by measures that intentionally prevent or disrupt access to or dissemination of information online and for the Internet to be open, affordable and accessible.”

 

The Militia Man That Killed My Husband Wanted Me to Marry Him #WithRefugees

The Militia Man That Killed My Husband Wanted Me to Marry Him #WithRefugees

Before Maombi was displaced from her a village in  Rutshuru region, North Kivu province in the Democratic Republic of Congo (DRC), She had a good life, she and her husband had property, were successful farmers until when her family became a target of a ruthless armed militia that was determined to destroy them. Her only crime was that she was from a different tribe.

“December 2010, the army men raided our home three times; the first time, they robbed our house, looted everything. A week later, took me away, they raped me, tortured me, beat me up and dumped me at a bush near my house. The third raid was on a Sunday evening; this time, they took my husband away. I got worried when he didn’t return home, my neighbours knew what was going on, we began searching for him. On Monday evening after a long day’s search, we found my husband’s body lying lifeless in the bush with what looked like severe torture wounds. I was devastated. On the evening of the burial, an army vehicle came to my compound, the rugged-looking army commander that had captured and killed my husband stepped out, he said that he was asking me to marry him. He said that that he was giving me one week to get back to him with an answer. He pointed at my husband’s fresh grave. “You’ll follow him if you refuse to marry me.”  We were sleeping in the bushes near our home. Two nights later, we heard people coming to our home, I held the younger kids; I told the older ones to run. I hid at my friend’s home overnight. My friend told me about a man that transported goods across the border to Uganda. She asked me not to worry about the two older kids. That she would make sure she gets them someone to bring them to Uganda. She was confident because she was from the tribe that wasn’t being hunted. He agreed to transport us. He put us in his truck with the maize that he was transporting. We reached Kasindi border through Bwera.

At the border, I was quiet, the truck driver is the only one that spoke. I had no paperwork, nothing. I dont know what he said to them but they did not ask me anything. He drove us to Kampala. I wasn’t thinking about my next move when I got to Kampala. He dropped me at the Gaaga bus terminal. I overheard a woman speaking Kiswahili, I walked to her, I told her all my problems. She didn’t know how to help but she told me that she knew a church that had several Congolese refugees. She paid my boda-boda fare. The church received me with open arms. They gave me food and a place for me and my kids to sleep. I asked people to take me to police but many were hesitant, two months later, I got someone that accompanied me to the police station. The police gave me a refugee card and told me to go to the Office of the Prime Minister where I received and an asylum seeker card.

I called Mama Gideon the kind lady that I had met at the Gaaga bus terminal, she was happy to hear from me. I told her that I wanted to start a business but I didn’t have start-up capital. Mama Gideon gave me 100,000 Uganda shillings. I began hawking necklaces around the city. So we formed a group as Congolese women. We started saving. I was able to rent a house in Makindye. Kampala City Council Authority was chasing away all vendors so trading on the streets was proving difficult. It is during this period that I began to feel sick, I didn’t know why because I had always been a strong woman. I went to InterAid because they give free medical care to refugees. After telling them my history, they carried out HIV tests. I tested positive. I couldn’t walk long distances like before, and I was tired of the running battles with KCCA.  So I was not making as many sales as before. At InterAid, they told me about two children that had a story that seemed to fit mine. They showed me their files, they were my children. I was so happy that they had made it. We were reunited.  When the children came, someone at church told me about Jesuit Refugee Council in Nsambya that sponsor children. They help with my kids’ education. I am hopeful that life will change. Life is difficult here, rent is due two months, one of my girls has dropped out of school to help support the family. I just wish they could find us a third country. going back home is not an option because those that tortured us and killed my husband will come for my children.”

Sexual violence has continued to be used as a tool for war, targeting victims on basis of their actual or perceived ethnicity. It has been employed as a tactic, of ethnic hatred, even ethnic cleansing. It is one of the least reported crimes, yet the victims suffer shame, stigma – consequences felt for a lifetime.

But seeking justice is the last thing on Maombi’s mind right now. The daily struggles with poverty in the Ugandan slums are her preoccupation as she seeks to give her children a better life against all odds. She is one of Kampala’s  350,000 registered refugees.

Breaking the Silence to End Sexual Harassment at workplaces in Uganda #SolidarityWins

Breaking the Silence to End Sexual Harassment at workplaces in Uganda #SolidarityWins

“On a project that I was working on, we had to work with Members of Parliament for their input on a legislation we were drafting. So, we went to parliament, to meet with them. As we were walking towards the room, one MP saw me, walked to me and then he started rubbing my back. He then he looked at my arms and said, “Oh my God you have very hairy arms”. He asked me If I understood what that meant to which I said I did not. He then said that “it means that during sex you’ll be very wet” and he could only imagine that the sex must be sweet. This was really annoying, he was a vulgar person, remember, this is the first day I had met him, that was 2013. Later, as we were seated around a table; myself, an Intern, and some other people he was saying sexually explicit stuff. That is one example. At my place of work, my supervisor kept telling me that I look sexy, the accountant in the same organization one day told me that I really really have big boobs. This made me feel very uncomfortable.” Sarah, a 28-year-old Human Rights Lawyer revealed to me. She was young, her career had just begun, so she decided keep this to herself scared of the bullying, stigma, shaming that comes with speaking out. Until today, she is not comfortable with speaking out about the ordeals.

In Uganda, sexual harassment at work places, though prevalent is hardly spoken about. Uganda’s 2016 demographic and health survey found that more than one in five women report having experienced sexual violence. Mostly, the vice finds its safe haven in silence, stigma, weak policies, high unemployment levels as I would discover when I asked a sample of corporate women where they would seek redress if ever faced with sexual harassment at work;

Eva, a 25-year-old Marketing Executive believes that “Reporting sexual harassment in this country and pointing out the committer leads to losing your job and sometimes no employer wants to work with you after that. And in this economy, we do not have rich parents or a lot of money to fall back to, so most of us will prefer silence to talking about it.”

Sandra, 26, a Social Worker said that “If ever I am sexually harassed, I would be afraid to report the case to the police because I believe most of the police stations do not have a gender desk and for the cases, I have heard, most times the blame is shifted on women.”

Kemigisha, 19, says that “I would report my case to the police but I would never share this issue on social media because I wouldn’t want the attention that comes with social media. I don’t be want to be labeled a whore – you know how our society is.”

Izzy, 32, a youth rights advocate says that “It really would depend on the harassment faced. If someone catcalled me, I wouldn’t report it. But if I had a near rape experience or an actual rape I would report the case to police.”

These responses offer insight on why coming out to speak about sexual harassment can be complicated.

 The question is, how can we foster solidarity to strengthen the violence against women prevention movement?

Knowing that silence is the frontline enemy, speaking up is an act of defiance. Collective campaigns like #Metoo #AidToo have given a voice to women to speak up. The key thing is for women to know that they have agency over their bodies, what they do with them is a dictatorship.

Facilitating Human Resource managers to understand what sexual harassment actually means will enable them to consistently pass on this message to staff members to keep it fresh in the organizations, not for the policies to just sit on shelves only to be presented during the auditing season.

In addition, workplaces ought to create safe spaces where staff members can unreservedly report cases major or minor.

“Workplaces should put in place policies against any form of sexual harassment and make avenues through which cases can be reported.  I would have a participatory session with the staff to know their understanding of sexual harassment in the work place, then use their views to build a policy which is accustomed for the work environment and one that’s clearly understood by the staff.  I would create confidential avenues, like an anonymous email chain where these issues can be reported, suggestion boxes among others.” Beatrice a 25-year-old Administrative Assistant suggested.

Safe spaces to speak up about sexual harassment come in handy; Not Your Body offers a great example of how an online platform has taken strides in creating a space where Ugandan women can speak about their experiences of sexual harassment and discrimination. Social media has indeed offered a voice to Ugandan women.

Police has to stand up to the times, the force should be equipped to understand how to deal with sexual harassment issues rather than trivialize the cases that are reported; Lindsey Kukunda speaking to News Deeply mentioned that “I also had a personal experience when I attempted to report sexual harassment to the police. I was lectured and made to feel like it was my fault, and this experience made me wonder what there was to do about it. It also made me wonder how many other women experienced something similar and also didn’t know what to do about it.”

Whatever means work for women in protecting themselves against sexual harassment, these means should be applied because ultimately, women’s lives matter.

From 14th – 16th June, 2018, join an online campaign on the theme Solidarity Wins for Stronger VAW Prevention Movements” by the Gender Based Violence Prevention Network, coordinated by Raising Voices in Uganda. Join the conversation on #SolidarityWins