November 30, 2023
Dr Paul Mushombe Nibhumba: Testimonial from Doctors of the World Medical Coordinator in Mali
For this month, Doctors of the World has taken a closer look, both at the international community as well as within its own chapters, to see how LGBTQ+ needs are identified, and more importantly addressed. Looking into the representation of LGBTQ+ needs in the global health landscape, it is clear that significant gaps exist, given the health disparities recorded. Doctors of the World has always been vocal on human rights, we firmly believe in confronting discrimination and violence taken against marginalized groups. To not speak up is to condone.
The United Nations 2030 Agenda on Sustainable Development Goals (SDG) was established as a guide to improve our world, with its overarching mission to “leave no one behind”. SDG 3 in particular was created “to ensure healthy lives and promote well-being for all at all ages.” Overall, the SDGs offer intersectional approaches that seek to improve the quality of life for all. However, due to the consensus nature of negotiations for this agenda, the document was unable to include LGBTQ+ as a specific group facing barriers to the right to development. Advocates were able to ensure that people that were marginalized because of their sexual orientation, gender identity and expression, and sex characteristics (SOGIESC) were inserted in commitments to “leave no one behind”. Nonetheless, by failing to specify LGBTQ+ in its agenda, it perpetuates the huge disparities that exist when it comes to LGBTQ health data, treatment, and inclusion.
A 2017 briefing published by the Global Forum on MSM and HIV and OutRight Action International, looks to amend the UNSDGs Agenda by providing recommendations on how to better improve LGBTQ+ health. The authors identified seven SDG 3 targets that Member States and civil society should work to address. The Agenda 2030 for LGBTQ+ Health and Wellbeing further stresses the importance of collecting and disseminating data and knowledge, so that evidence-based policy can be established that successfully addresses health disparities.
As part of the global humanitarian community, it is vital that Doctors of the World exchange research and knowledge on the topic. Today, we will discuss one of the projects we are incredibly honored to be a part of, the LGBTQ+ health in Uganda. However, if you are curious to learn about our other LGBTQ+ programs, be sure to keep an eye out on our social media platforms to get insights on other programs occurring around the world. It is vital, for the sake of this community, that knowledge is shared, that all voices are heard, and most importantly, action is taken.
Since 2009, the country has created extreme legislation against homosexuality, targeting their health and access to care. A bill even provided for life imprisonment for homosexuals, and the death penalty for those with HIV. Despite a certain progress in mentalities in recent years, in 2010, 37% of homosexuals in Kampala declared that they had suffered physical violence. 26% even admitted to having been raped. It is in this context that Doctors of the World has decided to act in order to fight against health discrimination linked to homophobia, and to provide care and reduce risks. Our programs look to address Sexual and Reproductive Health, Universal Health Coverage, and Training of Healthcare Workers.
In Kampala, DoTW decided to join forces with the Most At-Risk Populations Initiative (MARPI), an NGO which works at the hospital in Mulago providing sexual and reproductive health services to key groups (including gay and transgender people and sex workers). These services are tailored to their needs and the restrictions they face, and cover awareness-raising about STIs, contraception and gender-based violence.
Through the provision of training DoTW is also supporting MARPI as it expands its activities to regional referral hospitals, including the one in Mbarara in the south-west of the country. In addition to improving the services provided by the clinic, we are also training LGBTQ+ organizations in project design and fundraising. The partnership between MdM and local facilities is one of the milestones of this humanitarian mission in Uganda.
Furthermore, the Foundation of Friends of DoTW, chose to support community-based LGBT organizations, in addressing the repression and violence that is directed towards these communities. This partnership enables LGBTQ+ leaders to undertake a training program of humanitarian leadership and participates in the capacity building of community-based organizations that fight in favor of the rights and access to healthcare of the LGBTQ+ populations. The inclusion of LGBTQ+ voices is essential to ensure that health disparities are recognized and addressed.
Through our years of experience, Doctors of the World recognizes the importance of advocating and taking action for marginalized groups. Health disparities are staggering as a result of harmful policy, discrimination, exclusion and violence that is directed towards LGBTQ+ population.
The global health community has a responsibility to contribute by collecting and disseminating data, by working alongside civil society and grass-root LGBTQ+ organizations, and by advocating for policies that unconditionally respect human rights. For Pride Month, it is important that we celebrate the achievements that have been made and continue our work to address the gaps that still exist today.
© Sebastien Duijndam