KAMPALA – Ms Kemigisha Miriam, 28, is a mother of two who has been abusing drugs for 6 years now. She says she started using drugs when she was at the university and she didn’t graduate because of addiction.
Even when her home is in Bugolobi – a suburb of Kampala, Kemigisha spends most of her time in “my hotspots in Kisenyi and Bakuri” well-known spots for abusing drugs.
“I wouldn’t say I was influenced to do drugs but while growing up, I wasn’t given parental love although my family had money. They believed if you have food, and education that’s it, so I was a little isolated.”
In an exclusive with PML Daily, she says she also used to have insomnia, the inability to get to sleep or sleep well at night and resorting to abusing drugs (heroin) was her available option which she says, at first, gave her peace and comfort no matter the expense.
Although Kemigisha feels fed up, she notes that it’s not easy to leave drugs without very serious assistance.
“There have been breaking points I feel I should stop especially when the police raids, you are in the news yet you don’t want your family to see you, but also you end up doing all sorts of funny things to get money for drugs.”
“When I don’t use it, I get withdrawals, I shake, I get a running nose, running stomach, I can’t walk, I can’t do anything,” she noted.
At some point, Kemigisha reveals she was denied health services in a government facility – accusing her of being an addict.
“I was two months pregnant, I went to a government health center because I didn’t want to abort. Unfortunately, the lady refused to work on me because I’m an addict and she told me a lot of words. I decided to go to Butabika Medically Assisted Therapy – MAT clinic where I was helped.”
On 22 August 2023, the Parliament of Uganda passed a 94-clauses – Narcotics and Psychotropic Substances (Control) Bill, 2023 which only allows the licensed farming and use of marijuana strictly for medical use, and sets harsh penalties for a multitude of offenses related to substances abuse.
The new law pending the President’s signature, seeks to allow the cultivation of marijuana and khat strictly for medical and other authorised use, with extreme penalties including forfeiture of properties and lengthy jail terms and hefty fines for violators.
Although Kemigisha highly welcomes the Bill, she thinks jailing them (abusers) might just be adding an insult to injury.
“I highly support the Bill because it could save us. However, I would think they should deal with drug dealers for corporal punishments other than us abusers who need to be rehabilitated and come back to normal. Like I told you, we shall just die in prisons. Let them go for the dealers because they are the ones selling to us. For us, we just need help. You find very young students in our hotspots abusing drugs, even in a school uniform and the dealers don’t care,” she painfully revealed.
“Whenever we are jailed, we really suffer a lot and some of us die in the cells due to withdrawal because in the cells they don’t even know that at least an addict should be given some injections.”
Kemigisha is not alone.
Ms. Namudowa Vanessa is only 19 and has abused drugs for four years.
Unlike Kemigisha, she says she was influenced by fellows back home in Mbale before they would later come to stay in Kampala.
Madowa says has been on the MAT program for a week “because I’m fed up with this thing. It takes a lot of my money. It has taken almost everything from me.”
She, however, noted that jailing them would be like burying them because they won’t survive for long in prisons.
Alliance of Women Advocating for Change (AWAC), a Civil Society Organisation that works with female sex workers notes that the Act imposes the most punitive of sanctions on persons who are found to be in violation of the provisions including the abusers which would cause a lot of repercussions if implemented.
Mr. Mukwaya Robert, Research and Development Coordinator at AWAC noted those adversely affected and susceptible to drug abuse are the marginalized people like youth and female sex workers in poor communities who have little or no family support as well as limited access to education in school, individuals and communities torn or displaced by war or natural disasters.
“This law is very retrogressive and it does not serve the human rights and well-being of citizens because, ideally, the essence of a good law should be able to promote well-being and foster harmony and should be pro-development. This law looks mainly at the punitive aspects, putting the person in prison does not help.”
“Some people use drugs because they are dealing with pain, others because they are not sleeping enough, others because they are depressed. So its idea is somebody is already sick and is using substances to manage the situation. So putting them in prison is not proper,” he noted.
According to him, these people are already struggling and all they need is help to recover unlike corporal punishments suggested in the Act.
“The government should strengthen the rehabilitation services, and psychosocial services, instead of taking them to prison.”
According to AWAC, women constitute a third of the world’s drug users and low-level trafficking is attributed to the significant increase in the number of women that are incarcerated globally.
“Women who use and inject drugs lack harm reduction services that cater to their unique gender needs, are more cruelly affected by gender-based violence, face more stigmatization when HIV positive, and will face human rights violations such as losing custody of their children. Where the women are also sex workers, it has meant that the above challenges are only exacerbated.”
They note that the criminalization of people who use drugs not only prevents them from accessing crucial health services in the realization of their right to health but also increases stigma and discrimination and thus deters affected persons from seeking treatment and rehabilitation services, thereby rendering them more vulnerable to violence and abuse from both private and state agencies.
They add that the Act will give the police another justification to raid FSWs, arbitrarily arrest them, demand bribes and physically, emotionally and sexually abuse them unchecked by the law.
“Harm reduction approaches are a viable solution to drug abuse that Uganda needs to invest more time and resources towards. This approach puts into focus the need to put a humane public health focus and human rights lens on drug-related challenges for sustainable outcomes.”
AWAC recommends the government to employ the following to address the issues that come with substance abuse:
Decriminalise the possession and use of drugs for recreational purposes and in small quantities. The justice system should also look into the reasons behind drug use for particular groups of people as a basis for meting out justice. The juvenile justice system should focus more on care services that are gender-informed instead of putting onus on correction
Government should allocate more resources and funds towards quality and accessible harm reduction services including needle/syringe programmes, opioid substitution therapy like methadone and community distribution of naloxone which are evidence-based approach to prevent HIV and HCV people using and injecting drugs which states such as Senegal, Tanzania and others are doing. Community-based harm reduction methods should be investigated also because medically assisted therapy for PWUIDs can only be effective where it is accessible. The fact that Mbale Regional Referral Hospital and Butabika Hospital are the only government institutes serving the whole of Uganda is counterproductive and makes it easier for PWUIDs to relapse where they have to move long distances to access help.
Harm reduction services and policies should be more gender sensitive including provision for childcare, provision for sexual and reproductive health care, measures to address gender-based violence. A needs assessment of women who use drugs should be conducted to allow for the appropriate development of targeted services.
Dissemination of accurate and comprehensive information on drug-related issues that do not reinforce stigma and discrimination, a demand reduction approach which will prove productive. This encompasses how PWUIDs are treated and handled by society including at health facilities, health officials should be ethical and when assimilating back into society where they should not be stigmatized when looking for work nor going back to school if it is the case. The South African Central Drug Authority (CDA) a statutory body that advises government on drug policies and strategies National Drug Master Plan 2019 – 2024 launched on 26 June 2020 recognizes there are better approaches to solving the problem than any failed war on drugs and criminalization of users including demand reduction strategies.
“It is well established that criminalization and punitive policies relating narcotic drug and substance abuse and trade has done little to neither reduce nor end the scourge of drug abuse. In order to actually solve the problem with better results there is a need for the Government of Uganda to involve key stakeholders the community, civil society organisations, health sector and the Judiciary in the design and implementation of human rights-based drug policies, groups most affected by drug policies, such as people who use or cultivate drugs must have a leading role in policy-making. This would enable Uganda to be in conformity with the various international human rights instruments it has ratified.”