Last week Nurse Rose Namubiru was convicted of professional
negligence for pricking a baby with a needle she had already pricked herself
with. Namibiru is HIV-positive.
For anyone who is a parent this is a story that makes your
blood run cold and cuddle in your veins.
I understand that medical practitioners prick themselves all
the time in the course of their work, but there is a prescribed practice of
what to do afterwards to prevent possible infection to the health worker or/and
the patient. By her own admission Namubiru ignored this or forgot to observe
these protocals and coupled with her HIV-status set the scene for the landmark
case, whose conviction was passed down barely days after parliament passed the
HIV Prevention & Control Bill 2010.
The new law provides a legal framework for the prevention
and control of HIV, disclosure of sero-status to reduce transmission, provision
of testing and counselling services and prescribing criminal penalties for
intentional transmission of HIV.
The court passed judgement and there is very little else we
can add to the argument.
However as is always in such like cases, the human rights
element came up. Activists have been arguing that the arrest, trial and
eventual conviction of Namubiru was clear case of discrimination of
HIV-positive people in this country.
One can argue that hadn’t she been living with HIV the
ensuing drama may not have happened and the whole incident may have been swept
under the carpet, as has probably happened in numerous cases before.
It is no consolation to all the concerned parties, but its
good events took the course they did because this single case cuts straight to
the heart of the professionalism and ethical standards to which we hold our
health workers.
The law is useful in maintaining order but more importantly
there has to be a fear of social censure, that society will not look on and
allow certain behaviour to pass. So for example you wouldn’t help yourself on
the road side or walk around naked in public for fear of ridicule and be
ostracised. This a more powerful means of controlling public behaviour than all
the laws and enforcement agents that can be aligned against outlaws.
Which brings us around to the case by the human rights
activists. It is clichéd by now but worth repeating, we exercise our rights and
freedoms in as far as they do not infringe on the rights and freedoms of
others. Which presupposes that in exercising our rights we should act responsibly.
That Namubiru was the victim of a with-hunt and what she was
alleged to have done could be handled administratively by her peers is to
dismiss the concerns of the family and the wider society as irrelevant.
In addition these claims deny the breakdown of our medical
services, not only in infrastructure and inadequacy of health worker numbers
but also in practice.
One of the outcomes of this case is to put our medical
service providers and workers on notice that the days of medical workers doing
with us as they please without fear of scrutiny are over. It has also set a
benchmark of how such cases of alleged malpractice or negligence can be
handled, a useful precedence for society, which if anything advances the rights
of the medical practitioners and their patients.
And to that extent the case against Namubiru was not a
regression in the country’s pioneering efforts against HIV/AIDS.
In the more than 30 years since the struggle begun there has
been a lot of progress, some setbacks but the trajectory has remained forward.
We stigamtise the infected less than we do in the 1980s, testing and counselling services are much
more widespread, access to treatment is not only more widely available but
cheaper and there is a greater understanding of HIV/AIDS than before. A lot
still has to be done in those same areas.
We are looked up as a
reference point on AIDS prevention, treatment and even research, especially in
the context of a poor country. We are not perfect, but it is safe to say we
learn at every turn.
It wold be ideal if progress was made in a straight upward
line but that is not how life works.
The Namubiru case was not a cut-and-dried issue of criminal
liability. It was bigger than the convicted nurse, the aggrieved parents or the
wronged baby. It was a groundbreaking case which furthers the fight against the
pandemic going in to the future not only in Uganda but globally as well.
