The COVID-19 pandemic has greatly affected my routine and work as the Gender, Adolescent, and Youth Advisor for the new USAID Maternal Child Health and Nutrition Activity (MCHN) in Uganda. I was just settling in, when Uganda reported its first case and instituted a lockdown. The project team started working from home before we could meet key stakeholders, including the Ministry of Health; now, all the Ministry’s resources have been diverted to pandemic response. The computer has become a vital tool, but we have had some challenges. Sometimes, the data for Internet run out or the modem does not work. And most of us in Uganda are used to working in the field, so working from home is a new but good learning experience.
Gendered and Programmatic Challenges
The MCHN team is still starting up, so we are not involved directly in the COVID-19 response. However, I have been involved in other multisectoral working groups supporting the government in its response, including those focused on maternal and child health, nutrition, adolescent health, gender, and gender-based violence. These technical working groups are sponsored by implementing partners and United Nations agencies. Participants include Ministry of Health technical staff and key partners, including representatives from implementing partners, the U.S. President’s Emergency Plan for AIDS Relief, USAID, the U.S. Centers for Disease Control and Prevention, United Nations agencies, international organizations, and local civil society. Through the Gender and other Technical Working Groups, we have been working on health-related information, education, and communication materials, standard procedures, and guidelines for the health and education ministries. We have also been developing materials that target adolescents and youth. I supported development of a questionnaire intended to capture the experience of adolescents that will soon be available to them on their phones. I have been getting in touch with people in the east and southwest regions of Uganda, where I previously worked, to make sure young people are able to get the questionnaire on their phones to answer the questions.
The Gender Technical Working Group has been closely monitoring cases of gender-based violence during the pandemic, including domestic violence and violence against children. We are trying to bring about more awareness of the issue and how communities can address gender-based violence when it occurs. We have realized that because of the lockdown, people who experience violence are not seeking help, neither legal nor health services. We are trying to show people where to go to get services, so they can be supported and receive healthcare, and we are mobilizing resources and local NGOs to directly support people in need of services.
Data shared at a recent webinar showed an increase in the number of gender-based violence cases reported, with 1,211 cases from various gender-based violence shelters and 3,280 cases from the Ugandan police in March and April during the lockdown. Certainly, many more were not reported. Just the other day, there was a case of a mother—maybe because of lack of food—who gave her 14-year-old daughter to a man who ended up sexually abusing her. The daughter ran away, and her father reported it to the police, who arrested the mother. We are increasingly hearing these kinds of stories in the news, because of people advocating and mobilizing to report them. The media are praising that girl for speaking out.
I have observed that the pandemic is affecting different people in different ways. Many men in Uganda, for instance, are not used to being at home. Even religious leaders and people on the radio and TV have commented on this change, and it is one potential driver of violence. Of course, some men see it as a good thing to be together with their families and have taken this opportunity to help care for their children. There are others, however, who feel that being at home is not their place; they are becoming agitated and quarreling with household members about each and every small thing. Many of these arguments are rooted in gender-related norms.
It has been tougher for women in Uganda. Many women make their living in the market as informal sellers, and the lockdown has made it very difficult for them to work. This has led to a lack of food, especially in the urban areas most affected by COVID-19. Pregnant women have experienced challenges in finding transportation to health facilities due to the curfew. Some have given birth on the roadside or at home, attended only by their husbands. With awareness efforts and advocacy, the government has since responded by allowing pregnant women to travel past curfew for delivery.
Young people are having an even harder time accessing health services. Even before the pandemic, many young people did not access services such as sexual and reproductive health counseling, pregnancy services, and contraception. Transportation has been restricted during the lockdown, so young people are now unable to travel to health facilities, even if they wanted to. Uganda has one of the highest teenage pregnancy rates in the world, and we in the health sector are fearful of an increase. Pregnancies for girls under the age of 18 are already high risk, so missing out on antenatal care is especially dangerous. Those who experience sexual or gender-based violence are not seeking services, which puts them at greater risk for unwanted pregnancies and HIV infection.
Young people also experience greater financial and food insecurity—especially young women, so some engage in sex work to make ends meet. The head of an NGO supporting sex workers said transnational truckers are frequent clients, and a recent assessment showed transnational trucking was the source of 76 percent of COVID-19 cases in Uganda. There have been media campaigns for sex workers to avoid truckers during this time, but our fear is that they will have to choose between contracting COVID-19 and dying of hunger.
Envisioning Programming Realities in Post-Lockdown Uganda
As we are beginning to open back up, there is a lot that needs to be done. This pandemic has revealed a number of equity issues we thought had been taken care of. As a project, we will continue to support the Government of Uganda to coordinate and address gender, youth, and social inclusion issues, bringing together stakeholders from across government ministries to design culturally sensitive and gender-transformative approaches. We are looking at training those in the public and private sectors, but we need to think beyond that. We need to build the capacity of leaders—especially women leaders—to push for solutions to women’s issues in maternal, child health, and nutrition. We need to work across age groups, especially bringing in young people who can be champions and push the youth agenda to influence policy decisions. We also must not forget about including men, especially boys, in these discussions, because they have immense power to bring about change. As a local proverb states, “If you want to straighten a tree, you straighten it when it is still young.” We have the opportunity to work with the young people so they grow up to be powerful allies and partners for gender equality.
As unfortunate as this situation has been, I think we have learned a lot of important lessons. I am happy that the lockdown has made the government more aware of gender-based violence issues. As professionals, we have also seen the possibilities of working in a virtual space. In one day, I met and shared information with people from across Uganda, even across Africa, and this should continue even after the lockdown. This ability to connect brings about more learning, and is an opportunity for the government to focus on developing these networks to improve communication. This would allow more young people to get information when they need it.
Overall, this situation has shown me the importance of collaboration. When we partner with the Ministry of Health and others, we are able to do more. Seeing how partners have been able to coordinate a response during this pandemic has shown that if we do things together, we can bring about better results without duplicating our efforts. I would like to see us carry this lesson into the future.
How Is Your Program Responding at the Country Level?
If you are working on COVID-19 responses related to gender integration or gender-based violence prevention and response at the country level, please share your stories by commenting below, tweeting @EnCompass_World, or adding a note on EnCompass’ LinkedIn page or Facebook page.
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