Makerere Institute of Social Research (MISR) Collections

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"Abortion? That's for women!" Narratives and experiences of commercial motorbike riders in South-Western Uganda.

(Women's Health and Action Research Center, 2005) Nyanzi, Stella ; Nyanzi, Barbara ; Kalina, Bessie

Although constitutionally illegal, induced abortion is a vital reproductive health option in Uganda. This paper analyses men's narratives about meanings of, and experiences with, abortion. Men play significant roles in abortion as instigators, facilitators, collaborators, transporters, advisors, informers, supporters or punishment givers. Many participants were knowledgeable about abortion. Attitudes were ambivalent, with initial reactions of denial and relegation of abortion to women's private domains. Further exploration, however, revealed active support and involvement of men. Interpretations of abortion ranged from 'dependable saviour' to 'deceptive sin'. Though a private action, abortion is socially scripted and often collectively determined by wider social networks of kinsmen, the community, peers, law and religion. A disjuncture exists between dominant public health discourse and the reality of local men who interact with women and girls as wives, lovers, sex sellers, mothers, daughters and sisters. Interventions targeting men about abortion should include safe sex education, provide safe abortion services and create stronger social support mechanisms. Policy and law should incorporate local knowledge and practice.
The adventures of the Randy Professor and Angela the sugar mummy: Sex in fictional serials in Ugandan popular magazines.

(Taylor and Francis, 2005) Gysels, Marjolein ; Pool, Robert ; Nyanzi, Stella

In 1996 newspaper vendors in Ugandan towns started selling a new kind of locally produced ‘lifestyle’ magazine. On the covers there were young, scantily dressed girls and inside news articles, fictional serials, lifestyle articles, agony aunt columns, etc. The new magazines gained an enormous popularity in a short space of time. Everywhere people were seen reading them and copies became brown and tattered from use. Using content analysis, we analyse the fictional serials which appeared in three of these magazines. We focus on these because they were the most sexually explicit type of content and, from a public health perspective, the most relevant with regard to HIV prevention. The stories were presented as simple entertainment, depicting the adventures of stereotypical characters. They provided people with explicit and unrestricted sexual fantasy which was, at the same time, devoid of any real risk. Although they could be interpreted as providing a discourse which challenged the main messages of HIV-prevention campaigns (sex is good for you, have as much of it as possible, and don't let condoms spoil the enjoyment), they also suggest that behaviour change may be more popular if sex and sexual health are not separated from sexual pleasure, and safe sex is promoted from a positive perspective (emphasis on sexual enjoyment) rather than a negative one (prevention of disease). The popularity of the magazines underscores the importance of entertainment value when discussing sex, and suggests alternative possibilities for disseminating health messages. Illustrated popular magazines such as those discussed here could be suitable as intervention, though they would need some adaptation to counter gender stereotypes and sexual violence.
'African sex is dangerous!' Renegotiating 'ritual sex' in contemporary Masaka district.

(Cambridge University Press, 2008) Nyanzi, Stella ; Nassimbwa, Justine ; Kayizzi, Vincent ; Kabanda, Strivan

The sexual culture of sub-Saharan African peoples is variously utilized as an explanation for the high incidence of HIV in Africa. Thus it has been the target of behaviour change campaigns championed by massive public health education. Based on ethnographic fieldwork (using participant observation, individual interviews, focus group discussions, and a survey) in Masaka District, this article contests a reified, homogeneous and ethnocentric sexualizing of Africans. It engages with how prescribed ritual sex practices are (re)negotiated, contested, affirmed, policed, revised and given meaning within the context of a society living with HIV/AIDS. Among Baganda, sex is customarily a vital component for ‘completing’ individual prosperity, kin-group equilibrium and social cohesion. Various forms of prescribed customary sexual activities range from penetrative sex interaction between penis and vagina, to symbolic performances such as (male) jumping over women's legs or (female) wearing of special belts. Unlike portrayals of customary sex activities in anti-HIV/AIDS discourse, the notion of ‘dangerous sex’ and the fear of contagion are not typical of all ritual sex practices in Masaka. Akin to Christianity, colonialism, colonial medicine and modernizing discourses, anti-HIV/AIDS campaigns are the contemporary social policemen for sex, sexuality and sexual behaviour. In this regard, public health discourse in Uganda is pathologizing the mundane aspects of customary practices. The HIV/AIDS metaphor is variously utilized by Baganda to negotiate whether or not to engage in specific ritual sex activities.
Ambivalence surrounding elderly widows’ sexuality in urban Uganda.

(Springer, 2011) Nyanzi, Stella

The elderly are commonly stereotyped as asexual beings. Alternatively mainly negative images abound about the sexual activities of elderly people. Based on ethnographic data this article explores diverse sexualities of elderly widows and widowers in an urban periphery of Kampala city. Widowhood is socially constructed as an asexual period in this patriarchal society where heteronormativity and marriage prevail as the accepted norms. While widowers are generally encouraged to remarry after observing proprieties of mourning, sexual activity among elderly widows is heavily proscribed against particularly because it is not procreative. Adult children control the sexuality of their elderly parents, often by discouraging sexual liaisons. Adult children may also arrange for new spouses with utilitarian value such as providing healthcare for ill elders. Post-menopausal widows have less sexual appeal than younger widows for whom reproduction is a viable outcome of sexuality. Widowers and younger widows are more likely to remarry than elderly widows. Consequently for some older widows, the cultural institution of widow inheritance provides an opportunity to resume sexual activity, and benefit from the levirate guardian’s support. However other older widows rejected inheritance by levirate guardians because of fears of catching HIV/AIDS. HIV does infect elderly Ugandans, although prevention and care interventions generally exclude targeting the elderly. Loneliness was widespread among elderly widows. Many felt isolated, dislocated from former social circulation and missed being relevant. However there were a few elderly individuals who were actively engaged in providing sexual education, advocating for sexual health promotion, and defending the sexual rights of the younger generations in their immediate environs. There is an urgent need for more research about the realities of elderly people’s sexualities, sexual health and sexual rights particularly in resource-poor contexts.
Are HIV unaware persons the hidden population at high risk of HIV infection or re-infection in Uganda

( 1999-12-06) Kiirya, Stephen K.

Introduction: There has been a prejudiced view that HIV infection creates a state of desperation and a feeling of revenge that latently drives persons with HIV/AIDS (PHAs) into risky sexual and reproductive behaviors. This study examined child bearing, new sexual partnerships, disclosure of HIV status prior to coitus, and negotiations on condom use among HIV infected, uninfected and unaware persons as the basis for ascertaining the group at high risk of HIV infection/re-infection. Methods: HIV infected (86 females and 58 males), HIV uninfected (25 females and 21 males) and HIV unaware (59 males and 40 females) persons were drawn from one parish of Kampala, Iganga, Soroti,Lira, Masaka, Mbarara and Kabale districts. A pre-tested questionnaire which yielded a content validity index (CVI) of .79 was used to measure child bearing, new sexual partnerships, disclosure of HIV status prior to coitus, negotiations on condom use for the three groups. Focus group discussions were also carried out with each group to establish the etiological basis of these behaviors. Results: HIV infected persons (86%) reported higher levels of child bearing compared to the uninfected (66%) and unaware (57%) persons. Of the HIV infected persons who learned of their HIV status through a test, about 61% went a head to bear children. Also, more HIV infected (44%) and uninfected persons (44%) tend to disclose to partners their HIV status prior to coitus than the HIV unaware persons (35%). However, HIV unaware and uninfected persons reported higher levels of initiation and coitus with new partners during the past year from the time this study was undertaken than the HIV infected persons. Also, HIV unaware (77%) and uninfected persons (77%) reported higher levels of negotiations on the form of coitus (condom use) than the HIV infected (69%). This is especially so because it is easier to declare the HIV status if the test results are negative than positive., Males specifically surfaced as the group more complacent to risky sexual and reproductive behaviors, implying that they are more likely to spread HIV than females. Conclusion: Childbearing and non-negotiation with partners on condom use turned out as the factors that increase HIV re-infection among PHAs. However, initiation of new sexual relationships and despondency about disclosing their HIV status to partners prior to coitus seem to be the critical risk factors for HIV transmission among the HIV unaware persons. HIV unaware persons feel that if they disclosed their sero-status their partners would be scared and possibly stop the relationship on the suspicion that they have HIV/AIDS. False confidence arising out of the cognition and imagination that the problem of HIV/AIDS is not in vicinity motivates HIV unaware persons to think positively about sexual situations that, in effect, increase the risk of HIV infection. While more research merits in this area, broaden advocacy for and the coverage of all HIV/AIDS preventive campaigns to not only target the HIV infected, but also uninfected and unaware persons.
Attendance patterns and causes of dropout in primary schools in Uganda: a case study of 16 schools

( 2008-04-28) Musisi, Nakanyike B. ; Kasente, Deborah ; Balihuta, A. M.

In 1997 the Government of Uganda launched the Universal Primary Education (UPE) program. The 1999 enrollment data collected by the headcount exercise and the school census of 2000 demonstrate that the program has been successful in increasing enrollment rates both for boys and girls. More than 6 million pupils were enrolled in primary education in 1999. However, available information suggests that there are high rates of dropout to the extent that only about 39% of the children that enrolled in primary one in 1997 managed to get to primary five in 2001. High levels of absenteeism, repetition, transfers and non-enrollment have also been observed. The purpose of this study was to investigate the causes of such trends and to get views from various stakeholders about possible remedies to these problems. The study was commissioned by the Ministry of Education and Sports and implemented by Makerere Institute of Social Research (MISR). The Ministry considered the study to be important for several reasons. Firstly, when a student is frequently absent or fails to master a minimum of skills and competences and is forced to repeat the grade, the cost to educate that student doubles. Secondly, because any dropout before primary 5 will not have mastered literacy, the cost to the education system will not lead to a literate individual and will therefore have been wasteful. Thirdly, the government policy of poverty eradication aims at educating all children to the end of primary level and will have been let down if children who enroll in schools do not stay there. The EMIS 2001 data was used to guide selection of 16 schools from 8 districts in the four regions of the country taking schools that were reported to have the highest and lowest dropout rates in each of the selected districts. The data supplied to EMIS was verified in all the selected schools by scrutinizing school registers from 1997 to the present for absenteeism, repetition, transfers and dropout as well as interviews with head teachers and class teachers. A questionnaire was developed by the research team and used to interview individual pupils who have dropped out of school, those regularly absent and those who have transferred from other schools. Qualitative methods were used to get perceptions of local leaders, parents and teachers about causes of the problems under study and possible remedies. In each of the schools with the highest dropout twenty pupils were interviewed on the causes of absenteeism, dropout, repetition and transfers. This means that a total of 160 in-depth pupil interviews were conducted. The parents or guardians, community leaders, as well as the teachers and school administrators were also interviewed using focused group discussions on the level of seriousness of non-enrolment, absenteeism, repetition, dropout and transfers, as well as the causes of and remedies to these problems. In each high dropout Focused Group Discussions (FGDs) were held with 12 members of the community, including representative teachers, and parents, community leaders. This means that FGDs were held with a total of 48 persons. On the other hand, in each of the primary schools with zero the research group verified whether indeed that selected school had a zero dropout as reported in the EMIS data. The research team also carried out detailed observation of the schools and prepared profiles for each of them. The findings of the study are informed by triangulated data from all these data sources.
Attitudes to voluntary counselling and testing for HIV among pregnant women in rural South-west Uganda.

(Taylor and Francis, 2001) Pool, Robert ; Nyanzi, Stella ; Whitworth, James A. G.

This paper describes the results of a study exploring the attitudes of women attending maternity clinics to voluntary counselling and testing during pregnancy in rural areas in south-west Uganda. It was a qualitative study using focus group discussions (FGDs). Twenty-four FGDs were carried out with 208 women attending maternity clinics in three sites in rural south-west Uganda. The FGDs were all recorded and transcribed, and analysed using standard computer-based qualitative techniques. Almost all women were willing in principle to take an HIV test in the event of pregnancy, and to reveal their HIV status to maternity staff. They were anxious, however, about confidentiality, and there was a widespread fear that maternity staff might refuse to assist them when the time came to deliver if their status were known. This applied more to traditional birth attendants than to biomedical health staff. There were also rumours about medical staff intentionally killing HIV-positive patients in order to stem the spread of the epidemic. Women were concerned that if their husbands found out they were HIV-positive they would be blamed and separation or domestic violence might result. In conclusion: although VCT during pregnancy is acceptable in principle, much will need to be done to ensure confidentiality and allay women's fears of stigmatisation and discrimination during delivery. Community sensitisation will be necessary and male partners will have to be involved if interventions are to be acceptable.
Beyond ethnic patriotism: A comparative study of Toro and Kigezi Districts in Uganda

(Makerere University, 2020-09) Ngabirano, Evarist

To explain the ‘puzzle of tribe’ in East Africa, the historians of Africa claimed that it was African leaders they called ‘ethnic patriots’ whose intellectual and political work constituted their people into tribes. The claim emphasizes that these leaders wrote history books to validate and authenticate themselves as leaders of their tribes and that the successive postcolonial heads of states have exacerbated the problem through patronage. That is how the creation of kingdoms and districts and the distribution of national resources based on tribe, which are sources of violence, has been explained in the politics of post-colonial Uganda, particularly Toro. In response, I deploy comparative, historical, anthropological and political science approaches to examine archival material, oral interviews and literature to study three main realities. The first is that colonialism replaced pre-colonial politics of mobilizing society focusing on territorial residence with tribe and homelands (indirect rule). In Toro for instance, one tribe, the Batoro were officially recognized as native and all possibilities for others to be recognized were extinguished. This became a basis upon which natives qualified for political and socioeconomic inclusion and the Batoro used it to discriminate Bamba and Bakonzo. The second is that the colonized naturalized rather than challenge indirect rule. Such response was derivative of the colonial structure and inspired by colonial ethnographers. The Bamba and Bakonzo for instance called for a three-tribe solution, which was a demand that the British consistently apply indirect rule as an administrative practice. In Kigezi, the British applied the three-tribe solution from 1930 when they replaced Baganda agents with native chiefs of Bakiga, Bahororo and Bafumbira in their respective homelands. This arrangement created political majorities and minorities, which accounts for ethnic maneuvers in the local council elections of the 1950’s. The third is a response that steps outside the parameters of indirect rule to focus on building a residence-based identity/administrative unit that explains the absence of derivative responses in Kigezi. This thesis claims that such response was dialectical because it challenged rather than reproduced the structure of indirect rule. I argue that this response received inspiration from a multiplicity of sources including pre-colonial, colonial and the socioeconomic aspirations of the people of Kigezi. However, I claim that in Toro, Isaya Mukirane’s response does not necessarily represent only the negative in which the response was derivative. As manifested in his thought and actions, the move he takes demonstrates tactical rather than strategic calculations. Moreover, I argue that the struggle between accommodating and adopting the demands of indirect rule (derivative) and seeking to reform it (dialectical) can be found inside both Mukirane’s and Ngologoza’s agency in Toro and Kigezi respectively and not between the two.
Beyond Nuremberg: The historical significance of the post-apartheid transition in South Africa.

(Sage, 2015) Mamdani, Mahmood

The contemporary human rights movement holds up Nuremberg as a template with which to define responsibility for mass violence. I argue that the negotiations that ended apartheid—the Convention for a Democratic South Africa (CODESA)— provide the raw material for a critique of the “lessons of Nuremberg.” Whereas Nuremberg shaped a notion of justice as criminal justice, CODESA calls on us to think of justice as primarily political. CODESA shed the zero-sum logic of criminal justice for the inclusive nature of political justice. If the former accents victims’ justice, the latter prioritizes survivors’ justice. If Nuremberg has been ideologized as a paradigm, the end of apartheid has been exceptionalized as an improbable outcome produced by the exceptional personality of Nelson Mandela. This essay argues for the core relevance of the South African transition for ending civil wars in the rest of Africa.
Beyond Religio-Cultural Violence: A Historico-Political Re-contextualization of the Movement for the Restoration of the Ten Commandments of God

(Makerere University, 2023-11-05) Katumusiime, Jacob

In conceptualizing the emergence of the Movement for the Restoration of the Ten Commandments of God (MRTCG) and the mass violence that the religious movement orchestrated, scholarship and popular literature have accentuated the primacy of culture. The MRTCG is claimed to have arisen from ethnic Bakiga’s embrace of Marian and Millenarian religious traditions. The MRTCG violence which climaxed with the 2000 Kanungu Inferno is also essentialized as a predestined result of inherently violent ethnic and religious traditions. This study however de-emphasizes the culturalist conceptions of the MRTCG and its violence. It deploys decolonization as a methodology and critically utilizes aspects of anthropology, historicism and political science to explore the context within which the MRTCG both emerged as a breakaway religious movement and descended into violence. The study contends that the MRTCG arose from multiplicities of the history of political marginalization within institutions of the nation-state. It illustrates that the MRTCG is a product of the colonial politicization of ethnicity, political parties and religion. The study further argues that the MRTCG violence erupted within the context of Uganda’s regulation and criminalization of religious movements. In making sense of the agency of breakaway religious movements in postcolonial Africa, the study calls for a historicization that focuses on their interaction with institutions of nation-state power. It contends that breakaway religious movements arise not only as a critique but also a creation of the undemocratized state.
Breastfeeding practices and attitudes relevant to the vertical transmission of HIV in rural South-west Uganda.

(Routledge, Taylor and Francis Group, 2001) Pool, Robert ; Nyanzi, Stella ; Whitworth, James A. G.

Breastfeeding has been associated with a doubling of the risk of HIV transmission. In developed countries, it is recommended that HIV-positive women do not breastfeed, but this is not a feasible option in most of Africa. It is therefore important to know the extent to which breastfeeding practices are amenable to change. To study this, we carried out 24 focus group discussions with 208 women attending maternity clinics in three rural sites in rural south-west Uganda. Breastfeeding starts from a few minutes to a few days after delivery; most women reported starting after 2 days. The main reason for delay is lack of milk or that the breasts are 'blocked'. Most women thought that this delay was good for the baby, or at least not harmful. Almost all women reported giving the child a soup made of boiled mushrooms before starting to breastfeed. Once they have started breastfeeding, various supplementary foods are gradually introduced at 4-6 months. Women thought that ideally breastfeeding should last for 2-3 years, but in practice most stopped after 18 months. The father and his female relatives generally decide when the child should be weaned. The women thought that commercial milk formula foods were good but could not use them because they are too expensive and anyway unavailable in rural areas. Most women were unaware that HIV could be passed to the child through breastfeeding. Various practices identified as potentially risky are common in this population. Artificial feeding is not a viable option in this area, and although women were prepared to make sacrifices to prevent vertical transmission of HIV, practices are deeply ingrained in traditional culture and will need to be addressed in future interventions. Male partners will also need to be involved.
Bumsters, big black organs and old white gold: Embodied racial myths in sexual relationships of Gambian beach boys.

(Taylor and Francis, 2005) Nyanzi, Stella ; Rosenberg-Jallow, Ousman ; Bah, Ousman ; Nyanzi, Susan

Sexuality is a platform upon which ideologies are enacted. Based on ethnographic fieldwork in The Gambia, this paper discusses the embodiment of racial myths about male Black bodies and Western affluence. Methods utilized included participant observation, focus group discussions and in‐depth interviews. Beach‐boys, locally called bumsters, are a common feature of the country's tourism. Societal attitudes to bumsters are ambivalent. Bumsters variously indulge in a complex web of sexual activity ranging from commercial to non‐commercial, voluntary to socially‐imposed, individual to peer‐driven, heterosexual to homosexual, casual to regular, particularly with foreign tourists. Narratives about their sexuality reveal an enactment of myths about the male Black body and superior sexual performance on one hand, and images of plundered wealth sitting in ‘the West’—a dream destination flowing with milk and honey, and physically represented by the toubab—a local label for White foreigners—on the other. This highly fantasized wealth forms the core of youth aspirations to travel abroad. Sexual activity with a toubab is the ticket out of Africa's inherent scarcity. Metaphors and idioms of unlimited virility and dynamic manhood are reinforced through sex tourism and form part of the identity of Gambian bumsters. These self‐images reinstate and reinforce racial stereotypes.
Catalyst, nature, and vitality of African Canadian feminism: a panorama of an emigre feminist

(University of Toronto Press Incorporated, 1999) Musisi, Nakanyike B
Challenges to the realisation of the right to adequate food in post-war Uganda: A case study of Otuke District

(Makerere University, 2014-12) Amanya, Isaac

The study assessed the challenges to realisation of the right to adequate food in post-LRA war affected areas in Northern Uganda. The study objectives were to; a) To identify and describe the human rights instruments in relation to understanding the meaning of the right to adequate food; b) to assess the situation in relation to realisation of the right to adequate food in Otuke district; c) to establish the challenges faced in relation to the realisation of the right to adequate food in Otuke district; d)to recommend ways that can be undertaken to ensure the realisation of the right to adequate food in Otuke district. The study was carried out in Otuke District, one of the formerly war affected Districts in Northern Uganda. The study used both qualitative and quantitative methods adapting case study and descriptive research designs. A total of 118 households and ten key informants participated in the study. The study found that majority of households faced great economic challenges despite having physical aspects to enable them realize their right to adequate food. Most households (95.8%) had land for crop growing but only 22.9% of them had the recommended three meals a day. The study noted; land grabbing, customary land ownership system, infertile soils and low household incomes as the main challenges to the realisation of RtF in the District. Only 28% of the households were using modern farming methods to improve food production. Most households (77.1%) had less than three meals a day. Furthermore only 18.6% of the households often ate animal protein. The study concluded that the poor land tenure system, low household incomes, inadequate access to and use of modern farming methods are the major challenges facing realization of the right to adequate food in post LRA war Northern Uganda. As a result, most households have less than three meals a day which in most cases do not meet dietary requirements. Households have become reliant on the market for food which most households find expensive and not readily available especially during the dry seasons.
Challenges to the realisation of the right to adequate food in post-war Uganda: A case study of Otuke District

(Makerere University, 2014-12) Amanya, Isaac

The study assessed the challenges to realisation of the right to adequate food in post-LRA war affected areas in Northern Uganda. The study objectives were to; a) To identify and describe the human rights instruments in relation to understanding the meaning of the right to adequate food; b) to assess the situation in relation to realisation of the right to adequate food in Otuke district; c) to establish the challenges faced in relation to the realisation of the right to adequate food in Otuke district; d)to recommend ways that can be undertaken to ensure the realisation of the right to adequate food in Otuke district. The study was carried out in Otuke District, one of the formerly war affected Districts in Northern Uganda. The study used both qualitative and quantitative methods adapting case study and descriptive research designs. A total of 118 households and ten key informants participated in the study. The study found that majority of households faced great economic challenges despite having physical aspects to enable them realize their right to adequate food. Most households (95.8%) had land for crop growing but only 22.9% of them had the recommended three meals a day. The study noted; land grabbing, customary land ownership system, infertile soils and low household incomes as the main challenges to the realisation of RtF in the District. Only 28% of the households were using modern farming methods to improve food production. Most households (77.1%) had less than three meals a day. Furthermore only 18.6% of the households often ate animal protein. The study concluded that the poor land tenure system, low household incomes, inadequate access to and use of modern farming methods are the major challenges facing realization of the right to adequate food in post LRA war Northern Uganda. As a result, most households have less than three meals a day which in most cases do not meet dietary requirements. Households have become reliant on the market for food which most households find expensive and not readily available especially during the dry seasons.
Climate change perceptions, adaptation and mitigation strategies of livestock farmers in the Teso region Uganda

(Makerere University, 2016-09) Onyait, Ariko

Agriculture on which the majority of the population in Teso depends as a livelihood source is prone to negative effects of climate change. This study is about a determination of local farmers understanding of climate change and its adverse effects on livestock production and community livelihood. Data collection was by both qualitative and quantitative methods involving the use of structured household questionnaire and Participatory Rural Appraisal (PRA) tools such as focus group discussion and key informants interviews. Findings from the study reveal that the climate change experienced is extreme weather manifesting in the form of drought and floods due to precipitation variations whose frequency of occurrence have become alarmingly high. This has impacted negatively on livestock production. In addition, some minimal adaptation strategies have been employed with a high degree of limitation due to the prevailing poverty situation, inadequate knowledge and limited alternative livelihood sources. Some coping strategies have a potential positive feedback effect on climate change with likelihood of aggravating the impacts; these include clearing of forest land and vegetation for more cropping land, cutting down trees to provide fuel wood and charcoal sold to urban centers and towns as a source of income and encroachment of wetlands in times of drought. As with many developing countries, the study reveals that the communities in this region are very vulnerable to climate change impacts thereby threatening the achievement of millennium development goals of eradication of extreme poverty.
Colonial policy

(Anti-Slavery and Aborigines Protection Society, 1946-10) Jones, A. Creech ; Richards, Audrey I.
Community Knowledge, Attitudes and Practices Related to Female Genital Cutting (FGC) in Kapchorwa District

( 2008-10-23) Kiirya, Stephen K. ; Kibombo, Richard

Whereas several campaigns intended to create awareness and prevent female genital cutting (FGC) have been undertaken in Kapchorwa since 1995, it is not known how much cultural change these interventions have caused in the Sabiny. Evaluative studies indicate that FGC began declining since 1992, but the recent head count of women/girls who were circumcised in 1998 suggests an increase in FGC. This raised concern as to whether the FGC is really declining in the Sabiny. This study therefore examined the etiology and status of FGC among Sabiny aged above 15, developments and community views regarding ongoing FGC preventive campaigns, and why the practice is still going on in spite of the eradication campaigns in Kapchorwa district. Methodology: Research Design - The study employed a cross-sectional survey research design, and applied qualitative and quantitative methods. A survey questionnaire (KAPS) was used to collect quantitative data, while interview and discussion guides were used to collect data from key informants and discussion groups. Study Coverage - The survey was conducted in all the three counties of Kapchorwa district covering two sub-counties per county, two parishes per sub-county, three villages per parish and twelve households per village. Therefore, a total of six sub-counties, 12 parishes, 36 villages and 432 households were involved in the survey. The sample - The sample size was 432. Of these, an equal number of subjects were drawn from each sub-county involved in the study, and half of these were males. The sample was structured to reflect the population structure for Kapchorwa district in terms of age and sex. The distribution of the sample was 38% for the age range 15 â 24, 23% for age range 25 â 34, 24% for age range 35 â 54, and 16% for the age group above 55. Sampling strategy - Selection of the sampling units was done systematically. A first list of sub-counties, parishes and villages was obtained and arranged in alphabetical order. A second list was developed after eliminating sub-counties and parishes that were inaccessible, insecure or with substantial non-Sabiny populations. From the list of sub-counties within each county, two sub-counties were randomly selected using systematic sampling. After selecting a random start, every second sub-county on the list was selected. The sampling interval was 2. The same technique was used for selection of 2 parishes from each selected sub-county, and 3 villages from each parish, and 12 households from each village. In selecting the households, a random start was selected and then every second household thereafter was visited and included if it had subjects falling within the desired age and sex categories. This was maintained until the required sample of 12 subjects per village was obtained. Only one subject was selected from each sampled household. Instruments - The KAPS was developed to collect quantitative data on community knowledge, attitudes and practices related to FGC, and desired changes in the ongoing campaigns against FGC. It comprised of questions related to etiology, incidence, nature, information/skills, major actors, rituals and values/benefits, effects (before, during and after initiation) and eradication measures of FGC. The KAPS was pilot tested, reviewed and finalized before administering it to subjects. The completed KAPS were then coded, checked, entered and cleaned. Univariate and bivariate analyses were then performed to establish the distribution of subjectâ s responses against the study variables. The discussion and interview guides comprised of questions for the specific groups and key-informants targeted for the survey. Discussion and interview sessions explored the etiological basis and desired preventive measures of FGC among the Sabiny. Altogether, nine FGD sessions were separately conducted for each of the following subgroups: in-school male discussants aged 15â 24, in-school female aged 15â 24, out-of-school male aged 15â 24, out-of-school female aged 15â 24, uncircumcised women married by 1996, circumcised women, elders, mentors, and Sabiny opposed to eradication of FGC). Each FGD session comprised of six to eight discussants. Meanwhile, key informant interviews were conducted with a circumcisor, circumcision aides, in-charge of community health unit, midwife, TBA, district departmental heads (director of health services, education officer, chief administrative officer, probation and welfare officer) and politicians (vice chairman LC-5 and secretary for women affairs). Data accruing from these sessions were thematically summarized, analyzed and synchronized with quantitative data. Key Findings: Norms and taboos of FGC - It was established that several norms that discriminate against married women who are uncircumcised have been institutionalized in Sabiny culture with the view of regulating discipline and respect for the individual, family and community. These include denying them dignified roles in the family such as addressing gatherings or even taking up positions of responsibility in the community, climbing into the food granary to remove or store grain, stepping into the kraal to collect cow-dung for smearing houses, milking cows. Another aspect for which married uncircumcised women are discriminated against is serving food and beverages to elders or guests, and drinking local brew from a special pot, which is decorated with hides. Compliance to these norms is assured by attaching taboos to their contravention. For example, it is a taboo for married uncircumcised woman/girl to collect food from the granary because they are regarded as â girlsâ and wasteful, and as such they are likely to cause food shortage (famine) in the household if they did otherwise. Additionally, it is a taboo for a married uncircumcised women to milk cows because they are regarded as dirty or unclean, and as such they would contaminate the milk if this norm was contravened. There is a strong belief that if these taboos were contravened, the individual and household would encounter misfortunes and social disasters such as infertility and food shortage respectively. Although these norms and taboos are being abandoned, a number of community members especially the young males and females, they still provide a firm foundation for the continuation of FGC. Key players and benefits of FGC - The key players for this practice are the circumcisors, circumcisor's aides, mentors, parents, partners, in-laws, elders and the community as a whole. Each of these players benefits differently from FGC ceremonies. The benefits include money and physical items like chicken and local brew (for circumcisors and their aides), gifts and ceremonial attire (for candidates), lesu that candidates put on during the ceremony (for mentors), high dowry and respect (for parents and family members), and festivities (for elders and other community members). Discriminative norms do not apply to girls who are not yet married or circumcised. Such girls are allowed to collect food from the granary, cow dung from the kraal, serve elders and visitors and address gatherings (Comment given by a Sabiny elder aged 60). FGC related Discussions: Sabiny women/girls often discuss issues related to FGC with friends/peers (67%), parents (30%), family members (22%), partners/husbands (16%), social workers (16%), health workers including nurses and nursing aides (12%), elders (4%), teachers and circumcisors (3%). Peers and social workers includes the Sabiny who have been trained by FPAU and REACH as peers educators, community based counselors and key community members sensitized on the harmful aspects of FGC. During female initiation ceremonies, candidates are told never to reveal what they are told during the face-toface initiation so as to encourage uncircumcised women/girls to discover the unknown by undergoing the practice. They are also inducted with skills of resisting pain during circumcision, maintaining good hygiene,and marital relationship, avoiding extra-marital sex and responding when called upon or insulted by an elder or husband. Circumstances of undergoing FGC: The survey revealed that 94% of the circumcised women/girls braved circumcision voluntarily, implying that only 6% did so by force. Forced initiation was most prevalent among Christians (Catholic, Protestant and Saved), and those aged 25 â 34, who did not reach senior four and resident in Kaptanya, Binyiny and Bukwa sub counties. However, even some of those who reported having undergone FGC voluntarily did so with some form of pressure from peers, parents and family members (in-laws and partners) and for cultural identity. Of the circumcised women/girls involved in this study, only 21% reported that they had braved it due to personal conviction. Nature of genital excision: Results indicated that 33% of the circumcised women/girls reported that they had their clitoris removed, 38% had both the clitoris and labia minora removed, and 29% had the clitoris, labia minora and labia majora excised. Interview data further revealed that the clitoris is the genital part that every circumcisor in Kapchorwa is supposed to cut, but excision of the labia minora and majora often occurs accidentally. Excision of the clitoris was more common among women/girls resident Bukwa sub-county while excision of both the clitoris and labia minora was most prevalent among women/girls resident in Chesower, Binyiny, Kaproron and Kaptanya. Excision of the labia majora including the clitoris and labia minora was more common among women/girls resident in Kaserem sub-county. It is Because of the cultural belief that some persons use the genital parts that are cut to bewitch candidates, these parts are immediately collected by the â guardians/mentorsâ once circumcision is complete and kept in an undisclosed place. This is also intended to instill discipline and respect for the circumcisors, guardians and parents in the community. For example if a circumcised woman/girl degenerated in discipline and respect for elders, she would be reminded of the fact that someone is in possession of her genital parts that were cut to ensure that she behaves well and respects elders. Prevalence and Trends: Results indicated that FGC is often carried every even year mainly at age 18. However, some women/girls are initiated as early as age 11 and as late as age 28. This practice is most prevalent among women/girls who are or have ever been married, uneducated or educated but did not reach primary seven and resident in Bukwa sub county. FGC prevalence also tends to be high among the older generation, Catholics and Protestants. This is especially so because of the marginalization of married women who are uncircumcised and the big Sabiny population that is Protestant and Catholic. FGC began declining in 1990 and the highest drop rate was recorded between 1994 and 1996 due to increased advocacy, sensitization and mobilization of the community against the practice. Coital experience: Whereas FGC was previously used to regulate virginity and promiscuity of Sabiny girls, results indicated that it was no longer the case. Of the sexually active women/girls involved in this survey, 35% actually encountered first coitus before undergoing circumcision. This tends to weaken the position for the Sabiny who cherishes FGC on the grounds that â it preserves girlâ s virginityâ . Coitus with both circumcised and uncircumcised women/girls is also common among sexually active Sabiny males. Of the sexually active males who reported coital experience with both types of women/girls, the vast majority reported that uncircumcised females were more sexually pleasant and sensitive in the sense that they reached orgasm quickly. FGC attitudes: There is a strong negative attitude towards FGC among young males and females. Results indicated that 82% of the unmarried males favor marrying uncircumcised women/girls. Likewise, 85% of the females eligible for circumcision disfavor undergoing FGC. Moreover, at least 76% of the Sabiny would neither present their daughters nor recommend other women to undergo circumcision. These attitudes were stronger among the saved, highly educated and young Sabiny particularly for the residents of Chesower and Kaserem sub-counties. In addition, 68% of Sabiny wanted FGC to be eradicated, 11% wanted it modified, and only 29% wanted it maintained in its present form. The negative attitude towards FGC was attributed to the growing awareness and fear of the health risks and problems associated with the practice such as over bleeding, shock, trauma, lameness, HIV infection, sexual displeasure, birth complications and death. Health risks and problems FGC: Immediately after incision - The survey revealed that the Sabiny tend to be more aware of the short-term effects of FGC. These include over bleeding; HIV infection; difficulty in retaining/passing urine and walking; shock and fainting; increased pressure to get married; intermittent sickness; death and vagina constriction which often occurs when the genital wound is not well-treated. During pregnancy and delivery - The most encountered problems during pregnancy and delivery include uncontrolled vaginal discharge and intermittent sickness, painful birth, genital rupture, caesarian birth, over-bleeding. Others include stigmatization by the nurses due to the inelastic birth passage and Kelloids. They also encounter small painful septic wounds on the scar around the excised genital area caused when the excised genital area does not heal properly. In lifetime - Itching and pain in the urinary tract and vaginal lips when passing urine, and urine retention lapse most especially during old age; genital ulcers and painful scars during coitus and delivery; low sexual desire and ulcers around the genital area. The other common long term effect stigmatization by nurses and women who belong to tribes that do not practice female circumcision and fellow Sabiny who are uncircumcised. Some also tend to feel humiliated because they were not firm during initiation/circumcision, and often fail to control loud gassing and standing upright for long. Handling FGC complications: Most of the minor FGC complications are traditionally treated using herbs, by feeding candidate on cud of a ram, pouring cold water on the candidate in case of fainting, giving water and what remains at the bottom of the sauce pun after mingling millet, sorghum or posho to replenish energy. It was also established that the other form of treatment is tying a trouser of the husband around the waist of the candidate. However, severe complications are usually reported to health workers at the nearest health unit for specialized care or left to die specifically if there is no health worker in vicinity. The major caregivers for women/girls who encounter complications after circumcision are the mentors, family members, nurses/midwives and nursing aides. Persistence of FGC: It was established that as much as the FGC is declining among the Sabiny, it is unlikely to be completely wiped out in the near future. This is especially because society has cast a state of sacredness on FGC through: a) Attaching to it intangible benefits (values) such as using FGC as a means for preserving girlsâ virginity and regulating sexual desire and promiscuity, a measure of bravery/capability to defend Sabiny community and endure pain during birth, getting to know the relatives and interacting with elders and age-sets, bestowing dignity/respect for candidates and the family, and rejoicing as a community; b) Attaching tangible (material) benefits to FGC in a sense that it is a source of employment/income for circumcisors and circumcisorâ s aides, high dowry for parents/family and gateway to safe marriage for the candidate, and offers training opportunity for circumcisorâ s aides as future circumcisors through apprenticeship. It is also a source of gifts and pride not only for the candidates (ceremonial attire) and parents but also the community. In addition, the community benefits through festivities such as eating, drinking and dancing; c) Institutionalizing FGC norms by not allowing uncircumcised women/girls to undertake certain dignified roles in the community such as to collect food from granary, step into the kraal or pick cow-dung or milk cows, serve brew or food to important people in the community, share a pot of local brew with circumcised women and other persons, address public gathering, represent Sabiny, and perform other dignified roles in the community such as defending the Sabiny in case of war; and d) Linking contravention of FGC norms to social disaster or loss of society benefits. For example, it is believed that: If an uncircumcised married woman climbed the granary, she would be wasteful and cause food shortage in the household; if a sabiny girl avoided circumcision, she would remain a â girlâ and may never bear children. e) There is also a strong belief that if uncircumcised woman/girl milked the cows or addressed a gathering, she would contaminate the milk because of being unclean and be heckled or shouted down upon respectively. It is worthy noting that while these norms and taboos were highly cherished long ago, a number of Sabiny are beginning to abandon them. In addition, in spite of the fact that ongoing interventions have significantly contributed to the current FGC decline a lot still remains to be done. For example, little has been done to address girls/women education and economic empowerment to be able to make independent decisions, and strengthened and alternative cultural activities that would ensure reproduction of the positive norms and minus minus FGC. They have also not effectively reached or involved the custodians of the Sabiny culture such as elders and age-sets, religious organizations and other NGOs, grass root communities (save for saved groups) and the community as a whole, and improved access to reproductive health services in remote areas of the district. The ongoing interventions have also encountered several constraints and challenges that seem to inhibit accelerated cultural transformation. These include perceived corruption and nepotism in the peer education program; few, shy and unrepresentative peer educators; and lack of FGC change agents at village levels; and lack of/inadequate sensitization and follow-up activities for circumcisors, circumcisors aides, mentors,elders, circumcised women/girls and other change agents. Apart from the poor reproductive health infrastructure, service provision and equipment logistics, there is also slow progress towards the construction of a health unit in Cheptuya parish and inadequate staffing of the functional health units. The rugged terrain and social instability due to cattle rustling by the neighboring Pokot and Karamajong have also hampered effective delivery of RH services. Members of the Sabiny Culture Association (SCA) also strongly feel that anti-FGC initiatives are a ploy by â outsidersâ to destroy the sabiny culture. Conclusion: These results indicate that there has been a positive change in knowledge, attitudes and practices related to FGC as is evidenced by the declining trends and prevalence in FGC particularly among the young Sabiny. The educated and unmarried, saved and young women/girls seemed less likely to undergo FGC. In addition, FGC prevalence is high particularly in the remote and inaccessible areas of the district such as Bukwa and Kaproron sub counties. Kaserem surfaced as one of the sub-county with high FGC prevalence because the study was confined to parishes that had a substantial Sabiny population. Therefore education, marital status, religion, age and place of residence bear significant influence on FGC. Despite the declining trends in FGC, the practice is still deeply entrenched and institutionalized in the Sabiny culture through norms and taboos that are often reproduced in the home and family. Marriage provides the social space through which women/girls are pressurized into FGC. Besides the cultural pride, circumcised peers, parents/relatives, in-laws, partners and elders, were the major sources of ostracism that drives girls into circumcision. FGC is strongly cherished and jealously guarded by the elders. A number of young individuals, particularly those who drop out school and marry early were practicing it for cultural identity and dignity irrespective of the health risks and problems associated with it. This is because Sabiny elders are the custodians of culture and wild a lot of respect and influence on the young women and boys. Finally, much as FGC has negative short term and long-term health, biological and psychosocial effects, it is also associated with provision of information and values that promote respect of elders, good hygiene, virginity and fidelity interaction and togetherness through the age-sets in the community. Therefore, the sabiny still cherish FGC because they do not think these values could be sustained without maintaining FGC. This implies that an accelerated cultural transformation regarding eradication of FGC is unattainable without creating socioeconomic and cultural alternatives that would ensure what community members currently benefit from FGC is maintained as the practice is eliminated. Recommendations: Therefore, in order to accelerate cultural transformation regarding the eradication of FGC, it recommended that: 1. Community sensitization, advocacy and education seminars on the harmful aspects and women rights associated with FGC should be intensified and specifically target elders, women, youth, surgeons and the entire community particularly at the grassroots through village seminars/meetings and functional adult literacy campaigns. In so doing, local councils and elders at parish and sub-parish levels should be involved more in the ongoing FGC campaigns. This will go a long way to further increase advocacy for the eradication of FGC and legitimize change at community level; 2. Circumcisors and circumcision aides should be supported to start up alternative sources of income and livelihood; 3. Positive cultural values should be maintained by increasing advocacy for the elimination of the act of cutting female genitalia and maintenance of the positive aspects of female initiation. By so doing, the elders and leaders of age sets should be targeted and encouraged to innovate alternative ways of preserving the Sabiny culture not necessarily through circumcision of women/girls. 4. Family and individual counseling should be strengthened for women/girls who have been traumatized and stigmatized as a result of undergoing FGC; 5. Health service providers should be equipped with skills of counseling, detection and documentation of complications associated with FGC through continuous sensitization seminars and refresher training workshops. They should also be equipped with the minimum health care kits and adequate means of transportation to facilitate quick delivery of emergency RH services; 6. Apart from completing construction and renovation of the health units in each sub-county and some parishes, they should be provided with qualified health personnel and equipment with surgical tools to be able to handle minor surgical operations before patient are referred to the main district hospital; 7. Peer education should be intensified and expanded throughout the district. In so doing, recruitment, training and deployment of peer educators should put into consideration the social, economic and demographic diversity of the community such as sex, age, education level, marital and circumcision status, religious denomination and geographical location; 8. Religious organizations (the Saved, Catholic, Protestant and Muslim leaders) should be involved more in the campaigns against FGC. They should be encouraged only to teach community members about good morals but also about the harmful aspects associated with FGC. This would not only ensure cost-effectiveness in the approaches and strategies adopted to eradicate FGC, but also increase impact in the community; 9. Given that the current school infrastructure in Kapchorwa district is inadequate to cope with the demand for education, it is essential to establish secondary schools that give special preference for girlâ s education in each county. In the meantime, policy-makers, politicians, women and religious groups, human rights organizations and donor agencies should appeal for financial support in and outside Uganda to subsidize education for girls in Kapchorwa district; 10. UNFPA and other concerned agencies should facilitate the formation of an East African Association on FGC. This would go a long way not only in addressing intertribal and interregional dimension of this practice and promoting information sharing and regional coordination of activities intended to eradicate FGC, but also sustaining the positive social change regarding FGC; 11. It was assumed that the minimum age at which Sabiny females undergo circumcision is 15. Therefore,this survey did not include in the sample persons aged below 15. Results however indicated that some Sabiny girls undergo circumcision as early as age 11, thus suggesting that contrary to our assumption, individual considerations about whether to brave FGC begins earlier than the minimum age of the sample for the current survey. Therefore, there in need for further research to establish knowledge, attitudes and prevalence of FGC among Sabiny females aged 9â 14. 12. This survey also used scenarios and descriptions to determine the actual genital parts that are cut. The results on the nature of excision accruing from the current survey are therefore inconclusive. In order to effectively determine the extent of genital excision, FGC sentinel surveillance points should be established in all the maternity units of Kapchorwa district. This would enable health personnel to examine the genital area of all pregnant women who report for delivery and determine the actual parts that were excised and the resultant complications. 13. In addition, the results of this survey provide baseline information that is useful for determining whether ongoing and new interventions bear a positive influence on FGC knowledge, attitudes and prevalence. It is therefore recommended that similar surveys should be conducted after every circumcision season to keep track of the prevalence and social change being caused by the ongoing FGC eradication campaigns.
Contemporary myths, sexuality misconceptions, information sources, and risk perceptions of Bodaboda men in Southwest Uganda.

(Springer, 2005) Nyanzi, Stella ; Nyanzi, Barbara ; Kalina, Bessie

This article reports findings from a study conducted among 212 private motorbike-taxi riders, locally called bodabodamen, from two study sites--a slum area and the urban center of Masaka town. Qualitative and quantitative methods were triangulated; a questionnaire, focus group discussions, in-depth interviews, case studies, and interactive workshops were all used. There were high levels of awareness of HIV, much more than sexually transmitted diseases (STDs), because many participants had closely experienced HIV/AIDS. Knowledge about sexual health contained several misconceptions, misinformation, and myths rooted in both the historical and contemporary social cultural context. Due to high illiteracy levels, bodabodamen cannot access many standard health education materials issued by government and private health organizations through the print and electronic media, as well as those published in languages other than the local vernacular. These (and possibly other) disadvantaged groups remain at risk of HIV and STDs. Especial efforts need to be made to provide appropriate health education.
Crisis in Kabale District: a case study for food policy reforms

( 2009-02-24) Zirahuka, Charles Kashute

There is no shortage of literature on Food crisis in African countries. Yet there is surprisingly little in the way of objectives studies based on local observations so as to get the crisis right before any prescriptions. The purpose of this paper on food crisis in Kabale District is to review the causes in broad context that sheds light on long term development issues of the area and identifying policy prescriptions that may shape the future development. We urge that food crisis is a result of a combination of chronologically endemic factors which are actually specific to the area such as ignorance, low incomes, unchecked population growth, ravages of pests and crop diseases, poor storage facilities, poor transport, and un-organized markets, poor production techniques and lack of appropriate Government's policy regarding food and agriculture. Understanding the implications of these and their impact on development prospects are wide ranging and will entail long term adjustments. We shall therefore attempt to pinpoint what we consider to be the most appropriate response to these problems. In the first chapter is the description of the physical environment to determine the main features that characterize the area and the problem associated with these features. In chapter two, we discuss the cultural background and land use in order to prepare the ground for a discussion of the causes of food crisis. Chapter three analyses the effects of social, economic and political factors that have contributed to the crisis. Chapter four gives an analysis of field survey data and chapter five is a summery of observations and thereafter recommendations. The last part gives the conclusions

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