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Bitter Injustice: Ugandan Nurse Imprisoned

––HIV-positive nurse sentenced to three years for workplace accident––

May 20, 2014––A Ugandan court has done the unthinkable: sentenced a hospital nurse living with HIV to three years in prison. The court found the nurse guilty of “negligence likely to cause transmission of a dangerous disease” because she may have mistakenly reused a needle that pricked her finger. Although she was never on trial for consciously attempting to do harm, local and international media continue to portray the charge and subsequent verdict as intentional. No doubt reacting to this manufactured outrage, the court’s disproportionate sentence for her workplace error casts a further pall on Uganda’s treatment of people living with HIV.

The decision, handed down on May 19th, left little doubt that the prosecution viewed this case as a political litmus test, arguing that a stiff sentence was justified since President Museveni was preparing to sign the “HIV Management/Prevention Bill.” That pending law would criminalize intentional transmission of HIV (entirely irrelevant to this case, since the nurse was not suspected of intentional transmission). The pending law would also legalize a range of human rights violations, many of which target women in particular, including mandatory HIV testing of sexual assault victims and of pregnant women.

As previously reported by AIDS-Free World, Rosemary Namubiru, a licensed nurse, suffered an accidental needle-prick while attempting to insert an intravenous needle into a young patient diagnosed with a severe case of tonsillitis and dangerously high fever. Rosemary cleaned and bandaged her finger, returned to the screaming child in his mother’s arms, continued with the procedure, and then was relieved by a colleague. At some point during Rosemary’s lunch break, the mother raised the possibility that Rosemary may have picked up and used the same needle rather than a fresh one. Although the child has been repeatedly tested and found to be HIV negative, the possible re-use of the needle was the focus of the trial over the past few months. 

As Rosemary’s attorneys contemplate their next steps, the advocacy community is left with the sinking feeling that stigma and prejudice have carried the day. When a well-intentioned, experienced healthcare worker is sent to jail for three years, for what appears to have been a workplace accident, the inescapable conclusion is that Rosemary’s main crime was her HIV status.

From the moment the police were called in, only to immediately parade Rosemary in front of the media, the story was fodder for the tabloids. Newspapers covered the rampant allegations at length, making it clear they saw a way to play to readers’ fears by writing dramatic, and in most cases entirely fictional accounts of actions supposedly taken by Rosemary, whom they dubbed the “Killer Nurse.” Television stations produced animations showing a nurse drawing her own blood before injecting it into a patient, a scenario that bore no resemblance to the actual allegations. Perhaps most reprehensibly, the prosecutor’s office blindly followed the media’s lead, charging Rosemary with attempted murder without a shred of evidence to substantiate such claims. When they were eventually forced to withdraw the charge before the trial began, they decided to dust off Section 171, a never-before used provision of the penal code regarding a negligent act likely to transmit a dangerous disease. Yet the damage had been done: The media did not feature the drastically reduced charge, but instead continued to describe the charges Rosemary faced as “intentional” transmission of a disease. Even reports of today’s sentencing cited the “killer nurse” who was guilty of negligence with “intention to infect,” words that don’t appear in the actual law.  And an Associated Press story circulated worldwide erroneously claimed in its lead that Rosemary was found guilty of “trying to infect her patient with HIV.” No journalist or editor will spend time in prison for these workplace “errors,” whether intentional or simply negligent.

Was this hysteria solely due to Rosemary’s HIV status? It seems unlikely that similar reactions would have greeted a nurse with hepatitis, but Rosemary had the misfortune of bad timing: an increasingly strident and confident Ugandan parliament and president, bent on using controversial laws to distract voters from the real problems facing the country by focusing anger and fears on subjugated groups, such as people living with HIV or the LGBT community.  Even as a disastrous new HIV bill awaits the president’s signature, Rosemary’s case shows the dangers lurking in the existing penal code, which gave the judge the authority to sentence a 65-year-old woman to three years in prison for an unintentional workplace accident.

The media and prosecutor’s treatment of Rosemary are early warnings for those who believe the battle against HIV stigmatization is largely over. Parliament’s passing of the HIV bill is proof that Uganda has officially served notice: where once it was at the forefront of HIV treatment and prevention, the country has now succumbed to fear, with cynical politicians using bigotry, stigma and prejudice as self-serving tools.

The result is that one group of citizens is increasingly convinced that anyone living with HIV is dangerous; another group, those living with HIV, is forced to live in fear, wondering if their best defense against the new law and a newly emboldened prosecutor will be to simply avoid getting tested. If you remain ignorant of your HIV status, after all, you can’t be prosecuted for transmission. This would be a tragic outcome of Uganda’s new attitude. Surrounded by the near silence of the international community, we are left to hope that the vocal and ferocious indignation voiced over Uganda’s anti-homosexuality law will be repeated, and President Museveni will feel the world’s scrutiny as he decides whether to reject the new HIV bill or sign it into law. Without appropriate global outrage, we fear that HIV prevention efforts will recede, treatment programs will lapse, and HIV will once again spread silently in Uganda, with the world reacting only when it is too late.