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Health Care Workers Must Out LGBT Ugandans, According to New Guidelines

By Sunnivie Brydum

The latest revision of draft guidelines for Ugandan health care workers who may encounter LGBT people set a dangerous precedent that essentially requires those health care providers to report anyone who admits to being gay.

Signed by Uganda's director general of health services, the April revision of the "Draft Guidelines for Health Workers Regarding Health Services for Homosexuals," makes Ugandan health workers the "frontline enforcers of the newly passed Anti-Homosexuality Act," according to BuzzFeed, which obtained a copy of the draft policy. 

"The purpose of these guidelines is to clarify to health workers how to handle clients and patients involved in homosexual activities," reads the draft, "but not to promote acts of homosexuality."

After claiming that LGBT Ugandans have a fundamental right to medical care and privacy surrounding that care, the guidelines note a health care worker may "break confidentiality" when the person seeking care is a minor, when someone has been "sodomized," if the patient has a "compromised" mental status, or is guilty of "aggravated homosexuality" as defined by the Anti-Homosexuality Act.

According to the draconian law, signed by Ugandan president Yoweri Museveni in February, "aggravated homosexuality" is defined as any repeated instances of same-sex sexual contact — including such behavior in private, between consenting adults — any such instance where at least one person is HIV-positive or if one partner is a minor, mentally disabled, or under the influence of drugs or alcohol. 

Although the latest revision strikes a clause seen in last month's version that required LGBT Ugandans to inform the health worker treating them that they are LGBT, this iteration of the guidelines clamp down on organizations that may treat LGBT people, citing a provision in the law that prohibits "aiding or abetting" homosexuality. 

In a clause that appears to allude to the recent raid by Ugandan police on a U.S.-funded HIV clinic that saw at least one clinic employee arrested for "recruiting" young men into homosexuality, the guidelines note, "It is the sole responsibility of the researcher, investigator, health worker or his/her facility to ensure no acts of promotion or recruitment of subjects into acts of homosexuality as stipulated by the anti Homosexuality Act, 2014 occur. In the event of promotion or recruitment, they shall be held accountable."

BuzzFeed also notes that the guidelines are signed by Jane Ruth Aceng, the health services general director, who also served as the lead author of the so-called scientific report that convinced President Museveni that homosexuality was not an innate characteristic but rather a socially acquired ill that could be cured. Indeed, the guidelines' foreword notes that state officials are "well aware that homosexuality is not a medical disorder nor an abonormality [sic], [but that] those involved in the practice may present with direct/inderect [sic] consequences that require medical care/treatment." Nowhere in the forward or the draft guidelines are such treatments clearly enumerated, meaning it's entirely possible that such "treatment" may include efforts to "convert" gay people, or, as is more common in the cases of lesbians in homophobic African nations, such treatment may involve so-called corrective rape. 

Just two days ago, the World Bank released a report explaining that it would consider granting a thus-far-withheld $90 million health care loan to the Ugandan government if the government can prove that LGBT people and the health workers who treat them will be safe from penalty under the wide-reaching law. 

However, these new guidelines appear to move backward from the World Bank's suggestion, expanding the instances in which medical professionals are required to report an LGBT person to police. 

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