Health
I studied on Loans from Village Savings Group – Tabitha Audo, MakSPH First Class Graduand
Motivated to beat the statistic that none of the Irarak-Iworoi clan and her entire family has ever gone to university and obtained a degree, Ms. Tabitha Audo is graduating from Makerere Universiy, top of her class with a 4.63 CGPA in Bachelor of Environmental Health Sciences —BEHS.
Ms. Audo is overjoyed about accomplishing a major milestone of becoming the best performing undergraduate student at Makerere’s School of Public Health and setting the pace for her siblings.
She was born to Ms. Mary Immaculate Kiria and the late John Peter Ameu in April 1992 in Opiin village, Atiira Subcounty, in the Eastern Uganda District of Serere.
At the age of 6, Audo lost her father and that meant that the burden of raising her was left to her peasant mother. She was lucky that her step-mother Apio Angella, a VHT of Atiira Subcounty stood hand-in-glove with her mother to support her through her studies.
She sailed through her Primary education between 1998 and 2004 with the support of both mothers and obtained 19 aggregates at Apokor Primary School, Serere.
In 2005, she joined Rhema High School and sat her Uganda Certificate of Education in 2008 and obtained 43. But she would persist.
She had no hopes of joining A ‘level until a good Samaritan, Ms. Akwi Christine, the now the Assistant District Health Officer Serere District Local Government, currently acting ADHO- Environmental Health identified her and encouraged her to join Mbale School of Hygiene. “She encouraged me to join the Course after seeing my conditions in our home. She also helped me to get a sponsorship under Mvule Trust Fund to pay for the certificate Course,” recalls Audo.
Between 2009 and 2011, Ms. Audo concentrated on acquiring a Certificate in Environmental Health which she excelled with a Distinction at Mbale School of Hygiene before upgrading to a Diploma in 2014-2016 which she equally scored highly with CGPA of 4.62.
Upon completing her certificate course, she was employed by Serere District Local Government as Health Assistant in 2012.
“The institution had motivated us that when you would pass a certificate, they would give you a government scholarship. However, when I passed with a distinction, I learnt that the government scholarship had been scrapped for upgraders. God blessed me to get a job immediately where I got money to pay for my Diploma.”
Audo says studying her Diploma was the hardest because it was a full-time study program that required a lot from her. Yet, additionally, she was paying fees for two of her siblings, one in Secondary School and another in a Tertiary Institution.
“I also had to pay for myself and I had just got a loan to support my tuition needs. It also happened that I had a baby who was just 8 months old. It was tough on me to pull of that Diploma. It was very tight to balance but I had to keep moving,” says Audo.
She recalls her low moments in School to manage family, work, and School. She said the initial loan cleared her two semesters and also paid for her siblings’ fees but it wasn’t sustainable in the long run.
“I was with Atai Faith in the same class. They knew my situation and supported me through discussion groups and with their help, I was also able to concentrate like any other person. I learnt that if you keep focused, even when challenges come, you still find ways. You can’t just sit down and say; ‘now, I can’t do anything’,” Audo recollects.
Her family background played a huge role in shaping her views on education and her desire to change her destiny. She says the pain her mother suffered in search of money to pay for her fees was an eye opener to her.
“My mother is a peasant. She stopped in S.2 and she didn’t have any job with her. She used to get weekly loans in village groups. I used to see all that suffering she was going through. Even feeding, everything was difficult. It gave me a motivation that ‘I don’t want to live in this kind of life again. So, even after I got a job, I wanted to relieve her from that suffering and that is why I had to carry the responsibility to pay fees for my siblings,” Audo reveals.
Joining MakSPH
In 2014, while Audo was still studying at the School of Hygiene -Mbale, the School held a careers session where a one Abel Wilson, then a Student at MakSPH spoke to them about the opportunities to advance their career through a Bachelor of Environmental Health. She was on the look-out until an advert for diploma entry-government admissions came out.
“Of course it was following Abel’s visit to School of Hygiene. So, I kept on waiting for the time of the advert and when it came, the first person who forwarded it to me was my supervisor, by then, the Serere District Town Council Clerk,” recounts Audo.
Mukula Max Martin, the former Serere Town Clerk, who is now the Deputy Chief Administrative Officer Buvuma, a Central Uganda District coterminous with the Buvuma Islands scattered in Lake Victoria pushed Audo to study and further advance her career in 2018.
“Mukula motivated me and told me that he was sure I could make it. He told me I should study when I was still young and finish. He cautioned me against being comfortable and assured me that if I get admitted, I would get a study leave,” Ms. Audo says.
Her admission in 2018 was the proudest moments of her life but more to parents, she recalls. “The family didn’t know what government sponsorship means. But for them, they were overjoyed that I was going to study from Makerere University. They were happy for me because for the first time, I was going to stay in Kampala.”
Her admission however came on the heels of her promotion to Health Inspector of Serere District that had been affected in March 2018. She thought given that she had just been promoted, it would be difficult to secure a study leave; “My immediate boss, Mr. Mukula called me to his office and congratulated me. He straight away started processing for my study leave. When my study leave was approved by the district service commission in November 2018, it was with pay and this was a serious relief.
Her appeal to bosses is to never seat on employees’ opportunities to study and believes any employee with interest and opportunity to study should be given a chance. She is passionate about changing the health situation in her current employment station. Although she dreams of working with the Ministry of Health, international organisation such as the United Nations, UNICEF.
Audo says she is interested in improving water and waste management situation in Uganda’s towns/cities. “When you look at our towns, both liquid and solid waste is a serious gap that we have to work on. Waste is everywhere, people are not sorting waste, it’s not being well managed I should say. Look at the towns, small or big. I expected Kampala to be better. Even liquid waste, over floors are everywhere every time and we need to surely improve!”
He key take away from the course is the diversity of knowledge in all fields. “Being a preventive medicine course, that involves working directly with the community to address problems, the course is one of those that involves you and builds your research capacity. I admire the level of research and quality of researchers at School.”
Health
Mak Researchers Partner with Safe Bangle Technologies to Roll out a Real-Time Domestic Violence Reporting Bracelet
By Joseph Odoi
A Consortium of Researchers from Makerere University School of Public Health/Resilient Africa Network (MakSPH/RAN), Medical College of Wisconsin (MCW), Somero Uganda together with Safe Bangle Technologies have rolled out a real time domestic violence reporting bracelet.
This roll out was made possible with support from the United States Agency for International Development (USAID) under the PARTNERSHIPS FOR ENHANCED ENGAGEMENT IN RESEARCH (PEER) program and the National Academies of Sciences.
Dr. Juliet Kiguli, the Principal Investigator from Makerere University, along with Dr. Roy Mayega, Deputy Chief of Party at RAN, and Dr. Agnes Nyabigambo, the study coordinator, initiated the PEER program to identify entry points for testing SafeBangle Technologies (a social enterprise based at Resilient Africa Network (RAN) with a mission to create a safer and more secure environment for women and children through innovative, affordable, and creative technology solutions to curb GBV in Africa.) wearable safety bracelet in the informal settlements. This decision stemmed from findings of increased intimate partner violence (IPV) and gender-based violence (GBV) in three informal settlements in Kampala, Uganda, following a longitudinal study, geospatial mapping, and interviews. The project, titled ‘The Impact of the COVID-19 Pandemic on Gender-Based Violence among Women and Girls in Informal Settlements in Kampala,’ highlighted the urgent need for affordable and immediate reporting mechanisms for violence.”
‘’While carrying out a study after the Covid-19 Pandemic, we identified gaps when it comes to reporting and response to Gender Based Violence (GBV) among women in informal settlements. Therefore, we used incorporated the SafeBangle intervention to solve the problem of lack of affordable and immediate reporting mechanisms for violence using a bracelet that reports violence in real time’’ explained Dr. Kiguli.
Innovation details
According to Saul Kabali and Messach Luminsa, the innovators behind SafeBangle from SafeBangle Technologies, hosted at the Resilient African Network Lab. ‘’The inspiration behind SafeBangle came from a deeply personal place. ‘’We heard countless stories of women who couldn’t call for help during moments of danger. We were deeply affected by the story of Aisha, a young woman in a rural village who was attacked while walking home alone at night. With no way to call for help, she felt helpless and vulnerable. This incident made us realize the critical need for immediate reporting alert tools, accessible to women like Aisha. We knew technology could play a crucial role and this incident awakened a strong desire in us to create a solution’’
“While developing SafeBangle, we tested with the users in both rural and urban contexts. We piloted the innovation around Kampala with support from Digital Human Righs Lab and Naguru Youth Health Network as well as it in five districts of Karamoja region with support from Save the Children and Response Innovation Lab. Right now it has become handy in Kamapala‘s informal settlements. We envision a future where SafeBangle becomes a standard tool in the fight against GBV, ensuring every woman feels safe and secure as it has the potential to transform how we respond to GBV in Africa” added Kabali.
HOW THE SAFEBANGLE TECHNOLOGY WORKS
The SafeBangle is wearable technology similar to a smartwatch that sends an alarm by SMS to people chosen by a woman herself if she feels threatened.
In terms of the acceptability of the SafeBangle innovation as a solution to GBV among at-risk women in informal settlements Of the 72 adolescent girls and women who received the SafeBangle, 22 activated the reporting button, resulting in 19 receiving immediate and appropriate support, including counseling, police intervention, and health services.
All adolescent girls and women who experienced GBV received a phone call from Somero Uganda to discuss the most appropriate intervention, including counseling, police cases being handled by the probation office, referral for health services, and post-exposure prophylaxis. All the GBV survivors received support and are still receiving continuous follow-up.
Researchers conducted a survey among 644 girls and women in Kinawataka (Nakawa Division) and Bwaise (Kawempe Division) to gain insights into awareness and understanding of sexual and gender-based violence among adolescent girls and women in informal settlements. The survey measured socioeconomic factors, mental health symptoms, and exposure to GBV. Focus group interviews were conducted with a separate sample of women over 18 in the settlements to explore responses to GBV.
A tabular representation of the key findings and lessons learned from your study on gender-based violence (GBV)
| Key Findings | Lessons learned |
| Prevalence of GBV. – Overall prevalence: 34.1% of women and girls reported experiencing GBV. – Among adolescents (15-19 years): Over 50% reported experiencing GBV. | – The pandemic highlighted the need for accessible and comprehensive support services for GBV survivors. – Schools emerged as crucial safe spaces for girls, emphasizing their well-being during crises. – Economic independence proved crucial, enabling women to leave abusive environments. – Involving men and boys as allies in GBV prevention efforts is essential. |
| Age-related trends | – GBV prevalence tends to decrease with increasing age. |
| Physical and health consequences. | – Women and girls suffered physical violence, injuries, and deaths, primarily from domestic violence and unsafe abortions due to limited healthcare access. – GBV resulted in unintended pregnancies, unsafe abortions, and increased risk of sexually transmitted diseases (STIs) like HIV/AIDS. |
| Social and economic impact. . | – GBV contributed to family breakups, strained marriages due to financial stress. – Economic hardships forced some women and girls into transactional sex, exposing them to further health risks and exploitation. – Pandemic-related job losses and economic constraints increased financial dependence on abusers, trapping women in violent situations. – School closures and increased household responsibilities limited women’s job opportunities and subjected them to sexual harassment. |
| Psychological effects | – Survivors experienced guilt, shame, anxiety, fear, and suicidal thoughts due to ongoing abuse. |
| Long-term effects | – Post-COVID-19, survivors faced disrupted education, early marriages, pregnancies, social stigma, and persistent mental health issues. |
Reproductive Health Consequences: GBV resulted in unintended pregnancies, unsafe abortions, and increased risk of sexually transmitted diseases (STIs) like HIV/AIDS.
Family Breakdown: The rise in GBV led to family breakups as women fled abusive relationships. Marriages were strained due to increased financial stress.
Transactional Sex for Survival: Desperate for basic needs due to job losses and economic hardship, some women and girls resorted to transactional sex, exposing them to further health risks and exploitation.
One study participant stated, “The time of COVID-19 was so terrible for some of us. We in fact got a lot of diseases from it because you would want to get food and didn’t have money. That way you would be forced to get a man who would use you and pay.” – (FGD_Girls_19–24years_Kinawataka).
Economic Effects: COVID-19 restrictions caused job losses and limited economic opportunities, particularly for women in the informal sector. This increased financial dependence on abusers and trapped women in violent situations.
Limited Access to Employment: School closures and increased household chores limited women’s ability to seek employment, perpetuating gender inequality in the workforce. Some faced sexual harassment from potential employers.
Psychological Effects: Survivors of GBV experienced guilt, shame, anxiety, fear, and even suicidal thoughts due to the constant threat and unpredictability of abuse.
Post-COVID Effects: GBV survivors faced long-term consequences, including disrupted education, early marriage, early pregnancy, social stigma, and persistent mental health issues.
Lessons learned
The pandemic highlighted the need for accessible and comprehensive support services for survivors of GBV, the significance of schools as safe spaces for girls, and the need to prioritize their well-being during crises. Economic empowerment emerged as a significant protective factor for women and girls. Those with greater economic independence were better equipped to leave abusive environments and secure their safety and well-being, while dependent ones suffered abuses. Engaging men and boys as allies in the fight against GBV and involving them in prevention efforts can help promote positive behavior change and foster more equitable relationships.
Recommendations
To address GBV against women and girls, the researchers recommend the following moving forward;
- There is need to integrate technology-driven solutions like SafeBangle into national GBV prevention and response strategies. SafeBangle can be a valuable tool for policymakers as cases of violence that would have gone unreported will be brought to light and the would-be victims will be able to get immediate help from trusted relatives and friends.
- Provide economic opportunities and vocational training for women and girls to enhance their financial independence and reduce vulnerability to violence. There is therefore a need to introduce education and training programs that empower women and girls, by providing them with skills, resources, and opportunities to start their own ventures and to participate fully in community affairs.
- Strengthen and enforce existing laws and policies related to GBV, including laws against domestic violence, child marriage, and sexual assault without discrimination be it for law enforcers, leaders, and employers where such cases were suffocated. Ensure that perpetrators are held accountable through swift and fair legal processes that have no room for corruption.
- Establish and promote effective, accessible, and confidential reporting mechanisms for GBV incidents that provide confidence and can be trusted by survivors to enhance reporting of such incidences of GBV. Community Engagement and Involvement: Involve community leaders, religious leaders, and elders in discussions about GBV to promote gender equality, change social norms, and reinforce the message that violence against women and girls is unacceptable.
- Launch extensive public awareness campaigns to challenge harmful gender norms, report cases of GBV, raise awareness about the consequences of GBV, and promote positive behaviors and attitudes towards women and girls.
- Implement comprehensive sexuality education in schools and communities, educating young people about healthy relationships, consent, and reproductive rights to be able to make informed decisions about their own lives and well-being.
- Engage men and boys as allies in the fight against GBV, encouraging them to challenge harmful masculinity norms and behaviors. This will help minimize GBV because mostly they are the perpetrators. Strengthening Support for Survivors: Provide ongoing support and follow-up services for survivors of GBV mostly counselling services to aid their recovery and facilitate their reintegration into society.
- Provide ongoing support and follow-up services for survivors of GBV, mostly counseling services to aid their recovery and facilitate their reintegration into society.
- Provide avenues to seek free or subsidized services by survivors of GBV medical services and legal processes by survivors of GBV to enhance reporting of GBV cases, access to medical care, counseling, legal support, and other essential services.
- Encourage and support more research and innovations like SafeBangle to curb incidents of GBV.
- A comprehensive and inclusive approach is required. The efforts should involve government institutions, civil society organizations, community leaders, and individuals working together to address the root causes and provide support to survivors.
- Involve media in GBV prevention activities and for enhancing campaigns against GBV mostly on radio and TV.
MORE ABOUT THE STUDY
The core project team, included researchers at Makerere University School of Public Health (MakSPH), Medical College of Wisconsin (MCW) led by Prof. Julia Dickson-Gomez, SafeBangle Technologies, and Somero Uganda, a community-focused NGO, began the project by designing their research protocol and taking a CITI Program course on human subjects social/behavioral research. Team members also met with the Ministry of Gender, Labour, and Social Development (MGLSG) in support of the gender-based violence policy process, Ministry of Health and local government. They also established relationships with the Kampala Capital City Authority (KCCA) and Nakawa and Kawempe probation offices to support legal processes for the GBV survivors. SafeBangle Team also received an award from Defenders Protection Initiative.
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