Rape is common inside facilities, patients and others say. But accusers frequently aren't believed, and justice is rare.
The first time CJ was hospitalized for bipolar disorder, she alleges, a staff member who worked in security raped her one evening. She had been admitted at Butabika National Referral Mental Hospital, Uganda's only national mental hospital, which is about 12 kilometers east of Kampala. That night, CJ remembers trying to defend herself, pushing the man so he would get off her, then falling into a trench.
The hospital rarely investigates the reported cases, CJ says."They are dismissive. They won't listen," she says."They say you are telling lies. You are just having an episode." The country's primary care system is poorly funded and short-staffed. There are only 53 psychiatrists in the country, according to a 2022 study in the Lancet. That's roughly one psychiatrist per 1 million residents, which is much lower than the global average of 40 psychiatrists per 1 million people, according to a 2017 study published in Health Services Insights, an international health care journal.
In January, mental health advocacy groups in Uganda released a statement asking the Ministry of Health and Uganda police to investigate allegations that patients at Butabika National Referral Mental Hospital are being sexually abused while in the hospital's care. "Many can't speak in court. [The] court would want her to speak. You go to court, she can't answer. Justice can't be delivered unless she is pregnant and has delivered and a DNA test is carried out to bring evidence that can be corroborated," she says.
Shamim Nalule Rukiyah, a lawyer with Musangala Advocates and Solicitors, a law firm in Kampala, has worked on several cases in which women who struggle with mental illnesses were sexually abused. Nobody believes what they say, she says. One such case ended in acquittal because the person affected could not give evidence in court.
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