Different Civil Society Organizations call for the need to respect the rights of the LGBTQI+ community and other vulnerable groups within the National Health System, based on the principle that all citizens are equal under the laws in force in the Constitution of the Republic of Mozambique.
The Organization expressed this position last week (13 December) in Maputo at the International Conference “Promoting access to health for marginalized populations and the LGBTQI+ community.”
The conference, organized by the Citizen Observatory for Health (OCS), aimed at promoting access to health for vulnerable communities, especially the LGBTQ+ community and illicit drug users.
The meeting brought together organizations working with the LGBTQI+ community and other vulnerable groups, such as drug users, people living with HIV/AIDS, as well as people with disabilities, to discuss the challenges in accessing healthcare and possible solutions to overcome these barriers.
The organizations were unanimous in stating that there are groups that are marginalized in terms of access to healthcare. These groups are victims of discrimination and stigma and ultimately face difficulties in accessing hospital facilities, especially people with disabilities.
In this context, civil society is demanding respect for the rights of marginalized communities, and health professionals need to be made aware, from the time they enter training, of the need to treat people with disabilities, HIV/AIDS, drug users and those with different sexual orientations with dignity.
Specifically, the LGBTQI+ community, during discussions in group work, listed a series of challenges related to their gender identity and dress. This community claims that its members are segregated simply because of their appearance and excluded from hospital centers. In addition to difficulties in accessing disease prevention supplies, including lubricant gel, “there is no legal framework on the protection of people from the LGBTQIA+ community.” The lines and mechanisms for reporting issues of discrimination do not work and it is not known, for example, who monitors the complaint boxes.
On the other hand, the community considers that, due to the lack of this legal framework, health providers make and break their situation. The community also claims that there is a lack of disaggregated data on gender-based violence, a lack of mental health services and unsafe abortions for women from the LGBTQ+ community.
With regard to people living with HIV and AIDS, the major problem for this group is the issue of prejudice experienced in health centers, a factor that contributes to poor adherence to treatment. As such, this factor ends up being a reason for giving up antiretroviral treatment.
As solutions, the group proposes, among other things, more research into community health, given the lack of evidence. The community also calls for information to be made available on normative documents and reporting lines for people in the LGBTQIA+ community.
It also advocates reinforcing the need for civil society organizations working on gender-based violence to include indicators relating to sexual orientation and gender identity, as well as advocating the need for the government and local institutions to work in coordination.
Drug users claim to be discriminated
Like the LGBTQI+ community, associations working with drug users also face stigma and discrimination when they seek health services at health centres.
The limited access of people who use drugs (PUDs) to health services in general, as well as sexual and reproductive health (SRH) services for women who use drugs, are the main barriers for this social group.
As a way of influencing policy changes, organizations working with drug users propose continuous awareness-raising about human rights and humane treatment for health providers and law enforcement agents.
Also during the conference, a study was presented on “the problem of criminal liability of people who use illicit drugs in Mozambique under Law 3/1997 of 13 March.”
According to the study, authored by the OCS, this law treats the use of illicit drugs as a criminal policy issue, without referring to the public health approach. The study found that Law 3/1997 of 13 March is out of context, hence the need to revise it to bring it into line with current needs and realities. The current law, the research points out, criminalizes and puts drug users and dealers on an equal footing, which is why it needs to be revised.
Difficult access to healthcare for people with disabilities
In another development, associations working with people with disabilities spoke about the various barriers this group faces in accessing healthcare.
Among the difficulties, the highlight goes to the lack of information material for the visually impaired and the lack of specialization among health professionals to deal with anyone with special needs.
In many situations, the hearing impaired end up not receiving adequate care because they encounter communication barriers with service providers.
For disabled people who use wheelchairs, the first barrier is access to toilets in health centres, as these, almost everywhere in the country, were not designed for wheelchair users.
In this context, they propose as solutions the training of health professionals in sign language, as well as the implementation of humanization so that professionals can deal with patients, especially those with disabilities.
Organizations working with people with disabilities believe that the Charter of Patients’ Rights and Duties (CDDD), an instrument also presented at the conference, should be more comprehensive and inclusive.
Not only that, they demand that this instrument, approved by resolution 73/2007 of 18 December by the Council of Ministers, with the aim of defending and protecting the rights of users of health services, be transformed from a resolution into a law.
The event, which was part of the project “Empowering the LGBTQ+ Community in Mozambique”, carried out by OCS, had the main objective of advocating inclusion in access to healthcare for marginalized groups, by mapping the challenges and opportunities for networking.
The event also aimed to keep the public informed about the challenges faced by the LGBTQ+ population in accessing healthcare in Mozambique; to present and discuss research findings on the lack of inclusion in healthcare services, as a way of sparking an open and informative debate on discrimination against vulnerable groups in accessing healthcare services.