LGBT community decries stigma in health facilities

Friday December 27 2019

Members of LGBT community posing during the recent ICASA conference held in Rwanda. According to them, there is a national stigma associated with being part of the group and that they face several challenges when seeking health care in the country. PHOTO | CYRIL NDEGEYA


Lesbian, gay, bisexual and transgender (LGBT) persons and commercial sex workers are seeking formal recognition to access specialized health services.

They complained of stigma associated whenever they seek medical attention from health facilities.

Transgender, for instance, are not covered by any law and find it difficult to get medical services.

“We propose the inclusion of sex reassignment therapy to be permitted and to have laws that protect us when denied health services by medical practitioners,” said Felix Ndayambaje, a male transgender.

Mary Kamikazi, a commercial sex worker, said they are at high risk of contracting HIV because they do not have easy access to condoms, and Pre-exposure prophylaxis (or PrEP).

“The challenge is not only on prevention tools but also when it comes to accessing antenatal care, health workers refuse to help us once they identify that one falls in one of these groups,” said Ms. Kamikazi.


She said that once a health provider identifies that one is a commercial sex worker, they do not offer reproductive health services.

“When I was pregnant I was denied antenatal care like other mothers because doctors in the area new that I was depending on commercial sex work for a living,” she said.

“We are not recognised by the government hence discriminated against by the public. In Rwanda, there is no single policy that grants us an opportunity to access services as others,” she added.

David Masengesho, a gay, said there is a need for the government to consider them because they stand high chances of contracting HIV.

“Even though we are gay, we also have girlfriends on the side. It would be better if we have access to PrEP, condoms, and HIV self-testing tools,” he said.

“Failure to access necessary tools for protection against HIV do not negatively impact us only but all the entire community,” he said adding “apart from condoms, the rest of prevention and HIV self-testing tools are very expensive to manage,” In an interview with Rwanda Today, Cheryl Johnson, the World Health Organisation global technical officer for HIV testing services said Rwanda is doing well in prevention and treatment of HIV/Aids than other East African countries.

She said although Rwanda has made great strides in the fight against HIV/Aids, more effort should be put in addressing challenges like culture and social norms that lead to the exclusion of commercial sex workers and those engaged in same-sex relationships.

“In Rwanda, there has not been government goodwill to include this group like in other African countries but there is hope that with time policies and laws protecting the key population will be embraced,” she added.

Director general of Rwanda Biomedical Centre Dr Sabin Nsanzimana said the government is aware that the LGBT group faces multiple challenges in accessing health services, but the problem will soon be resolved.

“Although we have great numbers in access to health services to over 90 per cent, we know that the key groups are still being discriminated against by doctors or any other health practitioner in the country,” said Dr Nsanzimana.

“But it is not true that we have neglected the gays, lesbians, or commercial sex workers, we are aware that they exist in our communities and we are advising health workers to treat them as others,” said Dr Nzanzimana.

“Failure to consider them would mean failure to archive our set targets. We are advising those who are finding it hard to access services to reach out to any referral hospital in Kigali for the services,” said Dr Nsanzimana.

“We have trained the majority of doctors in referrals to easily recognise these people so that they offer them services well without being discriminated,” “We believe that the majority of people in the society haven’t embraced them especially men having sex with men and some policies aren’t being implemented well, but with time we shall achieve equal health services,” he added.

"We are working on strategies to raise efforts to reach out to them in their respective groups while offering training to all medical practitioners to consider them for health services,” he added.

The special group further urged the government to establish a fund to cater for all medical-related interventions for intersex people and to give them free or subsidised medical insurance under the Universal Health Insurance or any other schemes for intersex people.