Center for Health, Human Rights and Development v. Nakaseke District Local Administration

This case summary and analysis was prepared in partnership with the International Reproductive and Sexual Health Law Programme of the University of Toronto and the Centre for Human Rights at the University of Pretoria for Legal Grounds III: Reproductive and Sexual Rights in Sub-Saharan African Courts.

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Summary of Facts
Analysis and Decision

On May 5, 2011, Nanteza Irene went into labor and was brought to the Hospital for her delivery. Nanteza was admitted to the hospital at 1:35pm, and according to the state of her labor, she was expected to deliver by 5pm. However, a nurse attending her case detected that she was experiencing obstructed labor, an emergency condition which required intervention that only a trained doctor could provide. At 4:30 pm, the staff started to look for the doctor who was on duty, as the person trained to manage obstructed labor. Unfortunately, the doctor was nowhere to be found before Nanteza suffered a ruptured uterus and died.

The Center for Health, Human Rights and Development (CEHURD), her husband, and her three daughters submitted a petition to the High Court of Uganda, claiming damages against the Nakaseke District Local Administration, which had administrative responsibility over the Hospital. They claimed the was a violation on the rights to health against Nanteza, as well as the rights of the children she had left behind.

The Court found that Nnanteza was in labor for approximately eight hours, before she died because of a ruptured uterus resulting in blood loss. During this time, the doctor on duty who could have provided the appropriate care that she required did not attend to her.

The Court referred to paragraph 4.3 of the Code of Conduct and Ethics for the Uganda Public Service which required that public officers seek and obtain permission from a supervisor to be absent from duty, and report any absence from duty to the supervisor or relevant staff. The Court found that the doctor absented himself without communicating his absence to the relevant staff. The Court therefore found that due to the flagrant neglect of duty by the doctor, Nanteza did not receive the care and protection she was entitled to under article 33 (3) of Uganda’s Constitution which establishes “the State shall protect women and their rights, taking into account their unique status and natural maternal functions in society.”

Furthermore, the Court referred to Article 34(1) of the Constitution, which protects the right of children to know and be cared for by their parents or other care-givers. The Court found that the surviving children were denied their mother’s care and companionship which was an infringement of their rights. Therefore, the constitutional rights of Nanteza had been violated, as well as the constitutional rights of the surviving children and spouse.

On the other hand, the Court addressed the issue of the Nakaseke District Local Administration liability in this case. Section 30 of the Local Government Act, Cap 24 of the Laws of Uganda (LGA) establishes the functions, powers, and services of the Local Government Council, including the provision of health and medical services. Moreover, Article 176(2)(g) of the Constitution reads: “The local government shall oversee the performance of persons employed by the Government to provide services in their areas and to monitor the provision of Government services or the implementation of projects in their areas.”

The Court also recognized that Nakaseke District Local Administration was responsible for the operations and management of the Hospital, including the provision of medical services. In fact, the Local Authority had been informed of Nanteza’s death but failed to take action. The Court cited the principle that a defendant is vicariously liable for the negligent acts and omissions of its servants committed within the scope of the employee’s employment (See Christopher Yiki Agatre v. Yumbe District Local Government (HCCS No.22 of 2004. Uganda High Court) which applied this principle. The Court therefore held that Nakaseke District Local Administration was vicariously liable for the death of Nanteza Irene and her child, and also the violation of the human rights of Nanteza and her surviving children.

The Court did not award punitive damages to the defendant because it considered the scarce resources of the Local Authority which are used to run its operations and are frequently in short supply. It however awarded general damages amounting to 35 million Uganda Shillings (equivalent to 10,000 USD).