In Uganda, Nurse Accused of Spreading HIV

Goaded by journalists who wanted a clear view of her face, the Ugandan nurse looked dazed and on the verge of tears. The Ugandan press had dubbed her "the killer nurse," after the HIV-infected medical worker was accused of deliberately injecting her blood into a two-year-old patient.

The 64-year-old nurse, Rosemary Namubiru, was charged with attempted murder, denied bail and sent to jail in an unusual case that many here saw as a horrifying example of the lax hospital standards believed to be prevalent in this East African country.

But in the course of her trial -- on the revised charge of criminal negligence -- the nurse is attracting sympathy and emerging as the apparent victim of rampant stigma in a country that until recently was being praised as a global leader in fighting AIDS and promoting an open attitude toward the disease.

The nurse, while attempting to give an injection to a distraught child on Jan. 7, accidentally pricked her finger with a needle, according to AIDS-Free World, an international advocacy group that has been monitoring the ongoing trial. After bandaging her finger she returned to administer the injection, apparently using the contaminated needle. Uncertain about whether the same needle was used, the child's mother "became concerned about the possibility that her child had been exposed to HIV," the group said. After a test showed the nurse was HIV positive, she was arrested and prosecutors argued against giving her bail on the grounds that she posed a grave danger to the public.

If convicted, the nurse faces seven years in jail and would be the first Ugandan medical worker to be sentenced under a colonial-era law against negligent acts likely to lead to the spread of an infectious disease.

The child who may have been exposed to HIV was given post-exposure treatment and will be tested again for HIV in coming days, according to lawyers and activists familiar with the case.

Namubiru's trial has consequences for the rights of people with HIV and AIDS, say AIDS activists in Uganda and abroad. Uganda, which achieved global attention in the 1990s for its efforts to stem the spread of the disease, has about 1.5 million people living with HIV out of a total population of 36 million. Activists note that it's virtually impossible to find a Ugandan family that hasn't been affected by the disease since it was first reported here in the 1980s. Yet stigma toward people suffering from AIDS persists, shocking activists.

The nurse's case illustrates "the failure of both the media and the prosecutor's office to act responsibly" and could set "a dangerous precedent and could have grave consequences for the fundamental rights of people living with HIV and AIDS in Uganda and beyond," said AIDS-Free World, in a statement.

Namubiru shouldn't be on trial and her case should simply have been referred to the Uganda Nurses and Midwives Council, a statutory body charged with protecting the public from unsafe nursing practices, said Dorah Kiconco, a Ugandan lawyer who runs a watchdog group called the Uganda Network on Law, Ethics and HIV/AIDS.

"She was working and she got into a bad accident and it should have been treated as such," Kiconco said. "She's on trial because of her HIV status."

Jane Kajuga, a spokeswoman for Uganda's public prosecutor, defended the decision to press charges, saying there's evidence a crime was committed.

The Global Commission on HIV and the Law said the nurse's "life has been ruined. No matter the outcome of the trial, the panorama of ferociously intemperate accusation will haunt her and her family forever."

Uganda's HIV rate has been rising in recent times, confounding officials who succeeded in reducing the prevalence from 18 percent in 1992 to 6.4 percent in 2005. Now the rate stands at 7.3 percent, according to the most recent survey by Uganda's Ministry of Health. Ugandan health officials say more married couples are getting infected, in part because of what campaigners have dubbed a "sexual network" in which married people keep secret lovers. Billboards in Kampala, the Ugandan capital, urge couples to "put your love to the test" by testing for HIV.

Ugandan President Yoweri Museveni last year publicly tested for HIV in a bid to spark similar action among reluctant Ugandans. Although being HIV positive no longer spells a death sentence, even for poor Ugandans, public knowledge of one's HIV-positive status can destroy a life. A Ugandan man who worked in the presidential palace as a gardener recently accused his bosses of firing him after they discovered that he was infected with HIV.

Ugandan Maj. Rubaramira Ruranga, one of few officials who have publicly revealed they have HIV in a bid to discourage stigma, said the case against the nurse proves that "stigma still rages on" in Uganda.

"If I were her I would be very angry, I would feel isolated and I would feel dejected," he said. "She was brutalized."