Centre for Health, Human Rights and Development & Anr. v. Attorney General

Civil Suit No. 094 of 2015
Download Judgment: English

The plaintiff stated that the Butabika Hospital is the only public psychiatric hospital under the Ministry of Health in Uganda. Further it is the only mental referral hospital and cases referred to it by other health facilities are of acute conditions, which require a specialized and skilled management. A part of the procedure in the hospital is to lock patients of acute mental illness in seclusion rooms. The 2nd plaintiff was locked up in the seclusion room for more than a day. The room was merely of dimension 2 sq. meters and did not have a urinal. This forced him to urinate and excrete in the room itself. The plaintiffs further alleged that he was undressed before being placed in the seclusion room on two occasions regardless of the weather conditions. The seclusion room further did not have any bedding and only a raised concrete platform. The issues raised were whether the seclusion violated the patient’s right to freedom from torture, cruel, inhuman or degrading treatment under the Constitution of the Republic of Uganda. Further whether the acts of the defendants violated the mental health patient’s right to personal liberty, right to privacy, right to a clean and safe environment and right to health.

The Court dismissed the suit stating that the plaintiffs had failed to prove that the balance of probabilities was in their favour. The court stated that mental treatment is one of the exceptions to the right to liberty. It stated that seclusion was a standard procedure and it could not be per se termed as a violation of the rights of the patients. The Court further stated that the 2nd plaintiff was suffering from severe bi-polar disorder and therefore his evidence is not entirely reliable.

The Court stated that seclusion is for a limited period of time and it is based on the presumption that the mentally ill patients will harm themselves. The Court stated that there was limited evidence and lack of expert opinion on whether a toilet should be allowed in the seclusion room. The Court stated that undressing patients and locking them in the seclusion room would be a violation of their privacy but it was not proven by the plaintiff and due to lack of evidence, the Court dismissed this claim.

In this case, this court finds that the plaintiff did not prove on a balance of probabilities that the 2nd plaintiff was kept in seclusion for 24 hours without medical attention, without sanitation facilities. Further, this court finds that seclusion parse is not a violation of the rights of the patients. The defendant convincingly explained circumstances under which a patient is put in a seclusion room and also proved by providing Exhibit “D1” that the Hospital has guidelines for staff on the rules governing the procedure of seclusion of patients ” (Page 17)

I am not convinced by the submissions of counsel for the plaintiffs on this issue of liberty. I do not think that the discretion of the medical doctor should be overridden by a court order. The medical doctors at the mental treatment hospital should be able to make the judgment on what is the most appropriate form of treatment that will help recover the patient. In all the methods of treatment in the medical field there is some inconvenience suffered by the patient. I also find that asking for opinion of a person who has been determined to have mental problems not a wise suggestion at all…” (Page 20-21)