THE WOMEN OF KAMPALA'S SLUMS
As narrated by Maxensia Nakibuuka Takirambule, Founder and Executive Director, Lungujja Community Health Caring Organization (LUCOHECO)
Maxensia Nakibuuka Takirambule and her friends in Kampala, Uganda founded the Lungujja Community Health Caring Organization (LUCOHECO) in 2005 to “pay back” the community for the lifesaving support Maxensia received when she fell ill with HIV/AIDS. Patients with HIV/AIDS often face social stigma, but older women in the community offered Maxensia healthcare, moral support, and hope. She wanted to give back to others.
After nursing, and then losing, her husband and brothers to HIV/AIDS, Maxensia recovered from this personal tragedy to run in local elections and become a city councilor. Shortly after, she and her friends founded LUCOHECO.
At first, LUCOHECO was created as a community-based health and development organization in the Rubaga Division of Kampala, where 78% of residents live in slums. It aimed to offer practical healthcare support and economic empowerment to those most vulnerable and in need. As time passed, it became evident to the leaders that climate change was amplifying harm to community members. Urban flooding caused by intense rainfall and poor urban environmental management, wetland degradation, together with intense heat, were particularly to blame. It was only when LUCOHECO members visited residents for home-based care and community risk mapping to assess their needs, that the problem of urban waste contributing to urban flooding came to the fore.
LUCOHECO recognized that the rains were becoming heavier and more frequent as a result of climate change. Drainage channels and spring wells were blocked with plastic waste and were overflowing. Polythene bags, tossed idly into the streets, were the worst offenders. Heat waves were also taking a heavy toll on residents’ productivity and well-being.
Cascading impacts in communities included increased incidence of mental disorders (such as anxiety and depression), worsening physical health and nutrition status for those living with chronic diseases, use of unsafe water sources, as well as greater prevalence of heat-induced illness and infectious diseases. Based on these observations and community concerns, LUCOHECO members were determined to become active in climate change adaptation.
The environmental damage was closely entwined with social vulnerabilities. Kampala City is already overwhelmed by its current population, failing to adequately provide housing, employment, services, utilities, and amenities for the bulk of its population. The city also battles to absorb the current rate of in-migration.
LUCOHECO considered it impractical to address the urban environment without addressing the social problems faced by informal settlers. These included poor social safety nets (including insufficient HIV/AIDS care), poor sanitation and hygiene, and lack of economic empowerment – all of which exacerbate poverty and illness. Women and girls are the most affected and most vulnerable. Pregnant women suffer premature births and miscarriages, and even maternal mortality, from the lack of infrastructure and services.
In Kampala, where LUCOHECO is based, climate-related damages fall especially heavily on women and girls: labor and care work to clean up after natural disasters take them away from paid work and education, increasing their and their families’ economic desperation. This, in turn, increases gender-based violence, sexual exploitation, and forced marriage among young women and vulnerable communities. A local organization cannot fight the effects of climate change in isolation from these factors.
A Holistic, Well-being Approach to Adaptation in Kampala’s Slums
LUCOHECO’s focus quickly expanded beyond conventional healthcare support. The organization expanded to address sustainable development issues comprehensively. This includes, but is not limited to, managing urban wastes and drainage to improve fl ood management, and piloting resilient kitchen gardening methods to reduce the impacts of climate change. This is accompanied by ongoing outreach and support of Community Health Workers in the targeted informal settlements, and training for community women, including in psychological resilience, healthcare skills, personal finance, and small business management.
Approximately 414,750 people live in the informal settlements of Rubaga Division where LUCOHECO works. (Rubaga Division has 13 parishes and 936 villages.) The organization has 56 active volunteers who work as community health workers or watchdogs at community level, and 506 members who subscribe to the organization. LUCOHECO is affiliated with many networks of grassroots initiatives within Uganda that work with community women and their families on good governance, HIV/AIDS, land and housing, livelihood, and climate resilience.
LUCOHECO uses a theory of change encompassing the following steps toward locally led adaptation:
Strengthening women’s empowerment. LUCOHECO organizes community members and builds their leadership capacities and understanding of climate change: how it affects them and how they can craft locally relevant solutions. Its “women as leaders, not as victims” approach was built into the organization’s DNA from the start. This approach is also consolidated and strengthened by LUCOHECO’s participation in the Huairou Commission, for which Maxensia has acted frequently as an ambassador.
Gender equality training for everyone. Acknowledging that equitable opportunities are needed for both women and men, LUCOHECO runs training for Community Health Workers to address gender inequality gaps and forms of marginalization. This is critical for de-escalating vulnerability, reducing risk, enhancing resilience, and empowering grassroots women at the center of climate action. They educate residents to understand and navigate the available resources, facilitate communication, and collect and provide feedback on data about the conditions and demographics of the communities. These activities help to inform LUCOHECO’s planning processes, as well as to improve local services that address climate change.
Building constituencies, and resilient and sustainable processes and networks. LUCOHECO seeks to avoid working as individuals, and rather to achieve more as a collective. It does this through peer learning exchanges and grassroots academies, where grassroots women come together to share practices and learn from one another. For example, Maxensia leveraged her position as a local councilor to convene local policymakers, NGOs, and community representatives to document solid waste problems and seek solutions. She and LUCOHECO mobilized young people to collect plastic bottles to unclog drainage systems, and to bring the bottles to recycling facilities.
Influencing public policy and processes. When LUCOHECO meets with Kampala city leaders, grassroots women lead the process of policy advocacy: alerting them to the community’s priorities and needs, holding duty bearers accountable, and demanding access to available resources. LUCOHECO carries out local-to-local community dialogues among grassroots women’s groups, women affected by HIV/AIDS, women with disabilities, older people, and grassroots local council leaders (both men and women), as well as development partners of LUCOHECO from civil society, government line ministries and departments, and the private sector. This brings together power holders, duty bearers, grassroots women, and women’s organizations to discuss plans for increasing their mutual resilience on climate change, pandemics, and other future crises
Mapping of risks, opportunities, allies, and assessment of grassroots women’s understanding of their vulnerability and adaptability towards climate change. In 2021, LUCOHECO conducted an action research mapping of women’s access to resources and services, with a focus on disaster risk management, climate change and resilience of the targeted communities, as a result of the effects of COVID-19. The mapping aimed to update LUCOHECO’s understanding of community needs and drive collective actions to improve access to resources and services that would reduce community vulnerability to climate change and other disasters. The findings were used to inform planning, not only for the sampled project area but the entire Lubaga Division and beyond. The research findings are also intended to be used by other civil society actors and development partners to re-orient their services and streamline innovative ideas from the communities into their programming, to improve services. The research will shape the plans of LUCOHECO itself, as it reveals the real needs of the community members. The research was channeled through the Huairou Commission.
Procuring economic assets to enhance livelihoods. LUCOHECO began providing sack gardening supplies, seedlings, and livestock to enhance participatory, community-based, demonstration gardens. Subsequently, LUCOHECO provided seeds to individual families to enhance their nutritional intake. These activities are aimed at diversifying and expanding kitchen gardens. Kitchen gardening offers promise for crowded and flooded informal settlements, where many families were endeavoring to grow flowers for sale, but their small plots were often flooded and the products destroyed. The technique of growing tubers in sacks was adopted to enable residents to exploit small urban spaces to grow food for direct consumption or to sell, while reducing the likelihood of flood damage. The organization also uses various education techniques to support community residents in planting fruit trees and trees for medicinal products, as well as maintaining organic gardens to strengthen food security, improve dietary intake, and enhance family and community relationships. The sack garden pilot scheme and follow-on activities aim to double the production and consumption of beans and legumes, as well as generate stable financial savings for families.
Providing financial literacy training. LUCOHECO aims to give community members savings skills and knowledge about accessing microcredit. This includes support on how to start small-scale, income-generating projects for self-sufficiency. The training also covers mindset change to foster positive attitudes for improved resilience, business development, and record-keeping, as well as refresher training for community workers and volunteers to prevent burnout.
LUCOHECO uses these wide-ranging approaches because they recognize that climate change affects people differently – therefore, a holistic approach is important. These approaches put women at the forefront: not as beneficiaries of programs but as agents of change, because they are affected most by climate change.
How Challenges Are Addressed
Despite LUCOHECO’s very considerable achievements – in direct livelihood support, care provision to vulnerable families, and the advocacy arena – Maxensia is open about the significant challenges. It is hard to support every family to be climate-resilient and sustain their route out of poverty. And it is difficult, if not impossible, to expect members of LUCOHECO, who work voluntarily, to volunteer indefinitely without compensation. The reward of assisting others – of “giving life” – is vast, but members are torn by their personal responsibilities and finances. Maxensia works tirelessly (formerly a local councilor, she is not paid any more), and others also need to be paid for work.
LUCOHECO is not alone: there is a gap in fair pay for the workers in many civil society-based organizations such as LUCOHECO. If access to small predictable and reliable sources of climate finance to local organizations were available and accessible, this would make a STORIES OF RESILIENCE significant difference.