In the past few weeks there have been several negative developments in terms of LGBT human rights, particularly from Uganda and Brunei. Uganda, to adding legislation to the existing anti-LGBT laws enacted by the country in December of 2013 (life in prison if found guilty of homosexuality), passed a law that forces healthcare workers to out LGBT Ugandans and one that bans foreign NGO’s from “helping LGBTI peoples”. This came only shortly after Ugandan police raided a US military medical center that was one of the few places in the country that LGBT people could go to get tested and treated for HIV without stigma, the government officials claiming it was a training camp for homosexuality. The Sultan of Brunei publicly stated that the country’s sharia law system would allow for stoning to death for breaking laws against homosexuality and adultery.
Yet strategies to help LGBT peoples around the world through health aid and diplomacy are continuing from US international programs. The Kaiser Family Foundation last week published a brief titled “The U.S. Government and Global LGBT Health: Opportunities and Challenges in the Current Era” which sited challenges, opportunities and made suggestions for areas for future development to benefit the health of LGBT peoples around the world.
While it is heartening that the State Department, NGOs and think tanks recognize that the heath and human rights of LGBTI peoples around the world is worth fighting for, strategy is also key. In his book “The Honor Code; How Moral Revolutions Happen” noted philosopher Kwame Appiah presents case studies of programs to enhance social change. Looking at issues such as foot-binding in China, dueling, slavery in the West, and honor killings, his thesis is that the best campaigns have been won by engaging communities, through grassroots change, while those dictated top-down tended to fail considerably. With this in mind we should listen to LGBT activists in Uganda who say that sanctions from the Western world would further endanger LGBT lives in Uganda. For even if it didn’t bring about the collapse of social order as the activists suggest that sanctions could do, couldn’t it also shift the blame of the sanctions onto the LGBT community in Uganda themselves? In order to ensure community health, we have to remember that a key aspect is to work with the community, especially in an international development context. Working with activists and thought leaders on the ground, and not fall into the trap of we-know-best, top-down decision making, to truly work in unity with peoples with whom we are hoping to assist. Guaranteeing that their voices, concerns and needs be respected and met accurately, and engaging with their opponents with the cultural competence that working with local activist would bring, will yield the most effective results.