The Bwindi Community Hospital

Advancing Batwa Human Rights: Sustaining our Partnership in Bwindi, Uganda

  1. Context
  2. Projects
    • 1st Grant: The Batwa Outreach Project (2022)
    • 2nd Grant: Cultural Rights-Promotion for Health Strategy in Bwindi, Uganda (2023)

  3. Support

The Community

The Batwa Indigenous people

inhabitants of the Great Lakes region of Central Africa, the Batwa were semi-nomadic forest-dwelling expert hunter-gatherers. Currently, they speak many different languages and live in Rwanda, Burundi, Uganda and the eastern Democratic Republic of Congo, with an estimated total population of 86,000 to 112,000. The Batwa identify as Indigenous People and share many of the cultural traits indicated in Article 1 of the ILO Convention no. 169 Concerning Indigenous and Tribal Peoples in Independent Countries. And even though some still practice the ancient traditions that are part of their rich culture, their traditional way of life is disappearing. Their rights are systematically violated, and they suffer grave prejudice and discrimination.  

Conservation Refugees

In 1991, following conservation projects by the Ugandan government and Western international agencies primarily to create national parks to protect endangered mountain gorillas, the Batwa were removed from their ancestral forests. This was done without their free, prior and informed consent, any public hearing or compensation. Consequently, this ancestral forest-dwelling people, who lived in harmony with other species and their surrounding environment and were not responsible for the dwindling numbers of mountain gorillas, suffered a sudden and profound change in their way of life. Now, fortunately, mountain gorillas are no longer considered endangered. But the Batwa people and their culture are.

Dispossessed, Marginalized

Land. For many, if not all, Indigenous Peoples, land means home, the source of physical and spiritual sustenance, the source of medicine and health practices, and the source of culture and identity. Such is the case for the Batwa, who now live in a harsh and precarious situation, with limited access to food, shelter, clothing and healthcare. Dispossession of land meant being unable to hunt or gather, leading to extreme poverty and a breakdown of social relations. Without being able to practice their ancestral traditions and organize according to their traditional social structure, many felt they had lost their identity. This exacerbated the negative stereotyping: uncivilized, lazy, depraved and physiologically inferior because of their height.

The Need

Healthcare and Safe Water

Along with social marginalization, their small numbers and almost inexistent political representation mean institutional marginalization as well. Their access to state health services, clean water, shelter, food and education is minimal. The discrimination they face extends to the health workers who often ignore or neglect Batwa patients looking for care. Living in the forest outskirts, in small settlements with meager living conditions, also contributes to the problem. Once renowned as experts in medicinal herbs, without access to healing resources from their ancestral home and living in extreme poverty, they have become increasingly vulnerable to disease and substance abuse. As a result, rates of HIV and AIDS and other diseases are very high among the Batwa. Their life expectancy is 28 years old

The Grantee

The Bwindi Community Hospital

Started as an outreach clinic under a tree in 2003 by a US missionary doctor who came to Bwindi to serve the Batwa population, the BCH has become one of the few places in this remote region where the entire population can access quality healthcare. It serves 120,000 people living in the South Western corner of Uganda and provides vital services, such as Child Health, Sexual & Reproductive Health, Surgery, HIV Prevention and Care, Community Health & Batwa, Satellite Clinics, Out Patient, Adult Inpatient, Diagnostics, Research and Education. 

First Grant - 2022 

The Batwa Outreach Program 

USD 25.000 grant
to improve the water, sanitation, hygiene 
and psychosocial situation 
among the Batwa communities 
living in Kanungu District, Bwindi, Uganda

AWF's relationship with the BCH started in 2020 amid the COVID-19 pandemic. By raising donations, we were able to support the Bwindi Community Hospital with a grant to secure salary and transportation for a nurse to serve the Batwa community by explaining COVID-19 hygiene and prevention measures and providing soap. This crucial healthcare outreach lasted for eight months and served 1120 members of the Batwa community. Read more about our first grant to the BCH.

Last year, while evaluating our earlier support to the Bwindi Community Hospital's Batwa Outreach Program, we realized its incredible potential to improve many more aspects of the Batwa's quotidian.

In June this year, we gave the BCH a USD 25.000 grant to improve the water, sanitation, hygiene and psychosocial situation among the Batwa communities living in Kanungu District by working towards four objectives:

  1. Establishing the baseline situation;
  2. Increasing the number and usage of water and sanitation facilities coverage to over 90% in all the 210 households in all the 12 Batwa settlements in Kanungu district;
  3. Reducing the prevalence of skin and diarrheal diseases to less than 5% of the Batwa population in Kanungu District;
  4. Reducing the percentage of families and individuals with substance use and other psychosocial challenges from 35.5% to less than 15%.

Update #1 October 10, 2022 

We've recently received a very positive email update on the project from the Bwindi Community Hospital. Read on to learn about all the developments making a difference for the Batwa People in the Kanungu district.

Numerous studies back the claim that community participation in primary healthcare is critical. The evidence points to benefits such as a more adequate response to the needs and problems of the community, contributing by holding health workers accountable, and other significant advantages. More than that, community participation ensures a human rights-based and culturally sensitive approach to health, which is why this program has successfully bettered health indicators among the Batwa. The Batwa have long endured poor access to healthcare because of poverty, long walking distances to hospitals and few government healthcare facilities, but also, and more poignantly, because of the discrimination they suffer not only from other social groups but also from healthcare providers. In this context, community participation proves vital.

So, to improve community participation, the BCH, with its Community Health Department, started in early July of this year setting up inception meetings between their team and the settlement Chairpersons and Health Volunteers to increase cooperation and coordination between the two. In addition, to further facilitate daily communication and referrals between settlement health volunteers and the CHBD, the volunteers were given mobile phones, and the team bought a laptop for the department. The CHBD also installed twelve solar systems in all Batwa settlements so the health volunteers could charge their phones and have light at night, benefiting the entire community.

Building on the work started with their first grant from AWF that also targeted WASH conditions, the CHBD purchased over two hundred transparent buckets, jugs, cups and 10 L jerrycans to distribute in Batwa households. Additionally, they set up hand-washing stations. These steps will hopefully contribute to improved hygiene and help curb the prevalence of diseases such as diarrhea. And one of the measures that made us the proudest because of its success—monthly health outreaches in all the settlements. These target maternal health, child nutrition and immunization, and alcohol and substance abuse prevention and care, among other essential services. This time, these vital outreaches happened thrice and also covered much-needed and urgent sensitization about Ebola prevention because Uganda is battling Ebola again, and this time, an outbreak caused by the Sudan strain of the virus, for which there are no approved vaccines or treatments.

And finally, the CHBD implemented a livelihood, occupation and income project among the Bawa. For this purpose, they bought and distributed 60 chickens (44 egg-laying hens) and 12 cages to secure them against predators.

Hopefully, we'll have more good news to share very soon.

Here's an episode of our segment, "Voices from the Ground", featuring the Batwa Outreach Program team from the Bwindi Community Hospital explaining how the program is improving the lives of the Batwa living in Kanungu district, Uganda:

Update #2    March 15, 2023   

Oyesiga Barnabas, the Communications Team Leader at the Bwindi Community Hospital, kindly sent us an update on the project's progress. 

In January, when the rains eased, they started building the pit latrines. They began in the settlements furthest from the hospital. So far, the hospital's Batwa Outreach team, together with the community, have completed twenty-nine pit latrines for the Batwa settlements. They have built four pit latrines in Mukongoro, four in Bikuto, six in Kebiremu, two in Kanyashande, five in Kihembe, four in Kitariro, and six in Kitahurira. They expect to finish the remaining sixteen pit latrines (in Byumba, Rurangara, Karehe, Bwanya and Buhoma) by the end of next month.

Community members at Kabwana after getting tools

We've learned so much from our partners of the Bwindi Community Hospital and their holistic approach to addressing the Batwa's health inequities. The community's engagement in these efforts reflects how much this project is helping to lessen the burden of decades of marginalization and how their skills are invaluable in improving their living conditions.

Second Grant - 2023 

Cultural Rights-Promotion for Health Strategy in Bwindi, Uganda 

USD 15.000 grant
to promote health
and the traditional way of life
among the Batwa
by establishing and involving them
in livelihood projects
according to the Economic, Social
and Cultural Rights promotion (ESCR) strategy.

Since their eviction from Bwindi and Mgahinga forests in 1991 for wildlife conservation purposes, the Batwa have lost access to the once green and abundant environment that provided their livelihood. The forest, which used to supply firewood, building materials, traditional food, and herbal medicines, is no longer available to them.

As a result, many Batwa families struggle to have more than one meal a day and rely on less nutritious food such as maize, sweet potatoes, bananas, and beans. The loss of fresh fruits, green vegetables, honey, and wild meat from the forest has contributed to malnutrition and increased poverty within the community.

These challenges disproportionately affect women and children, with young girls resorting to risky relationships for survival. Teenage pregnancies are common, and fathers often abandon their children, leaving the burden of care on the Batwa families. This situation threatens the continuity of the original Indigenous Batwa community.

To address these issues, the Bwindi Community Hospital aims to promote the health and traditional way of life among the Batwa by establishing livelihood projects and incorporating the ESCR (economic, social, and cultural rights) promotion strategy among a community of 973 individuals.

One of the project's main goals is to empower women and girls by improving their nutrition, health and income from economic activities. This will be achieved through community health outreaches, tree planting, sack mounds, banana cultivation, goat rearing, beekeeping, and forming peer groups to provide social support.

The project also intends to leverage the importance of local leadership and community engagement in rights advocacy by involving local leaders from both Batwa and non-Batwa communities, along with other stakeholders, to ensure collective responsibility in addressing human rights issues, handling cases of abuse, guiding community members to prevent victimization and oversee project activities.

Another major goal is to create a sustainable livelihood for the Batwa community, reminiscent of their pre-eviction lifestyle, by reviving traditional food production and participation in culturally significant activities.

Concurrently, the project will also sustain the Health Outreach in Batwa settlements, building on previous funding achievements. For this purpose, monthly visits by nurses to the Batwa settlements will continue for monitoring, counseling, and data collection for analysis for the project report.

You too can support the Batwa and the extraordinary work of the Bwindi Community Hospital, head to

By accepting you will be accessing a service provided by a third-party external to