KAMPALA, Uganda — A psychiatric assessment of jailed opposition politician Dr Kizza Besigye has found that he remains mentally alert and able to understand information but that his inability to speak or write could significantly hinder his ability to participate meaningfully in his defence.
The assessment, conducted at Luzira Staff Hospital on August 16, comes as the High Court continues Besigye’s treason trial in his absence after Justice Emmanuel Baguma ruled that proceedings could proceed without him.
According to the medical report, Dr Besigye, 70, has been unable to speak or write since suffering a syncopal episode, or fainting spell, during court proceedings on July 29.
“Dr Kizza Besigye demonstrates preserved comprehension but has an expressive communication impairment (speech and writing),” the report states.
The doctors, however, warned that the communication difficulties could substantially interfere with Dr Besigye’s ability to participate in his defence and may require further intervention before he can meaningfully engage in court proceedings.
The assessment was conducted by Dr Nalugya Joyce Sserunjogi, a senior consultant psychiatrist, and Dr Julius Muron, a consultant forensic psychiatrist, following a referral by the Commissioner General of Prisons.
Besigye unable to communicate detailed instructions
The doctors assessed Dr Besigye through direct observation, his medical records, information obtained from prison staff and an alternative communication system.
Because he could not speak or write, Dr Besigye responded to questions by pointing to letters and numbers on paper.
The assessment found him alert, cooperative and oriented to person, place and time. His comprehension appeared intact, and he was able to follow verbal questions and provide relevant responses using the alternative communication method.
However, the doctors found the system cumbersome when more detailed communication was required.
The report said Dr Besigye was unable to give detailed instructions to his lawyers because of his inability to speak or write. His capacity to communicate preferences and engage effectively with his defence team therefore requires further assessment.
The doctors noted that an accused person should be able to communicate sufficiently with counsel, express wishes and preferences, provide relevant instructions and respond to information relating to the conduct of their defence.
“At present, his ability to perform these more complex functions through pointing to letters and numbers has proved to be difficult,” the report says.
No major psychiatric disorder found
Despite the communication impairment, the assessment found no evidence of a major psychiatric disorder independently affecting Dr Besigye’s ability to understand or participate in legal proceedings.
The doctors said his ability to follow proceedings, retain relevant information and make relevant decisions appeared to be preserved.
Medical investigations cited in the report also found no evidence of an acute stroke or brain haemorrhage.
A CT scan showed mild generalised cerebral atrophy and mild microangiopathic white-matter changes, while an MRI showed mild chronic microangiopathic white-matter ischaemic changes and cerebral volume loss.
An EEG, however, showed features of diffuse encephalopathy, according to the assessment.
The report also records Dr Besigye’s history of treatment for hypertension and hand tremors.
Doctors recommend communication assessment
The doctors recommended a formal assessment by a speech and language or communication specialist to determine the most reliable method of communication for Dr Besigye.
They further recommended that if he is required to attend court, he should be given adequate time to formulate responses using an alternative communication system.
“Speech, language, physical, occupational and neurological rehabilitation should continue as clinically indicated,” the doctors recommended.
The assessment noted that Dr Besigye suffered the syncopal episode after prolonged standing and an emotional outburst during the July 29 court proceedings.
Trial continues in Dr Besigye’s absence
Dr Besigye’s health has become a central issue in the treason proceedings after he collapsed in the dock while challenging the continuation of the case amid a dispute over his legal representation.
Despite his absence from court on medical grounds, Justice Emmanuel Baguma has allowed the trial to continue.
Prosecution witness Andrew Wilson Orlando has since given evidence in the case against Besigye and his co-accused.
Dr Besigye is jointly charged with Hajj Obeid Lutale and Capt Denis Oola with treason-related offences. They have denied the charges.
Also Read: After Dr Kizza Besigye collapses in court, son makes emotional appeal to Museveni
The psychiatric assessment was prepared following a High Court order requiring an updated medical report on Besigye’s condition.
Mulago National Referral Hospital Executive Director Dr Rosemary Byanyima forwarded the assessment to the Commissioner General of Prisons on August 17.
The hospital said the physicians’ report had initially been submitted on August 14.
The latest findings could become significant to the ongoing proceedings as the court considers Dr Besigye’s ability to communicate with his lawyers and participate effectively in his defence while the trial continues in his absence.
