KAMPALA — Jailed opposition politician Dr Kizza Besigye has been returned from the Luzira Prison hospital to his cell, according to his wife Winnie Byanyima, as a newly circulated medical assessment reveals that he remains unable to speak or write following his collapse in court last month.
The development has intensified the dispute over whether Besigye, 70, is medically capable of participating meaningfully in his treason trial, which the High Court has allowed to proceed in his absence.
Byanyima said on Monday that Besigye had been taken back to his prison cell and that his sisters, who had been helping care for him, had also been sent away. She described him as extremely weak.
The People’s Front for Freedom (PFF), Besigye’s political party, went further, alleging that prison authorities forcibly removed him from medical care and returned him to detention despite his deteriorating condition.
The party said Besigye was unable to walk, speak or hold objects and accused the State of deliberately removing his caregivers from Luzira Staff Hospital.
Those allegations could not independently be verified. Uganda Prisons Service has previously disputed claims that Besigye was being neglected, saying its medical team was managing his treatment and that his condition was improving.
Medical report confirms inability to speak or write
The controversy follows the release of a psychiatric assessment conducted at Luzira Staff Hospital on August 16, 2026, by Senior Consultant Psychiatrist Dr Nalugya Joyce Sserunjogi and Consultant Forensic Psychiatrist Dr Julius Muron.
The assessment was commissioned to determine whether Besigye understood the court proceedings and could participate meaningfully in his defence.
Its findings present a complicated picture.
Besigye was found to be alert, cooperative and apparently oriented to person, place and time. He appeared capable of understanding spoken information and following questions.
But he was unable to speak.
The report states that since the syncopal episode in court, “he has been unable to speak and is unable to write.” Doctors described the condition as a significant expressive communication impairment.
Because he could neither speak nor write, the psychiatrists communicated with him using a paper keyboard containing letters and numbers.
They asked questions and Besigye responded by pointing to individual letters and numbers.
The process was slow, but the doctors said his responses were consistent and relevant and that his comprehension appeared preserved.
The report does not simply declare him mentally incapacitated
The medical findings are more nuanced than the political reactions surrounding them.
The psychiatrists found no clear evidence of a major psychiatric disorder, delusions, perceptual disturbances or disorganised thinking. They said Besigye appeared able to attend to questions, understand verbal information and retain and respond to information.
His thinking, based on the responses obtained through the alternative communication method, appeared coherent, logical and goal-directed.
But the assessment of his fitness to stand trial was not complete.
The doctors said they could not fully assess his understanding of the charges, the roles of the court, prosecutor and defence counsel because he could not speak or write.
His ability to communicate his preferences and communicate with his defence lawyers also required further assessment.
That distinction matters.
The report does not say Besigye does not understand what is happening.
It says that he appears to understand spoken information while suffering a profound inability to express himself conventionally.
And that creates a difficult question for a criminal trial: is understanding enough if the accused cannot effectively communicate with his lawyers?
Brain scans show chronic abnormalities
The medical assessment also reviewed several investigations carried out after Besigye collapsed.
An ECG and echocardiogram reportedly showed no significant abnormalities, while an EEG showed features of diffuse encephalopathy.
A CT scan showed mild generalised cerebral atrophy and mild microangiopathic white-matter changes.
An MRI showed mild chronic microangiopathic white-matter ischaemic changes and cerebral volume loss.
The scans, however, showed no evidence of an acute infarction or brain haemorrhage.
The report links Besigye’s communication impairment to a syncopal episode following prolonged standing and an emotional outburst during court proceedings.
It also notes that he is undergoing speech and language therapy and had shown some improvement in attempts to pronounce words.
PFF challenges prison account
The medical report has also revived an earlier dispute over Besigye’s absence from court.
On August 18, the High Court allowed the treason trial to proceed without Besigye after Assistant Superintendent of Prisons Emmanuel Hiire told court that Besigye had declined to attend physically despite being offered virtual participation.
Besigye’s co-accused, Hajji Obeid Lutale, disputed the account, saying Besigye was not refusing to attend but had been hospitalised.
PFF now accuses Hiire of lying under oath about Besigye’s refusal to participate through Zoom.
“Prisons Officer Hiire claimed under oath that Dr. Besigye declined to attend court via Zoom, a lie aimed at covering up his critical condition,” the party said.
That allegation has not been established by a court.
The High Court, meanwhile, has already ruled that the trial can proceed in Besigye’s absence. Justice Emmanuel Baguma said medical professionals had cleared Besigye as fit to stand trial and that he had declined to attend court.
The ruling followed an earlier order requiring prison authorities to obtain a medical assessment specifically addressing whether Besigye was medically fit to stand trial and participate in the proceedings.
A trial caught between medicine and law
The dispute has now produced two competing interpretations of the same basic reality.
The State and the court have focused on Besigye’s apparent cognitive ability: he is alert, oriented, understands spoken information and can respond through an alternative communication system.
His political allies and family are focusing on the other half of the equation: he cannot speak or write and doctors say his ability to communicate with his defence lawyers requires further assessment.
Both facts can be true at the same time.
A person can understand a question without being able to answer it in the ordinary way. A defendant can remain mentally alert while losing the physical ability to communicate effectively.
That is precisely where the legal question becomes uncomfortable.
Besigye is facing treason charges alongside Hajji Obeid Lutale and Capt Denis Oola. The prosecution alleges that the accused participated in activities aimed at overthrowing the government; the defence has repeatedly challenged the conduct of the proceedings and the adequacy of their representation.
The trial began in Besigye’s absence on August 18, with the prosecution calling its first witness.
Now, with Besigye back in a prison cell and a medical report confirming that he remains unable to speak or write, the question of whether he can meaningfully participate in his own trial is likely to remain at the centre of the proceedings.
PFF has described the situation as evidence of “state-sponsored persecution”.
The government has not accepted that characterisation.
But the deeper question is not merely political: what does justice mean when an accused person can apparently understand the proceedings but cannot speak to the people charged with defending him?
That is the question Uganda’s courts must now answer.
