Mulago experts explain Besigye's persisting speech impairment

Medical specialists from Mulago National Referral Hospital have revealed that veteran opposition politician Dr Kizza Besigye has been unable to speak or write since suffering a collapse in court, although tests found no evidence of an acute stroke or brain haemorrhage.

The details are contained in a psychiatric assessment conducted to determine whether the 70-year-old former presidential candidate is fit to stand trial in the treason case against him.

The assessment was 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 report was signed on August 17.

Besigye, according to the report, suffered a syncopal episode (a temporary loss of consciousness commonly described as fainting), following prolonged standing and an emotional outburst while in court.

“Since that syncope episode, he has been unable to speak and is unable to write,” the report states.

Doctors said Besigye had previously received treatment for hypertension and hand tremors.

The medical team reviewed a series of investigations carried out on Besigye, including an electrocardiogram (ECG), echocardiogram, electroencephalogram (EEG), CT scan and MRI.

The report says his ECG and echocardiogram showed no significant findings, while an EEG showed “features of diffuse encephalopathy”.

Diffuse encephalopathy broadly refers to impaired brain function affecting the brain rather than a single localised area. The report, however, does not state that this finding alone explains Besigye's inability to speak and write.

A non-contrast CT scan showed mild generalised cerebral atrophy and mild microangiopathic white matter changes.

The MRI also showed mild chronic microangiopathic white matter ischaemic changes and cerebral volume loss. Crucially, the doctors reported “no evidence of acute infarct or haemorrhage”.

Other tests showed mildly elevated creatinine, low calcium levels, protein and blood in his urine, while his liver function, sodium and potassium levels were reported as normal. A malaria test was negative.

The report does not provide a definitive medical diagnosis for the loss of speech and writing ability.

The psychiatrists said Besigye's communication difficulties significantly affected their assessment.

He could neither provide information verbally nor write his responses. Doctors instead used a paper keyboard containing letters and numbers.

Questions were put to him and he responded by pointing to individual letters and numbers to construct his answers.

“This took much longer time than was expected,” the report says.

Doctors nonetheless, described Besigye as alert, appropriately dressed and groomed, cooperative and able to maintain appropriate eye contact.

He appeared oriented to person, place and time.

The report says his comprehension appeared preserved and that he could follow verbal questions and instructions. His responses through the alternative communication method were also described as consistent and relevant.

Besigye described his mood as frustrated, while doctors observed that he was tearful but responsive to the emotional content of the interview.

The specialists found no clear evidence of a formal thought disorder, delusions, marked suspiciousness or perceptual disturbance from the information they were able to obtain.

His thinking appeared “coherent, logical and goal directed”.

The report also says Besigye is undergoing speech and language therapy and has shown “some slight improvement” through attempts to pronounce some words.

While doctors found that several of Besigye's mental functions appeared preserved, they could not complete crucial parts of the assessment needed to establish his ability to participate fully in his trial.

His understanding of spoken information, orientation and understanding of the nature of the proceedings appeared preserved. He was also able to follow questions and provide responses by pointing at letters and numbers.

However, the specialists could not fully assess his understanding of the charges or the roles of the court, prosecutor and defence counsel because of his inability to speak and write.

His ability to communicate preferences and communicate effectively with his defence lawyers also required further assessment.

The report therefore stopped short of establishing conclusively that Besigye was fit to stand trial.

The findings have fuelled debate over the continuation of his trial in his absence.

National Unity Platform president Bobi Wine, cited the report while criticising the decision to continue proceedings. 

Kenyan politician and lawyer Martha Karua also criticised the handling of the case, arguing that Besigye was not medically fit to stand trial.

Besigye is facing treason-related charges alongside Hajj Obeid Lutale and Denis Oola before the High Court's International Crimes Division. His health has become a central issue in the proceedings following his collapse in court and subsequent hospitalisation.