Me, I was chased two times. They told me I can bring my husband’s ID but my husband wasn’t around. When they chased me, I just went back home. What could I do? I came home and used herbs. But if they chase you and you go back in a critical condition, they will say you are lying and that you were never there before. Another older woman recounted that both her grandson and granddaughter had been chased. The granddaughter was about to give birth, in pain, and in need of an operation. The health centre staff requested 300,000 UGX from the family in order to attend to her without her national ID—otherwise the family would have to travel to a larger facility at the district headquarters to seek care there. The family, fearing that they would just be turned away again and unable to pay for an expensive ambulance trip to a far off hospital, managed to scrape together the money by borrowing from a family member and selling some maize. They ultimately paid the 300,000 UGX. Staff at a few health centres did admit that they had chased away antenatal mothers seeking care because they had failed to bring their national ID cards after several reminders. Health workers at Buyinja Health Centre IV told us that it was a recent visit from NIRA staff that had triggered this policy. The NIRA staff had told them, “not to work on any woman attending maternal care services without a national ID.” To comply, the day before our visit they had sent away all the mothers who did not have Ndaga Muntu. For those who are rejected or chased, trying to access care often means spending money. This could involve the cost of traveling back and forth to the health centre, soliciting the LC1 Chairperson to travel with you to beg for access, or getting family members to bring you the necessary documents. In some cases, people are forced to borrow a stranger’s national ID card to access care. The value of the national ID has also meant that it has become a form of collateral. At least one health centre has adopted the practice of holding the national ID card until a person is able to pay their hospital bills. What also bears mentioning is that even when a woman is admitted without an NIC, there are certain services that may still be denied to her. For instance, if she wants the health centre to file a notification of the birth of her child, this is not possible without her NIN and NIC.132 Friction with the community Health workers have been torn between enforcing the ID requirement and providing care to people in their own community. One health centre in Namayingo reported that when the national ID requirement was introduced it led to a decline in the number of patients, prompting the workers there to decide autonomously to relax the policy. They were not only worried about denying care to members of their own community, but if their performance as a health centre would be called into question if the number of patients declined. In fact, some of the people we interviewed, including those of Asian descent (commonly known as ‘Bakyotara’), who have long struggled to get national IDs, no longer seek services at public health facilities because they know they will be asked to present a national ID. At Bukana Health Centre III in Namayingo, a staff member told us: Our turning point was a lady who came here with a very sick child. When we sent her back home to come back with a national ID, the child’s situation worsened, and she started getting convulsions. The village mobilised into a huge crowd and came to How a National Security Approach to Uganda’s National Digital ID Has Led to Wholesale Exclusion of Women and Older Persons 57