Health -trading places authored by Ddembe on 8. March 2008 at 12:22 NRM cadre says, “My claim (which still stands) is that an effort has been made to improve and make health services more available to the peasants of Uganda. My claim is that the situation in my home village was worse before than it is now. Maybe, before are health services had so crumbled that there was almost nothing to talk about! My point is that comparing where we were (i.e. some of us who have spent the bigger sections of our lives in the villages) and where we are now, there is a marked improvement. It may not be satisfactory by world or even Africa standards, but for some of us who have seen worse, it is still an improvement.” And my claim which still stands and is everyday confirmed by people who should know is that nowhere near enough has been done. As a matter of fact, there is a lot more we could have done in the last twenty years than we have done! It is not an accident that our health system is in a shambles or that we do not have enough doctors despite having the second oldest medical school on the continent with a very impecable pedigree -at least until the 70′s. We have systematically taken our skilled manpower for granted in favour of banalisation and seeking the lowest denomination. There is no point at all to training manpower that we cannot employ not because we do not need them but because of flawed government policy! I know some really good and world class doctors in Uganda. Interestingly many of them despite working in Uganda will advise a young Ugandan doctor not to work in Uganda. As a matter of fact many of them with children who chose the same professional pathway made sure their children leave the country! You trying as usual to rewrite history. You claimed that an improvement from 0 to 1 should be accorded the same accolade we would grant an improvement of 0 to 10!!! My response is that viewed against a timeline of 20 years there is really nothing to celebrate! Our progress in the provision of health services to our people is a catalogue of missed opportunities and misallocated priorities! Each and every one of my arguments then have appeared in the press since and in the speeches of government officials and WHO officials in part because I have discussed the same issue in other fora and in part because these are obvious issues well documented in the public domain! We keep talking about the shortage of doctors, nurses and medical assistants! At times you and some other misinformed people try to blame the failure to provide medical services to a shortage of doctors! Part of the reason Uganda continues to lose doctors is that bizarre as it may sound we produce more doctors than we can employ. The two main employers of doctors in Uganda are the private sector including missionary hospitals and the public sector. the private sector is supported by the genarl population who do not have private medical insurance and no financial means to sustain a private medical infrastructure. That makes the government the largest employer. Government however has got slow budgetary cycles, snail paced decision making and reactionary reflexes, misplaced priorities, dependency on external partners like the World Bank and IMF who dictate recruiting policy or spending caps plus of course the big ones -negligence and incompetence! There is abundant evidence that qualified nurses in Uganda are unemployed while those who are employed work in deplorable conditions for next to nothing! If say 145 doctors graduate in a given year, do their internship, finish and are not deployed because the government does not have enough money to employ them in a given year or maybe they are deployed ahead of the budgetary cycle and are expected to relocate to Bundibugyo or Gulu with no salary till the next financial year then you have a problem! if a post graduate doctor with 3 years working experience returns to Mulago in their late twenties or thirties with a family to look after, no salary for three years and a work roster that makes them work full time unpaid for seven days a week, then someone in the Ministry is sleeping! Idiots in the Ministry of Helth think that post graduate doctor should be the responsibility of the Ministry of Education yet they work for the Ministry of Health, the district where they worked before do not want to pay for them so they sack them the moment they enrol while the MOH will not take up their salaries and neither will Mulago hospital, the main beneficiary of their labour! These same people are expected to be so “patriotic” as t relocate their whole families and children to Budadiri to treat Mataka’s mother in stone age conditions! So when Mataka’ s cousin who has HIV arrives at the clinic in obstructed labour, the unpaid or poorly paid doctor is supposed to deliver her baby without gloves -as Budadiri does not have any! And no it is not because the poor impoverished unpaid doctor sold them -it is because they are simply not there because Muhwezi and company had to attend a conference in New York! These are real scenarios! Meanwhile Mataka gets to fly to budadiri every weekend in a government 4WD at 160 kph, send his children to good schools in Kampala while the doctor has to send his to mango tree UPE school in budadiri. To add insult to injury, Mataka always the guest of honour at local imbalu ceremonies in anticipation of his future candidacy as the local NRM MP, takes the photo opportunity to lecture the doctors who have given up their lives to relocate to the end of the world and work in stone age conditions with little or no pay providing some semblance of health service to Budadiri paesants to stop tealing drug from the health centre!!! He also reminds them that the NRM government will consider raising their pay to quote Museveni, “When they become productive”!!! Of course as Mataka says, compared to where he was (he grew up in a village) and where he is now (he live in a surburb of the capital Kampala, Buganda) and rubs shoulders and stomachs which other NRM big wigs who grew up in villages but have also come very far. The doctor however who grew up in surburban luxury and went to the best schools money could pay for is now supposed to reverse roles and take the place of Mataka and his friends who grew up in the villages or else be labelled unpatriotic!!! You refuse to listen to the people who are actually involved -doctors, nurses and consumers and instead sit in your rarefied air conditioned offices theorising! When doctors talk about their entitlements and right to good working conditions and a living wage, they are “saboteurs” trying to sabotage the NRM or they are being misled by the opposition! Does one need the opposition to tell them when they are being exploited and mistreated? By the time you work that one out, those doctor and nurses sitting around waiting for the government to make up its mind whether they need them or not, can afford them or not will have discovered that there are other places which can not only pay for their services but provide them with advancement and career opportunities as well as job satisfaction while making them feel valued. they will have discovered that their skills can actually be used anywhere on this planet to provide joy and health to people. There is no doubt that they would still wish they could use their skills at home but where does that leave you? Stealing money so that you can insure yourself against the day you may need to be flown out to South Africa to be treated by a Ugandan doctor!!!
Posted on: Thu, 11 Jul 2013 11:27:40 +0000
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