Health worker export to Trinidad & Tobago: Civil Society appeal to UN

Twenty–one Ugandan civil society organisations have appealed to the UN over the government’s export of health workers to the Caribbean state of Trinidad and Tobago.

Uganda and Trinidad and Tobago entered a bilateral agreement last year to export over 250 Ugandan health workers, including highly specialized personnel to “further accelerate the existing bilateral relations between the two countries,” but also to strengthen Trinidad and Tobago’s health service sector.

Among the medical personnel in line to be exported include; 15 of Uganda’s 91 registered internal medicine specialists, 4 of the 11 registered psychiatrists, 20 of the 28 radiologists, 15 of 92 paeditricians, 15 of the 126 gynaecologists, 4 of 15 pathologists, 4 of the 6 urologists, and 4 of the 25 ophthalmologists among others. Trinidad and Tobago will also take one of Uganda’s only three neurosurgeons.

In a letter dated Feb. 24, addressed to the special rapporteur on the right to health office of the High Commissioner for Human Rights based in Geneva, Switzerland, the civil society organizations are requesting the “urgent attention” and action regarding the bilateral arrangement entered into between the two countries.

“We are writing on behalf of the citizens of Uganda who are more than likely to suffer the consequences of the aforesaid arrangement,” the letter reads in part.

The civil society organisations insist that the arrangement entered into on behalf of the government of Uganda by the Ministry of Foreign Affairs will deteriorate the fragile health system of the country.

“The arrangement will significantly undermine the public health system as Uganda suffers from an acute shortage of health workers at all levels and specializations for all types of health facilities.”

Henry Okello Oryem, the state minister for foreign affairs told The Independent recently that exporting doctors was not a new arrangement; Russia and Cuba have always sent their medical workers to Uganda. Oryem said the medical workers are just going to be away for two years, and another set would be sent.

Currently, Uganda has a doctor to patient ratio of 1: 24,725 against a World Health Organization (WHO) recommendation of 1: 1,000; a general nurse to patient ratio of 1: 11,000 against a WHO recommendation of 1: 500. By contrast, Trinidad and Tobago, with a population of under two million people, has 10 times as many doctors per capita.

Uganda’s medical personnel— patient ratio even gets worse when you take into account regional disparities as far as the distribution of health workers is concerned. Whereas over 80% of the medical personnel are concentrated in Kampala and its metropolis, the rest of the country has to share the remaining 20% of the health workers.

Still, over 40% of positions in the health service are yet to be filled around Uganda’s public health facilities.

According to sources The Independent has spoken to recently, although the Health Service Commission has failed to fill over 30 vacancies of highly qualified staff at Mulago National Referral Hospital, the same hospital is set to lose 93 doctors if the short list that came out in December, last year, is to be believed.

The civil society organisations say the arrangement between the two governments sabotages the remarkable progress made in recent years to increase production of health workers and a multi-purpose nursing cadre that is able to perform both nursing and midwifery tasks.

It also affects the development of a comprehensive human resource health policy and strategy to address constraints and wage increment of medical doctor at Health Centers IVs.

“The exportation of health workers is likely to exacerbate the situation hence a continued violation of the right to life, dignity and enjoyment of the highest attainable standard of physical and mental health,” the letter says.

Uganda loses 100,000 people to malaria every year and 16 women during labour every day while the HIV/Aids rates are on the rise and the country suffers disproportionately from other burdens.

Health rights advocates in the country led by the Institute of Public Policy Research, a Kampala-based think tank, filed an application in the high court for judicial review seeking for a temporary injunction to halt the recruitment process.

However, although the application for the interim order was filed, the registrar of the high court declined to grant the order stating that there was no immediate danger and as such requested the parties to file written submissions in advancement of the main application for the granting of a temporary injunction.