The Independent Uganda: You get the Truth we Pay the Price
The problems of the healthcare sector in Uganda are not the fault of anyone. On the contrary they are a product of our shared mentality i.e. the belief that the state should take care of all the healthcare needs of all its citizens – regardless. But blaming our shared mentality is too abstract to attract mass hysteria. In Uganda’s case, it makes sense to identify a villain (Museveni) and blame him for the problems in the health sector.
Reading about comparative experience liberated me from conjectures that made a good sound byte but were hardly a source of good public policy. In fact, accounting for her low per capita spending, and factoring in the destruction of her physical infrastructure (hospitals and their equipment), human capital (death or exile of medical professionals) and social capital (loss of values, norms and ethics) during the Idi Amin years and civil wars that lasted from 1979 to 2005, Uganda’s healthcare outcomes show the country performs better than most of her peers.
So what health policy is best suited for Uganda given her context of limited financial and human resources – and her politics of multiple ethnicities? Our government needs to focus on primary healthcare, which is affordable and affects the vast majority of our citizens. Here it can do things like vector control (e.g. killing mosquitoes to reduce the incidence of malaria), ensure mass vaccination and immunisation (which reduces infant and child mortality) and implement public hygiene measures (like provision of clean water).
Government should abandon its pretence to take care of such illnesses as cancer, brain surgery, heart disease, diabetes, hypertension, organ transplants, etc. because it cannot afford them. If someone needs such expensive treatment they should pay it themselves and their families or rely on charitable institutions.
Government needs to ask itself whether it makes sense to spend Shs 50 million of public funds trying to save the life a 70-year old (or even a child) suffering from cancer when the same amount can save the lives of 100,000 kids if spent on immunisation and vaccination. Many people may not share this utilitarian vision (the highest good for the largest number), but public policy should not be based on emotions.
People rightlyask whether government should watch its citizens die ofcomplicated illnesses that are expensive to treat.Doctors care about every patient. If allowed to make policy they will insist everyone should be treated. But our resources are limited and need to be used selectively. This requires making hardnosed trade offs that doctors’ training may not permit.
The biggest cause of low life expectancy in poor countries is child and infant mortality. Public health measures such as immunisation, vaccination and vector control, if implemented well, can significantly increase life expectancy, taking it closer to that of rich nations. Government has not focused on these measures, as it should, because huge resources are spent trying to cure complicated illnesses. Who will speak for the children of Uganda, especially from poor families, when public debate on health policy is dominated by ignorant and self-interested adult elites?
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amwenda@independent.co.ug
Mr Mwenda, you have written : “The problems of the Health sector in Uganda are not the fault of anyone”
As a journalist, what does it take for you to say, of anyone, “Your performance is grossly unsatisfactory; you are unfit for the job you hold”? Your article is illustrated by the picture of someone who has been in charge of Uganda’s public Health services for decades. The analysis of Uganda’s health problems that you give is a recitation of data that was known twenty five years ago. The policy approaches you suggest are out of a textbook, they were also known decades ago. The national leadership has chosen to seek medical treatment abroad for themselves and their families while ignoring the rotten hospitals at home.
You are probably too young to know this but there was a time when Uganda was the beacon country on the question of delivering medical services in a low income country; it even produced the standard textbooks on the matter.
“not the fault of anyone” is a coward’s conclusion. You are saying you have no desire to take on the powerful who have openly stolen hundreds of millions of donor dollars; who get their own treatment abroad at public expense; who just don’t care.
YES, was going to say exactly the same thing, M 9 says that “it is not any ones fault” YET he goes on to say the mistakes are because of the policies we have in place. The government is responsible for policy, its not our grandparents in the villages.SO , if the policy is wrong, it is the person who has put the said policy in place who is wrong.
IT is as simple as that in my book, that is why football managers are held responsible for the performance of a team even when they are NOT on the pitch.
MIND you, the same people who do not want to take blame, are the same people who want to take credit when we win a gold medal in the Commonwealth games, even when their input was ZERO.
SOMETIMES I wonder if M 9 passes his work to another person just to give him a second opinion about what he has written and to tell him if it all makes sense or not.
AND the likes of MWENDA, either by design or by default, conveniently forget that even during all the so called bad years, we had private medical care side by side with public health care. In NGORA for instance, you had the missionary hospital, FREDA CARR hospital, next to the government hospital, and most times those who could afford the private went there, and these were the majority. Likewise , even in the government hospital, you had MASABA wing, which was private
Well said
1.A bird in hand is worth 2 in the bush;with reference to the Uganda’s health care system Ugandans who get medical care from government facilities are better off than those who pretend to get medical care from expensive private facilities why do i say so?Just go to any top privately owned medical hospital in Uganda yes the ambience may look like a hotel but they also rely on consultants from Mulago Hospital so why would a ugandan want to pay three hundred thousand shillings in a private hospital to treat cough yet he would get free medical treatment from Mulago?
2.Those who opt to pay for medical services in private hospitals do so coz they care afford.
3.NDA must be having quality assurance challanges for example, why would the dosage for treating malaria vary especially if the tablets are made in UK,India or Egypt?
4.It would be good for govt to offer free medical insurance to those with complicated diseases like Cancer,Heart complications.
5.Most private companies offer fringe benefits like medical insurance to its workers probaly to dodge taxes why do i say so on average a normal adult falls sick once in 5 or 10 years.
6. Diseases like HIV can be avoided when men keep their pants on and women keep their legs closed.
7.Ugandans have very poor working habits at times i think the wages govt offers is worth their work.
8.DIGP Sabiiti we know you have have nice eyes but please bring some order in Munyonyo I know that people who live in Munyonyo always have dubious life styles but why would Byran White the new (Don/Sheriff in town) be allowed to be escorted to and from his home by a line of rowdy boda bodas, a police lead car for me once those goons hit my expensive car with their recklesness,i will sue police.
I went to Mengo Hospital for a minor eye treatment i was so impressed with their services can you imagine the consultation fee was just 5000/= i would have paid 50000/= in a private facility and the whole medication cost me 15,000/=that is about 3 dollars i guess if i went to Mulago Hospital it would have cost even less so what does this say about the health facilities in Uganda?i think its promising and secondly with the freedom of speech and the social media,its easy to expose a medical officer who is always not on duty.
Mwenda is always shamelessly apologizing for Museveni’s corrupt government including writing fictitious letters or memos on their behalf. It is so pathetic and tawdry, the groveling, like a puppy. Not being a wealthy nation is not an excuse for corruption and incompetence and mendacity. It should be a motivation to be more creative and innovative. In Uganda Museveni’s government has the country in a headlock and guns pointed at their heads. They can do whatever they wish. Thirty years of the same huffing and guffing; the tyranny has been more than normalized; it has been glorified, deified.
Mwenda leave matters health to the experts, and let the bag holders(Politicians/beuraucrats) listen and implement the advice given by the experts.
“Who will speak for the children of Uganda, especially from poor families, when public debate on health policy is dominated by ignorant and self-interested adult elites?” So who does Mwenda speak for when he states: “The problems of the healthcare sector in Uganda are not the fault of anyone.” when in fact Uganda has office bearers; is he speaking on behalf of the poor Ugandan Child, or on behalf of the ignorant and self-interested adult elite Ugandan?
Sorry – ladies and gentlemen – if I may sound a bit inward looking on this issue: The fundamental problem with Africa’s and Uganda’s health care – like with all other so called ‘social services’ has to be an insufficient supply of scientific and consequent technological minds within its human resource! You see, all health problems giving us headaches and debates today have a direct root in science. When Mwenda and others before him talk of primary health care, they are really referring to tackling causes and/or development of disease: Understand what, how, where and when these diseases are caused and developed – then you will, with a bit of creativity and innovation – be able to either eliminate them or disrupt their progression within whatever available non human resources. But to do so systematically, first we need a set of nature-inclined inquisitive/curious people to establish or even unequivocally confirm the critical linkages (scientists). Then a second set is needed to understand work of the first and consequently – using available human and non human resources – design, construct, and operate – where necessary) systems either to destroy or to distort the linkages (engineers/technologists/technicians/artisans). There are no two ways about this except in so far as you could be lucky enough to get rare individuals serving in both sets. It is after the existence of these two sets whether from without – but most preferably from within – that others can come on board. These ‘good for nothing’ politicians claiming to allocate resources they do not produce; both the ‘informed’ and ‘half baked’ economists pushing pencils to compute wealth they never generate; both the ‘pundit’ (i.e. the Mwenda likes) and ‘semi literate’ journalists/commentators (most others) —- all come later in importance of putting our health care right.
I do not have space-time here to illustrate my view point (and Mwenda & Co – you are in part responsible for this —–). In summary however, our African/Ugandan societies ought to start channeling their youth to these fundamental knowledge creation/discovery/creativity areas and to consciescise them about our problems and resources. It used to happen in precolonial days but European invaders ensured a long term stoppage of that process. And today, it is unfortunate, we cannot simply leave it to governments because almost all of them are manned by compromised semi illiterates in these matters.
Cheers brothers and sisters,
Dr. Eng. Kant Ateenyi – Cape Town
Andrew mwenda is more of a govt spokesman than a journalist.he is doing ofono’s job defending an indifenceable regime.he forgets that Uganda’s bigedt cause of health care decline is corruption and embezzlement. its not anyone but the nrm regime.
Failure starts from govt failing on policy.