Time to rethink VIP treatments abroad?

Investing in a well-equipped hospital in Uganda would be cheaper than sending people to foreign countries

Kampala, Uganda | MUBATSI HABATI ASINJA | The growing list of prominent Ugandans dying outside the country on account of seeking better medical care is raising concerns about the quality of health care services to the population.

Latest on the list is the late Speaker of Parliament, Jacob Oulanyah, who died in Seattle in the U.S on March. 20. Oulanyah had been in office for only nine months.

In January this year, the Bank of Uganda Governor, Prof. Emmanuel Mutebile, died in a Nairobi hospital where he had been rushed for a better medical care. This is in addition to other prominent Ugandans who have died abroad while seeking for better treatment.

But this trend is worrying a section of the population, questioning why the government isn’t investing enough in specialised medical services. Yet even attempts to invest in such services has been scuttled and riddled with incidences of corruption.

For instance, in the 10th Parliament, there was an attempt to finance a specialized hospital at Lubowa. However, the hospital building is yet to get out of the foundation three years since the money was appropriated.

The government through parliament guaranteed a loan for construction of this specialized hospital that would include a 264-bed hospital, an 82-room budget hotel, a 5000-seater conference hall, a health training school and staff housing to be established on the 85,000 square meters of land.

These facilities were estimated to cost $249.9m (over sh926b) including medicines for one year and training of Ugandan health professionals. There was also an additional $129.81m (over sh481b) cost representing interest rate of 6.49% on the loan to be secured by the project’s joint venture contractors; FINASI and ROKO. This brought the total cost to $379.71m (over sh1.4trillion).

The government allowed the joint venture partners through irrevocable promissory notes to secure funding for the project and committed to repaying the money expended on the facility over six years after construction.

During the debate of whether to guarantee the FINASI/Lubowa specialized hospital, the Uganda Medical Association advised that there needed to be a review of what it called the exaggerated cost of the project or the scheme be dropped and resources directed to the refurbishment effort at Mulago National Referral Hospital.

Equipping hospitals locally is ideal

Some observers in the health sector say, it would be better to spend money on building facilities and installing equipment in Uganda than send every sick person to in other countries including India. They argue that a better-furnished hospital would be ideal.

They advise that investing in a well-equipped hospital in Uganda would be cheaper than sending everyone who needs treatment to foreign countries.

This based on the view that while the country has attempted to invest in the health facilities, they still lack specialised facilities to diagnose many diseases.

Doctors on the Uganda Medical Board, a body that makes final referral decision of a government official, say most referrals abroad are due to lack of requisite medical equipment in Uganda’s hospitals.

In addition, Uganda does not have modern facilities and expertise to perform sophisticated medical procedures, according to reports. A 2020 audit of registered radiology equipment in Uganda revealed 625 pieces of equipment spread over 354 health facilities.

The majority (397) were plain X-ray machines followed by Dental X-ray machines at 120. There were only 3 Radiotherapy machines. Most were recorded as being functional with only 0.1% of the equipment non-functional. Most of the equipment was in the central region which has the third highest population density. The majority of the equipment belonged to private health facilities.

The study concludes that: “Uganda lags behind the WHO recommended ratio of equipment versus the population (20 per million Population). Most of the equipment is the plain X-ray machine with a few more advanced technologies in both public and private health facilities.”

Some sources say Uganda government spends between $100million-$300 million dollars annually on “medical tourism” for VIP’s families to travel abroad to seek medical services, yet the total amount government budgeted for health services in the current financial year is a paltry $500 million dollars (sh1.4 trillion).

In the case of Oulanyah, Government spent at least Shs1.7 billion to airlift and treat him at Fred Hutch Cancer Centre in Seattle, USA where he died.

In 2016 alone over 5000 government officials sought medical treatment to India alone costing the tax payer Shs $123m (sh455b). The Ministry of Finance vouched for the private specialised hospital at Lubowa arguing that the International Specialised Hospital of Uganda (ISHU) would stop the haemorrhage of foreign exchange from Uganda. The hospital is yet to make its mark as construction is yet to start.

In 2014, the government spent $73m (sh270b) on treatment and $113m (sh418b) on travel and upkeep for its patients abroad.

A ministerial retreat which was convened by the Office of the Prime Minister’s in December 2011 to assess the government’s performance in the previous year, revealed that the government spends at least $150m (about Shs400b) on treatment of mostly top government officials abroad annually. This figure reportedly drew President Yoweri Museveni’s attention who is quoted to have said the number of patients seeking specialised health treatment abroad, costing the country about Shs400b annually should be curbed and restricted to only severe conditions.

Ironically, when Oulanyah was very ill, Uganda’s Minister of Health, Dr. Ruth Aceng, was one of the members of a delegation sent to comfort him in a US hospital! It was revealed that since he was taken to the USA, Oulanyah was still being stabilized and therefore had not got the much sought after specialized treatment he wanted.

Oulanyah’s brother, Francis Emuna, who travelled with the Uganda government delegation to Seattle says the late Speaker was struggling to speak. “He was in pain and perhaps thought we had come to take him home,” Emuna told the press.

In a moving eulogy, Chief Justice, Owiny-Dollo, who is one of the friends of the late Speaker, told mourners how the Oulanyah was struggling with life in a hospital abroad. “We left the body of Jacob Oulanyah lying in a cold room in a top cancer institute; a world-renowned cancer institute in Seattle,” Justice Owiny-Dollo said; adding that Oulanyah had kept his sickness secret only his doctor Dr. Jackson Orem, the director of Uganda Cancer Institute knew.

Soon after taking up the Speakership position at parliament, Oulanyah travelled to Dubai for specialized treatment. He returned but a bit weak. He did not want to show the public how sick he was. “I am told that even when he was at the hospital, if his children were the ones talking with him, he did everything for the children not to know that he was in pain,” said Justice Owiny-Dollo.

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