Uganda At 57 and the future of Health Care Delivery

Today is that one day in the year where we all gather and pat ourselves on the back for being patriotic. Which really is synonymous with enduring everything that comes with existing in this beautiful country of ours. The most heroic act Ugandans continue to do is excelling in spite of a system that makes it impossible.

I am aware that today is supposed to be that one day in the year where we reflect on all the goodness in the pearl of Africa and for once turn a blind eye to the rot. So before we go any further, Happy Independence Day.

Photo credit : ShotByMu

The health care system in the country has been on the spot for a while. We have seen health workers demand increased pay ,medical interns demand change of unfair policies and working conditions, patients die from treatable causes because resources are misappropriated , and the list continues.

Before we get into the post I’d love to First of all applaud the good people of the ministry of health, Health workers and Ugandans for the good work they have done this far. The ministry of health, for improvising and always coming through whenever there are disease outbreaks. Health workers, for doing the thankless work of providing services in the absence of relevant equipment and diagnostic tools. Ugandans as a whole for being compliant with their medication, educating their neighbors on their health, giving towards surgeries and treatment of the less fortunate etc.

With that out of the way, let’s get into the gist of the matter, shall we?

1. Patient Care

After 57 years of independence you would expect that Ugandans would be enjoying free or in the very least descent health care services but no. The state of most regional referral hospitals in the country is pathetic. Just a while back the National referral Kawempe Hospital’s Neonatal Intensive care unit was on the spot which pushed stakeholders to work towards renovation and improvement of services. I will not go into the lack of basic diagnostic equipment or staff in the same regional referral hospitals.

I have seen countless people rant and share their experiences in health centres on the internet. For some it’s was that they were overcharged for horrendous services and for others it was that health workers were unethical.

What we need to remember is that every time there are gaps in our health care system, the patients suffer the most. Every time medicines and hospital supplies are misappropriated, real people (not just statistics) die from treatable diseases.

The other day Andrew Mwenda was asking us to applaud the government for the cancer Institute that according to him was providing free drugs for “poor Ugandans” and that drug availability was at 80%. What he didn’t explore is how many of the cancer patients are able to benefit from this and how Ugandans from further parts are constantly being referred to Mulago which is already overwhelmed by the patient number. The constant move by politicians to mask the problem by only parading the shiny parts of our health care system does not benefit anyone since the lives of many Ugandans are hinged on how health services are delivered.

The health care system does not need digital influencers. If good services are being provided, they will speak for themselves. What we need to look toward is upgrading all our regional referral hospitals and health centres to the level of Mulago, for now.

2. Working conditions For Health Workers

Medical interns rioting

If you follow me on twitter, you are probably tired of my constant rants on this. As a fourth year medical student, I have had the opportunity to work in and also visit different health centres and interact with colleagues working in different health centres. Nurses, medical interns and medical students are doing the lion’s share of the work in most of these places and yet are given very little pay. I was excited to read the presidential orderon salary increment for health workers but also saddened by the fact that those that are more readily available and do most of the work were not considered. I hope the ministry of health looks into ways of harmonising pay and work load instead of only focusing on academic qualifications.

Because of the working conditions for health workers, we have so many of them leaving the country for greener pastures. Which means despite training an increased number of medical workers many of them do not directly benefit the country.

3. Basic Health Care Information in Communities

camp Karamoja by Federation of Medical Students of Uganda (FUMSA)

Last year when the issue of nodding disease was raised in Northern Uganda, the minister of health was quoted saying whatever was there was not nodding disease but Epilepsy. All which she was able to find out without doing any kind of mass diagnosis or sensitization. In 2018 December when I was in Parabongo I met a family in which most of the children had nodding disease and the mother thought she was cursed.

Other acts like Infantile Oral mutilation continue to happen in Bushenyi where many neonates and infants die because of these scientifically baseless beliefs to mention but a few.

Ordinary Ugandans continue to suffer and die from preventable causes and others have to live with life long complications of treatable diseases.

Associations like FUMSA and the Uganda Medical Association (UMA) have set up medical camps in these far to reach areas to spread relevant information and provide free services. But since these are only once in a while they are not as effective as would be permanent health centres.

You would expect that after 57 years of independence and in 2019 we wouldn’t need to have certain conversations and that more Ugandans would have the basic health information. The reluctance to act and the constant move to parade health care service delivery in Kampala and privately owned hospitals as the standard of the state of health care in Uganda is probably why action has not been taken.

4. Health Care Policies

Every time I read the World Health Organisation standards for health service delivery my heart literally breaks for us. Uganda is described as a low income country which naturally makes achieving some of these standards more difficult. What I don’t understand though is how easy it is for the same ministry of finance to readily avail funds each time members of parliament demand an allowance for doing basic things like resting their bellies in the Parliamentary building.

Our ministry of health has mostly great policies, just that most of them are not implemented especially in the more remote parts of the country. Hopefully moving forward we will have a more harmonised and equitable distribution of resources.

As we celebrate 57 years of independence my thoughts are with Ugandans and I call upon everyone in their different capacities to act towards the improvement of health care delivery in the country.

Aluta continua

Bellows of love

ยฉTales of a Curious mind


15 thoughts on “Uganda At 57 and the future of Health Care Delivery

  1. Uganda is 57 years old.. Shit! No wonder South Africa is throwing tantrums. Why does your article as amazing as it is fail to mention anything about pension because you guys are approaching it and fast

    Liked by 2 people

  2. I’m saddened by the state our our health care facilities and everything you’ve mentioned here. I hope the government does better and everyone who is called to this mountain of health care.
    Thanks Fiona for this.very enlightening

    Liked by 1 person

  3. Thank you for the insightful article. It will break my heart rereading this 5 years later only to find that the same problems are still plaguing our healthcare ๐Ÿ˜•. All these things our government has the power to change if only they prioritized health as a sector because nothing in the economy works if the workforce are not healthy.

    Again thank you for this. We need more health workers sharing their thoughts about the sector they care about so much.

    Liked by 1 person

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