Why Can’t Our Health System Deliver for The Common Ugandan?

Health

Pictured below is a running drip hanging from a suitcase in Accident & Emergency (A & E) ward, Mulago, on one of the several busy mornings.

That and similar kinds of ingenious inventions are what the medical students, interns, nurses, and senior health officers on rotation in A & E have to resort to.

Like former US President Theodore Roosevelt said, “do what you can, with what you have, where you are.” Where we are is, as one famous girl child activist Dr Stella Nyanzi in the media called it, the Boda-boda generation, and what we have is a health system in desperate need of revamping.

With the convenience of a boda-boda comes speed, and every other day the Casualty Department of Mulago Hospital wheels in victims of boda-boda accidents; users, riders, innocent passers-by. But there are only so many inventions a health professional can come up with and at the end of the day, when even basics like gloves become scarce, our hands are tied.

About $150m, about Shs 400bn annually is spent out of the country on medical bills for senior government officials, MPs, senior Army officers! Yet Mulago Hospital complex altogether receives only about 7bn annually from the Ministry of Health’s share of the national budget. The lack of prioritisation for our health system is and has been, killing it for a very long time. And unfortunately, the average Ugandan solely relies on the cheaper government-run health facilities like Mulago National Referral Hospital for health care without the luxury of insurance in private clinics. Recently when Kitgum Woman MP Beatrice Anywar was involved in a road accident, she was promptly airlifted to Case Clinic in Kampala—a privilege the average citizen does not enjoy. If our leaders understand the preference of Case Clinic over Mulago Hospital, it’s a wonder a drip hangs on old suitcases in hospital corridors. Do we vote badly then? Why does the common man continue to suffer?

Has all hope been lost? There has been a promising though dragged conversation on the Uganda National Health Insurance Bill 2007. The possibility of Ugandans to afford universe health care coverage is exciting! The proposed plan will have the scheme financed by 4 percent monthly contributions from an employee’s earnings, with the employer contributing an additional 4 percent. But meanwhile, Ministry of Finance has already given negative feedback as regards the certificate of financial implication. Mbu ‘where will government get money to cover for indigents?’; When Shs139b in FY 17/18 budget is planned for special meals, drinks! More to this reality is whether our national healthcare centres will be responsive and satisfactory when the working class come knocking. Have doctors and other health personnel been motivated enough! What has been/will be the fate of the informal sector ( tomato sellers, hawkers, boda-boda riders and peasants) who are the bulk!

And finally the fundamental contradiction still lingers; how people in top government positions, even the president of Uganda can’t consume the same exact health care services they plan. This hypocrisy needs to stop!

This is a Guest Blog By Ahimbisibwe Prosper

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