Northerners are rarely affected with diabetes

August 16, 2009 at 11:14 pm (Food and health, HEALTH)
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Dear Mr. Otto Patrick,

I generally agree with you on the two types of Diabetes. Where I do not agree with you is, associating the “Os” predominantly in the Northerners’ names, with blood types. “O” in a name of a Northerner does not mean the person has type “O” blood. Northerners generally have names starting with the “O” letter of the alphabet; it has got nothing to do with blood type.

So, I am kind of failing to know why you should lump Peter Senoga with the Obargots from the North, & Abbey Semuwembas with Joe Ochienos from Eastern Uganda. Blood wise, the Obargots of Northern Uganda are closely linked to their brothers and cousins of the Ochienos of Eastern Uganda. Take a look at even the physiques of the two Luos and you will agree. I personally went to school with so many Ochienos of Eastern Uganda; some, who were called Okoths, were close friends of mind. We in the North called their “Okoths”, Okots!

Amongst Northerners, there are not very many cases of Diabetes. Diabetes of the type II tends to manifests itself amongst people with excess body mass. Amongst the people of the North generally, you rarely find people with excess body mass. Most Northerners are lean and mean; tall; &c. This is partly because of their gene and partly because of their diet. Of course Northerners eat foods like meat, beans, peas, millet, cassava, potato(sweet), &c. All these foods are eaten by the rest of Ugandans. However, the North is hot too, which means during the hot season, heat helps people burnt out and sweat off excess fat plus other impurities that normally accumulate during the cold season. Consequently you don’t find many people suffering from Diabetes.

If you happen to find a case of Diabetes amongst Northerners, it is most likely because of pre-existing medical conditions that impact negatively on the body metabolism thereby overworking body organs, contributing to the type II Diabetic condition. What therefore you are stating here thus: “Blood group Os like Mr Peter Senoga (O+) and the Obargots of this world are better off with a meaty diet of the original Cro-Magnon of 30,000 years ago.  You the Group Os eat the grains and starches only to suffer the pain of heart burn (acid reflux) in the short run, peptic ulcers in the medium term and Diabetes Type II in the long run.” is again hogwash. Its NOT TRUE!

Northerners eat grains and starch on daily basis; in fact, all our food of daily intake include grains and starch like: Corns(maize), Millet, Sorghum, Cassava, potato. A Northern eat one of these everyday! Ask anyone. Every freaking day a Northerner is either eating Corn(Maize), Millet, Cassava, Potato, or Sorghum! All these food items contain starch, yet I do not hear anyone complaining of heart burn and peptic ulcers! You are again being true to yourself, lying, lying, and lying, about the North! What is your freaking problem?

In the South, especially in Mbarara, Buganda, Busoga, &c, the body mass are different. In these areas, people are a lot more heavier, naturally - gene-wise. Their diet also contribute to the development of the body mass. Which means, although in those areas people eat most of what are eaten in the North, the outcomes normally differ because of gene and also the surrounding climate. The South is generally cold and wet, almost throughout the year. So, a person’s body does not get purified naturally because of the surrounding temperature like in the North. In Western Uganda, in places like Mbarara, you should also note that milk consumption is very high. Although milk is good for bone development – the reason they grow tall – dairy products tend to make people develop excess body mass. Mbarara in fact boast women with the best bahind in the country. One such woman, with the best behind in all of Mbarara, and therefore the best in all of Uganda, is an hotel owner. Do you deny it? Go to that hotel you will eat very good meal mister!

People who consumes lots of dairy products tend to grow fatter than those who don’t. But these situations are now being complicated by the consumption of fast food products: French fries, hamburgers, plus other chemically pregnants drinks like coke, which Gook is alluding to. All these contribute not in small terms, to the explosive Diabetes in Mbarara.

In my opinion, the government needs to take serious steps to stump out all of these foreign products. They are not healthy for the populations. Failure to do so means the situation is only going to get worse!

Obargot Pabwoola
UAH forumist

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DEODORANTS AND BREAST CANCER

August 12, 2009 at 3:42 pm (HEALTH)
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Dear friends,
I have been closely following the discussion on breast cancer and deodorants on UAH, and I am concerned about the rise of breast and cervical cancer in Uganda, especially that it is appearing in ages younger than the general average in the world. could it be because of the poor socio-economic factors make us vulnerable to cheap brands that are dumped in africa from the developing world after they have been banned there? I wonder…
However, not all deodorants are bad, and before you damp all your deodorants, take note that it is only those that have aluminium salts in them that have been implicated in causing breast cancer, and that is a known fact that they increase the chance of breast cancer. Look at your deodorant among the ingridients and if you see ‘aluminium cholorohydrate or any salt of aluminium, throw it away faster than you can imagine. These are the salts that get absorbed by the sweat glands and find their way to the lymphnodes and can accelerate the process of cancer formation in those predisposed to developing cancer, hence that can increase your chances. These salts in the deodorant will usually show as white precipitate in the armpit when the deodorant dries…Deodorants therefore form one of the many enviromental factors that will precicpitate cancer. The same applies for men too. In the few years I worked in Mulago, I encountered two men with breast cancer and it really is terrible in men as they lack the fat cushioning effect that womens breasts has so it spreads so fast, and they are also not usually subject to regular breast exam. So by the time they come to hospital it has spread beyond repair.
Back to the deodorant there are alot of natural aluminium free ones available on the Market so you don’t have to be doomed to a life of stench. If you don’t know where to find them, contact me or look on www.mollynn.myflpbiz.com under personal use products you should be able to find one
Dr. Mollynn G. Mugisha
Supervisor
Forever Living Products International
ID no:     310002001827
Mob:     +31641693450
Tel:        +31708889443

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Both the Bible and Quran prohibit eating pork

July 22, 2009 at 3:37 pm (HEALTH, RELIGION)
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Fellow Ugandans,

Not only does the Holy Koran prohibit the eating of pork, so does the Holy Bible. However, the people,especially Christians eat pork without any regard for the Holy Bible’s prohibition.
As I was growing up I noticed that pork was forbidden in our home. Attending Christian schools in which Church service was compulsory and Scripture being part of the school’s curriculum, it was easy to realize that pork was forbidden as food. However, the Holy Bible explains the prohibition of pork as, the Law of purification. I don’t know for sure how the Holy Koran states about the prohibition of pork for food or being close to a pig.
At home we, the children were told to go and call a devout Muslim whenever a bull, a goat or chicken had to be slaughtered. My parents said that eating meat of an animal which was not slaughtered by a devout Muslim was considered unholy and that God could not bless such food. That meant, at least for our understanding as children, that such food would not be nutritious.
With this ”Swine flu”, I don’t know how I would explain it to my parents who did not speak much English, perhaps could describe it as ”Senyigga y’empunu” (Influenza of pigs). My question to the UAH forum is, did the Prophets of God see the danger in pork that the people continued to ignore the warning? I use the tittle, Prophet to include Jesus Christ without any offence intended. I realize that some Churches refer to Jesus Christ as the ”Son of God”.
BJ. Rubin.

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Buganda culture on men

March 25, 2009 at 11:55 am (CULTURE, HEALTH)
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Dear Ugandans,
The men in Buganda have Ssengas and Jjajja’s to couch them.As you already know, Baganda of Buganda are basically farmers.  They have always grown  almost anything because the land was fertile, The sun was always there and the worry was rain or no rain season.
Their main food was all types of bananas including Matooke, Ndiizi, Bbogoya and Gonja for eating. Then there were embidde for banana beer or wine, whatever you call it in English.  In addition Baganda grew groundnuts, beans, peas and all sorts of green vegetables.
Furthermore, they had goats, chicken, and a few cows from our neighboring herdsmen.  With chickens came eggs. All over Buganda there was fish of some kind and Baganda fished for food. There were also fruits, passion fruits, guava, avacadoes, oranges, tangerines, nkenene, berries, papaya amakoma mawanga etc etc.  The list is quite long.  When one says there were only Matooke and nothing else, I do not understand which part of Buganda they grew up in.
To cut the long story short, when preparing for marriage, the Muganda girl was taught how to cook and take care of her future husband; not only in the bedroom, but also in the kitchen and at the dinning table.  Whatever Matooke contain for nutrition content, they were always served with:  beef, chicken, goat, groundnuts, or fish stews or whatever the lady of the house chose to accampany Matooke with. The combinations kept everyone health, men and children alike.
Some of the foods a woman was taught to feed her husband  before and during marriage, were eggs, chicken, fish, raw groundnuts because they were known for being good for the man especially in the bedroom.  Something else they always talked about was hot pepper.  When you say a Muganda man is left by his woman because of issues in the bedroom, I do not get it.  The system had everything taken care of.
Then came western education and the Baganda men were the first to go to the schools before their girls, but the tradition continued. The men accepted the British jobs after school, but the traditions at home continued.  The Muganda man has always been the head of the household.  Even though husband and wife disagreed, there would be no shouting at each other.  They would go to bedrooms when children were asleep and talk respecting each other.  I do not know how much of this culture is still alive today.  I have not been in Uganda to observe.
Traditionally, if there were issues of anykind in the bedroom, the Ssengas , Jjajjas were informed, because marriage was not for the two in it it was a family affair and community affair.  Everyone wanted it to succeed.  They would come up with remedies.
If Baganda women today leave their Baganda men, or get acquired by other men from other tribes in Uganda or overseas, it is not because of Men’s inneficience; it is because many people know the Buganda culture pertinent to women and want a piece of it for themselves.  Besides many of us have gone to school learned the Queen’s language and tend to over look the tribal differences because we can communicate and get careers.  Again, it has nothing to do with the Muganda man.  Times are changing so first and our cultures are getting eroded fast too. Just because I am a Muganda woman, does not mean I have to marry a Muganda man as in the old days.  Where I am located any man with qualification is candidate and I will make a choice.  Just because you are a Muganda man, it does not mean you have to be married to a Muganda woman.  The doors are open to you for any woman in Uganda, Kenya, Tanzania, Ruanda, Canada, USA and the list goes on.  I trust you get my point.

Assumpta Mary Kintu

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Mulago and Nurses should be facilitated enough

March 10, 2009 at 7:32 am (HEALTH, POLITICS, PRESIDENCY)
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Dialysis is not a rocket scientist’s procedure.Extreme caution and great knowledge are essetial in carrying it out  though. There is nothing medical that Mulago will not do if the right personnel is trainned for the appropriate equipment/procedure. Mulago is doing well on removal of prostates, using one of the  most non invasive surgical methods(forget those bloody laporatomies for prostatectomies) I have known in modern medicine. Dr. Kagwa, who trainned in the US is a real shinning star on this one. He will do dialysis in a heart beat if the equipment is in place. Remember so much has been done with olden equipment and obsolete medications( for the west).Prioritising in health investments should not be embattled at all as health is the pivot of our lives.

On the issue of man power,according to the original plan, Mbarara University was to start and  help the  already trained allied health professionals to upgrade into medicine mostly, Medical Assistants now called Clinical officers like their compatriots in Kenya and TZ. But the plans changed when Museveni came onto the political scene. The unfinished university buildings were suddenly occupied by fresh students whom Makerere medical school could not take due to different reasons, space, level of passing etc. In a heartbeat, Cuban doctors were brought in to teach the fresh medical students. This has in the long run become a good thing, but at the same time, there has been a tremendous loss of manpower to be tapped into by not facilitating further education for people who are already in the system.

Nursing is still looked upon in Uganda and yet revered in the US. Bottom line is that the practice of medicine in general is simply based on patient care which is done by a team (forget the hard academic hassles). Many times doctors will do work that one would consider fit for a nurse and a nurse will act as a doctor in times of emergency. A case in point is airway management, say in case of an accident and someone sustains a head injury, is unconscious, bleeding from the nose and mouth  and probably through the ears(bad stuff here). Do you think a nurse at site will stand with arms akimbo saying, OK, this is a doctor’s case, may be a neurologist to see so I will not secure the  airway?


NO, unless she is in the US where legalities and red tape are the order of the day. Remember the first caesarean section was done by a midwife. She managed to save the baby but the mother died. This mentality of overlooking nursing should stop and the nurses be allowed to study more and become nurse practitioners as they do here in the US so that quality care to patients could extend to remote areas of the country as the nurse practitioners would be allowed to open up private clinics just like their colleagues in the US. I am sure they would be able to determine the types of cases and emergencies they would handle and be able to refer the rest in time.

I just remembered the Lines of patients on Rubaga Road that used to zigzag into Dr.Mumpi’s clinic. This was real madness, as one doctor or medical assistant could not accurately investigate, diagnose and treat diseases of all those many people that flocked into his clinic every day. Something has to be done by the government of Uganda to improve the quality of health care as well as improving the training standards of the medical personnel. Buying new text books, introducing high tech equipment and supplying ample sundries for practical work for the students will greatly improve our people’s health. But how will this be possible if the financial resources are wasted on non priorities like buying new presidential jets or when our people have been told not to pay graduated taxes, so that they keep in a happy state(euphoria) , happy enough not to disagree with a selfish Museveni who hates  and fears democracy?


One is tempted to  bet that the books some people used at the Albert cook Library in the 70s, the Cunninghams, the Gray’s Anatomy, Nzarubara’s book  on surgery  are still the same  volumes that  fill that beautiful library annexed to a perennially blocked private place, while the modern world is writing new books with new information almost every day! This is our Uganda and its president of 23 years.

Jenifer Biri

Ugandan resident in New York/UAH member

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Uganda has got enough doctors,nurses and public healthists

March 10, 2009 at 7:13 am (HEALTH, POLITICS)
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On the issue of manpower, when one talks about the healthcare system doctors are on top of the pyramid and we usually think that everyone has to be seen by a doctor. Uganda has a large group of Medical assistants who are the equivalent of physician assistants in America. These medical assistants work like horses and they never get rewarded as they should. Ugandans must have heard of people who used to swear on Doctor Mumpi on Rubaga road. He had patients lining out his clinic yet he was just a medical assistant. If this group of workers is given more support and training emphasis on continuing medical  education plus being shadowed by a physician you will have your local community health center fully covered. We can train these easily and within a short period.

We also have a big supply of nurses. Unlike the past the nurses most of the nurses we have these days have finished high school, they are very bright and very hard working. I don’t see why the government of Uganda can’t come up with a nursing practitioner program. At this level if you bring back the pride of being a nurse in Uganda we can even get college graduates to join the nursing profession. You can then shift to doctors. Previously we had only Makerere hospital graduates, but now we also have Mbarara University. My guess is that we might be graduating up to 120 doctors every year. If you arrange your patient flow and change the referral system you can down the road have a large number of primary care doctors. The beauty is that you then start pushing these docs into further training and we will surely get there. We can have enough medical personnel to take care of our population.

Doctors in Mulago are very well trained, the issue though is that you can only be as good as your teacher or can only use what’s before you. Medicine is a continuous learning process that’s why a very strong continuing education unit in the ministry of health is very important. You can’t know it all, you have to study all the time, you need to be exposed to those that are better than you all the time, you must be challenged and rise to the challenge. In well developed countries you don’t only have to maintain your status but the patients will challenge you and the fear of making a mistake will cloud you all the time. We need this in Uganda.

By the way, has anyone ever figured out how efficient doctors in Uganda are? They can see patients at an imaginable rate; they diagnose in a flash and come up with treatment plans like lightening. Consultation between each other is causal, and they so often can go days without reading a medical book or magazine. Next time you visit your doctor in the states just ask him why he leaves you in the room and takes long before coming back to see you? Is he calling some one?  Checking with a colleague? Reading in a book or searching on the internet? Why are they quick to refer you to the specialist? Why can’t they read there x-rays for goodness seek? Let me know what their answers will be.

Ugandan doctors are very good doctors but in the rush to make as much money as they can, they tend to put continuing medical education on the side. We also need more specialists who have trained outside Uganda to teach our medical students.

Lastly, we have a very strong public health sector; those in public health have trained widely and have the knowledge we need on this front. Having said that, I personally think public health’s success is one of our problems. Some of the best students in my class, I mean the best have turned to public health and abandoned the practice of medicine. Public health pays. Public health has also messed up the foundation of our health system.

Eddie. MD

Ugandan Doctor based in USA

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Uganda does not need a Dialysis Machine now

March 8, 2009 at 3:17 pm (HEALTH, POLITICS)
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I am again going to go with the argument I have been using on HIV and AIDS in Uganda . It is not important for Uganda to run AIDS centers as it is not important to run dialysis machines. I look at medical systems like in Ontario , the Ministry of health here does not even own dialysis machines it rents them from companies like Baxter or GE medical. And  they run them from corner to corner of the great country of Canada for we have the ability to fly them  to wherever they are required. It is a very expensive structure that to run the needs of the ministry of health in only Ontario a single jurisdiction, one needs more money to run the entire governments of East and central Africa if not more. Why should Uganda government own them?

But here is the most important question. Even if we were to run them, what will be the cost? And is that the best manner in which we should spend this money? In other words, health care money is spent with a calculation of saving more lives and not spending for the sake of spending, how many people would the ministry of health for example heal from dying of curable diseases than running a dialysis unit? And I am not being cruel here but I live in Ontario where medical care is run on a social democrat principle, every one in Ontario   is entitled to health care, from a broken toe nail to a heart transplant. But that service is only delivered based on what benefits will be to the recipient. Should Uganda care more about dialysis machines than say fight a curable disease like Malaria? Should we care more about heart surgeries than for example again fight road accidents, when more Ugandans die of car accidents than Malaria across the board?

There is a danger of copying the medical structures out here and we cry for them to be installed in Uganda when we actually have not even developed to use such. Let me ask you Doctor, how are you going to run a dialysis machine on Uganda electricity that is not stable? So what is more important for Uganda to do today? Setting up a dialysis unit or stabilizing the power supply? Again I am using the meagre resources we have and pointing it to where it can be of greater value given the circumstances. There are places in this country where you will die for you cannot get a dialysis machine. Oh and let me put it this way, when you have cancer and you are admitted in a hospital barely 45 minutes outside Toronto, let us say Oshawa, you will die faster than if you are in a Mount Sinai which is in the city center. For Oshawa simply does not have the facilities Mount Sinai has.

I just hate to see that we open up that country to more advanced systems before we can even sterilize a damn needle before we pock it into a human being. Setting up priorities I guess is my argument. And I know I am going to be burnt on this posting for somebody saw something called a dialysis machine out of Uganda why not take it to Kapchorwa hospital?

Edward Mulindwa
Toronto

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Dialysis Unit requires a lot of money

March 8, 2009 at 1:43 pm (HEALTH, POLITICS)
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Mr.Kaluma,

Thanks for your candid expression of your feelings and frustration with the medical infrastructure in Uganda.

You have essentially described a state that is known as end stage renal disease. This occurs most commonly after a long time with high blood pressure. The kidneys basically just die off, after repeated assault of their arteries by the high blood pressure. At this stage medications can’t help and the only permanent solution would be a renal transplant. During this period however dialysis will prolong a person’s life.

As we discuss the issue of Uganda having a dialysis system we have to realize that there different types of renal dialysis and it’s a high end form of medical care. Running a renal dialysis unit requires a lot of expertise, patient dedication; close monitoring and the equipment used calls for high maintenance. It’s not just a matter of the government or private hospital buying the equipment it’s also very expensive to run these units. At the present time I wouldn’t feel comfortable advising someone to use a renal dialysis unit in Uganda except for a matter of dealing with an acute renal condition awaiting a transfer outside the country.

As to who is to blame in this and many tragic deaths is a matter of intense debate. The doctors surely know what to do but they are handicapped in away, the government has a big role in acquiring these equipment but one can argue that they are also not available in the various private hospitals we have some of which definitely have the funds to acquire them but lack the necessary expertise to run renal units. This is very unfortunate and it doesn’t seem like there is a plan in the immediate future set out by the ministry of health to address this problem. More funds to date are geared towards primary health care in hopes that in this way they can save more people and be cost effective. You can now figure one of the reasons why the life expectancy in Uganda is put close to 43 years.

I would advocate for the government and the medical community to establish a renal unit. The kidneys are very important organs and they need some help in many cases. A renal unit is not only of use in end stage diseases but in many other conditions both in the old and the young.

The medical field is such that when you don’t advance the tier below suffers. A dialysis unit is essential at least in a referral hospital and there is no excuse for not aspiring to get one. The funds to acquire one, train the specialist and run it can easily be got if there was a fundamental change in the healthcare system at large. We spend way much money unnecessarily and there is no way we can argue against this. We currently can’t have a well functioning unit because of lack of  expertise and the lack of vision in the ministry of health but these socialist tendencies can’t be used to destroy our very precious lives. The irony is that those who are currently owning the country and running the deals can afford to go anywhere outside the country for such procedures as they need on government or embezzled funds. Where there is a will they surely will be a way.

One can use the same argument on acquiring an MRI,CT scan, heart and lung machine and several other equipment. All medical equipment are very expensive. With a streamlined system whereby at the least every citizen has a mandatory check up every year and those who can’t afford be on the governments tab we can surely wean away at early stage those people who would have used these expensive procedures in the future. If we diagnose hypertension for example at an early stage we can treat the citizens at a cheaper price with medication and reduce the number of those who would have needed the use of a renal unit it the future. By doing this you are not only reducing future cost but you are at the same time improving their quality of life, increasing productivity and life expectancy. However the structure we have now is not meant to treat everyone, to me the primary health structure is a total failure but that’s a topic for another day.

So I will argue that we need this unit for good medicine, we need it for our medical community, we need it for our citizens the government owes it to the people to provide the best healthcare to date and each and every life is precious. Some things have to be done, it’s just like going to the moon.

Eddie. MD

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Lack of Dialysis Machine & unprofessionalism killed Sekyanzi

March 8, 2009 at 1:35 pm (HEALTH, POLITICS)
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Fellow Ugandans,

Who is the Doctor who sent Sekyanzi ,the long term member and cofounder of Afrigo band home to his death?

Sekyanzi was seen by Doctors in the US last year and indeed diagnosed with chronic hyper tension–Yes High Blood Pressure” which will eventually kill us all off, -the group of Physicians who treated him found him with “NO AIDS”, but were wondering how he could have carried on with such high numbers of Blood Pressure for so long, causing his Kidneys to show irreparable fatigue.  He said that he had been a patient at Mulago and had visited several physicians in UG.

For fear of releasing a patient without providing some relief, the USA physicians did their due diligence and kept him in the hospital while they carried out a complete diagnosis like any well trained profession would. His kidneys were flushed and his BP was brought under control using a couple of drugs that can be found in Africa- they went a step further and provided him with a clinical care plan a treatment blue print that can be read by a non-physician –knowing fully well that whosoever treats him next might not be privy to such a high level instrumentation.

Wouldn’t you believe that even with the fool proofing of his treatment plan, this man who has touched many and has serenaded all of us professionally by singing sweet soul music for four decades, one who survived all the past regimes and all their brutality-he could not survive the last act of brutality, he was sent home a couple of weeks ago from Mulago hospital with probably both Kidneys not operating well and within a day or so his system had become so toxic that when he returned to Mulago his entire body had been so damaged that it simply expired.  Had the professional roles been reversed he, Sekyanzi, would have spent nights and days trying to produce what sounds sweet to the ear- he would have never released music half dastardly like-you see that is professionalism  to him it was quality control to the end!

What should we tell his children that yes there are a couple of Forest Gumps sent their dad home unaware that they could have dialyzed him? or should we all blame the government for not providing enough dialysis machines.

The Dialysis machine is a debate that has kandoyered us –well, since the new car debates in parliament. Can someone tell our legislatures in both branches that –High blood pressure like adult onset diabetes is prevalent among people of African descent-and they will eventually meet this last brutal act that was meted out to Sekyanzi in due course if they choose not to act and get us more dialysis machines and other diagnosing equipment in all our hospitals.

As for our Physician at Mulago please educate the public that kidneys can be ruined by uncontrolled “Blood Pressure”. Do not riot for compensation alone or demand for better working conditions .Get the necessary equipment –just like the army generals do- so that when we the consumers start judging your professional integrity, it would be done with a degree of certainty that you were armed with the proper tools!

Tendo Kaluma

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Health insurance in uganda

March 2, 2009 at 11:43 pm (HEALTH)
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Health Isurance scheme is  full of valid questions and I hope it won’t be rolled into the budget before its being fully discussed. Our government is full of business men more than civil servants, these ladies and gentlemen spend their time figuring out ways they can fleece our country in the name of helping the people. In the end what we get are ventures which don’t succeed but have generated monies for those involved during their span. I hope that more questions will be asked, all parties involved should be given a voice.

Personally I think that many other measures have to be taken at the same time as any form of health insurance is rolled in. Health care in Uganda is not just about money. This insurance scheme resting on the current health system will be much more costly than the current stipulated funds. I hope the president will keep this scheme out of the upcoming budget which is just 3 months away. Howcan you expect to have a valid and extensive discussion in such a short period? What’s the rush, are some afraid that they won’t be in a position to swindle after 2011? Our Health system has been dead in the water for years, if the president embarks on it recovery its worth doing it the right way other than bungling and rapidly firing hoping to fix it anyhow.

I alluded to this when I mentioned ghost patients in the UAH forum, I just don’t know how they even came up with the monitory figure, I guess they used census figures. Evidently many people are already in the system especially those employed by the government, but that’s a small percentage of the whole population.A unique identifier is very crucial not only for the management of theinsurance scheme but also for the follow up and insurance of individual health and a check on duplication of services.
These are some of the discussions that have to be embarked on hand in hand with the proposed insurance bill.

In my opinion the three main problems that the needed healthcare
system overhaul face are :

1. Politicization of the process.

2. Greediness and corruption of the involved leaders.

3. Fear of change by the old healthcare guards.

If the president can tactically figure out a way of addressing these issues there will be a very health discussion on the needed changes. Fundamental change before pouring funds or a concurrent happening of the two should be the goal. The health care discussion can no longer be left to those in the ministry of health or parliament. It’s not a purely political or health issue, it needs economists, auditors, architects, engineers, and many more careers, the whole population has to partake and understand the needed changes. An aggressive campaign, to overhaul our health system will not only create many needed jobs but will also bring in more investors and restore the pride of in our health care institutions.

In regards to the national identification, we need some form of identifier; it will also be the basis of a needed massive health information system that should cover the whole country.

The supply side can be manipulated. We can train enough doctors to meet our demands going forward. We have a big pool of doctors in private practice and in diaspora who can rejoin the service with very minimal incentives. A lot has to be done with the nursing personnel. Medical assistants who in Uganda work as physician assistant have to be given more support and training. To me the issue of supply is the easiest to fix. We shouldn’t even burn midnight oil over that.

One Ugandan suggested starting the project in July; I think that is
like delivering a premature baby. You can aggressively manage the baby outside the mother’s womb and sustain it at a very high cost and manage complications for years to follow with a risk of losing it at any one moment, or keep the baby in the mother’s womb and deliver it when it’s due. You chose.

The reason this scheme is not appropriate at this time is  not necessarily because of lack of doctors. The problem is that its being introduced in a health care system that is already broken and wasteful. That’s why I used the analogy of a concrete beach and sand. We have to reform our health care system before pouring in such amounts of monies. The ratio of doctors per patient in Uganda is in the range of 1:25,000. We can reduce this ratio by training and retaining more doctors within public service, but a gain you have to realize that some patients can be seen by well trained medical assistants or even the introduction of a nursing practitioners program would be welcome. That’s why I said that the supply side can be manipulated to work for our population as we build up our physician pool. We need some form of insurance but it should be blanketed by other necessary changes which are not currently discussed.

Next step is the insurance agencies are going to have a field day in Uganda, and the few doctors we have are going to be forced out of work or forced into private care or pick and choose who they will see.Having said that it’s good to have a tough hand hanging around the doctors, it forces them to handle cases more seriously than they have been lately.

What is needed more than this though is the improvement of the quality management arm of our healthcare system before we go on threatening to sue our doctors. If you did a quality check in Mulago hospital you will be forced to close the hospital on spot.Quick examples, the most feared and serious cause of deaths in hospitals world wide is infections patients get while they are in the hospital. Washing hands after every patient is a song every medical provider should sing in there dreams. I challenge any one of you to visit Mulago hospital and just look around at the nurses, medical students or doctors, make your count as to how many patients these providers examine before they wash there hands.
Patient identifiers; there is a reason why you are tagged when you get to a hospital, its no joke, by the way how many times have you seen a doctor in Mulago and asked about your full names or date of birth to confirm that you are the actual patient the provider has to see.
Medication errors; who takes which medications? Have you ever been give a medication list in Mulago after being discharged? Well may be you don’t have allergies to any medication but few providers even ask about that.
When was the last time the blood pressure machine the doctors you saw in Uganda was recalibrated? Or, so you thought that these machines actually work to perfection?
Those are just a few examples and each of those mishaps has actually killed more patients that we can figure. Who are we going to sue then? The ministry of health? Before we give sound bites that will sell the plan to the people, let’s get our foundation steady.That is my only short coming with this plan. The monies so mentioned can be used to make the system far much better before introducing this money guzzler on the road.

I was one of the interns who did strike for better pay being led by Dr. Sam Lyomoki. I have to say that demanding and striking can’t really change the system.We,Ugandans abroad have been exposed to a good healthcare system and it takes some one who has seen the best to make this a reality. The leaders the president has been choosing to revamp the healthcare system have not invested in dealing with the basic foundation of our system. They come up with promises of the best sex ever but then deliver on a concrete bed. That hurts if you know what I mean.Good intentions, but wrong footing.We have to work our way up from the roots and all the rest will come into place.
Through out my writings I have tackled different sectors that have to be fixed before we bring out the big guns. About the specialist issue, we actually have many specialists, but when you get the specialists to do primary care work then they won’t serve you well. The referral system has been totally screwed. Mulago as a referral hospital should not actually see any patient who just walks in with out referral from another doctor. Primary care services in Mulago should totally be shut out. We should even go as far as creating another referral hospital before getting to Mulago. It’s a waste of brains to have a senior consultant or resident run a primary care clinic or fill a hospitalist position. Well cared for consultants have no need of running private clinics. And its not only about higher pay, but paying for further studies in other countries, conferences, providing them with the necessary equipment and support there research ventures to make them shine among there other collogues is a big bait for the healthcare providers. Supporting their associations is a big push forward.
By the way I don’t even know why the government doesn’t actively work towards more Ugandan doctors or nurses coming over to the states or Europe or South Africa for further training and then go back home to serve for some years, a deal can be actually worked out. Medical student observer-ships, the best of our best can be sponsored to visit other hospitals while in training. What about the government arranging for the likes of Dr.Sarah Matovu who are shinning in thir fields to go back annually and teach or work in our hospitals, I know friends of mine who are practicing in the states who never even step in any hospital when they go back to Uganda.Cardiologists, anesthiologists you name it. A well managed plan for exposing our providers and circulating our hospitals with those that have been exposed to a better system will be a good start.  LPNs, CNAs , RNs, MDs, Healthcare managers, information system specialists,who have practiced out side Uganda should have a program within the healthcare ministry where by they can be channeled into our system for varying periods, paid or on a voluntary basis to teach and pass on there acquired knowledge. How can they change unless they are shown?
All these steps will create a foundation on which the necessary major changes will be made and make it possible to control the unnecessary waste of our merger funds.

Dr.Eddie Kayondo

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Should we take traditional medicine more?

November 21, 2008 at 12:35 am (HEALTH)
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Now we are tackling a real issue that is killing Ugandans everywhere. Brother/Father Anatoli Waswa and I carried out a twenty year research in witch-craft and we concluded that traditional medicine is the best, BUT it must be devoid of okusamira where the witch-doctors invoke supernatural powers.
Taken simply without kusamira, evil spirits worshipping, in spiritis shrines, okusamira mu masabo, one can get all the medicine the witrch-doctors, abasamize claim to give but adding supernatural powers like invoking lubaale, amayembe etc.
Indeed, in Uganda as long as people still believe inthe powers of the basamize (witch-doctors) who tell blatant lies and play trick, this country will continue to be held hostage of these thieves and liars.
You can read the resultls of our research in a book we titled, UNVEILING WITH-CRAFT,  by both of us. You will find it in all bookshops in Kampala. Of late we have been privileged to get the secrets of the witch-doctors on how they make spirits, amayembe, talk and “walk” around. Yes the ex-wtich-doctors spilled the beans and revealed everything. Indeed,we have demonstrated the lies and trick of the witch-docgtors at the highest institution f learning at Makerere University, and you cannot
believe it, when we announced that we have the spirits with us, Makerere students took to their heels and left the room to be accosted by the spirits.
What we had goen to show them were the lies and trick of the basamize. More than ten lecturerrs and ove 100 students attended our demonstration and they could not believe that simple-minded abasamize can fool intelllectual to that level and for so long. We passed on the message to HE The President and his PPS, Amelia KYambadde, has agreed to arrange a n audience with HE, we are eagerly waiting to go een to Parliament and show thaose MPS who visit spirits shrine seeking the blessings of the spirits in order to win elections that they are being foold by simple minded unlearned people.
Hence, read that book and see that it is time Ugand moved out of the last century into the 21st century.

Henry Ford Mirima

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Children out of rape or incest are innocent and need protection

November 21, 2008 at 12:17 am (HEALTH)
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There is now a suspected relationship between abortion and mental illness according to the available research. Here in the UK, following the publication of a report by the House of Commons’ Science and
Technology Committee, at the Government’s request, The Royal College of Psychiatrists is currently in the process of pulling together its research on the subject.

The move to update research in the field brings into question the longstanding assumption in Britain that a woman’s mental health is at greater risk from continuing with an unwanted pregnancy than from the possible emotional or psychological backlash of ending it. This sensitive new ground highlights the importance of the work that counsellors do in this field, both with women considering a termination, as well as with those coming to terms with having had one.

UK has got two organisations (Marie Stopes International (MSI) and the British Pregnancy Advisory Service (BPAS)) offering counselling services and advice to women planning to do abortion in the UK.
According to data from these organisations, abortion affects a lot of women such that some feel as if they have lost a real child. There are so many women that end up in mental health hospitals as a result of abortion.

One may argue that a child born out of rape needs to be aborted because of the obvious reasons people but I again beg to disagree on this. Some women grow to love the children they got after being raped. The child is always innocent whether he was manufactured as a result of rape or incest and this child needs our protection and love as a society.

Yes, I agree that the decision to have an abortion should be a matter of individual conscience but individuals need to be guided on what is right and wrong when it comes to abortion. Some people argue that religion should not be a basis to help one make a decision regarding abortion but I think they are wrong. Religion is a way of life for some people and when one goes against it, one feels guilty most of the time. Religion should form a basis of decision making. As a Muslim, I will never support abortion except in fatal situations. So religion should be allowed to trump individual conviction.

The most important thing in all this discussion is to allow women to be entitled to safe pregnancy, safe delivery, and safe abortion. Clinics in Bwaise(Angola Zone) should not be allowed to be places
where women got for safe pregnancy, safe delivery or safe abortion. So the streamline of any abortion law should clearly be looking into this area other than legalising abortion. For instance, South Africa
reformed the abortion law in order to improve the health of women and prevent deaths among women. Abbey .K.S

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Family planning:Children out of rape or incest

November 21, 2008 at 12:06 am (HEALTH)
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I know this is taboo but here I go.   

 Actually, abortion would not be necessary if women did not use it as a form of family planing. Some people sleep around carelessly without taking precaution.  One would expect such fornicators to take matters in their hands and religiously use the contraceptive pill-best protection. If they did, 995 they would not conceive. And without conception, there is no need for abortion. It sounds simple and common sense. 
 But matters related to sex are not that simple in patriarchal societies such as Uganda. That is where family planning comes in. I am not saying women should not please their men or than men should not love their wives/lovers.  That is  none of my business. What women should do is use their agency and go for family planning. If they can’t deal with the daily pill, they should go for other means to protect themselves against unwanted pregnancies. To their credit that is what white women realized since the 60s. They can have their cake and eat it too.  They not only sue the pill religiously, they also insist on condom use.  
They may be liberal, but nobody get it without the condom period. Why can’t it be the same among Ugandan or African women for that matter?   Teenage pregnancy among people of African descent in North America is 30%, way higher than the national average. Why? Because African parents have failed and failed miserably to teach their daughters and sons the dangers of fornications.  They pretend that their daughters and sons are angels. Wowe.  On the other hand white parents do not. They know and even encourage their teenagers kids to be sexually active.  but to take the necessary precaution.

Girls are told to use contraception to void pregnancy. Both girls and boys are told to use the condom to protect themselves against sexual diseases.  in many ways, the women who use the pill and insist in condom use have two and not one protection. Needless to say, they are not likely to get pregnant even in cases where they fornicate without the condom. In Uganda and I don’t want to sound harsh, it is the other ways round. fornicate endlessly and find out later. That is a disaster in country where abortion is banned.
No, abortion should not be legalized. What should be encouraged and promoted is family planning coverage all over the country. If family planning services are affordable and available to all the women who need them at a reasonable cost or even free in a country on the population brink such as Uganda, there would be no need for legalizing abortion.  The women of Ugandan should know that they can have their cake and eat it too.  

Take charge of your lives dear wowen. You and you alone can avoid unnecessary pregnancy without sacrificing the ‘fan’ of sex.  Moderate sex is even good for us so we are told by experts.  And it can be enjoyed without worries about pregnancy. Folks, the pill works very well.

And why would women want to endure the emotional torture of abortion?. Abortion is not an easy decision. It is emotionally draining. The good news and should I say common  sense thing is that unwanted pregnancies can be prevented. If they can be prevented, then there is no need for abortion. It would not arise in the first place.
Now and this pains me. In Uganda today incest is on the rise. In such cases, abortion should be allowed to save the victims and those are true victims of such horrors.  The other areas include rape.  Those victims too should be allowed to procure an abortion legally. It would at least eliminate the evidence to perpetuate the stigmatization of victims of rape or incest.

Now, you see, there is nothing controversial written here. What I have said is that choices for women in the form of family planning services should be increased. Women should be provided with family planning services for free to ensure that all those who want them get them.  Married couples who are faithful-yes there are still many-should be encouraged to use either the pill or natural planning method. Natural family planning is not effective for casual fornicators. Those should go for the pill and if they can’t remember to take the pill, they should go for an injection. Some will retort that the pill is dangerous. I say very minimally. The pill is safe. It works. It is effective and above all saves women the agony of an abortion.  

 If the women used the pill and men used condom, Uganda would be safer place. there would be fewer babies and certainly less poverty than is the case today. There would also be fewer HIV/AIDS carriers. It is common sense people. Why it is that we refuse to do the right thing?  If women or girls decided that they want to fornicate, then they should go for the pill to guard against unwanted pregnancy. I don’t which is more dreaded: unwanted pregnancy or HIV/AIDS or both?  The good news is that both are can actually be prevented.
Talk of legalizing abortion should be avoided. It will simply inflame the debate about women’s reproductive rights. There are safer and lesser controversial choices for women. Prevention prevention people. 
 WB Kyijomanyi

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