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Day March 8, 2009

Possible looting after Museveni


Dear Ugandans,

Politics is always local politics. Now that Aisha Kabanda, fomer presidential aide,  expressed all those good things that have happened in her area while writing on the UAH forum, how many Ugandans can stand up and state that they have received a half of such from this government? It would be very good if Aisha Kabanda give me an example of such a Ugandan especially in Northern and Eastern Uganda. What scares many of us especially the Ugandans out of Uganda is such an imbalance of services, for now Aisa have managed to put those services to her home and the next home is not attended to. I do not know how old Aisha Kabanda is but there was one time a leader called Iddi Amin, and he delivered these services in such a manner, he never had a national policy, so it was very important for you to live in Bombo to access the services of even basic service as a Republic Express bus.



At Amin’s departure we had an angry population which turned into a mob and looted all these services that in a single month, there was no single Republic Express Bus to be seen in a state of Uganda. Men like Maliyamungu, Abiriga, No Parking, Alli Towilli, Kemis Safi, Dustman Sabuni that had built mansions for themselves in Uganda, they were left empty in a single week. Bombo that had expanded to almost a level of Kampala was so looted that they  ended up even looting the tiles off the roofs. The operative car at a time was Honda Civic and Honda Accord, those were littered all over Bombo Gulu Arua road that they lost value. And all this was a direct result of Amin’s failure to create a national program to the state, and I say this for when Obote one and two was thrown out of power, there was no looting, for Obote had a national program.

Aisha Kabanda did not have to work in a president’s office to get electricity or a health center, it was her right as long as she was a Ugandan. I am great that either her or he father have managed to receive these things, but Aisha what about tomorrow? Has Aisha Kabanda ever sat in her good office and reflected at a picture of what will happen to her home village when this government leaves power? Will that power line remain functioning? Will that health center have an Aspirin after Museveni has left office, after she has lost that job and after her dad has moved on? I guess what I am pointing at is has Aisha Kabanda built those services on her village due to a national policy or because of who she is? And I guess I am not pointing at only Aisha Kabanda but as any Ugandan that have made any development in your locale. How do those developments click into the  national massive plan?

In Eastern and Northern Uganda, we have Ugandans that have been deprived basic services as basic as food on the table or a roof on their head. Suppose one of them becomes a next leader of Uganda after YKM which is a very possibility, will those services remain functioning? After Amin’s departure, a British reporter wrote a report that Ugandans need 5 hours to loot a city of London naked. At a time the population of Uganda was I bet half of what it has today, but we had not made it a government policy to turn the population into maniacs as the Movement has done. Had this British written this report based on the population we have in Uganda today, I think the time span would have been narrowed into a single hour. Ugandans, isn’t it better to build these services based on a national plan?

Again just asking !!

EM
Toronto

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Uganda does not need a Dialysis Machine now


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

Dialysis Unit requires a lot of money


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

Lack of Dialysis Machine & unprofessionalism killed Sekyanzi


Less beds in Mulago hospital

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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