People are brain dead when it comes to the economics of health care. I can hardly remember anyone i schooled with who did not want to grace the medical profession- its the chemistry that betrayed us to the arts- we ought to respect the brilliant medics by upping their pay. Why does everyone think that a doctor, who earns 300USD a month, and is responsible for providing public health services to 100,000 people, should be able to provide any sensible quality of care?
The nurse is worse off because she earns averagely 150USD a month in Uganda. So when people complain – doctors are late, nurses are rude, does society have any social contract with them? Is the public health service an army of volunteers or missionaries? Are doctors deaf to the stories on billions lost in Public Service, OPM etc?
I think health is no longer a public good in Uganda, and like some countries in the developed world, is now excludable. The doctor’s child cannot go to Kampala Parents because the fees there are equal to their salary for one term. Based on what doctors and nurses earn (compared to the judges who work 30 days a year, and the billions spent on political patronage), everybody who gets quality health care in Uganda depends not much on the public service standing orders, but on the kindness, goodwill and resilience of health workers.
The effort paid for by government ends on the 5th day of each month – the rest is voluntary service. No one can control the way people chose to volunteer. Government knows it, and thats why they can’t do anything to the health workers.
Only a United Voice can overcome such absurdity. Ugandan doctors need a stronger union. A union that will support their welfare and development in Healthcare systems outside the failing government. Doctors are controlled because they live in Hospital accommodation etc. fear for their families if thrown out. Starting point would be clear contracts with a strong legal team within the union.
Government pretends to pay health workers and they also pretend to work. It’s the miserable peasants donning dry banana leaves that continue to deservedly suffer.
Uganda Judges who work 30 days a year are paid more money than the doctors and nurses. Is this fair?
Max Choudry brought out the statistics at the judges’ retreat in Feb 2014 – judges only work 30 days – they have annual leave, court leave, retreat leave, legal year leave, workshops leave, health leave, etc etc.The entire thing of moralizing the medical profession is an archaic paradigm that no longer works anywhere else in the world – the medical profession is not an assembly of moralists or missionaries – it is an assembly of professionals who offer a service and that service costs money to deliver. Doctors are also human beings like any other. In medical tort, it is clear that a doctor is expected to do ‘that which another colleague at the same level would have done’ – that’s the standard.
Another irritating issue. A doctor drives a 4×4 and it’s national news. Why should Drs in high positions drive Kikumis?. It’s the same as saying MOD heads should also drive suzukis because they failed to catch Kony for 30 years? I know doctors have some oaths but they are not sworn to poverty like nuns or priests!! Therefore, the harsh conditions create a position where a doctor is at risk of breaking the oath without their will. Please note that there is no oath for poverty.
The apple rots from the core. The snake dies from the head. It’s impossible to change one ministry without changing the others.I think government’s number one priority is Administration, followed by selective patronage. The rest is political gerrymandering – as a country, we have enough resources to create average satisfaction.
Perhaps a strategic board/committee needs to be set up (or revamped if it exists) in order to instil a proportional or fair resource allocation and ensure the primary function is given the deserved share and the excesses of the secondary function are clipped!
By Rahimu Jabeno
“War is nothing but a continuation of political intercourse, with a mixture of other means. Man will never be free until the last king is strangled with the entrails of the last priest.”