Chicken thief gets to die and billions thief lives freely in Uganda!

Matress in one of the wards at Jinja Hospital

Matress in one of the wards at Jinja Hospital

The so-called ‘Medicines Monitoring Unit’ (headed by a one Dr. Diana Atwiine) is so palpably quiet on the attempted theft of billions of drugs money by Ministry of Health and NMS big-wigs. To them, the only people who steal drugs are the distraught medical doctors and nurses who work in the ramshackle death-holes that characterize our pathetic primary health care system. It was so clear that someone attempted to siphon Global Fund money into a bogus account in a certain bank, purportedly paying for some ‘ghost drugs’, yet the same Diana who went blackmailing her own colleagues has hardly made any statement to the public’s interest.

Nobody seems to be taking issue at this.This is Africa where the chicken thief gets to die and billions thief lives freely.Ugandans have been made to believe that its health workers frustrating the the health sector,teachers responsible for the failing education sector and civil servants for rampant corruption in public offices!mbu them the revolutionaries are innocent.
Doctors and Nurses were arrested and embarrassed for a handful of drugs, and were blamed for the entire shortage of drugs in the country, yet the ‘Kamabaales’ of this world (the so called NMS CEO) go Scot free when caught pants down attempting to steal billions. Funny thing is that all this ‘filth’ call themselves ‘born-again Christians’, somehow appointed by God to clean our world.No wonder Lord Mayor described their legal mavericks as ‘Flimsy, Frivolous and Vexatious’.It is more like ‘Murphy’s Law’, which states that: ‘Everything that can go wrong will go wrong’.

Diana Atwiine and Lukwago(PS minister of health) are both system “cadres”, Mbarara University contemporaries,it is even rumoured mbu Diana was supposed to be Ag. P.S or P.S, then the person she helped(recommended) to get a presidential ward became and is now a D.G, around the same Mrs. J.K M7 was supposed to be Minister of Health. I only make my reserved comments on Lukwago because he is the only Muslim PS in the country, but kitalo nyo!

We should not sugarcoat the bad health system in Uganda. This affects everybody including Muslims. There is no substitute to building a better functioning health system supported by adequate infrastructure and a well motivated health workforce. All the other vertical programs (like the daily behavior change adverts that assume we are so duffed hence the need to repeat them all the time at a cost in millions, like the so called ‘mass immunization’ and ‘family planning’ campaigns, the ill-timed addition of new antigens to Uganda’s immunization schedule, the vertical malaria/TB/HIV programs, etc) are a waste of time because they do not address the root cause of the problem.

You cannot verticallize immunization, and assume that whenever we need to immunize everyone, we shall rely on mass immunization – we need to strengthen routine immunization instead and pay the GAVI incentives to the last-mile staff – not the so-called ‘champions of child health’ who are based in Kampala, and are responsible for the death of millions of children because of corruption, poor programming and a self-aggrandized vision.

We need to carry forward Dr. Crispus Kiyonga’s hypothesis of investing significantly in the health system and empowering the District and Sub-District Health Teams to drive the health system. We need to place our gamble on the lower system, even when it fails repeatedly, because repeated failure is what nurtures innovation.

They are spending billions on adverts, posted on their own FM Radios based in Kampala, and creating the impression that Ugandans are so stupid they need to be reminded 5 times daily for 20 years that they need to wash their hands after the toilet – why not take the message to the rural folk by providing sufficient funding to the health assistants and nurses in the lower health units; these are closer to the people than the FM radios which run their adverts in English; Mbu ‘this message is brought to you by XXXXX’.Yes, the nurse in the lower level unit is closer to the people, and even more able to communicate with them in the local language they understand. Besides, most of these radio stations have limited (have to climb a tree to access airwaves) or no coverage in these areas.

I remember the last time they had a measles mass immunization drive and kampala town was filled with colorful posters telling people to go immunize their children. Interestingly on the allotted days some facilities didn’t even have the vaccines….you can clearly see these people (strategically) think in reverse!!!

Imagine there is a village in Kamuli,Precisely Kibuye Parish. The Health Center was closed for close to a month in May 2013. I was surprised whether the DMOs office was still functional or the Ministry never gets to know when such things happen. These poor peasants have to walk miles to access health care.

Some of these matters are slightly beyond my competence but I can tell the Ugandan health system is indescribable!!! The strengthening of the health sub district system is crucial for the improvement of our health system. I have had a chance to study quality of health care and patient safety,but i am always crying deep inside my heart because of the poor organization of our health system. we are fond of bombarding new systems (like the PCV) vaccine without sensitizing the primary implementers of such systems who at the end can deliver well. This has on many occasion failed the new technologies. We have also failed to work on the motivation of the health workers whom we keep piling more work and taxes and in the end they themselves will fail the system.

I am a product of community driven initiative to over come health problems. Indeed lets expound on this launchpad! Lack of political commitment is the real problem in this country. Our brothers in Rwanda have proved more committed and the results are now good enough for us to spend sector funds in the name of reaching out to appreciate their best practices.Rwanda is expanded to 13 antigens in their routine immunization program while conducting the mass immunization campaigns (including the most recent Measles/Rubella vaccination in March 2013). We only need to get our priorities right and let professionals lead the how rather than political mediocres running our country.

If children can be protected from pneumonia and diarrhoea, and effective vaccines are available, so be it. Anyone who has seen, lived or buried a cervical cancer patient, and/or has a daughter will appreciate the introduction of cervical cancer vaccine to prevent such deaths. As a country, we can surely do better in the way the health system is managed. The starting point I guess is to answer the question: whose interest comes first?



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