Guerrilla governments in Africa have failed in social services


By Simon Peter Okurut via UAH forum

I think the guerrilla governments in Africa have failed in social services delivery yet Cuba for example was/is able to serve its people very well.

To prove that observation, at 5;10 a.m.this morning, I listened to a BBC documentary on the state of health services in Ethiopia. The health services in Ethiopia are more sick than the sick Ethiopians, to say the least. The BBC program presenter interviewed medical students about their concerns and 80% of them planned to leave Ethiopia immediately they graduate because of several reasons including poor pay ($300/month), lack of facilities, overcrowding in hospitals and too many students in medical schools about 30 times the original planned number with many sitting on the floors when attending lectures, lack of further studies etc. Practising doctors prefer to work in urban areas because at least they can “moonlight” to supplement the meagre pay. One doctor decried the poor services in the main hospital ( their Mulago) where in one ward, there are only 11 beds for mothers delivering yet they admit over 50 per day so the rest just deliver on the floor and this doctor says that they helplessly watch patients die because of lack of nearly everything. Next the minister of health was interviewed who said that they are trying, that their priority is on primary health care which he said would reduce the number of those seeking treatment; and that the problem is compounded by doctors who leave Ethiopia for greener pastures elsewhere especially in eastern USA where there are more Ethiopian doctors than the total number of doctors in Ethiopia and they receive a salary of not less than $5,000/month. In his view he wanted the US to pay Ethiopia $200,000 per one Ethiopian doctor employed in the US since it costs the US government that amount to train one doctor. I failed to see his logic, at least if he had proposed the US to pay the equivalent that Ethiopia had spent training that one doctor, it would have some good argument. I was surprised to hear Ethiopians decry the poor health services now, and those interviewed calimed that same services were better some time back.. This revelation made me turn on my bed terribly wondering what curse had befallen Africa. I wondered how governments led by visionaries can fail to foresee shortages and plan accordingly in order to avert the crisis.

This is exactly what happened to Uganda when Idi Amin chased non-citizens (Indians), the government proceeded to allocate the well stocked shops to soldiers and those sympathetic to the regime; slowly but surely, the shops became empty and emptier and by 1978, most shop counters/shelves were filled with bananas, banana leaves or kabalagala with many shopkeepers yawning and sleepy early morning.

While we can suggest good ideas that could improve the social services ( medical services) in Uganda, I think the first thing we should do is to get the government directly involved by it spearheading the discussions so that we are sure that the policy makers and implementers are all on board and are ready to move forward. We need to engage various stake holders so that a strategy can be developed, otherwise none of the brilliant suggestions can be implemented or even discussed. I am not suggesting that we leave it all to government, no, what I am saying is that we need government to be a participant in the discussions so that whatever is agreed upon is put into practice; for we cannot achieve much without the government’s participation since it (govt) has more mobilization groups/resources.

Leaders should ensure that institutions are developed, strengthened and allowed to be independent. What you are talking about qualified ministers is the tendency to depend on individuals which has caused failures. Obviously, it was Idi Amin’s mistake to give out property to people who did not own it in the first place and the policy of sending non-citizens was wrongly done/implemented:this should have been in phases while local people were being trained to take over.

It would be a mistake to expect any president to know everything under the sky! And this is exactly the problem we face; our leaders assume that they know everything and when challenged, they get jittery. Politicians’ role is merely to oversee work done by technocrats. There are many ways of monitoring developments in constituencies not necessarily being there physically, though NRM government has found pleasure in dishing out millions of shillings to MPs during elections for “monitoring developments” in their constituencies some of which were abandoned for nearly 5 years!

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