Monday, October 28, 2013


“First they came for the communists, and I didn't speak out because I wasn't a communist.
Then they came for the socialists,
and I didn't speak out because I wasn't a socialist.

Then they came for the trade unionists,
and I didn't speak out because I wasn't a trade unionist.

Then they came for me,
and there was no one left to speak for me.”

-          Martin Niemöller

The poem above was written as a criticism of the elite during the rise of Nazism in Germany.

Looking at Uganda you can substitute this same sloth to any number of issues that our elite are ignoring, seemingly oblivious of the possibility that the ills studiously ignore will come back to bite them one day.

Last week a pregnant mother and her unborn child died in Mukono from unforgivable negligence. She is not alone just that her story caught the eye of the press.

According to the latest World Bank numbers 310 in every 100,000 mothers die during child birth or about 4300 annually. While we seem to be ahead of the region in this statistic – Kenya 488 and Rwanda 340.

The problem with statistics is that it reduces invaluable human lives to relatively meaningless number. The truth is regardless of the gains we have made in our health sector, this is still about 300 taxi-loads of women too many. It’s actually worse than other incidents we refer to as massacres.

Like the president likes to say, let us stop comparing ourselves with midgets, the equivalent number for Mauritius is 60 deaths for every 100,000 deliveries or Egypt whose number is 66 or Tunisia’s 56.
And that is only a tip of the ice berg. Our health statistics are not anything to write home by whatever parameter you look at.

The news really is that the health sector which has been the biggest budget allocation since independence is so run down and incapable of rising to its obligations. But what is even more scandalous is that this sector is administered by the country’s brightest minds.

They will tell you that budgets are not adequate. That even the billions that the ministry receives are a drop in the ocean in respect of the health needs of the country. That there are shortages in infrastructure, man power and any other resources that would require to make the sector live up to expectations.

This is all true but these are just symptoms of a wider problem.

At the heart of these inadequacies is a strange sense of invulnerability, even immortality among our planners and executors of our policies. They seem to believe that they and their loved ones can circumvent the public health system and get private health care here or abroad and so they turn a blind eye to the collapse of our health system or even worse work actively to undermine it.

They forget that the private health care providers, being  businesses, will only do a little above the public health care system, just enough to show a profit. This means they are not very much better than what the downtrodden of our land are suffering in our public health centers and referral hospitals.

Attempts at fixing the sector have been piecemeal at best and haphazard at worst, and it is not for lack of knowing what to do.  

Let us be serious and fix this health system once and for all – we will not be inventing the wheel it has been done elsewhere, if only because we do not know when we will need to patronise our village health center with a life threatening, but very treatable condition.

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