UGANDA BLOOD SHORTAGES ARE A SCANDAL

 

The Country is in the throes of a sever blood shortage.

According to health officials we need 300,000 units of safe blood annually, which would be managed by collecting at least 350,000. As it is we are collecting only 250,000 units.

To the lay man the first reaction would be to recommend that we have a blood collection drive, that people are not donating enough blood. As it turns out Ugandans are more than willing, but apparently we do not have enough testing kits to process the blood.

The Uganda Blood Transfusion Service (UBTS) budget is sh18b but only received sh7b, just a third of their requirement and as day follows night we have a full scale crisis.

As if that is not enough the categories most often in need of blood are pregnant mothers and children.

To state the obvious, you don’t need blood until you need it and by that time the situation is often life threatening.

The budget reading is next week. And the health ministry is expected to remain one of the highest votes. But for all the hundreds of billions of shillings allocated to the sector annually it still remains insufficient, and this is before you factor in the thieves and robbers of public funds.

According to the World Health Organisation (WHO) the health expenditure per person in Uganda is about $124 a year way below the international average of the $1200 in 2011.

Our budget has come under strain in recent months.

Last year donors pulled the plug on up to $300m in budget support and one can expect that lack of funds to buy the testing kits is a direct consequence of this action.

If ever there was a direct connection between official corruption and the lives of ordinary Ugandans this is it. That a handful of individuals help themselves to public funds and as a result jeopardise the thousands of lives goes beyond a scandal, it’s criminal.

That being said the time has come, maybe long overdue when we determine that certain things we shall finance with our own resources and leave the crumbs to the donors and well-wishers.

We might not finance the whole health budget but surely we can find the odd billion shillings to ensure that our blood banks are fully stocked at least. Just as we ring fenced money for roads or for dams we should do the same for priority areas like our blood bank.

In the greater scheme of things the sh18b required by the blood transfusion services is a drop in the ocean compared to the monies that went missing in the public service and prime minister’s office, some of which we refunded to the donors.

Let us not fool ourselves.

We can build all the roads, dams and railways in the world but if our human capital is inadequate for lack of education or good health the benefits of these investments will not accrue to Ugandans.

This may seem like commonsense but clearly the budgeting process follows a logic all its own, a logic which clearly needs to be realigned with the needs of the Ugandan public.

KCCA PROGRESSING SLOWLY BUT SURELY

Anyone who drives through Nakasero can’t help but noticing the working being done on and around the roads.

Lumumba Avenue and Nakasero Road, previously death traps for your car’s shocks are now a smooth ride, but in addition there is a lot of work happening on the drainage systems around those areas.

KCCA says this is part of an sh18b project.

Quietly too our city is much cleaner and greener than it was a two years ago.

Many years ago someone in the financial sector told me how KCC – as it was known at the time, would never lack for funding if they did a few things right.

If they did nothing else and just verify their revenue sources they would have the world at their feet.

At the time KCC would lay claim to revenues from market dues, ground rents and trading licenses but there was no clear record of how much was due to the authority and therefore how much they should collect.

KCCA has done a commendable job of roping in more and more of what is due to itself.  So far authorities say they have collected in the region of sh51b up almost 70% from last year’s sh31b.

They are looking for more. They have now installed an automated revenue management system that will help track revenue from all sources.

As a first step this is commendable but it has far reaching repercussions as well. Our natural instinct is to pay for things with cash, but to finance the major infrastructure and social services required in the city debt will be required.

In other parts local governments issue municipal bonds, essentially they borrow from the public, to finance such investments.

In my mind there are two long term benefits to this.

One, that KCCA will develop the capacity to not only collect but ferret out all possible sources of revenue due to it, important for the long term health of our city. Secondly, KCCA will subject itself to more rigorous scrutiny of its operations making it more efficient in service delivery for the benefit of its citizens.

And one may also add that you expose yourself o the limitless pool of financing sloshing around the world in search of a home.

Last month Rwanda issued a Euro bond, essentially borrowed from the open market. They were looking for $400m but the interest in the offer was more than eight times what they were looking for. It goes to show that there are investors out there that are not cynical about Africa’s prospects and have a sufficiently long term view to put their money where their mouths are at, all they need is the right instruments for them to concretize their interest.

In the world of high finance anything can be bankrolled it’s how you package it that will do the trick.

The detractors will argue that why should we borrow money at market rates when we have donor money that is going for a pittance with longer repayment periods?

Inexpensive money is always welcome but free things, or cheap things in this case, often turn out to be more expensive than they seem. By failing to wean ourselves off the cheap donor money we are failing to mobilise our own resources to fund our own priorities. Apart from keeping us addicted to the indignity of always going around begging bowl in hand it also doesn’t help our democratic processes – we end up more accountable to the donors than our own Ugandans.

If we have to extract more and more taxes from Ugandans we would have to show results in the way of improved service delivery, if not we run the risk of angering the population and in danger of them refusing to pay taxes. Such a government would be forced to negotiate with its people to raise revenue.

You have to like the trajectory KCCA is on, which makes you wonder about the people trying to throw spanners into the works at every turn.  But that shouldn’t be a mystery the chaos that was KCC benefited some people and that clique cannot be amused at the regularization of its operations. A straightening out of its activities will inevitably lead to a loss of revenue or leverage for these individuals and hence their heckling and sniping.

KCCA needs to be supported if only to stand out as an example that what was previously thought to be impossible can be achieved. Who knows their example may spread out to the rest of the country and to the central government …. But no! I am getting ahead of myself!

SORT POVERTY, POPULATION GROWTH WILL TAKE CARE OF ITSELF

Last week it was announced that Uganda will be the first African country to benefit from a new multi-million dollar global campaign to increase demand for family planning services and information.

Alarmed by our high population growth rate – 3.2% the third highest in the world, everybody is scrambling to prescribe all number of family planning options.

I am ambivalent about the urgency to lower our population growth rate.

That at the current rate we will double population by 2040 and this will put undue strain on our resources as a nation. But this argument really does not stand up to scrutiny. 

"South Korea has a third the surface area of Uganda with a population of 48 million and we don’t hear that there population situation is an emergency. The UK which is slightly larger than Uganda has almost twice the population size and no alarm bells are going off there. Singapore, which for all practical purposes is just a rock in the ocean, has 50 times more people per square kilometer than Uganda....

Uganda, by the way has nearly fifty percent of all the arable land in the community and has one in every five units of area under water.

We all understand the logic of a manageable population that can be well catered for and can enjoy a better quality of life. And it is virtuous to cut your suit according to the cloth you have. 

But a high population growth is a symptom of poverty, it therefore follows that we should be attacking the cause and not the symptom to be more effective.

Take for instance the statistic that our women have a high fertility rate. That on average the Ugandan woman bears seven children. This masks the fact that the urban woman on average has four children, meaning the rural woman’s average is higher.

Even in our own reality we see that there are some women who deliver less than the national average. The question should be, what is it that the urban woman does (or does not do) that makes her have fewer children?

The immediate thought is to suggest that this is because they use more contraception, but average contraception use in Uganda is so low – about two percent of married women use contraception, that it cannot in and of itself explain why the urban woman is giving birth to fewer children.

What is more telling is that the urban woman is in school longer and therefore delaying her first pregnancy. Some survey last year showed that there was some decline in the teen pregnancies in Uganda and some analysts attributed this to the greater enrollment of girls in schools as a result of UPE.

Not only does the urban woman delay her first pregnancy, therefore reducing the number of babies she can get, but urban families are very busy. The number one safeguard against pregnancy is abstinence. No sex, no babies.

This is not to take away from the libido levels of the urban couple, but it would be logical to think that urban couples are having less sex. The reason is obvious. Beyond the 9-to-5 day job there is also so much else occupying our minds – the bars, tv, golf, gym, every added activity lowers the chances of having procreative sex.

The running joke is that because there is no electricity in the larger part of the country the closest form of recreation is sex. It would be interesting to see whether there was a spurt in urban population growth during the load shedding years.

The point is that a decline in poverty levels will be accompanied by a corresponding drop in population growth figures.

For those looking for the quick fixes they may wonder, why not uplift the girl child and the problem will be sorted?

But it is futile to do so in the context of prevailing poverty with her father – who needs her labour in the fields, her dowry as soon as she sprouts breasts and her brothers who for lack of nothing to do will have sex anyway.

So we should be working towards better, education, the more educated you are the higher the income; health, to increase on productive days at work; general infrastructure, so farmers can have access to markets and adopt more efficient work methods in all our economic activites, so we can produce more and more with less effort and of course resolve our land issues, so that the soil under our feet can be better utilized. We do all this and poverty as we know it now will fade from our memory.

However there is another agenda behind this drive for lowering population growth in Uganda and in the third world as a whole.

According to the World Watch Institute the 12 percent of the world’s population that lives in North America and Europe account for three in five dollars of global consumption. Going by this figure alone if the whole world raised its level of consumption to that of the west it is unlikely this world could sustain us. Yet it is agreed that in order that the poor in Uganda and elsewhere  lift themselves out of poverty they need to consume more.

"The moral thing to do would be to ask the west to reduce its consumption levels to more normal levels so the rest of us can raise ours...

I would be laughed out of the room if I suggested this in polite company!

IRYN NAMUBIRU IS OUR WAKE UP CALL

This week singer Iryn Namubiru made it back on home soil after a harrowing two weeks in Japanese detention. Her trip to perform in Japan went only as far as the airport where a search of her bags found her to be in possession of illicit drugs.

The singer needs to thank her lucky stars.

Asia has been fighting the drug problem for centuries – the Opium wars between the England and China in the 19^th century were over the Asian nation’s desire to stop the importation of the potent drug by British merchants. As a result of this long history many have a zero tolerance policy for the trafficking and use of illicit drugs.

China is world famous for sentencing hundreds to death for trafficking in drugs, other Asian nations also prescribe death sentences but at best long prison sentences in the deplorable conditions.

The details are still scanty about how her release came about but it probably helped that Namubiru holds a French passport.

Drug related crime has been growing steadily over the last two decades in Uganda. Anecdotal evidence suggests that we have moved from being a transit point for drugs from Asia to Europe and become consumers.

Part of the reason is that our laws against offenders are lenient with drug trafficers suffering a fine of a million shillings or a year in prison. This is ridiculous viewed against the street value of a stomach full of cocaine, which may run into billions of shillings.

Everything happens for a reason and Iryn’s experience should serve as a wake up call for our politicians and law enforcement agencies.

The drug trade does not work in isolation. The same networks used to traffic drugs are used in human trafficking, smuggling, gun running and any number of illicit trade enterprises.

To think that as long as my family and friends are drug free is to take a narrow view of the situation.

In terms of the economy the proceeds from illicit trade have to be laundered. It has been known for a long time that the land inflation in Kampala is due to hot money and is not supported by general income levels in the city. These funds distort the economy, knocking out genuine businessmen out of work and living the field open to counterfeit and substandard goods endangering the society as a whole.

But even more scary is that if these networks take route in our backyard they tend to proliferate like a virus, inserting themselves in every aspect of our lives and in extreme cases they take over whole governments.

And if you think about Uganda would be a prime candidate for takeover.

We are literally at the center of the world, with less than a day’s flying to Asia and Europe. We have relatively weak security systems. Our officials are corrupt to the gills and we have a lot of desperate people seduced by the good life and willing to do anything to make a quick coin. Our national budget is under $5b, it would take considerably less to secure this country as a illicit trade hub, a funnel for billions of dollars sloshing around in the shady underworld of drugs, human trafficking and money laundering.

And once crime takes over our streets it’s only a matter of time before its running our government, with rest of us working as indentured labourers or markets for their nefarious products.

As farfetched as this scenario may seem it has already happened in the recent past in Europe.

In Montenegro, to get around western imposed sanctions on the former Yugoslavia in the 1990s, they leased ports and airports to cigarette smugglers. With a foot in the door these gangs have never gone away trafficking in addition to cigarettes,  in women and narcotics.

Organised crime induced corruption was so bad that Italy had a warrant out on the head of former Prime minister Milo Djukanovic for his role in smuggling cigarettes.

So let Irynn’s ordeal not be in vain lets clamp down on this vice now before it spirals out of control.

THE TIME VALUE OF MONEY

They say the rich measure wealth in terms of time and the rest in terms of money.

To illustrate. One group of investors every so often get called to Rwakitura to meet the President. For an afternoon meeting they often send their drivers off on the 300-odd km by road to Mbarara. When the drivers get to Lyantonde, past Masaka, their bosses take off from their private airstrip and get to Mbarara airstrip just in time to jump into their cars for the onward trip to Rwankitura.

During the duration of the drivers’ journey the investors hold a series of meetings, probably close a few deals and attend to pressing administrative matters, activities of which will help to put a few billion shillings on their balance sheet by year end.

Not to take away from the drivers – their skill and perseverance in doing the route, but they only get a few thousand shillings as their day allowance for making the trip.

If we measure efficiency as a function of money made over time, clearly the drivers have go the short end of the stick.

To drive the point further.

Given the choice between receiving sh100m on January1st or taking the proceeds of one shilling invested at the rate of 50% a week from January 1^st to December 31^st , which option would you choose?

It seems like a no brainer. But if you chose the sh100m up front you would have forgone sh1.3b in potential earnings. Do the math!

In both cases we put an inordinate amount of value on money. In the first case we would rather jump on a taxi rather than drive because it is “cheaper” to ride in taxi, we do not factor in the lost revenue that accompanies the lost time using public transport.

In the second case we are often guilty of overestimating what we can accomplish in a short time and underestimating what we can achieve over a longer period of time exercising diligence and good sense.

These two errors in judgment cost us thousands even millions of shillings as individuals, imagine what it costs us as a nation?

The current impasse with Karuma dam is like a bad case of déjà vu.

Bujagali dam was mooted in 1995. After almost 20 years of sniping from environmental do gooders, rear guard action from our very own political elite, the ejection of one investor and the acquisition of another, the dam’s first megawatt of power hit the grid in 2011. The losses as a result of lost economic activity due to loadshedding, raising of tariffs to accommodate thermal generation power plants and the near two-fold increase in the project cost must be in their billions. Monies which would have been better spent improving health care facilities or subsidizing education or building roads.

Our inability to solve the land question is another case of time wasting. Attempts by this government to regularize the land laws started with the constitution in 1995, stumbled on in enacting the Land Act and the continued tinkering.

The lack of clarity with our land issue is frustrating commercialization of agriculture and is a main reason behind the ever widening gap between the rich and the poor. Because ownership is often unclear no durable investments can be done on it. As a result the productivity of our farms is one of the lowest in the region frustrating efforts to grow an industrial base driven by agriculture – our most logical route to industrialization. The losses in terms of lost opportunities, uncreated jobs and lost tax revenues must run into the billions of dollars not shillings.

One can throw up examples of procrastination by our country until the cows come home.

Looking back over the last 27 years it is actually amazing what has been achieved, because for instance the government did not twiddle its thumbs about key policies like privatisation and liberalization of the economy, the decision to ally with the donor community to rehabilitate the economy or the pressing forward with regional integration at all levels. Imagine if our communications were still the monopoly the government telecomm company? Or we were still laboring under some socialist model, creating no wealth and distributing the ensuing poverty? Or the movement of goods and services were still restricted in the region?

I shudder to think!

We need to generate a sense of urgency, optimize our time usage because they time and tide wait for no man.