By Derrick Mugabe
As Uganda prepares to sit on the same table with middle class countries by 2020, we would expect the health system to be at-least slightly below or above “standard” by now. By this, I mean there should be equal access to health facilities by all, having enough medicines in the stores as well as ensuring that all our medical personnel are motivated enough to do their jobs satisfactorily. We are just two years away from 2020 but accessing health care services is still expensive. For example, segregation on factors such as one’s level of income, family background, and “technical-know-who” among others, are still prevalent in many healthcare facilities in the country, and have contributed to delayed healthcare delivery to patients or death.
It goes without saying that the health system of Uganda is dying. The illnesses that are leading to death start right with away from the clinics and health centre IVs in the different areas. Politicians and other VIPs have been airlifted to other countries for medical attention when sick because they do not trust Uganda’s healthcare facilities. At all government health centres, services are supposed to be free that even the lowest caliber of a person is able to get medical care. However, due to the fact that medical personnel are demotivated, they end up selling the medicine in hospitals to patients. The situations transit from worse to worst especially in cases that relate with disability both cognitive and physical. In this, little or less attention is given to children and young adults with disability. Those with cognitive disabilities suffer most as their survival entirely depends on the medical attendants’ mercy and patience.
It is worth noting that mental health care remains one of the least addressed aspects of health care in Uganda’s health system despite a continued increase in the number of people suffering from some form of mental illness or disability in the country. It is even worse in children. Despite evidence that early management and treatment of mental illness is important in addressing its effect on health and well-being of a person, very little effort is being made to prevent, identify, diagnose and manage cases of mental illness among children in Uganda.
Unavailability of diagnosis machines has become the core of the poor living or health conditions of mist people especially those with cognitive impairments. Conditions like Autism and Down Syndrome are in most cases diagnosed verbally by “merciful doctors”.
“…Irrespective of the number of times I went to hospital about my son’s stunted growth, poor health and unusual features he had, none of the doctors at the hospital told me he had Down Syndrome. I was only told to consider him dead and give birth to another child. It was after a few years that I met a friend who took me to a private hospital and I was told the health condition of my son but after a long time struggle in the dark” a parent who preferred anonymity remarked.
This is not the only case as there are more other similar stories.Late diagnosis of some health conditions has also increased the severity of disability.
The government of Uganda has come in to resolve a few issues but there is still a lot that has to be done. For instance, the Government of Uganda promise medical personnel (doctors and mid wives) an increment in salary and a few benefits that are yet to be received by the medical personnel as a way of motivating them.
More focus is still needed on earlier prevention and intervention but this is all possible after getting the right diagnosis. Generally, some health conditions can easily be avoided or managed following early diagnosis. For instance, although most neurodevelopmental disabilities are not “curable”, they can be managed through early intervention programs implemented by both parents and medical personnel. This will help prevent experience problems with independent living, employment, social relationships, and mental health.
Also, when the budget is being drawn, I would recommend that priority be given to health facilities as it is healthy Ugandans that make Uganda a better place. I also feel there is need to train medical personnel on how to handle people with different health issues. Such trainings should mainly be held for the nurses and other hospital support staff who happen to spend more time with patients. Therefore, there is need to make all health facilities accessible and inclusive for everyone. Then, we’ll at-least have moved a big step in our journey to the middle class.
If we continue spending on less useful things like consultation meetings by Members of Parliament and yet they had already made decisions about a subject, the health of most Ugandans will continue deteriorating and it is only the rich who will survive because they will have the money to rush them to hospitals out of the country.