When the health system is sick, take charge of your health


Published in Daily Monitor on Tuesday, September 17 2013 at 01:00

By Nicholas Sengoba


Amidst all the glorious statistics of growth and the implications of prosperity and progress, Uganda is contending with a crisis in the health sector.

We have the perennial challenges of corruption, low staffing levels, lack of well motivated personnel, equipment, medicine and the rising number of patients due to factors like poor hygiene, diets and population growth. There are the complications that have come with ‘new’ diseases like HIV/Aids and the spread of life style aliments like heart diseases, cancer, diabetes, high blood pressure etc.

This predicament has been exacerbated in the last two years with increasing donor aid cuts and unrealistic national budgetary allocation. The little that is proposed in the budget is actually not delivered to the health sector.

Most of the stories we read about and the actual experiences we encounter as we seek for health services are at most harrowing.

What is humbling is the way we aspire to stem the tide. The classic case to solving health issues is the time tested one. Taxes are collected into one basket. The political powers that be then distribute them to priority sectors including health. Then patients present themselves and are taken care of.

This is why everywhere you hear people ‘calling upon the government’ to honour this and that commitment to increase funds to the health sector. Unfortunately, the reality is that it is not working and it may not work in the near foreseeable future. The reasons are clear. Efficient public health systems work better in environments or societies where leaders depend squarely on the vote of the people for their existence and survival.

In Uganda and many African countries, a government can capture power, and perpetuate itself by manipulation, bribery and vote rigging. There is nothing like viewing the next election as a pressure point that gives leaders sleepless nights because they fear that if they do not improve the welfare of the people they lead, they will lose the election.

What then can be done in a realistic way since our government will not stop collecting taxes even if it is evident that the revenue is not exactly helping the intended recipients?

Since you just cannot tell when your next health challenge will strike and how debilitating it will be, it is important that we organise ourselves as health consumers to sort out the future. The alternative is dying in the midst of the fallacy that there is such a thing as the government coming to care for our health needs.

And it is very possible. One of the unique aspects about our Ugandan and African culture is the way we voluntarily organise, and contribute to social causes like weddings and funerals. In the case of the later, there are times when the resources contributed after someone has passed away actually dwarf what one needed to solve the ailment that killed him/her.

How do we borrow from that culture of coming together in times of need to set up health cooperatives devoid of politics that act as a safety net in times of need? How do we bring on board those who cannot contribute financially? If they are small scale farmers, is there a way we can set up mechanisms and systems to market their produce and capture the proceeds to make them eligible for the benefits of these schemes?

Can we organise those who loaf around playing ludo and board games claiming they have ‘nothing’ tangible to sell? Can their labour be mobilised, and hired out with a percentage being saved for their health? We cannot fool ourselves that management of such schemes would come easy and cheap in terms of time, and intellectual resources but we must start somewhere.

The alternative which is what we have is not going to work and is deteriorating on a daily basis. These are new times with new challenges. They require new thinking and new solutions. For your own life you may have to roll up your sleeves and put on your thinking cap.

Woe unto those who wait upon the so called government and even spend time condemning it. Those who run government are not your legendary mother goose that fends for its young ones. They are just unpatriotic and selfish and view politics as a vehicle for self aggrandisement.

Nicholas Sengoba is a commentator on political and social issues. nicholassengoba@yahoo.com

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