Sunday March 3 2013

Has the medical profession in Uganda gone down the drain?

By Harold E. Acemah

As a young man during the 1960s, my ambition was to be a medical doctor, but the Lord had other plans for me and His will has always taken precedence over mine.

Despite that, I have retained an abiding interest in and respect for the noble medical profession. Against this background I was thoroughly shocked by some revelations made by Dr Margaret Mungherera in an interview published last week. Dr Mungherera is incoming President of the World Medical Association (WMA) and outgoing President of the Uganda Medical Association (UMA).

I remember during the 1960s, the Makerere Medical School was the jewel in the crown of the University of East Africa. It produced world-class doctors and undertook pioneering research in cancer and malaria. The graduates of the medical school went out to build for the future of Africa and the world. In 1981, I was amazed to meet and interact with a team of Makerere-trained doctors in Melbourne, Australia where I had gone to attend Chogm; among them was Dr Somers, a hall mate when I was an undergraduate.

In a frank interview published Sunday, February 24, in one of the local dailies, Dr Mungherera expressed dismay at the state of the Ugandan medical profession. She said that contrary to the international code of medical ethics, a large number of health workers in Uganda were not registered and hence they operate illegally! “Recently, it emerged that out of about 6,000 doctors and dentists, just over 3,000 had renewed their licences,” she said.

She added that a spot-check done in Kampala found that 75 per cent of private health workers are operating illegally. Unbelievable! As a result health workers violate many ethical practices with impunity; for example, they do not respect patients’ right to privacy and they prescribe drugs for diseases they are not qualified to treat.

In a nutshell she expressed deep concern about rampant corruption among health workers; “Some of whom operate under the influence of alcohol. We have health workers who sexually abuse their patients” and many do not offer free medical treatment to fellow doctors who fall sick, as per medical rules.

Dr Mungherera gave three reasons to explain the unethical behaviour of medical workers which are applicable to other professions. First, our universities are admitting “the wrong people to medical schools”.

They admit people who join the profession to make money when the medical profession is a calling. Second, the training provided leaves a lot to be desired and thirdly, the rotten political environment in which doctors and indeed all Ugandans operate does not encourage and promote ethical behaviour.

What a sad commentary! How did a profession which was once the pride of the public service of Uganda sink to this level? It should not come as a surprise to anyone that in rural Uganda, where most wananchi live, witchdoctors and traditional healers “treat” more patients today than medical doctors with their degrees from Makerere, Mbarara university and Kampala International University. Most of our political elite prefer to fly abroad for treatment at taxpayers’ expense.

These actions are clearly a vote of no confidence in Uganda’s medical service, but especially in a regime which routinely invokes hypocrisy and lies as part of its public policy!

There are, however, some well-trained, professional and dedicated Ugandan doctors in the service, such as Dr Mungherera who has done Uganda proud by her election as President of WMA. I congratulate her for a job well done. Let me recognise a few other exemplary Ugandan doctors: William Worodria; Munini Mulera; Ben Khingi; Oola; Omagino; Geoffrey Buwa and William Obote (RIP), one of the finest surgeons Uganda has produced.

The institutional decay in the medical profession is part and parcel of the overall decay and collapse of the State which has been taking place for many years. It is one of the indicators of the fact that Uganda is now virtually a failed state; a fact which the NRM regime’s apologists keep denying, but to no avail. The legal profession is not any better.

In Uganda injustice is now more or less legal. On February 18, a registrar announced a ruling in which a court had the audacity to award a lawyer a mind-boggling Shs12.9b in a dubious case. It is a classic case of daylight robbery which all people of goodwill must condemn. What is quite telling is that all the conspirators come from the same region.

As Scriptures teach, the love of money is the root of evil. The obsession with money is one of the enduring legacies of the NRM regime which has turned Uganda into a den of thieves replete with ghost soldiers, ghost teachers, ghost pensioners, absentee MPs as well as fake and counterfeit products. Is this the fundamental change NRM promised Ugandans in January 1986?

The bitter truth is that most African countries, including Uganda, are fundamentally very badly governed. The challenge is to identify and install a new breed of committed, enlightened and selfless leaders of integrity to lead Africans forward. I wish our Kenyan brothers and sisters free, fair and peaceful elections tomorrow.

Mr Acemah is a political scientist,
consultant and a retired career diplomat.

hacemah@gmail.com

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