Like grasshoppers in a jar, we’ve become hostage to our despair

This story proves the effect of patronage but it does not show what causes it or how to end it.

Two ministers were recently taken ill; deputy Prime Minister Eriya Kategaya, who is also minister in charge of East African affairs, and Hilary Onek, who is in charge of Internal Affairs.

As often happens, the two were promptly flown abroad for treatment. Eng. Onek is an old friend from the days before he became a big chief and I hope they both recover fully.

Your columnist has argued here before that the government has a subterranean interest in the patronage of health care.
Let’s take the case of Mr Kategaya. A childhood friend of the President, Mr Kategaya famously opposed the amendment of the Constitution to remove presidential term limits that would have sent Mr Museveni into retirement in 2006.

Kategaya was promptly fired from Cabinet and soon found himself down at the heel. Struggling to stay above the water, he ate humble pie and meekly returned to the fold. He’s not said a word since.
That decision to return to the kraal and graze quietly is, in present times, and for lack of a better expression, is a matter of life and death for Mr Kategaya.

If he had kept true to his word and stayed out of government, he would have been much respected but might have been done in by a week or so in the decrepit Mulago Hospital. In effect, he traded his credibility for his life, choosing to be a live, purring cat over a dead manly lion.

This story proves the effect of patronage but it does not show what causes it or how to end it.

At a government retreat last year ministers heard that the government spends about Shs375 billion every year treating its loyal officials and cronies abroad.

That is almost half of the total annual health budget and more than 10 times the amount of money that the government spends on Mulago, the country’s largest and once-best hospital. It is also 63 times more than the government spends on all district hospitals.

Cabinet recognises this as a problem; that is why it was discussed at the retreat in the first place. Why, then, is it unable to deal with it?
The obvious answer is that the ministers are beneficiaries of this patronage and self-interest dictates that they maintain the status quo.
However, the ministers cannot be blind to the criticism or the political dividend that effective service delivery offers.

There can be two alternative explanations. The first is that a government that has thrived on patronage and inefficiency cannot, however well intentioned its efforts may be, suddenly become efficient and equitable.

Positive change, when it happens, is slow and often against all odds.
The other possibility is that patronage offers a higher political return than investing in efficient service delivery.

Initially, citizens complain about the poor state of services. Then, when their cries go unheard, they begin to ‘privatise’ the state. They hire private guards (security), buy generators (power), storage tanks (water), take their children to private schools (education) and go to private hospitals (health).

Some citizens are wealthy enough to afford to pay for all of these and more, including private treatment abroad.
Many others opt to pay for it by privatising public resources through theft or receiving pay-outs from those who push the political pork barrel of patronage through the village paths.

At this stage moral outrage is replaced by selfish cunning. Instead of questioning why a minister gets to fly abroad to have their bottom pricked while 16 mothers die every day while giving birth, citizens start schemes to either become ministers or steal whatever they can.

Like grasshoppers in a glass jar, citizens then turn against one another; maids steal from masters, employees from employers, even spouses from one another.

It is in that catch-22 situation that we now find ourselves. The government is unable to clean up a lot of the rot and even if it tried we would receive those efforts with cynicism.

Similarly, citizens see a lot more of the rot around them but they are more likely to try and join it than work to clean it up. So people like Kategaya are vilified for sponging off the state but they are also envied for having access to the dining table. Who would have thought that so many years later it would all come down to this?

dkalinaki@ug.nationmedia.com