Friday January 10 2014

Why quack doctors continue to thrive in the country

A nurse writes on a box of medicine. Many quack

A nurse writes on a box of medicine. Many quack doctors thrive because the monitoring of the law against them is weak. Photo by Faiswal Kasirye 


In Uganda, finding a “doctor” is almost as easy as looking out of your door. Self-made doctors treat in both government and private hospitals and sometimes open clinics operating 24 hours a day.

In a shocking revelation, a self-made Dr Ssekimbi (not real name) confesses how he has practised medicine for the last eight years and out-competed professional doctors around him in Kampala in patient numbers and trust.
Mr Ssenkimbi, a Senior Six drop, says his passion to practise medicine stems from his family’s wish for him to be a medical doctor, which wish faded when they died.
His parents succumbed to HIV/Aids in 2003 when he was in Senior Five at Nabumali High School in Mbale. He was able to complete his A – Level and that was the end of his formal education.

“My father was a doctor and he used to tell me that I must be a doctor too. He would leave me in the clinic to attend to patients and also tell me which drugs to give depending on a patients’ condition,” he says. Ssekimbi feels his father passed on the necessary skills to him and he now calls himself an expert on almost everything. To succeed in what he does, Ssekimbi uses his father’s academic documents such as the licence, to authenticate the busy clinic.

He has also mastered the art of customer care and fair pricing of his medical bills.
“Our charges are lower compared to other clinics and we avoid carrying out operations from here. We arrange for private treatment at Mulago and after the operations, we treat them at our clinic,” Ssenkimbi says. They avoid carrying out the operations as it saves them ministry of health investigations in case an operation goes wrong, and the resulting consequences. This helps to consolidate their “clean” name, he says, acknowledging though, that what he is criminal. He says, he however, cannot stop as this is now his job.

Becoming a doctor is a rigorous process with most universities’ medical programmes requiring high Uganda Advanced Certificate Level entry and lasting over five years. Further specialisation means yet a longer amount of time spent in school.
This and the high demand for doctors implying availability of jobs could be among the reasons that there are many quacks masquerading as professional doctors.
Other reasons are the seemingly neglected health sector which many people have described as being sick, a few available doctors willing to treat patients due to poor pay, bribery of health inspectors and poverty and ignorance of the public. This, of course, means many people’s lives are at stake.

Dr Katumba Ssentongo, the registrar of the Uganda Medical and Dental Practitioners Council agrees that the public is in danger if these quacks continue to thrive but he is quick to point out what different medical councils are doing to avert the situation.
“We now have an electronic information register of all doctors, for people to verify who is a genuine doctor or not .We also have a mobile directory where you can SMS the doctor’s full name to 8198 and you will know,” he said.

Dr Ssentongo, however, says the public is to blame for not reporting quacks in their vicinity and sometimes resisting the arrest of such people. “We can’t fight quacks without the local people but some communities surround us when we go with the police to arrest them,” he said.

He also says there are quacks in different professions and it would be unfair to state that they are found only among doctors, adding that each level is handled by their respective council, for example, nurses are handled by Nurses and Midwives Council Uganda and clinicians by Allied Health Professionals Council.
But traditional healers he says are not regulated and will not be, until a bill of Parliament that seeks to regulate them is passed.

Breakdown in the law
The doctor states that there has been a general breakdown of the law which requires that the council writes to a quack requesting him or her to appear before the council. A quack doctor is given two weeks within which to do this, before action is taken against him or her. However, most of them do not comply and limited staffing which makes monitoring very weak, thus quacks have taken advantage of that.
By the close of 2013, the council had a total of 4,531 registered general doctors, three times less than what the health ministry needs (13,593).

The 4,531, however, also includes those who are currently in private business not related to medicine, administration or have turned into politicians, lowering the number of doctors who treat, even more.

Last year, the National Drug Authority closed more than 3,000 drug outlets and shops that did not conform to the required standards and regulations. Most affected were operators who sold unauthorised, expired and counterfeit drugs, lacked trained pharmacists, had unsuitable premises, and had no licences for the businesses and products they were trading in or were not licensed at all.

Different government agencies across the country arrested several quacks but many people like Dr Ssekimbi are likely to continue working if the root causes are not dealt with.