Ghetto is not a place, we are the ghetto

Friday November 15 2019


By Benjamin Rukwengye

Let me tell you about a guy, an evil genius called Bernie Maddof. He ran the biggest Ponzi scheme in history, estimated at $65 billion. His con went on for 20 years, but as with all Ponzi schemes, it collapsed in 2008, landing him a jail sentence of 150 years.

While discussing the perils of starting an enterprise with a friend recently, I told her that for everyone in the startup business, the arrival point should be that you wake up without having to worry about transport and food. And mostly, pray for good health.

Once in a while, I buy food from the thriving roadside market close to my home. First, because it is cheap, but also because it circumvents the rigours of cooking – a chore where I will plead incompetence.

The problem is that you can’t always vouch for the sanitation of roadside food, and more than once, I have found all the evidence in the intolerable stomach upsets and bacterial infections. Then it hits you how we are all living on a literal health crisis edge.

If you are reading this and do not have health insurance, please put up your hand. We are many; and the reason we are still alive is down to God (if you believe in Him) or sheer luck. Think of the amount of money you earn and whether you would survive if you had to foot a medical bill of Shs1m. Do you ever wonder what would happen to you if you had a medical emergency that required even as ‘little’ as Shs15m?

The ongoing scramble for the ghetto seems to have deluded us into believing that the ghetto is some place in Kamwokya or Kikubamutwe or Katanga. A home for the wretched-of-the earth, with dodgy English accents and dreadlocks.


But fall sick and you will discover real fast that the ghetto is not a place. First you have to pay out of pocket because you have no medical insurance. So you hope that the bill is within your means – if you have any means that is – because anything higher and you are the next face on a poster for a car wash, making rounds in WhatsApp groups.

And that is before you factor in contributions to your relatives’ medical bills. Oh! And you better not get depressed by the pressures of life because you can’t afford a therapist. Then it hits you, that you are the ghetto.

Meanwhile, in a country where others have enough connects to access first class medical services abroad or in Kampala’s top private hospitals on taxpayers’ bill, you on the other hand will end up in Mulago or Kiruddu hospital, or if you borrow from friends and relatives, in one of those private facilities that are also just trying to make ends meet.

I discovered only recently that Uganda has the sixth highest number of annual deaths from malaria in Africa. And that our national hand washing average is a laughable 36 per cent yet we can reduce instances of diarrhoea and same such infections by between 35 and 50 per cent by simply washing hands with soap at the right times.

A quick Google search will reveal that most of the leading killers are ironically, preventable diseases. Which should then shine a light on the absurdity of our health intervention strategy. Ordinarily, we could invest in prevention and primary health education in order to eliminate/control diseases and ensure that only those who are sick – from other unpreventable ailments – show up at hospital. Or we could equip our hospitals well enough to make that when patients show up, they have an affordable chance of going back home.

We are doing neither. Even in places where the ‘ghetto president’ and the ‘People’s Government’ hold sway, there is no leadership on these issues.

It’s all fun and games to discuss the evident intellectual deficiency of Buchaman, Full Figure and Catherine Kusasira – subject to their recent appointments – but in the grand scheme of things, they have now gone up the food chain and can access quality health care on your money; but you can’t.

Here is how a Ponzi scheme works: Basically, investors are promised high returns with little risk. Early investors benefit mostly from new recruits (investors). In the case of Maddof, family and friends were early investors and made the most, before the whole thing came crushing down.

I am not saying anything, but if a Ponzi scheme were a country…

Mr Rukwengye is the founder, Boundless Minds.