Doctors’ strike deserves win-win solution, not threats of arrest

Tuesday November 14 2017



Dear Tingasiga:
The academic requirement to become a member of the Ugandan Parliament is an Advanced Level Certificate or its equivalent. “The equivalent” certification includes “diplomas” obtained from shop-front operations that serve the needs of those whose performance at O-Level examinations has been unsatisfactory.

An MP earns a monthly salary, allowances and other benefits in excess of Shs36 million ($10,000.) Among the privileges enjoyed by the MP is a new car, excellent healthcare benefits at home and abroad and a State-funded funeral, valued at Shs68 million (almost $20,000), that includes something called an “American-style coffin.” Many get paid to travel abroad to attend conferences and seminars, including Diaspora gatherings, that do not add value to the lives of Ugandan citizens.

Whereas the majority of MPs actually work hard to serve their political parties and their constituents, they are under no obligation to do more than enjoy their titles. To receive his generous package, all that an MP must do is show up at Parliament, sit in the chamber, remain silent, take a long nap and, where necessary, vote on Bills that he is not mandated to read. The academic requirement to become a medical doctor in Uganda is a minimum of five years of post-A-Level medical school education at a recognised university, capped by a rigorous pre-graduation examination, followed by a medical internship and licensure by the Uganda Medical and Dental Professionals Council.

A medical intern is paid Shs960,000 ($267) per month. The salaries of medical officers, consultants and senior consultant physicians and surgeons are Shs1.1 million, Shs2.6 million and Shs3.4 million, respectively. This is equivalent to $300, $720 and $940 respectively.
To keep her job, the medical intern must show up for work nearly every day; act as the frontline doctor caring for dozens of sick Ugandans daily; remain on-call to respond to medical and surgical emergencies at night, on weekends and public holidays; document detailed patient encounters and report the same to her supervisers; and study current literature to provide the best evidence-based care for ill citizens, including MPs.

To become a consultant or senior consultant physician or surgeon, one must pursue postgraduate training for a minimum of four years, often followed by a fellowship in a subspecialty programme that ensures great expertise in one’s chosen area. Among the responsibilities of a consultant or senior consultant medical or surgical specialist is teaching and supervision of undergraduate and post-graduate students caring for patients. The consultant often participates in committee and other administrative work, research activities and, of course, they must constantly read to stay abreast of developments in medical sciences.

A Member of Parliament exercises their right to take holidays and join her constituents during various festivities and breaks. They are under no obligation to abandon a feast on a count of some legislative crisis that cannot wait a week. A medical doctor is obliged to abandoned a half-eaten dinner and rush to the hospital to save the life of a woman in labour, a foetus in distress, a wounded soldier or an MP who has fainted. He cannot advise a bleeding police officer or a wheezing honourable minister of government to wait until the Christmas holidays are over.

An MP does not risk prosecution or immediate loss of her job on account of failing her constituents. The doctor faces the constant risk of litigation and loss of license if their conduct or performance falls below professional standards. The doctor must make do with substandard resources to provide a service to sick citizens. The MP cannot be under-resourced in his work, for all she needs is a working voice and at least one hand to debate and vote on Bills and other parliamentary matters. The contrast between the circumstances of these two sets of public servants speaks of the country’s skewed priorities. Uganda rewards political operators and penalises surgical operators. Yet both must live in the same country and meet basic necessities of life and family.

Whereas MPs enjoy the right to award themselves enhanced salaries and other benefits, doctors are threatened with arrest and loss of employment when they protest through a strike that is obviously a course of action they have been forced to take. One understands why President Yoweri Museveni’s reaction to the doctors’ strike was a threat to call on his guerrilla’s kit to fight workers struggling for justice.

What is very hard to understand is the reaction and threats by Dr Ruth Aceng, a medical doctor, who is the current Minister of Health. Perhaps political power blinds us to the reality of life around us. Or is it fear of the “appointing authority” that makes this medical doctor talk and act as though she was another militarised autocrat?
Whatever her reasons, Dr Aceng is wrong to use intimidation and threats against her professional colleagues. A good administrator does not use threats. She listens carefully, seeks to understand the grievances of her subordinates and invites them to genuine dialogue that is aimed at finding a win-win solution.

Declaring the doctors’ strike illegal is a meaningless strategy. Aggrieved people do not need permission to seek justice. If Dr Aceng doubts this, she should ask Mr Museveni whether or not he sought permission before embarking on his illegal protest against the injustice of the stolen election of December 1980. We supported him. Considering the enormity of their work and responsibilities, the salaries that the doctors are asking for are still very modest. I encourage President Museveni and his ministers to abandon the confrontational approach and find a win-win solution that brings the doctors back to work.