Senior House Officers (SHOs), qualified doctors who are training to become specialists while serving in public hospitals, have declared a nationwide strike effective today over payment of arrears.
The doctors, 693 in number, in their April 28th letter to the Permanent Secretary of the Health Ministry, said they have not been paid their allowances for 4 to 6 months.
“The last payment of allowances was made in February 2023 and this went only to a section of SHOs,” the letter signed by Dr Robert Lubega, the head of SHOs, reads.
The SHOs said: “First year’s and a group of other SHOs and fellows were left out. SHOs and fellows are demanding four to six months allowance arrears, yet they are expected to study diligently while serving their fellow Ugandans amidst challenges of scarcity of medical supplies.”
The SHOs are also concerned about the government’s plan to stop paying SHOs and medical interns in the next financial year because of financial constraints.
SHOs and fellows are qualified medical doctors registered with the Uganda Medical and Dental Practitioners Council who are undergoing postgraduate work-study training to become specialists in various specialities of medicine.
They are expected to attend classes and at the same time, attend to patients. This, the SHOs said, makes them “full-time Masters students who cannot meet their basic needs without the allowances provided by the government.”
The SHOs, based on the year 2021 directive by President Museveni, are supposed to be paid Shs2.5m monthly as allowances to support them as they study and offer services to the patients. But the Health ministry said it does not have money to pay them.
The move to strike comes amid protests by pre-medical interns, who, according to the Uganda Medical Association (UMA), have also been waiting for deployment to internship centres for nine months. The absence of interns, the UMA said, has hindered service delivery.
The protests by pre-interns in the recent weeks have attracted arrests by police, a move criticised by the public.
Dr Othiniel Musana, representing the Association of Obstetricians and Gynaecologists of Uganda (AOGU), said interns and SHOs make up about 70 percent of the human resource for doctors.
He said they are the “first responders to emergencies and deliver more than 90 percent of the emergency obstetrics care in regional referral and national referral hospital where 78 percent of all maternal deaths occur”.
“A failure to cater to the needs of these two cadres will lead to a reversal of the gains made through the partnership of the Ministry of Health, AOGU, and the midwives associations in ensuring the delivery of emergency obstetrics services nationwide,” the AOGU said in their April 30 letter to the Health Minister, Dr Jane Ruth Aceng.
The letter says: “This means the state will deliberately have failed to protect the life of our Ugandan mothers and their newborns.”
Dr Musana said previously that the country loses around 191 babies and mothers every day, with birth-related causes as the leading driver, but the Health ministry said this is not true. The figures from the health sector performance report for 2021, indicate that around 62 mothers and children who are below five years die daily.
Health ministry reacts
Dr Diana Atwine, the permanent secretary of the ministry, told Monitor yesterday that they are looking for money to clear the arrears.
“We explained the situation and assured them [the SHOs] they would be paid as soon as money is provided. Now if they have decided, I don’t know [the] best way to engage them,” she said.
Ms Anifa Kawooya, the State minister for Health in-charge of general duties, said they are struggling to address the issue of delayed deployment of medical interns.
Ms Kawooya said of the Shs80.5b they requested from the Finance ministry to cater for interns and SHOs, only Shs10b has been committed.
Ms Kawooya said discussions are also going to determine whether payment for interns and SHOs should be stopped, citing shortage of funds.
She added: “We still have arrears for those who were already deployed, so we cannot deploy [more] within the Shs10b availed by Finance ministry.”
The SHOs said during the strike they would offer emergency services. “We are aware that most Ugandans who seek our services are the vulnerable. As such we maintain our ethical obligation to provide emergency cover during this strike,” they said in a press statement yesterday.