Regulate medical tourism to improve health system, UMA tells govt

The Uganda Medical Association (UMA) has said reducing approvals for government officials to be treated abroad would significantly improve the country’s health system.

Speaking to journalists on Sunday in Kampala, Dr Herbert Luswata, the president of UMA, argued that the country already has some facilities and doctors who can handle complicated medical conditions. 

“This thing of “I will get healthcare from outside Uganda easily” is why the healthcare system is not a big priority to them [government officials]. So we need to cut this one [medical tourism] down,” he said.

“We need to strengthen the policy on which a government official is supposed to receive medical care from outside Uganda through the medical board. If any government official doesn’t qualify to go and receive care abroad and they can be treated here–we have Women hospital and Mulago Specialised Hospital,” Dr Luswata said.

The Health Ministry, through a survey, estimated in 2014 that the country was losing around $73 million (Shs278 billion) per year through medical tourism, and this figure could have gone up over the years.

The UMA president said: “When we start asking ministers to go to Women’s Hospital [in Uganda], you will see them becoming more active and involved to ensure the healthcare system in Uganda improves and looks like where they want to go. All Ugandans will be able to benefit from the good healthcare system, better than wasting our little money in other countries and for us we are remaining backward.”

“When government appropriates money while making budgets, there is money allocated to pay bills for government officials outside Uganda. These budgets are big. Sometimes you hear that a Member of Parliament or Minister went and received medical care outside Uganda and you look at the bill which was paid and when you calculate, you can get at least one or two CT scan machines or one MRI which can go to the regional referral hospital and benefit over three million Ugandans. But this money is spent on one government official in two weeks or even a month and some leaders are not even bothered,” Dr Luswata added.

Dr Luswata’s argument is coming amid a growing list of prominent Ugandans and leaders dying outside the country on account of seeking better medical care, a reality which is raising concerns about the quality of health care services in the country. Some are private patients -not supported by the government. 

Among the top government officials who died in foreign hospitals are late Speaker of Parliament, Jacob Oulanyah and the Bank of Uganda Governor, Prof Emmanuel Mutebile, who died in Seattle and Nairobi hospitals respectively.

When some people were protesting in 2022 over the money spent by government in an attempt to save the life of Oulanyah, the Minister for ICT and National Guidance, Dr Chris Baryomunsi, said medical referral is unavoidable in the medical profession because a hospital may not have everything.

“A medical referral is one of the ways of managing a patient. It isn't an indicator that services have collapsed where the patient is being referred from. From a medical point of view, there is nothing wrong with referring a patient even to another country,” he said then.

The Health Minister, Dr Jane Ruth Aceng also said then that some referrals are made to access advanced care. “Myself, Rt Hon Anita Among [the Speaker of Parliament] and the Chief Justice Owiny Dollo, would always meet to talk and to plan on the when to send our brother [Oulanyah] for better treatment. Not better because we are not good enough but better in that the technology and the service that he required was not available in Uganda,” she said then.

The Initiative for Social and Economic Rights (ISER), in their December 2023 report, noted that despite some progress in infrastructure and quality of care in some public health facilities, “Uganda's health system is not effective, universal, or equitable.”

ISER argued that; “Health workers are not yet working in sufficient numbers in rural districts, mothers continue to be at high risk of death due to complications of childbirth and a lack of skilled care.”

“Workforce constitutes of medical interns (young doctors) and senior house officers (graduate doctors who are training to specialize in different medical disciplines such as gynaecology) and they have been on strike over non-payment of allowances,” their report reads.

“The impact of this has been dire in public health facilities as patients Most of Uganda’s health are satisfied with the quality of healthcare. As of now, the essential package of health services is underfunded, culminating in stock outs of essential medicines and poor quality of health care,” the report further states. 

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