MPs buying ambulances to fill health service gap

Often times, Members of Parliament (MPs) have come under public criticism for making promises outside their mandate during campaign time.

The promises range from providing basic health services to huge capital undertakings such as road construction, establishment of community schools and hospitals.

Whereas many fail to fulfill their promises, several others have honoured their pledges.
In the end, those who fulfill their promises have been paid back by being re-elected to Parliament, while those who are “selfish” get kicked out at voting time.

Although the principal roles of an MP are representation, oversight, legislation and appropriation, Saturday Monitor has established that at least 60 MPs have bought aAt 336 deaths per 100,000 live births, Uganda still has one of the mbulances for their constituencies, while others have invested in boreholes, schools, among other activities.

Most of the existing public health centres in both rural and urban areas, have no ambulance services.
Many of the MPs who have bought ambulances say the primary target is to help vulnerable patients, especially pregnant mothers.

At 336 deaths per 100,000 live births, Uganda still has one of the highest maternal mortality rate in the world. Some of the maternal deaths are attributed to the fact that some expectant mothers cannot easily access health centres. The MPs hope to deal with this problem by providing ambulance services.

Whereas some of them have signed memoranda with the (district) local governments to Most of the existing public health centres in both rural and urban areas, have no ambulance services.
Many of the MPs who have bought ambulances say the primary target is to help vulnerable patients, especially pregnant mothers. cater for payment of drivers and routine servicing, some MPs meet all costs of purchasing the ambulances and maintaining them.

In most cases, the patients only foot the fuel bill. But even then, a number of MPs say the patients will call to plead that they cannot afford the cost of fuel, meaning the MP has to come in and provide it.

Government’s take
Whereas the government appreciates the effort by the MPs, Health ministry officials are concerned about the standard of the ambulances used.

Ms Joyce Moriku, the minister of State for Primary Health Care, says there is need for guidelines, lest the lives MPs want to save are ended in the ambulances.
“We wanted to make guidelines on how this works but some of them get memoranda with districts to cater for drivers, servicing and repairs,” she said.

The minister added: “All they are doing is to support the government but what is important is we are streamlining the use of these ambulances because if we don’t, we cannot know what comes in the long run.”
The minister said the guidelines may not necessarily be a policy but at least what the legislators should consider before buying one.

The guidelines, according to Ms Moriku, will help on specifications on what a good ambulance should have.
Ordinarily, an ambulance should have first aid drugs, life support equipment and oxygen, as well as a good air conditioning.

Meeting the costs
Kilak South MP Gilbert Olanya (FDC) says he bought his first ambulance in the Ninth Parliament after seeing that there was no ambulance in his area.
“People would tie dead bodies on the bicycles, pregnant mothers would have to walk to hospital and this was not sustainable,” he says.

The ambulance cost him Shs45m, while the second one he bought in the 10th Parliament went for Shs52m.
Mr Olanya pays each driver Shs200,000 and manages the ambulances himself other than partnering with the district administration.
“There is a lot of mismanagement at the district so when you leave the ambulance with them, it will break down in just a few months,” Mr Olanya says.

Like Mr Olanya, Bukooli County MP Gaster Mugoya says he manages his ambulances.
He has so far bought four ambulances, with two already in the constituency, while the other two still in Kampala awaiting registration.

Besides the fear of corruption at the district, Mr Mugoya is concerned that placing such a “precious service in the hands of the local government” is political suicide.
“It is very suicidal for a leader to deal with public service leaders at the district or any level of the local government,” says Mugoya.

Whereas his submission is filled with fear of losing his political seat when he lends out his “free service,” Mr Mugoya hides this fear in what he calls ‘conflict of interest’.
“You are supposed to exercise oversight over these people [district leaders] and sharing resources with them would result into a conflict of interest and would compromise your ability to perform your oversight role,” he says.

But not all MPs take full control of the services.

Mr Noah Mutebi Wanzala (NRM Nakasongola County) owns three ambulances, operating in the three sub-counties of his constituency; Nakasongola Town Council, Kakooge Town Council and Kalungi Town Council.

Unlike his colleagues, he has entered a Memorandum of Understanding with the district.
“The district pays Shs280,000 to each of the drivers per month and meets repair costs but I do a monthly top up of Shs120,000 for every driver,” he says. Mr Mutebi adds that “the ambulances have eased movement of patients from hard-to-reach areas to referral points.”

The community members cater for fuel.
Nakasongola has no government hospital and only operates a health centre IV, in Nakasongola Town, about 21km from the military barracks.

More needs to be done
Whereas the MPs have tried to beat the odds, they have issues they want the government to address to support their initiatives.

Mr Louis Mbwatekwamwa (NRM, Kasambya County), says he has five ambulances that he claims have since reduced maternal deaths in Mubende District.
“The government should improve our roads because these are far-to-reach areas, the ambulances frequently break down and cost heavily in repairs,” he says.

The lawmaker also argues that the hospitals should be equipped with drugs to support the lives ferried from afar.
His other demand is that the government should consider elevating Kasambya Health Centre III to at least a health centre IV to handle the increasing concerns of maternal health.

It is not in Kasambya alone, the government has often promised to operate a health centre IV at every constituency and a general hospital at every district.

Uganda has got only 147 health centre IVs, of which only 170 are run by government, 15 by non-governmental Organisations, while eight are privately owned.
Most of those run by government have failed to meet minimum standards, often falling short on basic drugs and related medicare, leaving the population with little options.
Even those with improved facilities have no ambulances, creating a huge vacuum.

OTHER MP INTERVENTIONS
Besides providing ambulances, MPs have spread their wings beyond healthcare to increase their visibility in the electoral areas.
Some MPs have ventured into community agricultural projects, supported youth groups and women self-help projects.
These are not only the core of their manifestos but also political catch points.
Mr Francis Mwijukye (FDC, Buhweju County), has bought solar panels for each of the primary health centre units in his constituency.
He has also distributed sanitary towels to community schools.
Bukedea District Woman MP Anita Among (Independent) has distributed plastic chairs and tents to every sub-county, solar panels to all primary schools in addition to her ambulance that serves the district.
She has also constructed a technical and vocational school, which offers free education to learners from within the district.
Ms Among has also extended scholarships to children who score first grades at all levels of education in addition to a mattress and Shs100,000 for every first term/year of the academic calendar, at least for the last two years of her tenure as area representative.
Similarly, Katikamu North MP Abraham Byandala has ventured into construction of valley dams for the pastoral community, as well as constructing community boreholes.
Others such as Mr Peter Ogwang (NRM, Usuk County) have bought tractors for farmers in addition to the ambulances.
Mr Mugoya (Bukooli North) has now ventured into supplying oxen for farmers, while Mr Peter Ssematimba (NRM, Busiro South) has given out water tanks to schools.
Many MPs have chosen to provide such services because they maintain a routine visibility as compared to weekly donations and fundraising activities.