{UAH} Dr Olive Kobusingye, M.B.Ch.B., MSc., M.Med(Surg), MPH | On Medical Workers Strike
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Dr Olive Kobusingye, M.B.Ch.B., MSc., M.Med(Surg), MPH | On Medical Workers Strike
I listened carefully as the Minister of Health & Minister of Public Service addressed the press in a statement that aimed to delegitimize the doctors' industrial action.
"… some doctors under the Uganda Medical Association laid down their tools on Monday November 6, 2017, against claims that Government has not heeded to their cries on better remuneration and favorable working conditions.
A series of engagements have been held … to address the concerns raised by the doctors. However, while engagements are still ongoing, the Doctors decided to start their industrial action."
And further, that 'Government applauds all patriotic Health workers who remained at their work stations to save lives.'
The intended meaning of this carefully crafted statement is that the Uganda Medical Association is not unified around the industrial action, since only some doctors are involved.
That doctors are unpatriotic, irrational, and unreasonable because patriotic and reasonable people would have waited for the engagements to be completed.
And that because the UMA has no recognition agreement with government, it does not have the legitimacy to organize in the interests of its members.
CONTEXT
So – let us just put this in context.
The UMA is not an association of doctors employed by the government.
Its membership is open to all registered medical doctors in the country, including the Minister of Health Dr Aceng, should she wish to retain her identification with her peers.
The association exists to advance "the social welfare and professional interests of medical doctors in Uganda and to promote universal access to quality health and health care", irrespective of employment.
And the grievances that led to the strike have been going on for decades. The doctors have been patient to a fault.
THE LIES
Doctors – and other civil servants such as prosecutors and teachers – have been lied to, disrespected, exploited, and taken for fools for so long that in the eyes of the privileged political class, their problems are no longer urgent. In fact they must wonder – these workers have been trodden upon for years, why are they making noise now?
That is probably why the Minister of Public Service thought there might be another force behind the strike.
NOT REWARDING PROFESSIONALS
Surely, the docile and gullible doctors were not capable of putting two and three to make five.
Or, put differently, doctors cannot comprehend this math:
Five years of medical school,
one year of internship,
three or four years of specialization,
and then year on painful year of accumulating experience to become a capable consultant
How does this compare with the A-Level certificate that is the only academic requirement for the MPs that are determining the remuneration of the doctors?
The MPs that earn ten times what the doctors earn, while dosing in air-conditioned parliament chambers, or being driven in cars that cost Shs 100 millions of tax payers' money to go and attend funerals of people that died because the doctors had no medicines to use.
This math is too complicated for doctors, it would appear.
So another force must be behind this awakening.
PRIORITIES
Enough ink has darkened paper to describe the ailing health sector, which has been ceding revenue to other sectors over the years, until it seems to run on next to nothing.
The cost has been passed to the patients. Ugandan patients bear some of the highest 'out-of-pocket' payments for health care in the world of countries with similar health systems.
By the ministry's own data, close to 40% of all Ugandans households experience catastrophic and impoverishing health expenditures.
These are the voters, whose taxes are being used to buy the luxury cars that transport politicians, or to take the privileged for health care abroad.
Many health workers cannot afford their own health care, and there have been shameful examples of senior doctors stranded in hospitals or their own homes when they needed care that their meager savings could not pay for.
THE OBVIOUS
Dr. Aceng, these doctors are not driven by attention seeking, or self-interest.
They are stating what should be obvious – they cannot perform miracles. If they are going to help Ugandans, they must be able to pay for housing, decent meals for their families, transport to work, and education for their children.
Is this too much to ask for a profession that spends up to 13 years of specialized training, and that then spends the rest of their working lives giving service, at times in very difficult circumstances?
STRUGGLE FOR ALL
Finally, to my colleagues right now caught in the crosshairs.
I am confident that you all know this is not just your struggle.
It is the struggle of all Ugandans demanding for accountable governance.
You have a much stronger voice than the bulk of your patients.
They are relying on you to hold out, and to remain resolute, professional, compassionate, and, yes, patriotic enough to not carve in until your legitimate demands are met.
Dr Olive Kobusingye is an Accident and Emergency surgeon and injury epidemiologist. She is the writer of The Correct Line? Uganda Under Museveni
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