Mr Muniini K. Mulera
Dear Tingasiga:
I gather that my president gave a civics lesson to 210 medical doctors that have recently been subjected to something called “patriotism and ideological training” at the NRM political indoctrination school at Kyankwanzi. This school has the benign sounding name of “National Leadership Institute.”
My president, who is reported to have met the doctors at his palace at Entebbe on August 24, announced that the government did not have enough money to pay medical interns. He reportedly suggested that interns should be paid by whoever sponsored their undergraduate medical education. If this is true, the president may have understandably confused the term “medical internship” with undergraduate school.
Medical interns are not “students” in the traditional meaning of the word. They are bona fide medical doctors. Whereas a medical student is technically not licenced to perform any procedures or to prescribe treatments without the direct supervision of a qualified doctor, the degree of Bachelor of Medicine and Bachelor of Surgery (or equivalent designation in other countries) confers upon the recipient the right and responsibility to work relatively independently and to be paid as a medical doctor.
For ease of understanding, I suggest that we view graduation from medical school as the transition from being a student to becoming a relatively independent “life-long professional learner”, which begins with internship. The relative independence of a medical intern increases rapidly during their year or two under formal supervision. Truth be told, in most cases, the interns receive limited guidance by their supervisors, not because of neglect, but precisely because most are perfectly competent to put into practice the enormous knowledge they have acquired in medical school. Medical interns are the indispensable frontline workers in accredited teaching hospitals.
Following internship, medical doctors remain life-long-learners. Those who pursue post-graduate learning to become specialists and subspecialists work under limited supervision by their consultants and certified teachers in their fields. This phase of learning may last three to seven years. Nobody would do that if they were not paid a good wage.
Those who complete their graduate education and become consultants and/or university lecturers and professors, still work under supervision by their heads of divisions and departments. All doctors, regardless of level in the profession or their years of experience, work under formal supervision by their hospitals, by their regulatory bodies and by their specialist organizations.
Therefore, working under supervision, which is a normal part of a career-long process, should not be used to deprive medical interns or any level of medical practitioner their right to be paid well and to be respected as essential workers.
It may help President Yoweri Museveni to understand the importance of medical interns if we use an analogy from the army. Interns are like the privates and non-commissioned officers of the Uganda People’s Defence Force (UPDF.) If Museveni believes that the lower rank soldiers should “show patriotism” by working without pay, then our conversation with him will change. However, he will face strong opposition on that one too, for most of us believe that soldiers, police, and prisons officers are as essential as medical interns in the security of our country.
Which brings us to “patriotism”, that highly misused word that has become a synonym for blind loyalty to the ruler. The word is cynically used in Uganda and some other countries, not with its original meaning in mind, but with the intention to divide the population into them-and-us. Derived from patrios (Greek meaning “of one’s father) and patriote (French meaning “fellow countryman” or “compatriot”), patriotism should mean love of one’s country. This is manifest as attachment, and devotion to one’s country, and a willingness to defend the country’s people, their shared values, their human rights, their constitution, and their institutions.
Now, how is it patriotic to disrespect the country’s constitution, and to abuse the human rights of citizens? Does a patriot steal votes and elections? Does a patriot promote the wealth of foreigners and a select few among citizens, at the expense of the majority? How is it patriotic to distrust education and health services in one’s country, while lecturing others to make do with what is available at home? How is it patriotic for a government to send a select group of citizens for medical treatment abroad, while the rest of Ugandans are impoverished by very expensive healthcare at home? How is it patriotic to dismantle state institutions, promote and celebrate mediocrity, and create conditions that nurture and sustain corruption?
Patriotism is not about support for a political ruler or a political party. It is not about surrendering to enslavement and manipulation. It is not about sacrifice by some (such as medical interns) and parasitism by others (such as the rulers and their political associates.) If unpaid medical internship is a required sign of patriotism, the same should be expected from the political class.
If the president and the rest of the political class want medical interns to do unpaid work, let us hear a presidential directive that effective from October 9, 2024, the president, his ministers and all MPs shall cease to be paid monthly salaries, and they shall not enjoy any free services and other benefits. Instead, their giant salary and benefits envelop shall be fairly shared with other professional workers, including medical interns. This, together with redirection of the billions of shillings annually wasted on buying political support from religious leaders, cultural leaders, entertainers, opposition opportunists, and Diaspora Ugandans, should be sufficient to pay medical interns and other professionals very well.
Patriotism is an ideal to which we subscribe without reservation. However, one does not need to be lectured to love anything. Love is a natural emotion in response to a relationship with another person, or a thing such as one’s country, an institution, a job, profession, the arts, or sports. The positive vibe towards someone or something is triggered, nurtured and nourished by the feedback one gets from the loved object. An abusive spouse can demand love from their partner. It will not happen.
Likewise, reciprocity between citizen and state undergirds patriotism. Being born in a country, and nurtured, educated, nourished, respected, protected, uplifted, and fulfilled by said country triggers reciprocal love and total commitment to the wellbeing one’s homeland. Most of our countrymen on the medical frontlines perform their duties with professionalism and patriotism that they did not acquire through indoctrination at Kyankwanzi. These patriots do not expect special treatment. They are entitled to fair pay for their essential service to the country.
Mulera is a medical doctor.
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