Government must fix our health system

I will limit my reflection more to my experience and that of many other citizens on the ambulances services, medical personnel/specialists, and medical infrastructures/equipment. 

Ambulance services: Most ambulances plying the road are ill-equipped with machines, personnel/staff and slow in response. The government needs to oversee and manage the ambulance systems in the country with all the mushrooming health facilities and MPs flooding their constituencies with these vehicles, with ambulances signs and/or logos. Standardisation of ambulance prices and services is paramount. 

Medical personnel/specialists: Most facilities up country lack the different specialists such as ENT, Cardio, etc., and depend heavily on referrals to either private facilities within a district and/or region or to Kampala. As for specialists, if available, operate on specific days or more from privately established facilities and surely not weekends which leaves most patients at risk of death in case of emergency.

For the sake of one’s life, this would still not be a problem, but does it even work the way it’s operating? The quick answer is no; it takes more than it requires for the dots to connect to translate to service. Quite pathetic a situation though. 

Response at health facilities is characterised by long hours of waiting to access services at the different service points at the facility with their inbuilt bureaucracies for registering patients, payment of bills or verifications of insurance cards, tired and rude staff, think of it and name it. This is irrespective of whether it’s in normal situations or emergencies as well as private or government-owned facilities. Must this be how citizens of a nation-state should be treated? My answer is a no, however, it will depend on the status of the reader and the privilege he or she commands. 

Equipment and infrastructures: CT scan machines are a myth for instance in the greater north except for one I know in Aber hospital in Oyam District that has done a great service to the people despite the distance they have to trek to reach it with a terrible state of the road in a sick and critical condition. Regional hospitals would make services closer to the people, but what is their state of affairs? Still in terms of equipment and specialists, how effective are they in dealing with the needs of an average Ugandan who cannot afford to go to a privately owned facility or distant ones on referrals? A good case in point is the many survivors of armed conflicts living with war injuries across the country. We need a clear healthcare access and utilisation strategy and/or policy in Uganda to help cater for the average citizens. 

My mixed experiences and that of many other citizens with the health services in both private and government give me very little appetite to talk more about it. However, I cannot just cut my losses, and frustrations and move on, lest the problems will continue. Can government act fast to rescue citizens from this mess? Or are we destined for failure in this death trap? We need to ensure tangible and impactful services. 

Yet on the contrary, short-term emergency epidemics such as Covid-19 and Ebola are given much attention from the reporting and well managed, let alone the issues associated with the management of the funds. Therefore, why are we failing to fix long-term solutions? How do we avoid wastage of money or resources and instead build resilient systems? There is a need to enhance our accountability and transparency across all stakeholders in the health sector for a robust healthcare system. 

We must work towards and advocate for action in the healthcare needs, lest we perish. What has happened to the oversight role of Parliament with all these irregularities in our health sector and society? We cannot leave our health behind yet many other petty issues occupy our daily order paper, for without good health none of those would matter, nor would we have a citizenry or electorate to vote. The time is now or else we shall be wiped out of the face of the earth in record time. 

With such unpleasant situations existing, in my opinion, it’s unfair and unjust. We need to work towards investing in a health system (both public and private) that’s not only seen as working or a death trap but one where citizens derive satisfaction in service as well as better healthcare. 
A healthy citizenry is the answer to a safer future. Let’s invest in their health.

Joel Innocent Odokonyero, Transitional Justice Practitioner and Ethnographer    [email protected]