Where have all the doctors gone?

By Dr. Jean Chamberlain Froese

One morning we are all going to wake up in Uganda and there won’t be a health worker anywhere to help us.  No doctor. No nurse. No midwife. And we’ll have no one to blame but ourselves.

This is because of the current, trendy message: health workers can’t be trusted and they need to be punished for their crimes.  The result? One obstetrician takes off for South Africa, another to Canada, another somewhere else. There they can practice their profession in peace, without fear.

Yes, another Ugandan doctor, Dr. Daniel Ssegirinye, recently spent two nights behind bars like a common criminal.  The allegation against this physician who I personally helped to free?  Asking money from a patient, a woman that, interestingly, he had never even met.

I cringed as I heard NTV praise itself for bringing this case to the Mukono police.  On the contrary, this is an example of poor journalism. Facts were distorted and the deeper cause-and-effect was left unexplored. All the report did was inflame the community against Uganda’s lifeline, their medics.

I have worked with such medics in various parts of the world, professionals who work hard to save lives and bring new life into the world.  Uganda’s doctors are no different. In fact, prior to Dr. Ssegirinye’s arrest, he had worked on call for 24 hours a day, seven days straight, at the Mukono Health Clinic.

President Museveni recently noted that Ugandan doctors and nurses are underpaid and need better compensation. He’s right. Ugandan doctors get a mere pittance for work that is both highly-skilled and risky, with exposure to all kinds of disease and even death (remember Ebola’s toll on health workers).  That risk can’t be avoided.

What can be helped is this new risk facing medics in Uganda, this risk of being jailed, of innocent health workers being thrown into a political blame game.

The deeper issue is that Ugandan citizens are left to pay for things like blood or IV fluids or medicines when the public health system should cover these costs.   Your taxes should ensure hospitals and clinics are stocked with supplies for their citizens.  This simple system works in many countries around the world.

When this doesn’t happen, medics are forced to ask you to pay for the supplies, or, if you’re lucky, send you to a clinic that’s stocked. If one is not close or transportation is not available, they have to helplessly watch you die. There are no other options. This is the real story, the one that the media missed.

So what really happened in Mukono? With no intravenous fluids in the health unit and the patient unable to supply them, Mukono health workers helped transfer her to a Kawolo hospital which was better stocked. She delivered, and both mother and child are fine. They were lucky. Often, when time is critical, they’re not. They’re dead.

If the Mukono health centre was properly stocked, this mother could have delivered there. And Dr. Ssegirinye would not have been questioned and jailed. And this destructive attitude towards Ugandan medics would not continue.

But this is not what happened. And now your helpful doctors and nurses and midwives might be eyeing the next proverbial plane out of here. Too bad for Uganda.

Then after we’ve chased all of our health workers out of the country, we’ll wake up to that frightening reality: there is nobody left to treat our pregnant wives and daughters and sisters. We’ll ask, how could this have happened? And, for sure, we’ll have nobody to blame but ourselves.

The writer is a Canadian obstetrician and director of the charity Save the Mothers.  jchamber@mcmaster.ca