By Anthony Masake
When you visit your doctor or health worker, how much are you prepared to engage in the decision making in as far as your treatment is concerned without being judged as the unappreciative know-it-all type? When your right is violated, do you ever seek redress? These are just some of those shelved patients’ rights.
Rights of a patient are basic human rights which ought to be protected at all times.
However, despite of having a plethora of laws such as the Constitution, Uganda Medical and Dental Practitioners Act, the Medical and Dental Act, Allied Professionals Act, and Pharmacy Act in place to guarantee the respect of patients’ rights, I can tell you the situation still remains pathetic.
As a public health policy to promote better practices which uphold patients’ rights, the Uganda Patients’ Charter was launched in 2009. This charter outlines a set of rights, responsibilities and duties under which a person can seek and receive health care service.
Despite all these well-intentioned developments, our patient-burdened, ill-equipped healthcare system incessantly promotes and often protects violations of patients’ rights. Access to quality health care from patients’ rights centred approach tailored to advance lucid and ethical practices still remains elusive.
Recent statistics reveal that after almost three years since the introduction of the Charter, 81.5% of patients and 69.4% of health workers were not aware of the existence of the Uganda Patients’ Charter in a survey conducted at Mulago Hospital. 79% of patients who felt their rights were being affected never attempted to demand for them. Only 40% of patients were “aware” of their rights. If this is the state of affairs at Mulago National Hospital in the capital Kampala, it can only get worse in the countryside.
The question then is, why do we find ourselves in this quagmire? How much has been done to create awareness about the Patients’ Charter? Or do the patients actually know their rights but simply choose to remain passive for fear of victimisation. Is it all about institution-related factors? Or are we simply dealing with health workers who have ethical issues and other complex issues related to their superiority in the healthcare chain?
Either way, a few things are clear.
Only a handful of patients and health workers really appreciate the contents and spirit of the Patients’ Charter. How then do we expect them to promote what they do not know?
Few patients who have some knowledge about their rights understandably feel powerless. They fear discrimination as a result of being perceived as to be questioning the clinical skills of health workers. What else would you expect from a patient who considers any treatment at these public facilities a favour and not a right? That is what the system has made them believe.
It is also a fact that the health sector is grappling with serious resource constraints which creates loopholes for rights abuses. Only 56% of health posts have been filled, doctor to patient ratio is at approximately 1:22,000 and the basic facilities such as beddings, lighting, water, oxygen, drugs etc are largely inadequate.
The system continues to be largely reactive rather than proactive.
We clearly must engage in massive sensitisation and empowerment to enable patients demand their rights.
We also need to fund the health sector better. However, this argument ought not to be used to justify violations of patients’ rights in many instances which only require observance of simple ethical practices.
The need to address intrinsic patient and health workers issues through the implementation of a multi-sectoral patient-centered approach to practically integrate patient’s rights approach in patient care is evident.
The writer is the Team Lead, Social Justice Support Center