Should our doctors go for greener pastures elsewhere?

SIR— It is true Uganda is among the poor countries in the world. Most of our health indicators say so. Access to static health unit is estimated at 49%. Life expectancy at birth is 47 years. The maternal mortality rate is 506 per 100,000 live births, infant mortality rate is 97 per 1000, and the children under 5 years mortality rate is 147 per 1000 live births. Infectious diseases and malnutrition continue to predominate as main causes of infant and child morbidity and mortality.Our health sector is starved of trained human resources. The doctor to patient ratio is 1:28,000 and the nurse to patient ratio is 1:8000. The percentage of women attended to at delivery by a trained health person is 38%, yet Uganda is rank the third highest in Africa of teenage pregnancy at 43%.Uganda started experiencing a mass exodus of doctors in the early 1980s to ‘greener pastures’ in South Africa, Zimbabwe, etc. The main reason for emigration has been their dissatisfaction with medical emolument package in the public service. On average currently a medical officer is paid an equivalent of US$226 per month, which cannot buy a brand new Sony 14” television! Doctors deserve a better package as they are highly trained, they are at risk from communicable diseases from patients (Ebola, HIV, TB etc) and above all health care is an essential service. I should remind readers that however healthy one is today, we are reserved at one time for hospitalization in one way or another whether you like it or not. The government should recognize the impact of this on health workers and that poor remuneration is contributing to the apathy and shortage of doctors.We know that Uganda has enjoyed political stability and democratization since the NRM came to power. We the health workers argue that the money is there but the government has the wrong priorities. This is a big problem with Third World countries in putting to proper use the meager resources at their disposal. The national health budget is about 7.1 billion, and the per capita health allocation is about $7, whereas the World Health Organisation recommends US$12. Compare this allocation with those of the Ministry of Defence, Office of the President and State House.There have been other problems as a consequence which deserve mentioning. In addition to the total apathy, some have resorted to pilferage and private practice. We have witnessed twice the worst ever strike of health workers that left nationwide hospitals paralysed. Should our doctors leave the country?Dr Drake AdupaLira Hospital