FRANCIS Omaswa was working as head of cardiothoracic surgery at Kenyatta National Hospital in Nairobi, in 1982, leading an open heart surgery team, when he decided to take a slight detour.
At the invitation of the Association of Surgeons of East Africa, Omaswa travelled back to Uganda and set out for a remote mission hospital in the town of Ngora.
He spent the next five years on an experimental project testing the most cost-effective ways of delivering quality health services in a rural setting. In so doing, he figured out how to make health systems work.
And, according to Omaswa, one crucial thing about making health systems work is that they need health workers. â€œMoney cannot take drugs from the airport into the mouths of humans. You need people. The world does not work like that.â€
More than two decades later, Omaswa looks back on his time in Ngora as a pivotal training ground for his current role as the executive director of the World Health Organisationâ€™s (WHO) Global Health Workforce Alliance (GHWA).
The group, which will hold a major conference in Kampala this week, is charged with coordinating the global response to the massive shortage of doctors, nurses and health workers that is paralysing the health systems of many countries throughout the developing world.
â€œIt is the basis on which I understand health systems and health care in low-income countries,â€ Omaswa says.
Indeed, a career that has ranged from rural hospitals to the highest ranks in the health ministry, where he played a key role in the fight against HIV/AIDS, has left him familiar with the complex factors that are fuelling the current crisis in human resources for health â€” such things as low salaries, the lure of lucrative jobs in wealthy countries, outdated and run down training programmes and diseases like HIV/AIDS.
It was not always this way, notes Omaswa, who was born in Mukura in 1943, and earned his medical degrees at Makerere University Medical School in the late 1960s. Upon graduating, he and his classmates were paid well.
â€œWe were paid salaries that were sufficient for us to live comfortably.â€
However, things turned differently for much of the continent, many African economies declined and the conditions of service for doctors and nurses followed.
Omaswa became a fellow in the Royale College of Surgeons of Edinburgh during a fiveâ€“year stint in the UK, and then returned to Africa.
After spending time in Nairobi and Ngora, Omaswa was called by the government in 1986, as peace took hold and Uganda attempted to build new health systems.
He became professor of surgery, founded the Uganda Heart Institute, and was soon appointed chief surgeon and head of the quality assurance programme in the health ministry, where he worked until 1999. The experience raised Omaswaâ€™s profile and helped lead to his current job, which he has held since 2005.
The GHWA was launched in 2006 to coordinate various international institutionsâ€™ efforts to address the problem and avoid duplication.
â€œThe most important constraint is no longer money, but skilled workers,â€ Omaswa says. â€œIt is being recognised now as a big barrierâ€.
Omaswa is now working to instigate action, in part by the formation of â€œcountry action teamsâ€ that can help assess and manage the health workforce in various countries.
Prof Omaswa vows to fight shortage of health workers