Search
Close this search box.

Uganda needs 3,000 surgeons

By Francis Kagolo

http://www.newvision.co.ug/news/631729-uganda-needs-3-000-surgeons.html

The high rate of brain drain is continuing to wound Uganda’s health sector with fresh revelations indicating the country is short of over 3,300 surgeons.

An expert said many people who would have survived treatable surgical conditions like cataract blindness, hernia, clubfoot and injuries end up dying due to inadequacy of surgeons in the country.

“Every year, Makerere University, other institutions and hospitals pass out surgeons. But due to low pay, many quit the country for greener pastures abroad,” said Dr. Edward Naddumba, the secretary general of the College of Surgeons of East, Central and Southern Africa (COSECSA).

“Currently we are less than 100 specialist surgeons for 34 million people. This means one surgeon for every 340,000 people.”

Other potentially productive people become disabled and destitute because of treatable surgical conditions, he said.

Naddumba made the remarks while briefing New Vision online on COSECSA’s efforts to improve the numbers and working conditions of surgeons in sub-Saharan Africa.

The efforts include offering specialized postgraduate surgical training at major hospitals like Mulago, Nsambya and Masaka.

The college passed out four graduates at its first graduation ceremony in 2004. About 113 trainee surgeons are to sit the COSECSA exams this year, 51 of whom are in their final year.

The college charges $1700 (about sh4.2m) as entry, examinations and graduation fees.

His revelations come amidst a public outcry over the underfunding of the health sector.

A report by Makerere University Medical School two years ago revealed that health spending in Uganda covers about a third of what the country needs to meet its minimum healthcare package.

It said Uganda spends only $14 per-capita on health. Of this, $9 is out-of-pocket and $5 from public sector (government and donor funding).

Today, less than 100 specialist surgeons available for 34 million Ugandans.

Yet, as the country’s health system remains in a coma, the Government still spends at least $150m (about sh368b) annually treating top government officials abroad.

This amount is nearly half of the combined budgets of health and education ministries.

Makerere’s development expert Prof. Augustus Nuwagaba recently argued that Uganda’s problem is not lack of medical practitioners but poor remuneration.

“Almost half of the 40,000 Ugandan professionals in North America are health personnel, which means our problem is not the human resource,” he said.

Health workers tip government on safe abortion

By FLAVIA LANYERO

Medical practitioners have urged government to relax restrictions on abortion and make reproductive health services available to the youth, if abortion is to be managed in the country.

The health workers during a national conference on safe abortion last week said most foetal terminations are as a result of unwanted pregnancies yet little guidance is offered, especially to young women in schools. The young women always end up in desperate measures to get rid of the pregnancies.

Strict law
Currently, the Ugandan law does not permit abortion except when the mother’s life is in danger and neither are medics facilitated to educate young girls about reproductive health issues and rights.

This is in addition to government ratifying several international treaties, conventions and agreements including the 1995 Beijing Platform for Action that recognises that abortion should be safe and available to the full extent of the law.

“Restrictive laws do not prevent abortions. New technologies like the vacuum aspiration and Medical Abortion bring safe abortion care closer to women and governments need to honour their obligations to protect, promote and fulfil human rights,” said Dr E. Brookman-Amissah, the vice president for Ipas Africa, one of the leading organisations in reducing maternal health in the continent.

Abortions
In Uganda, World Health Organisation estimates that 300,000 women carry out unsafe abortions every year, many of whom risking their lives and leading to complications including death. However, even safe methods of abortion in the early months of a pregnancy are not readily available and are quite often expensive.

Avail drugs
Dr Charles Kiggundu, a gynecologist and obstetrician with Mulago Hospital, said threatening girls from abortion does not solve anything as they are usually determined to get rid of an unwanted pregnancy and urged government to make available drugs like Misoprostol for safe abortions.

The Commissioner for the Reproductive Health at the Ministry of Health, Mr Anthony Mbonye, said unsafe abortion still remains a challenge which will require a multi-faceted approach to address. He urged, especially parliamentarians, to increase funding for the health sector in order to tackle such issues.

flanyero@ug.nationmedia.com

Source: http://www.monitor.co.ug/News/National/-/688334/1425602/-/agpb1tz/-/index.html

Ugandan Activists Pressure Government to Reduce Maternal Deaths

By Andrew Green

KAMPALA – Uganda’s health activists are demanding an increase in skilled medical workers to save the lives of the country’s mothers. An advocacy coalition has kept national attention focused on the issue for more than a year. But, as 16 women continue to die every day from complications giving birth, activists have yet to realize any new funding for health workers.

Tragic case recalled

Jennifer Anguko bled to death in a government hospital in October 2010, waiting to deliver her child. As her husband, Valente Inziku, begged health workers for attention, he says his wife told him she was dying and then lost consciousness. By the time Inziku convinced someone to help, it was too late. Their unborn child died as well. More than a year later, Inziku says he is still struggling to raise their older three children alone.

“How am I going to bring up the children? That’s now the question I’m asking myself,” Inziku wondered.

Calls for change

Anguko’s death became one of the rallying points for a coalition of Ugandan health activists to reduce maternal mortality. Uganda has seen maternal death rates almost cut in half in the past 20 years, but it remains one of the most dangerous countries in the world to give birth. The United Nations Population Fund says Uganda registers 310 maternal deaths per 100,000 live births.

Activists argue the majority of maternal deaths could be prevented with more health workers and consistent access to medical supplies.

Uganda has 2,500 government health centers, but nearly 50 percent of the positions are unfilled. That means at least one out of every two pregnant women has no skilled medical person to help them give birth. The U.N. Population Fund says at least 2,000 more midwives are needed to address the situation.

Without more midwives and nurses in the system, Rukia Nansubuga, a grassroots organizer in Kampala, says expectant mothers will continue to suffer and die, so they will not even go to medical centers.

“They fear to go to health centers, because the health centers are not well-facilitated. The health workers are not well-facilitated,”Nansubuga said. “The ones who go there are neglected.”

Civil society groups joined forces a year ago to more effectively pressure the government. Robina Biteyi is the national coordinator of the White Ribbon Alliance. “This is a very good development, because we have all worked on maternal and newborn health, but separately,” she noted. “We felt we needed to come together and make sure we have more strength in demanding for accountability for maternal, newborn and child health.”

The coalition took the unusual step last year of suing the government in constitutional court, arguing that women’s right to life was undermined by health worker shortages and a lack of supplies. They also initiated an international resolution calling for governments to prioritize safe motherhood, which was passed in April at a meeting in Kampala.

Setbacks

Although the efforts have raised the profile of the maternal mortality crisis, they have not yet resulted in a concrete victory. In early June, the constitutional court threw out the case against the government, saying it was a political issue.

Sylveria Alwoch, of the Uganda National Health Consumers Organization, says the decision was a setback, but it will not undermine the coalition’s larger efforts.

“We are still there and we are going to continue advocating. Advocacy doesn’t end in one day,” said Alwoch. “And, when you get disappointed, it doesn’t mean you go and cover your head and stop there.”

Despite the court setback and the Ministry of Health’s announcement that there would be no new funding for health workers this year, the groups are continuing to lobby the government ahead of the release of the budget this month, hoping money will be reallocated for hiring.

Source: http://www.voanews.com/content/ugandan-activists-pressure-government-to-reduce-maternal-death/1205834.html

Activists hold a peaceful march in the capital Kampla to protest the delay by a Ugandan court to deliver a ruling in a landmark lawsuit regarding the cases of two women who unattended bled to death during childbirth

Dark days befall health Rights advocates in Uganda

On Tuesday 5th  June, 2012, Health rights activists filled the constitutional court to get news of a declaration they had sought from Court to interpret Acts and Omissions done by government health workers in Public health facilities as a violation of their rights to life and health respectively.

Their bid to secure a declaration against violation of reproductive health rights was frustrated as it dawned on them that court could not listen to their grievances as it called them “political questions” which should be left to the Executive and the legislature.

“This Court has no power to determine or enforce its jurisdiction on matters that require analysis of the health sector government policies, make a review of some and let on, their implementation. If this court determines the issues raised in the petition it will be substituting its discretion for that of the Executive granted to it by law.” the Judgement reads.

Angry activists walk out of court
Every opinion outside court was freely expressed
Every opinion outside court was freely expressed

Advocates Reject Constitutional Court’s Ruling that it has no Competence to Address the Crisis of Preventable Maternal Mortality in Uganda: Appeal to Supreme Court Planned

(June 5 2012) Advocates have sharply criticised the ruling by Constitutional Court on whether or not the Court has standing to hear Petition Number 16 of 2011, a landmark case on preventable maternal mortality, the rights of women, the right to health and the right to life.

Justices ruled that the case, Petition Number 16 of 2011, must be dismissed, they believe that they have no competency to hear a case regarding realization and protection of these human rights.

“We are deeply disappointed that Constitutional Court has ruled that it has no standing to address a life and death issue affecting all Ugandans. We feel this is a grave mistake,” said Nakibuuka Noor Musisi of CEHURD and the Coalition to Stop Maternal Mortality. “This ruling means the Court wants the status quo to continue. They are standing in the way of constructive solutions to a crisis.”

“We did not receive the ruling we sought today. However, we are confident that in the near future, the Judiciary will realize its role in addressing the crisis of preventable maternal mortality in this country. We will not be deterred,” said Lillian Mworeko of the International Community of Women Living with HIV/AIDS East Africa. The advocates called for an appeal of the ruling to the Supreme Court. The ruling was in response to a preliminary objection raised by government on 26th October 2011.

The Petition was filed on 3rd March 2011, highlighting the cases of Sylvia Nalubowa and Jennifer Anguko, both of whom died unnecessarily in childbirth. It seeks a declaration that non-provision of essential maternal health commodities and services in government health facilities leading to the death of expectant mothers is an infringement on their rights to life and health.

While this case has delayed, many more preventable maternal deaths continue unchecked—Cecilia Nambozo, Nanteza Irene, Sanyu Kassaga and Sarah Nalukwago and many more. These people died as a result of failed maternal health care system in Uganda.
80% of maternal deaths are caused by severe bleeding, infections, unsafe abortion, high blood pressure and obstructed labor. Lack of access to life-saving HIV treatment is another major contributor to maternal deaths—and results in high rates of mother to child transmission of HIV.

In Uganda, untreated HIV contributes to about one in four maternal deaths—and triple-combination HIV treatment for all pregnant women would substantially reduce maternal mortality (See: Trends in Maternal Mortality, 1990-2008. WHO, UNICEF, UNFPA and the World Bank. 2010). Petition Number 16 of 2011 argues if the government does not provide essential medical commodities and health services to pregnant mothers, it is a violation of the Constitutional rights of Ugandans, including the right to health, and the rights of women.