Media report that the government is to double the salaries of doctors is a positive response to the demand that has taken years. Previously, we had between 10 and 20 per cent increments after strikes by health workers. Therefore, the doubling of doctors’ pay should be the beginning of a wider response in the quest for effective healthcare services.
However, there is need to look beyond the salaries as some factors may still hinder effective service delivery. I have visited some health facilities in Kamwenge District where a health centre IV is the main health facility. Rukunyu Health Centre IV did not have a functional theatre until recently, courtesy of funding by PEPFAR. As a partner, PEPFAR operationalised the theatre by providing equipment. It also supports health workers in the district.
However, the health facility still lacks electricity despite the fact that the power lines cross the compound of the facility. Whatever salary doctors will be paid, a health facility such as Rukunyu, which lacks power, will still struggle to offer effective services. Without electricity, it is not possible to use the ultra sound machines used to ascertain the condition of the baby in the womb. Yet such investigation is necessary for a doctor to make critical decisions regarding the lives of the mother and the unborn baby. Even children born premature cannot receive adequate care because the incubators cannot work.
Refrigerators for storing essential medicines will not be operational hence medicines will rot and sterilizing theatre equipment, a must-do, cannot happen. We have heard stories of health workers improvising lamps or mobile phone to provide light in labour wards as they help mothers to deliver. But such a situation is neither desirable nor sustainable. Fears that the power bills may be high for the health facility to afford cannot be reason enough for not connecting power to it.
However, the bills may not compare with the amount of fuel for ambulance and associated costs that may be required to transport a mother to Ibanda or Fort Portal for emergencies. Beyond, the salaries, urgent steps must be taken to address some of these issues as they have a direct bearing on service delivery.
Even a well-remunerated health worker at a facility that lacks the necessary tools, theatre, gloves, medicines, etc, may find themselves unable to offer effective services.
Paul Mayende Nicodemus, firstname.lastname@example.org