From: Richard Mangwi

Dear Colleagues, Dear Readers,
One article in last week’s letter draws my attention: The daily monitor-regarding the theme for this years AU summit in Uganda. “Maternal Mortality”. I have a very divergent view about the actual contributors to a high maternal mortality specifically in Uganda. I may not be very familiar with what goes on in other countries.The commom reasons advanced is few health workers, inadeqaute facilties. I have been a frontline worker in the most difficult places in my country Uganda, and my personal experiences inform me otherwise: The number of health workerss per se in Uganda is not necessarily a cause for alarm; the number of health infrastructures is not a major issue either; equipments is not a problem. Even the direct finances for healthcare delivery (excluding salaries and wages) could still do better.The number one problem for me is Health workers pay! Visa-vi the ordinary cost of living in Uganda. The pay of any ordinary health worker in Uganda is not adequate to feed him/her the family for a few days; cloth them; shelter them; pay for decent education; and participate in the most basic social interactions. The taxes we pay are exhorbitant. What do health workers resort to? Alternative sources of additional finances to complement their welbeing: the easiest is to take away what belongs to the public; stay digging in the gardens, sell other commodities; smuggling; or simply resign and stay away frustrated. That explains why every second shop in the cities and rural centres is a drug shop, clinic, pharmacy etc; absenteeism is rampant; agressive and abusive health workers etc Every human being needs shelter, food, education-very basic-this is very difficult to come by. One thing-meaningful engagement-pay well-enough to find a decent accomodation, a decent education for the children, a decent meal. The system in Uganda will blossom overnight! Richard Mangwi Ayiasi.

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