February 29, 2024

Uganda loses 58 doctors, nurses within one year

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KAMPALA

Uganda lost at least 58 doctors and nurses in the last 15 months, some to Covid-19, according to Uganda Medical Association (UMA).

Records of the association, which is the umbrella body for doctors in the country, show that 11 doctors of Ugandan origin died abroad including in the United States, the United Kingdom and India.  Others passed on in South Africa, Eswatini and Nigeria.

Among the dead are 19 consultants or senior consultants and UMA President Dr Richard Idro said last evening that it takes about two decades to train and rise to the top professional rank.

It takes five years of training and one year of internship for one to qualify as a medical officer in Uganda upon which an individual has to work for two years at a general hospital before undertaking a three-year Master’s degree to become a specialist medical officer.

Upon graduate studies, one has to again work for five or seven years to be eligible for appointment as a consultant and senior consultant, respectively, subject to availability of the senior rank slots.

Considering the length of training and experienced amassed, Dr Idro said the loss for Uganda in the deaths of the consultants, most of whom moonlighted as lecturers or mentors, is incalculable.

“We were not able to mourn the people who trained us, our seniors,” he said in reference to restrictions on burial attendance due to Covid-19.

In an earlier interview, the UMA president said many of professionals lost in the past year – some to the pandemic – were highly trained specialists, mentors of demonstrable expertise and teachers of the next generation of star medics.

Notable among the deceased include former Mulago hospital executive director Edward Ddumba, who later worked as director of St Francis Hospital Nsambya, Prof Richard Kanyerezi, co-founder and director of Kampala Hospital and senior consultant psychiatrist, Dr Fred Kigozi, a former director of Butabika Hospital.

Others are senior consultant cardiologist Wilson Nyakoojo, who worked at the Uganda Heart Institute, consultant forensic pathologist Martin Kalyemenya, senior consultant paediatrician Israel Kalyesubula, who was also one of the leading HIV specialists in the country.

The deaths of Ugandan health workers in the past year is almost double the numbers lost the year before, a scenario that Dr Idro described as “scary”.

There are less than 50 consultants and senior consultants in Uganda, according to UMA records, majority concentrated in Kampala.

The country trains about 150 specialists and 500 general doctors a year from nine medical schools, officials said.

On March 12, the medical and health fraternity organised an inter-denominational memorial mass at Sheraton Kampala Hotel to celebrate the lives of health professionals lost to Covid-19 and other diseases in 2020.

Church of Uganda Archbishop Stephen Kaziimba, who was the main celebrant, said health workers sacrifice a lot, including their lives, while serving the country. He urged government to increase their remuneration.

“We see people who are getting a lot of money that they have not worked for. Doctors; the people who are always taking care of us should be paid enough so that they are not tempted to go into the evil of corruption when no one is there to deliver them from it,” the prelate said.

Remuneration

The starting salary for a medical officer in government employment is Shs1.1 million while senior consultants earn Shs7 million, rates that the medical fraternity wants doubled.

“Since 2017, and for the past four years, the government endlessly promised to raise our pay so that an entry level doctor gets at least Shs5 million, but this has remained just words. We hope these words end on June 30 and from July 1 [the start of the new financial year], a new pay structure will be put in place,”  Dr Idro said.

Doctors and nurses have gone on strike multiple times over the past five years over poor pay and working conditions, which officials acknowledge as the reason for flight of health professions abroad.

In an article published in 2013, this newspaper quoted Uganda Medical and Dental Practitioners Council as saying that 2,000 Ugandan doctors had left the country within a decade, with South Sudan that had newly become independent, being the leading destination.

The brain drain remains a teething problem for the health sector, with many clinicians taking up juicy managerial posts, particularly in non-governmental organisation and projects.

The ongoing pandemic has magnified the problem and the deaths of the 58 doctors and other health professionals have made an already bad situation worse, Dr Idro said.

The 58 health workers who have passed on comprise dentists, pharmacists, nurses, doctors, laboratory technologists, a health inspector, psychiatrists and village health team member Eunice Chamadala, who became the first confirmed Covid-19 fatality in Uganda when she died on July 21, 2020.

This was four months after the disease was confirmed in the country. Ministry of Health records show that Coronavirus has claimed 334 lives in the country to-date out of 40,700-plus infections.

Kiboga District health officer Michael Musiitwa and Rakai hospital medical superintendent Yasin Kiyembe are among those who succumbed to Covid-19 at a relatively young age, although they were reputed to have gained significant managerial experience in ways their deaths create a gap in health sector service delivery up-country.

Ms Hadijja Kyakuwa, the mother of Dr Kiyembe, said she knew about her son’s demise only after the neighbours asked her to confirm reports at the time being treated as rumours.

In November 2020, a team from Mulago National Referral Hospital took Kiyembe from his home after he tested positive for Covid-19

“They told both (Rakai) hospital and the world on television, but we [as relatives] did not know anything. That whole process was scary,” Ms Kyakuwa said.

She added: “People were asking me.  They were saying ‘your son passed on, is it true?’ I tried telling them it was not true. I could not just believe it like that. Not until I called my other sons and they called Rakai hospital and they confirmed the rumours.”

The deceased’s relatives have been distressed the same way many families have suffered stigma after their loved ones tested positive for Covid-19.

For Ms Kyakuwa, the problems have not ended and the pain has intensified.

The mother says she spent almost three months chasing for her son’s death certificate from Mulago National Referral Hospital.

She finally got the certificate but has to officiate it from National Identification and Registration Authority.

In a separate interview, the Health Permanent Secretary, Dr Diana Atwine, said the number of health workers dying in the line of duty has increased due to coronavirus.

“Under normal circumstances we do not lose so many health workers. But we cannot sit and watch the services getting affected because of this,” she said.

She said some of the experts who died had already retired from government service, and they will be most missed as great mentors.

Recruitment underway

The PS said arrangements are underway to recruit replacements for some of the health workers who died to ensure “that the services continue without affecting patients”.

To stem the loss of lives, Dr Atwine encouraged health workers and all eligible Ugandans to get Covid-19 jabs in the ongoing immunization that started on March 10.

“The government is making sure that all health workers are vaccinated. There are those that are refusing to get the vaccine, but that is their problem. The option will still be there for them should they change their mind,” she said.

The Oxford-AstraZeneca vaccine being administered in Uganda is to help prevent severe illnesses in the event of contracting Covid-19, but does not prevent catching the disease, according to World Health Organisation (WHO).

Prominent among those that have taken the shot include President Museveni and First Lady Janet, Vice President Edward Ssekandi, First Deputy Prime Minister Moses Ali and Health minister, Dr Ruth Aceng.

The government last month secured 964,000 doses of the Oxford-AstraZeneca vaccines through COVAX, the global facility that WHO created to enable poor countries such as Uganda access the vaccine. India topped up with a donation of 100,000 doses.

Dr Atwine said if more health workers receive the jabs, it is likely not many will again succumb to the pandemic.

“Of course, death is inevitable. They (health workers) may survive COVID and die of other conditions since those conditions have not taken holiday, she said.

“But we will continue to do our preventative measures as we remind the health workers to take extra precautions when handling patients and making sure they take care of themselves and ensure they get the vaccines to stay protected,” she added.

Dr Idro said they jointly organized the March 12 remembrance prayers with other fraternities because Covid-19-related restrictions did not enable them attend or give decent burials to fallen colleagues.

The inter-denominational prayer was organized by UMA, Uganda Dental Association, the Pharmaceutical Society of Uganda, the Nurses and Midwives Union, the Medical Clinical Officers, Allied Health and Association of Laboratory technologies. Families of the departed health workers, government officials and health workers were among those who attended.

Source: Daily Monitor

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