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Uganda’s biggest public health threat is the drain of its medical brains to Trinidad and Tobago.<\/p>\n<\/section>\n
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\"Skeleton <\/a><\/figure>\n
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Since his childhood days in northern Uganda, Geoffrey Orijabo wanted to be a nurse \u201cbecause of the ignorance\u201d. \u201cI saw children and women dying because there were few health workers [and] they were treating me using local herbs,\u201d said Orijabo (34), the first of five children born to peasants in \u201ctotal poverty\u201d in Arua.<\/p>\n

\u201cI said, let me go to medical school, then I\u2019ll come back to save them.\u201d<\/p>\n

After secondary school studies Orijabo put himself though Mbarara University in western Uganda, completed a year-long internship at Mulago National Referral Hospital in Kampala, and practiced at Mbarara public hospital.<\/p>\n

Yet since 2007, the nurse, who specialized in maternal health, an area in which Uganda ranks disastrously, has been \u201cfloating\u201d, unable to find full-time work, a problem faced by thousands of other qualified professionals in the East African nation.<\/p>\n

Uganda has admitted that it is difficult to retain senior medical staff, as there are too few resources. About 42% of health positions remain unfilled in the public sector.<\/p>\n

Now Orijabo believes he has \u201cno choice\u201d but to leave his family for Trinidad and Tobago, a country some 10\u00a0000km away in the Caribbean, under a controversial \u201cexport\u201d plan facilitated by the Ugandan government.<\/p>\n

\u201cIt was a blessing,\u201d said Orijabo about seeing an advertisement last March in Uganda\u2019s pro-government newspaper, New Vision<\/i>, for Ugandan health workers to take up employment in Trinidad, to \u201caccelerate the existing excellent bilateral relations\u201d between the countries.<\/p>\n

Attractive package<\/b>
\n\u201cThere was nothing to think about,\u201d added the medic, who applied immediately for a position, which Uganda\u2019s foreign affairs ministry promised came with an \u201cattractive\u201d salary, a gratuity of 20% of gross earnings, free flights and housing, plus other perks.<\/p>\n

But now Orijabo, whose name is on a shortlist of 283 professionals that includes midwives, anesthetists, radiographers, gynecologists, pediatricians and surgeons among others, may be blocked from upping sticks.<\/p>\n

In what they claim is one of the first public interest litigation cases on medical \u201cbrain drain\u201d, Ugandan think-tank the Institute of Public Policy Research (IPPRU) has taken the government to court.<\/p>\n

It is asking for the final preparations for the \u201cimminent\u201d deployment of their country\u2019s health workers to Trinidad to be halted. The institute says the \u201cexport\u201d would be \u201cfutile\u201d and breaches the constitutional and legal obligations Uganda has to its citizens.<\/p>\n

The institute\u2019s executive director, Justinian Kateera, said they did not have an issue with doctors leaving Uganda of their own accord but \u201cwith government officials effectively withdrawing health services from Ugandans for the benefit of Trinidad and Tobago, knowing thereby that we will die\u201d.<\/p>\n

\u201cIt is different if a government official, whose sole mandate is to protect the citizen\u2019s interests, decides to undermine their health by diverting resources to Trinidad, which has 10 times as many doctors,\u201d he told the Mail & Guardian<\/i>. Based on World Health Organization figures, Trinidad\u2019s doctor-to-patient ratio is 12 times better than that of Uganda.<\/p>\n

\u201cThe teachers that have gone to South Sudan or Rwanda or wherever have gone privately,\u201d added Kateera. \u201cIt\u2019s an odd thing to do that. No one has ever done it before.\u201d He said the biggest public threat to Africa was a \u201cvery weak health system\u201d without human resources to deliver life-saving drugs.<\/p>\n

The recent Ebola outbreak in West Africa, a region also plagued by a shortage of medical professionals, was the greatest example of the danger of a health system without \u201cthe human resource that diagnoses, prescribes, performs surgeries and monitors progress\u201d, said Kateera.<\/p>\n

Then there is the lost \u201cinvestment\u201d of locally educated doctors who leave for developed countries. A 2011 British Medical Journal<\/i> report by Canadian health experts on doctors migrating from sub-Saharan Africa to Australia, Canada, the United Kingdom and the United States found South Africa suffered the worst from this economically.<\/p>\n

Setting a precedent<\/b>
\n\u201cThis case is very important in setting a precedent on the medical brain drain, whether it\u2019s in Malawi, South Africa, Ghana, Zambia, Zimbabwe, India, the Philippines or the Caribbean,\u201d said Kateera, ahead of an injunction ruling scheduled for March 2 in Uganda\u2019s high court in Kampala.<\/p>\n

\u201cWe want this to be the starting point at which we have a broader discussion on how to stem medical brain drains and reform healthcare.\u201d<\/p>\n

As he waits to see whether he will be able to go to Trinidad, Orijabo admitted he would \u201cdefinitely prefer\u201d to stay at home with his wife and two children, aged three years and six months.<\/p>\n

Orijabo doesn\u2019t know of any \u201cdirect benefit\u201d the Ugandan government will gain from the \u201cexport\u201d, although activists opposing it have claimed those shortlisted, some of them not even qualified health workers, have paid money to various officials. Orijabo said he has \u201cnot paid anything to anyone\u201d. Uganda\u2019s ministry of foreign affairs is adamant the process has been \u201ctransparent and fair\u201d.<\/p>\n

IPPRU points out there is no bilateral arrangement between Uganda and Trinidad, although the latter has vowed to train Ugandans in oil and gas and reportedly gave Uganda\u2019s police force money. According to a September 2014 news story from Uganda, Trinidad has trained 103 Ugandan students and 11 instructors in oil and gas technology. In December 2014 it was reported that the Ugandan police force got 27-million shillings from Trinidad. The Ugandan government did not comment.<\/p>\n

According to the advert by Uganda\u2019s ministry of foreign affairs, the \u201cexport\u201d deal between Trinidad and Uganda will also \u201cstrengthen\u201d Trinidad\u2019s health services sector.<\/p>\n

A big issue in re-election<\/b>
\nAs Ugandan President Yoweri Museveni campaigns for re-election in 2016, health will be a big issue, according to research by Columbia University and the Coalition to Stop Maternal Mortality in Uganda, which last year found a quarter of voters believe it is the top national priority.<\/p>\n

\u201cRather than helping Trinidad poach Uganda\u2019s health workers, Museveni\u2019s government should be delivering on its campaign pledges to increase the number of health workers in the public sector and increase workers\u2019 salaries, so they stay in Uganda and are motivated to work for the people,\u201d said Asia Russell, executive director of Aids advocacy organization Health Global Access Project.<\/p>\n

\u201cThese problems are fixable but only if government considers an epidemic of preventable Ugandan deaths a political priority.\u201d<\/p>\n

Orijabo isn\u2019t upset about the legal challenge but insists the activists are not addressing the real problem. \u201cHealth workers are not recruited and kept in the health facilities,\u201d he said. The nurse said whether he goes to the Caribbean or another African country, he was determined to find a better opportunity so he could support his family from outside Uganda.<\/p>\n

\u201cSudan \u2026 Congo, there is Rwanda,\u201d he said. \u201cThe next time you come to [talk to] me, I may be leaving for Sudan. The issue is poverty. I am not getting money to help my people. Staying near my family when they\u2019re hungry is more stressful than me going away.\u201d<\/p>\n

27.02.2015 M&G Amy Fallon<\/p>\n

 <\/p>\n<\/div>\n<\/section>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Uganda’s biggest public health threat is the drain of its medical brains to Trinidad and Tobago. Since his childhood days in northern Uganda, Geoffrey Orijabo wanted to be a nurse \u201cbecause of the ignorance\u201d. \u201cI saw children and women dying…<\/span><\/p>\n

Read more ›<\/a><\/div>\n

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