Uganda suffers as doctors go abroad By Carolyne Nakazibwe WEEKLY OBSERVER As Uganda strives to keep its record near the top in Africas health service delivery, persistent brain drain threatens to shut a good system down. According to the Director General of Health Services, Prof. Francis Omaswa, Uganda loses 30% of the doctors it trains every year to other countries.
He said in a telephone interview that Makerere University produces 100 medical doctors a year, while Mbarara produces 50. Prof. Omaswa Of the 150, fifty get certificates of good standing from the Uganda Medical and Dental Practitioners Association, which are needed before a doctor can leave the country to study or work abroad. Omaswa said this has created labour shortages in the system when doctors are most needed. The Ministry of Health has for the last few years been pushing to implement its health service strategic plan, which includes building health centres up to sub-county level. But the doctor: patient ratio remains disturbing at 1: 18,000 (2002 estimates). While this is an improvement from the 1:23,000 in 1986, it is still way off the recommended ideal of 1:2,500 for poorer countries. A country such as Cuba, on the other hand, has one doctor for every 200 patients, which is better than Western Europes average of 1:300. For Uganda, it means the country has just about 1,400 doctors in active service instead of the ideal 10,000. Scaled down of specialists, the situation is even grimmer. Uganda for example has only one neurosurgeon serving the entire public health service. There is a big shortage of doctors. Posts at Health Centre IVs cannot be filled. We need specialists, high level doctors and there are many vacant posts at consultant and senior consultant level, Omaswa said. And now with the scale up of anti-retroviral drugs, we need doctors. Nurses are also leaving. It is a big problem. In February, the ministry using Global Fund for HIV, TB and Malaria money, started giving out free AIDS drugs at hundreds of health centres, but this is a process that requires a patient to be under proper supervision to monitor CD4 count and adherence. One of the factors cited for this brain drain has been the poor pay of health workers in Uganda. Analysts have reasoned that Ugandas priorities are still skewed, with a medical doctor (consultant level) earning Shs 1.3 million a month. A graduate of human medicine and surgery earns much less than this, pushing many ambitious professionals out of the country for greener pastures. Omaswa said some leave for further studies, which still creates a gap. The BBC recently reported that the Commission for Africa is calling for an extra one million health workers to be trained in Africa by 2015. The commission also wants the worlds richest nations to provide $7 billion to develop Africas health infrastructure. But this has raised questions about who benefits more from doctors trained in Africa. Africa or the donors? In Uganda, it costs Shs 9.6 million to train one medical doctor at Makerere University for five years. According to this years admissions, 81 freshmen will be studying medicine and surgery come October, while 8 will go for dental surgery. That means, Shs 855 million will be spent on just one lot, if they are all to complete the course. If thirty percent of this lot ends up working in developed nations instead of beefing up the health system here, the country will virtually have wasted Shs 279 million. Currently, African health systems are in the grip of a brain drain; in Zimbabwe, three-quarters of all doctors emigrate within a few years of completing medical school. The number of doctors trained in Ghana but now registered in the UK has more than doubled between 1999 and 2004, the BBC reported. The challenge now is upon the government to make practising medicine in Uganda more lucrative. [EMAIL PROTECTED] \\\\\\\"Always be a first rate version of yourself instead of a second rate version of someone else.\\\\\\\\\\\\\" Njoki Paul University of Pretoria _______________________________________________ Ugandanet mailing list [email protected] http://kym.net/mailman/listinfo/ugandanet % UGANDANET is generously hosted by INFOCOM http://www.infocom.co.ug/
