Doing It For Themselves: Social Entrepenuers in Uganda
J Silver | 22.07.2003 12:28 | Globalisation | Health | Social Struggles
IMF and World Bank restructuring was suppose to pull Uganda into the globalised world, but the rollback of healthcare and education has hit the country hard. With increasing health problems in the country, the government run hospitals and clinics cannot always treat the poorest or those most in need. In response to this has been a surge in social entrepenuerialim in Uganda society from people not prepared to let international institutions dictate their peoples health.
Another torrential rainstorm lashes the plantations of eastern Uganda as the wet season picks up momentum. Dr Sydney has worked a shift stretching back days. As the chief clinical officer at the Shared Blessings health centre he is responsible for the treatment of malaria patients in the area. With the annual, wet season related surge in malaria cases, the doctor knows full well the importance the health centre plays to the well being of the local population.
Here at this privately run health centre, Doctor Sydney is in the frontline in the battle to help the rural poor from a constant stream of treatable but often-deadly disease.
Later the same day as the sky clears to reveal the intensity of the African sun, medical staff at the regions main hospital in Mbale town toil to treat the uncountable number of children on the wards. Years of under-funding in the health sector have paralysed the central hospital, leaving them without even basic equipment to fight the ravages of the wet season. The constant stream of patient’s relatives to the pharmacy testament to the empty supply rooms in the hospital. The heat becomes more oppressive as mothers push past the crowds wailing in grief. As nervous group look on a young doctor desperately tries to resuscitate a limp child. With a syringe nowhere to be found the weakened child stands little chance against the onslaught of malaria. A lack of ‘O’ type blood is worrying the consultant. Hushed workers in the blood bank wait anxiously for news of the day’s blood collecting in local schools. As the hospital struggles to cope with the constant suffering, the cracks in Uganda’s healthcare system are shamelessly obvious.
The global financial institutions of the World Bank and International Monetary Fund hold up Uganda as a model African economy. Strict adherence to liberalisation of national markets and the roll back of welfare budgets seemed to be fuelling a boom, with a growth rate of over seven per cent annually. The price of crumbling hospitals coupled with an underpaid and under motivated medical staff for a healthy economy might have seemed an acceptable trade of in the past. Fast forward a few years to a health care system that struggles to keep afloat and a slowing economy and its no wonder even President Museveni has openly criticised the World Bank’s policies.
The influence of the World Bank and the IMF in tightening the health budget has brought many Ugandans to their knees. Unable to afford the cost of even basic treatment in the hospitals it is the poorest in Ugandan society that are directly affected by the policies of these institutions. However the chronic under funding, widespread corruption and unfairness in the health system have brought a fierce response from a certain breed of social entrepreneurs in Uganda. This is not so much a new reaction to the problems facing the rural poor but something deeply engrained in the culture of Ugandans. These are a people determined to fill the void left by the government and its backers. Perhaps the best known of these interventions came with the establishment of TASO (the Aids Support Organisation). Set up independently, in 1987, by Mrs Noerine Kaleeba, the wife of a prominent sufferer, it is now acknowledged as a world leader in HIV/Aids support and care. TASO services include: HIV prevention education counselling and support activities; basic medical care for opportunistic infections, sexually transmitted infections, and skills training for income generating activities. With President Bush prepared to spend billions of dollars to battle HIV/Aids, it is an organisation run independently of government, established not by a foreign aid organisation but by the bloodymindesses of its founders, that is being held up as the plan to cure Africa’s woes.
It is not just headline grabbing organisations such as TASO that are breathing life into Uganda’s decrepit health system. Husband and wife, Wilber and Elizabeth Madaba, comfortably based in the capital Kampala, returned to their home village in Sironko district after many years, and what they term ‘a call from the bush’ to confront the tragic system that had left many of their neighbour’s children dying from preventable disease. Operating outside the confines of government bureaucracy but often resented by local officials, Wilber and Elizabeth were able to introduce and tailor services that make a real impact on the communities’ welfare, rather than relying on a hospital 40 minutes drive away. The health centre operates as a base for immunisation and outreach work focusing on prevention rather than cure. The vaccination of over 10,000 children and continued health and family planning education has immeasurably improved the lives of surrounding villages. However it is on the wards of the Shared Blessings that the difference with government run operations comes to the fore. With hard won foreign and local subsidies on the drugs the 60 percent of villagers unable to afford treatment are not turned away but welcomed into a loving and efficient environment. The treatment-for-all focus of Shared Blessings has brought patients from all over the district and even further field who often bypass government health units to be treated by Dr Sydney..
The work of Shared Blessings has not gone unnoticed in Mbale hospital. In a staff room away from the trauma of the wards, doctors lay exhausted but wide-eyed with the adrenaline of their previous shift. “The importance of primary health care facilities is vital if we are going to successfully beat the scourge of malaria,” suggests a junior doctor. “We simply cannot cope with the huge numbers of patients we receive daily and that doesn’t include the people too poor to afford basic treatment. Without units like the Shared Blessings people would be in big trouble especially those in the villagers away from us”.
The success of both NGO’s can be attributed to their willingness to confront injustice in Uganda’s health provision. A government that is constrained in its health spending by donors and corrupted by a wedge of resentful and on-the-make employees is forced to watch on as TASO and the Shared Blessings show health officials how to tackle the countries desperate health plight, in a confident and respect-making manner. It is this group of social entrepreneurs that will shape Uganda’s future, not the economists in the World Bank or the high ranking officials in the health sector. With the help of international funding these organisations will continue to grow and hopefully one day provide the model to combat rural Africa’s desperate health needs. Back in Sironko and Dr Sydney smiles at a child he has just given a blood transfusion to, “Before our health centre was built that child would not have survived, now she’ll make a full recovery”.
Here at this privately run health centre, Doctor Sydney is in the frontline in the battle to help the rural poor from a constant stream of treatable but often-deadly disease.
Later the same day as the sky clears to reveal the intensity of the African sun, medical staff at the regions main hospital in Mbale town toil to treat the uncountable number of children on the wards. Years of under-funding in the health sector have paralysed the central hospital, leaving them without even basic equipment to fight the ravages of the wet season. The constant stream of patient’s relatives to the pharmacy testament to the empty supply rooms in the hospital. The heat becomes more oppressive as mothers push past the crowds wailing in grief. As nervous group look on a young doctor desperately tries to resuscitate a limp child. With a syringe nowhere to be found the weakened child stands little chance against the onslaught of malaria. A lack of ‘O’ type blood is worrying the consultant. Hushed workers in the blood bank wait anxiously for news of the day’s blood collecting in local schools. As the hospital struggles to cope with the constant suffering, the cracks in Uganda’s healthcare system are shamelessly obvious.
The global financial institutions of the World Bank and International Monetary Fund hold up Uganda as a model African economy. Strict adherence to liberalisation of national markets and the roll back of welfare budgets seemed to be fuelling a boom, with a growth rate of over seven per cent annually. The price of crumbling hospitals coupled with an underpaid and under motivated medical staff for a healthy economy might have seemed an acceptable trade of in the past. Fast forward a few years to a health care system that struggles to keep afloat and a slowing economy and its no wonder even President Museveni has openly criticised the World Bank’s policies.
The influence of the World Bank and the IMF in tightening the health budget has brought many Ugandans to their knees. Unable to afford the cost of even basic treatment in the hospitals it is the poorest in Ugandan society that are directly affected by the policies of these institutions. However the chronic under funding, widespread corruption and unfairness in the health system have brought a fierce response from a certain breed of social entrepreneurs in Uganda. This is not so much a new reaction to the problems facing the rural poor but something deeply engrained in the culture of Ugandans. These are a people determined to fill the void left by the government and its backers. Perhaps the best known of these interventions came with the establishment of TASO (the Aids Support Organisation). Set up independently, in 1987, by Mrs Noerine Kaleeba, the wife of a prominent sufferer, it is now acknowledged as a world leader in HIV/Aids support and care. TASO services include: HIV prevention education counselling and support activities; basic medical care for opportunistic infections, sexually transmitted infections, and skills training for income generating activities. With President Bush prepared to spend billions of dollars to battle HIV/Aids, it is an organisation run independently of government, established not by a foreign aid organisation but by the bloodymindesses of its founders, that is being held up as the plan to cure Africa’s woes.
It is not just headline grabbing organisations such as TASO that are breathing life into Uganda’s decrepit health system. Husband and wife, Wilber and Elizabeth Madaba, comfortably based in the capital Kampala, returned to their home village in Sironko district after many years, and what they term ‘a call from the bush’ to confront the tragic system that had left many of their neighbour’s children dying from preventable disease. Operating outside the confines of government bureaucracy but often resented by local officials, Wilber and Elizabeth were able to introduce and tailor services that make a real impact on the communities’ welfare, rather than relying on a hospital 40 minutes drive away. The health centre operates as a base for immunisation and outreach work focusing on prevention rather than cure. The vaccination of over 10,000 children and continued health and family planning education has immeasurably improved the lives of surrounding villages. However it is on the wards of the Shared Blessings that the difference with government run operations comes to the fore. With hard won foreign and local subsidies on the drugs the 60 percent of villagers unable to afford treatment are not turned away but welcomed into a loving and efficient environment. The treatment-for-all focus of Shared Blessings has brought patients from all over the district and even further field who often bypass government health units to be treated by Dr Sydney..
The work of Shared Blessings has not gone unnoticed in Mbale hospital. In a staff room away from the trauma of the wards, doctors lay exhausted but wide-eyed with the adrenaline of their previous shift. “The importance of primary health care facilities is vital if we are going to successfully beat the scourge of malaria,” suggests a junior doctor. “We simply cannot cope with the huge numbers of patients we receive daily and that doesn’t include the people too poor to afford basic treatment. Without units like the Shared Blessings people would be in big trouble especially those in the villagers away from us”.
The success of both NGO’s can be attributed to their willingness to confront injustice in Uganda’s health provision. A government that is constrained in its health spending by donors and corrupted by a wedge of resentful and on-the-make employees is forced to watch on as TASO and the Shared Blessings show health officials how to tackle the countries desperate health plight, in a confident and respect-making manner. It is this group of social entrepreneurs that will shape Uganda’s future, not the economists in the World Bank or the high ranking officials in the health sector. With the help of international funding these organisations will continue to grow and hopefully one day provide the model to combat rural Africa’s desperate health needs. Back in Sironko and Dr Sydney smiles at a child he has just given a blood transfusion to, “Before our health centre was built that child would not have survived, now she’ll make a full recovery”.
J Silver
e-mail:
jonathan.silver@talk21.com