Humanist

“What are the funding gaps in the healthcare sector since the withdrawal of USAID assistance?” was among the five major questions discussed on Saturday, 29th March 2025, on Capital Gang, a highly listened to political radio talk show on 91.3 Capital FM.

Listening in, I was saddened by the generic-sound-bite type of politicking statements that were especially made by the three Members of Parliament on the Gang, throughout the debate on funding gaps in our public healthcare.

I was shocked that none of them took responsibility on behalf of Parliament. To own up that even before the cancellation of USAID our public healthcare was grossly underfunded and was not prioritized by Parliament.

None of them shared an understanding of the total funding to public healthcare; the proportion of the budget that was being funded by USAID; and what they, as Parliament, are doing about it to re-allocate funds to fill the gap.

I have continued to be bothered by how the Capital Gang made it appear as though all has been well before; and we are now dealing with a new challenge of funding gaps in our public healthcare services, because of USAID cancellation. Far from the reality.

Photo @ Daily Monitor – Opio, a nodding disease patient.

To contextualize, at the height of the nodding disease scourge, I reminded our politicians and public servants that Uganda is people and not those vague indicators, such as Gross Domestic Product, that are full in their speeches, as the measure of success.

Even then, under funding of healthcare services provision was the norm. “Ferrying nodding patients to Mulago was uncalled for: WHO (World Health Organisation),” was the title of a story published in Daily Monitor.

As a I read the story, I wondered:

• Did the Daily Monitor make a mistake, was Opio really 15 years old?
• If the Daily Monitor was right, did the nodding disease so emaciate Opio, to the extent that he looked like a boy who was hardly 10 years old?
• Is this what the nodding disease does to those it afflicts?
• Did the nodding disease find Opio already ailing?
• Is it plausible Opio might have been afflicted by other diseases related to malnutrition, which were presenting similar to nodding disease symptoms?

Many questions abound. Why did those who ferried nodding disease patients from Kitgum to Mulago, subject them to a six hour drive, for a distance of approximately 440 kilometers?

There were 42 health facilities in the wider Kitgum area, of which one was a government hospital and 32 were government owned health centers, according to Uganda Bureau of Statistics (UBOS).

Why did those who ferried the patients decide that none of the hospitals in the wider Kitgum area were sufficient to managed nodding disease? If they were right and the Kitgum hospitals were insufficient in capacity, why is it the case?

Using Kitgum’s life expectancy rate at the time, which according to UBOS, was only 29 years, it is plausible to conclude prevalence of insufficient healthcare services provision in the district.

Kitgum’s low life expectancy and the seeming stunted growth of its children, such as Opio’s, is indicative of poor access to healthcare services. A symptom of our failure, as a nation, to ensure that our people stay healthy and alive.

Judging from Opio’s size at 15 years old, his access to food during his formative years was insufficient. Opio’s condition and others afflicted as he was, is an indicator that Uganda is malfunctioning.

Sadly this was the status quo in Uganda in 2014 and is still the case over 10 years later in 2025. Hundreds of mothers and children die every day from ailments that are not ordinarily deadly if the requisite health services were accessible to them.

In 2014, nearly 500/1,000 births ended with a mother dying at birth, from manageable complications such as bleeding to death.

Uganda’s national health policy whose intention is to reduce poverty through promoting people’s health, certainly seemed then to have be gathering dust on some shelf somewhere. And from the debate on the Capital Gang, it still is.

A version of this post, was first published on 19th September 2014.