2 BMM 41st Edition- DECEMBER, 2019 Editorial content

UNFORTUNATE: Health has been particularly vulnerable and the recently approved guarantee of loans of up to US$379 million to build a specialised hospital in Lubowa stinks most, critics have said.

FROM PAGE 1> Reigniting the crusade to end theꢀ of public funds and impunity! This 41st edition of the Black Monday newsletter focuses can imagine. Our analysis shows that over the past 34 years, Uganda has lost close to 30 tril- on the plight of the health lion in theft. sector in Uganda, and teases Against this backdrop, we have found it pru- out the different challenges dent to relaunch the Black Monday campaign facing the sector which need as our contribution to the anti corruption to be urgently dealt with to struggle. The Black Monday Campaign seeks to mobilize citizens to mount a sustained assault give a clean health bill to against the injustice of theft of public funds. Ugandans. We hope you enjoy The ultimate result is to see that integrity in reading it. Black Monday is public life is restored through a citizen-led pro- a campaign that focuses on cess that rejects theft of public money. In this protesting the of public new phase, we are going to have a dual strategy. First is work towards a Public Private Partner- funds with impunity and ship including key government agencies, civil promoting integrity. society, and the private sector. We shall also have purely citizen focused engagements to inspire citizens to reject corrupt political and gandans continue to struggle with public officials. We are also aware that even an ailing public service delivery in the civil society sector, there are stories of BUKEDEA DISTRICT. Residents of Bukedea airing their concerns about the worrying conditions at the score card, yet day in day out we are corruption and abuse of donor funding. Aware Various hospitals in the District. bombarded with news of increasing that citizen organizations receive this money thefUt of tax payers money. Ugandans continue on behalf of Ugandans, we commit to launch an citizens to take are restated below: working honestly to wallow in poverty, while a few privileged expose on such corruption, and push for cor- • Wear black clothes every Monday as a sign • Demand political action from the State individuals benefit from their plight. The re- rective action by the relevant actors. We will of your resolve against theft of public funds against public money thieves cent rumors that some 90 billion shillings was continue with publication of our monthly news- and shun corruption at a personal level • Speak to at least 5 Ugandans about dangers printed by some individuals in collusion with letter to give citizens well analyzed information • Isolate all public money thieves and de- of theft of public funds and actions needed. the central bank are sickening. More sickening that they can use to cause and take action. nounce them wherever you encounter them is the public secrete that this may not have been • Boycott all businesses and enterprises a one but rather done more regularly than we Some of the actions that we encourage of the corrupt and supporting Ugandans

CONTINUED HONOR AMONG THIEVES: UGANDA’S ODIOUS DEBTS IN THE NAME FROM PAGE 1> OF THE SICK AND DYING

liament was told would be through irrevoca- activities that was rumoured to have been What is in the Lubowa hospital deal that is ble promissory notes. To some, the eagerness claimed even before the ink dried on Parlia- The Mystery Lucky investor unnerving observers? with which government pushed the loan cover ment’s approval. and the form of coverage raised red herrings. What has raised further suspicion is that Then there are questions about the mystery On March 11th 2019, Parliament approved How unique was this project that government government has demonstrated uncharacter- lucky investor. Official records indicate the in- a government request to guarantee a loan of was staking everything to cover for the inves- istic efficiency in mobilizing money for this vestor as a joint venture between FINASI, said US$379million (about Shs1.4trillion) to Finasi tor? project ramming through approval processes to be an Italian firm and Roko Construction Group to secure funding for the ultra modern Soon after approval questions emerged where much smaller needs like a radio therapy Company to make FINASI/ROKO described in hospital. The government’s commitment, Par- about a US$50million for pre-project start machine at Mulago which required a minute official documents as a Special Purpose Ve- fraction of the amount for the Lubowa Hospi- hicle. But information about FINASI on their tal project took for ever and a series of state- own website is scanty, from shareholding to ments and back and forth following a public projects undertaken, nothings seems to pass outcry. a few clicks for verification or more detailed It is this uncharacteristic and unexplained information. flash of efficiency that has led to questions An analysis by the international anti-cor- about interests beyond delivery of a special- ruption organization, Transparency Interna- ised hospital. tional lays bare the hollowness of the group drawing mind boggling conclusions “Please note there is absolutely no connec- tion linking the company to Italy or Milan, outside of their own marketing documents. The Italian business register has NO com- pany registered as Finasi srl and it is unclear whether this entity actually exists,” notes TI in a brief on a fact check on the address and registration credentials of the firm. A Kampala law firm helped incorporate FI- NASI/Roko in Uganda but details about the shareholding of the company are scanty. On its website www.FINASI.com the com- BUKEDEA HOSPITAL. Pictures displaying the leaking roof of Bukedea . 2 BMM 41st Edition- DECEMBER, 2019 BMM 41st Edition - DECEMBER, 2019 3 Editorial content HONOR AMONG THIEVES: UGANDA’S ODIOUS DEBTS IN THE NAME OF THE SICK AND DYING UNFORTUNATE: Health has been particularly vulnerable and the recently approved guarantee of loans of CONTINUED FROM PAGE 2 >> up to US$379 million to build a specialised hospital in Lubowa stinks most, critics have said. KEY ISSUES pany states “Finasi was founded and started its operations in 1969. The Company was established as =• Previous why their argu- FROM PAGE 1> a 360° Importer/Exporter and pri- scandals have ment makes a lot Reigniting the crusade to end theꢀ of mary goods trader in the Middle targeted everything of sense. East and Africa. During the decades from immunization The medical Finasi has innovated and developed funds under the workers at the specific know-how in the Health- Global Alliance institute are su- care field delivering state of the art per committed, facilities and providing solutions for Vaccines and the facilities ap- public funds and impunity! Immunisation and added value services to its cli- palling inspite ents. Today, Finasi is a global turn- (GAVI) to critical of recent billions This 41st edition of the Black key provider for Healthcare facili- funding for injected from Monday newsletter focuses can imagine. Our analysis shows that over the ties,” but TI’s analysis has a rather HIV/Aids and largely private on the plight of the health past 34 years, Uganda has lost close to 30 tril- damning conclusion Tuberculosis under funding sources, lion in theft. “There is no evidence to suggest the Global Fund the situation is sector in Uganda, and teases Against this backdrop, we have found it pru- Finasi have the experience required initiative. Climate dire and given out the different challenges dent to relaunch the Black Monday campaign to undertake a project in this sector, change. the fact that the facing the sector which need as our contribution to the anti corruption of this value or of this size.” Lubowa project to be urgently dealt with to struggle. The Black Monday Campaign seeks to The company proudly claims to • On March 11th is designed as a mobilize citizens to mount a sustained assault have undertaken a number of hos- 2019, Parliament Build Own and give a clean health bill to against the injustice of theft of public funds. pital projects including the Sheikh approved a Operate (BOO) Ugandans. We hope you enjoy The ultimate result is to see that integrity in Khalifa Bin Zayed Hospital in Mary, government for at least the reading it. Black Monday is public life is restored through a citizen-led pro- Turkmenistan; Sheikh Zayed Uni- request to first ten years, a campaign that focuses on cess that rejects theft of public money. In this versity Hospital in Khost Afghani- guarantee a loan chances that protesting the of public new phase, we are going to have a dual strategy. stan; Sharg Al Nile in Khartoum, Su- of US$379million the minions lan- First is work towards a Public Private Partner- dan and Famboni General Hospital (about guishing on the funds with impunity and ship including key government agencies, civil in Moheli Comoros Island. corridors and promoting integrity. society, and the private sector. We shall also But TI and independent inves- Shs1.4trillion) to floors of Mulago have purely citizen focused engagements to tigation by Black Monday reveal Finasi Group to will find solace inspire citizens to reject corrupt political and nothing more than photos pur- secure funding for there. gandans continue to struggle with public officials. We are also aware that even ported to be of the projects on the the ultra modern an ailing public service delivery in the civil society sector, there are stories of BUKEDEA DISTRICT. Residents of Bukedea airing their concerns about the worrying conditions at the Finasi website and nothing on the hospital. The Yet it is this score card, yet day in day out we are corruption and abuse of donor funding. Aware Various hospitals in the District. ground. government’s despair that bombarded with news of increasing that citizen organizations receive this money TI concluded separately; “There commitment, government has thefUt of tax payers money. Ugandans continue on behalf of Ugandans, we commit to launch an citizens to take are restated below: working honestly is no information online about ANY tapped into to STANDED PATIENTS OUTSIDE Nyamiko Health Center IN Bushenyi District Parliament was to wallow in poverty, while a few privileged expose on such corruption, and push for cor- • Wear black clothes every Monday as a sign • Demand political action from the State of the hospital projects they claim told would be sell the project. individuals benefit from their plight. The re- rective action by the relevant actors. We will of your resolve against theft of public funds against public money thieves to have undertaken. None of the through irrevocable That it is meant cent rumors that some 90 billion shillings was continue with publication of our monthly news- and shun corruption at a personal level • Speak to at least 5 Ugandans about dangers hospitals are in existence. The only to alleviate some printed by some individuals in collusion with letter to give citizens well analyzed information • Isolate all public money thieves and de- of theft of public funds and actions needed. references to them are from the Fi- promissory notes. of this suffer- the central bank are sickening. More sickening that they can use to cause and take action. nounce them wherever you encounter them nasi website.” To some, the ing and the huge is the public secrete that this may not have been • Boycott all businesses and enterprises These revelations are at best eye eagerness with costs that both a one but rather done more regularly than we Some of the actions that we encourage of the corrupt and supporting Ugandans popping and at worst startling, which government individuals and leading to the question of who ex- pushed the loan tax payers en- actly is government committing tax cover and the form dure to get the payers money to by guaranteeing of coverage raised much needed through promissory notes payment red herrings treatment. of US$379million or Shs1.4 trillion? The govern- CONTINUED HONOR AMONG THIEVES: UGANDA’S ODIOUS DEBTS IN THE NAME Is the project, as its name sug- ment’s justifica- FROM PAGE 1> gests, indeed merely a special pur- tion is premised on the high cost of OF THE SICK AND DYING pose vehicle to transport tax payer seeking treatment abroad. Part of money through a web of bank sys- this cost, an estimated US$150milli liament was told would be through irrevoca- activities that was rumoured to have been tems in form of a loan while a cord on(aboutUsh550.1billion) is tax pay- What is in the Lubowa hospital deal that is ble promissory notes. To some, the eagerness claimed even before the ink dried on Parlia- The Mystery Lucky investor is tied around the tax payer for ers money that government dolls unnerving observers? with which government pushed the loan cover ment’s approval. smart Kampala brokers who will out to the well connected, the rest and the form of coverage raised red herrings. What has raised further suspicion is that Then there are questions about the mystery also claim the chunk of Prime real is private money some of it raised On March 11th 2019, Parliament approved How unique was this project that government government has demonstrated uncharacter- lucky investor. Official records indicate the in- estate in Lubowa just off Entebbe through fundraisers like car washes a government request to guarantee a loan of was staking everything to cover for the inves- istic efficiency in mobilizing money for this vestor as a joint venture between FINASI, said road? and church solicitations for people in US$379million (about Shs1.4trillion) to Finasi tor? project ramming through approval processes to be an Italian firm and Roko Construction The fact that the face of the proj- desperate need of specialized treat- Group to secure funding for the ultra modern Soon after approval questions emerged where much smaller needs like a radio therapy Company to make FINASI/ROKO described in ect, Italian Enrica Maria Aristidina Patients sleeping on the veranders of Nyamiko Health Center in Bushenyi District. ment abroad. hospital. The government’s commitment, Par- about a US$50million for pre-project start machine at Mulago which required a minute official documents as a Special Purpose Ve- Penetti has a long and troubling Beyond the direct medical costs, fraction of the amount for the Lubowa Hospi- hicle. But information about FINASI on their history does not help give comfort government argues, millions more tal project took for ever and a series of state- own website is scanty, from shareholding to to the project; “ Ms Pinetti clearly has worked out a network of accep- are lost on extra caregivers and liv- ments and back and forth following a public projects undertaken, nothings seems to pass has a troubling past which needs to tance and support for the project ing expenses. It has argued that the outcry. a few clicks for verification or more detailed be questioned in light of the privi- partly in fulfillment of the idea of planned 240 bed specialised hospi- It is this uncharacteristic and unexplained information. leged opportunities she, and her collective responsibility on the one tal will save all this money and also flash of efficiency that has led to questions An analysis by the international anti-cor- company Finasi, has been given by hand, on the other, indications of help the country tap into the growing about interests beyond delivery of a special- ruption organization, Transparency Interna- GoU,” concluded one critique seen how well-oiled systems that fa- medical tourism dollars. ised hospital. tional lays bare the hollowness of the group by this publication. cilitate the exit of public resources The logic of this all sounds good drawing mind boggling conclusions from government to private pock- and that is the problem. This is why. “Please note there is absolutely no connec- Who owns the project and to ets operate—smoothly. Health and disease has proved a lev- tion linking the company to Italy or Milan, whose budget will the promissory Ministry of health has embraced eler once it fails with the only differ- outside of their own marketing documents. notes be charged? the project and spoken in its sup- ence being where those with connec- The Italian business register has NO com- While the project falls under port, Parliament was easily con- tions go to beg and where ordinary pany registered as Finasi srl and it is unclear the Ministry of Health, investiga- vinced and fell in line with few folks go. whether this entity actually exists,” notes TI tions for this article reveal that the questions, other government enti- A dilapidated toilet and Stretcher at one of the government health For the connected, the treasury is in a brief on a fact check on the address and project does not belong to health ties have only voiced objections in centres. raided while for ordinary mortals it registration credentials of the firm. instead it is the Ministry of Finance muffled grumbling. is fundraisers in form of car washes A Kampala law firm helped incorporate FI- that has been at the centre of nego- The Uganda Medical Workers prove facilities already existing in- ful. One just needs to pay a visit to and requests for special collections NASI/Roko in Uganda but details about the tiations and pushing for the neces- Association (UMA), the most for- cluding the Mulago National Refer- the Cancer Institute at Mulago to in churches. This often after savings, shareholding of the company are scanty. sary approvals. midable critics of the project so far ral hospital and other centres like appreciate the sheer scale of inad- immediate family contributions and On its website www.FINASI.com the com- It is however important to note have questioned its wisdom. They Kiruddu and the network of district equacy of facilities vis the growing other family resources have been ex- that whoever is pushing the project argue, such money invested to im- hospitals would be more impact- number of patients to appreciate hausted. BUKEDEA HOSPITAL. Pictures displaying the leaking roof of Bukedea . 4 BMM 41st Edition - DECEMBER, 2019

Ongoing construction of The International Specialized Opinion Hospital in Lubowa, Kampala. The $379 million (Shs1.4 trillion) specialized hospital in Lubowa sends signals on how policy makers continue misallocating resources, neglect local hospital accessed by millions of Ugandans, and also raises fears that investments at Mulogo Hosital specialised services might be a waste says Dr Ekwaru Obuku, president, Uganda Medical As- Lubowa is ‘a black elephant’ to stop death from road accidents Question. As medical practitioners vestors with minimal local content, and at and mothers dying during births. do you have big reservations about an exorbitant cost. This looks like a collec- If you are not taken to a private the Lubowa project which is seen as tion of rents by the powerful people in the hospital in case of an accident, an addition to the industry starved “deep state”. The argument of saving foreign you die. It would even make more of quality facilities and services for exchange is defeated by giving the project sense if Government provided especially the majority poor but also to foreigners. Even Roko is not local, it is only US$100 million soft loans to the privileged as they have to seek just registered as a local firm but owned by private players like Case Hospital, the services abroad? whites. Bugolobi Medical center, Kampala The Ugandan medical health workers wel- Medical Hospital, Gulu Indepen- come this initiative as specialized medical Question: But definitely the project dent Hospital, Paragon Hospital, care services are urgently needed to tackle comes with positives? Nsambya Hospital and Rubaga the emerging none communicable diseases Sure it will improve health services sector, Hospital among others to fill up epidemic in Uganda and similarly, the low in- reduces the cost of Ugandans flying abroad the gap. come countries. and also create employment. It will be a train- ing ground for health care professionals in Question: Any other message Question. If you were given opportu- specialized care and provide commodities in to Ugandans regarding the nity to invest this money in the health medical supply. sector what would be your priority project? area? Question: Is there a way of stopping We should have put this money the project? to improve referral hospitals, I would still invest this in the Lubowa hos- Answer: We have no plans to stop the proj- health centers III and IV by equip- pital, however at half the price or less. ect, but we are saying it is a duplication of ping them with diagnostic ma- But it isn’t clear if we need this hospital what is happening at Mulago. The mafias be- chines and ensure that theatres now, given that Mulago Specialized services hind the Lubowa project are the ones delay- are working. Ensure that at least is completed but yet to open. The Lubowa ing the opening of Mulago. Uganda’s popula- midwives, nurses and doctors hospital project is duplicating what was en- tion is projected to be 104 million by 2040. have houses. Lubowa is ‘a black visaged in the new strategic directions of Mu- It could generate revenue from DR Congo, elephant’. It is overpriced by far lago. Therefore in order to serve the greatest Burundi, Rwanda and South Sudan. It may compared to similar hospitals all good for the greatest majority, it would be create demand in the medical school to pro- over the world suggesting that prudent to decentralize specialized care to vide such skills. We are also looking at inter- the money is being stolen. In fact the fifteen Regional Referral Hospitals and national skills transfer. US$39 million already has disap- over thirty District Referral Hospitals. peared subject to investigation Question: In your opinion, how does by parliament. Disagreements be- Question: But policy makers insist the country balance the health needs? tween the actors Roko and Finasi that the Lubowa project comes to is a clear sign of political connota- save the country the million foreign The Lubowa project contradicts the pur- tion. Government can still salvage The Lubowa hospital project is duplicating currency spent on sending Ugandans pose of the refurbishment of Mulago’s spe- its self by ensuring Ugandans are what was envisaged in the new strategic abroad. What is your take on this? cialized services. The two facilities are in at the front seat of planning and directions of Mulago ,” the same radius. It is not timely and it’s op- implementation comprehensive DR EKWARU OBUKU, PRESIDENT, UGANDA MEDICAL ASSOCIATION The contradiction is that the little forex portunity cost is poor. The funds being in- strategy for specialized medical we have is being given to so called foreig in- vested in the Lubowa project can be invested care.

Ongoing construction of The International Specialized Hospital in Lubowa, Kampala. BMM 41st Edition - DECEMBER, 2019 5 The Black Monday Pictorial

Conjested Patients in the floor of one of the wards at Mulago National Referral Hospital

A cry for help! Ugandans need your help in ending corruption

Patients in one of the wards at Mulago National Referral Hospital

Dilapidated staff quarters at one major referral Hospital

A bushy compound at a health centre Bunyoro Sub-region 6 BMM 41st Edition - DECEMBER, 2019 Civil society in fight against corruption n a citizens’ memorandum read to the district that serves the population of approximately 2000 peo- officials, Mr Leonard Opeti hailed the local gov- ple. This calls for immediate intervention for Kikingura ernment for investing in the health sector but Health Center II. This makes the work of health work- with some reservations. ers difficult. We therefore, call upon the CAO to ur- “As citizens, under our various citizens’ gently intervene.” In a bid to address orgIanizations, we bring to your notice that there are some the health persistent drug stock outs. The population and disease Hygiene in some schools and health centers is another mess in burden has increased but the supplies and facilities the area. challenges among have stagnated. Constructed in 1971 for the Railways “Though some schools and health centers have pit others, RDP-Uganda, workers and targeting only 70 patients, Masindi hos- latrines, they are not enough for the population. For pital now serves Thousands of patients. This therefore example the two latrines constructed at Kilanyi Mus- Actionaid Interna- means that there is still a lot required in all depart- lim primary school have not covered the gap since the tional Uganda, Buny- ments at the hospital including maternity ward.” population ratio to the latrine is 1:68. Kirasa Health He further read the memorandum, “There is unpro- Center II also has a latrine that needs quick attention oro Choice Uganda, fessional behavior of public health workers towards since it doesn’t have doors. We therefore call upon the Bomido and Fowode patients. There has been community outcry for quite The Civil society memebrs in primary schools CAO to plan and contract these facilities because with- organized a Masindi long period of time. Health workers are rude, report to in the campaign Demanding like Kigezi, Ntooma out them the community is prone to diseases” he said. work late around 10:00am and leave by 1:00pm, but no full transparency and and Nyakato where “We have high hopes that above mentioned issues district service deliv- serious action has so far been taken. We therefore, ask accountability of all taxes some teachers have will equally be worked on,” Opeti noted. ery day at Boma play Chief Administrative Officer (CAO) to take action and and other public money. stayed for over five To address some of the challenges at the hospital, also organize a refresher training of all health workers years and thus Masindi Corporate League (MCL) has organized a ground on June 26th, in all the health facilities within the district on their their performance marathon on September 21st, 2019 to raise funds for 2019. code of conduct and intensify inspections to curb ab- has started declining. We kindly, request DHO (District the maternity ward. senteeism.” Health Officer) and DEO (District Education Officer) to According to Mr Hassan Mugisha, the chairman, The day was used to work on transfers of these public servants who have MCL, registration for the run is Shs20,000. share and celebrate They are also worries of civil servants who over stay in one work over stayed at the health facilities and schools.” “The Masindi and Bushenyi scandals are some of the place. many corruption cases that have health delivery. Most the achievements the “This has also contributed to poor performance of The locals are also troubled with adequate water sources in the health centers and hospitals are ill equipped and also challenges in service these public servants, a case in point is Kijunjubwa district. lack drugs. The little drugs government supplies ends delivery and forge a Health Centre III and Kijenga Health Centre II where “In Pakanyi Sub County, Kihaguzi Village, there is up being stolen by health workers and sold to private some health workers have over stayed at the place in limited water since the available water sources have clinic while some is exported to DR Congo and South way forward. that they have resorted to their personal work and pay dried up due to eucalyptus planted at the water source Sudan. less attention to the patients. This same issue is also (spring well). The village is left with only one borehole Health sector funding: are we getting our priorities right? On the 13th of June this year, the Minister of Finance, Planning and Economic Development Hon Matia Kasaijja read out the budget speech highlighting allocations for FY19/20. The 40.4tn budget made huge allocations to the works and transport sector, security, energy and debt repayment. There is urgent need to he minister allocated maternal and neonatal unit at Mulago hospi- on treatment of government officials abroad, scale-up prevention mea- Ugx2.6tn to the health sec- tal and recruitment of atleast 900 new health yet these resources can significantly trans- tor, representing a slight in- workers by the Health Service Commission. form our health sector? sures through campaigns crease from Ugx2.3tn allo- Despite these successes and the consid- Why spend on Ugx1.4tn on a specialised on lifestyles to avert a loom- cated in FY2018/19. Nearly erable amount of funding, the sector is still hospital in Lubowa in a potentially fraudu- half of the health sector grappling with multiple challenges. The lent project, yet this money can staff, equip ing time bomb caused by budget is still funded by stagnant financing for medical supplies has and capacitate regional and national referral the increasing cases of non- external donors. This budget will be spread contributed to the incessant drug stockouts hospitals to handle the same disease burden? communicable diseases like acrToss recurrent wage, non-wage and devel- at nearly all health centres across the coun- Renovation at the national referral hospital, opment expenditures. try. In essence, the National Household Sur- Mulago, has stalled due to inconsistent fund- cancers and heart-related The 6.4% allocation to the health sector is vey 2016/17 by Uganda Bureau of Statistics ing! illnesses. still far below what is expected to handle the (UBOS) identified unavailability of medicines/ In a nutshell, Uganda’s heath sector alloca- challenges affecting the sector. Uganda has supplies as a major concern for the citizens. tion coupled with malaise and malfeasance the Uganda Cancer Institute and Uganda consistently failed to meet the commitments Despite an increase in population, currently that has permeated the sector, cannot pro- Heart Institute as well as referral hospitals it made during the 2001 Abuja declaration, at over 40 million, plus the ever-increasing duce a healthy and productive population to handle these cases. Government should where it pledged to allocate atleast 15% of the number of refugees (currently at over 1.2 mil- that effectively contributes to socio-eco- also urgently address the issue of drug stock- annual budget to the health sector. lion), government has deliberately reduced nomic growth, as envisaged in Vision 2040. outs through increased funding and tackling The current health budget allocation is funding to referral and regional hospitals and Failure by government to pass to pass the malfeasance at the National Medical Stores. insufficient to address aspirations in the Vi- specialized institutions. National Health Insurance Bill, 2014 means More support is needed to the Uganda sion 2040; improving nutrition among chil- Information from monitoring reports by that majority of Ugandans cannot afford ef- Blood Transfusion Services to collect more dren, provision of community based Primary civil society organisations also shows that ficient, equitable, accessible, affordable and blood to avert stock-outs. Blood is critical Health Care (PHC), establishment of regional the sector is still grappling with malfea- quality health care. to treating expectant mothers, victims of herbs for quality health care provision, estab- sance including; stealing of drugs, absentee- It is important as government plans for road accidents and anaemic patients. Prior- lishment of international and national hospi- ism and extortion. The health ministry has subsequent financial years, to fully opera- ity should also be given to health facilities tals in each regional city and operationalisa- consistently failed to utilise borrowed funds tionalise health facilities that have been up- grappling to high numbers of accident vic- tion of a national health insurance scheme. and reports have pointed to blatant wastage graded, through the provision of funds and tims including; Kawolo, Iganga and Masaka The National Development Plan II (NDPII) of public resources through procurement staffing. hospitals. which is in consonance with the Sustainable of drugs whose shelf-life is short, failure to There is urgent need to scale-up prevention We should harness Public-Private Partner- Development Goal (SGD) 3 also envisages utilise loans which attracts interest on the measures through campaigns on lifestyles to ships as one the ways of addressing the chal- attaining: universal health coverage, sexual Uganda taxpayer and leaving medical equip- avert a looming time bomb caused by the in- lenges affecting the health sector. Emphasis and reproductive health, ending malnutrition ment to waste away. creasing cases of non-communicable diseases should be on provision of quality, accessible in all its forms, reducing maternal mortality, Having a healthy population is key to at- like cancers and heart-related illnesses. More and affordable health services for all Ugan- ending preventable new born, infant and un- taining Uganda’s development agendas in funding to Primary Health Care (PHC) is re- dans. der-five deaths, ending HIV/AIDS, TB, malaria Vision 2040, NDPs and SDGs. As a country quired to support implementation of preven- and neglected tropical diseases and reducing we have to get our priorities right. Why for tive strategies to further reduce the disease The writer works with Anti Corruption premature deaths due to non-communicable instance would we increase allowances for burden. Government should also strengthen Coalition Uganda. diseases. Members of Parliament by 39%, and reduce referral systems to prioritise diagnosis and Commendable work towards this endeav- funding to Primary Health Care? Why do we treatment of non-communicable diseases. our has been done in the sector over the last create new administrative units when several With the medical bill for government offi- financial years. Some of the successes reg- health centres are not yet functional? Why cials seeking treatment abroad ever increas- istered include; the rehabilitation of some spend a lot of resources on the purchase of ing, government should prioritise funding health centres, completion of the specialised vehicles, on conferences and workshops and and staffing specialised institutes such as SAVE UGAN DANS & STOP CO TH RRUPTI IEVES - DECEMBER, 2019 ON ST BMM 41st Edition OP IT! 6 ! 7 BMM 41st Edition - DECEMBER, 2019 DILAPIDATED: Kasenyi Health Center II constructed with funding from Netherlands is also HEALTH vandalised with a bush growing around the building. The lightening conductor and some windows have too been stolen. The floor was dotted with human waste (feaces).The theater at Bushenyi Civil society in fight against corruption District Hospital constructed with support from Japan Embassy is in a sorry state too. n a citizens’ memorandum read to the district that serves the population of approximately 2000 peo- officials, Mr Leonard Opeti hailed the local gov- ple. This calls for immediate intervention for Kikingura ernment for investing in the health sector but Health Center II. This makes the work of health work- with some reservations. ers difficult. We therefore, call upon the CAO to ur- Ministry Of Health Probed Over Procurement “As citizens, under our various citizens’ gently intervene.” In a bid to address orgIanizations, we bring to your notice that there are some the health persistent drug stock outs. The population and disease Hygiene in some schools and health centers is another mess in burden has increased but the supplies and facilities the area. challenges among have stagnated. Constructed in 1971 for the Railways “Though some schools and health centers have pit Scandal others, RDP-Uganda, workers and targeting only 70 patients, Masindi hos- latrines, they are not enough for the population. For pital now serves Thousands of patients. This therefore example the two latrines constructed at Kilanyi Mus- By Stephen Wandera which does not meet the minimal required Actionaid Interna- means that there is still a lot required in all depart- lim primary school have not covered the gap since the theater standards. tional Uganda, Buny- ments at the hospital including maternity ward.” population ratio to the latrine is 1:68. Kirasa Health USHENYI – Inflated procurement “This building first of all is short and it He further read the memorandum, “There is unpro- Center II also has a latrine that needs quick attention costs, shoddy construction works should be having air conditioning which is oro Choice Uganda, fessional behavior of public health workers towards since it doesn’t have doors. We therefore call upon the and doctors soliciting bribes be- not available. But with these ventilators, dust Bomido and Fowode patients. There has been community outcry for quite The Civil society memebrs in primary schools CAO to plan and contract these facilities because with- fore operating patients are at the will enter the theater exposing patients to in- long period of time. Health workers are rude, report to in the campaign Demanding like Kigezi, Ntooma out them the community is prone to diseases” he said. centrBe of the current investigations by the fections. The walls have to be tiled for easy organized a Masindi work late around 10:00am and leave by 1:00pm, but no full transparency and and Nyakato where “We have high hopes that above mentioned issues President’s office in Bushenyi and Masindi cleaning. The floor is already cracked as you district service deliv- serious action has so far been taken. We therefore, ask accountability of all taxes some teachers have will equally be worked on,” Opeti noted. districts. can see said a doctor who requested not to be ery day at Boma play Chief Administrative Officer (CAO) to take action and and other public money. stayed for over five To address some of the challenges at the hospital, This highlights the wide spread corruption named because he is not authorized to talk to also organize a refresher training of all health workers years and thus Masindi Corporate League (MCL) has organized a compromising health services delivery in the the media. ground on June 26th, in all the health facilities within the district on their their performance marathon on September 21st, 2019 to raise funds for country. Worse, the multimillion health facili- “Carrying out an operation in this place is 2019. code of conduct and intensify inspections to curb ab- has started declining. We kindly, request DHO (District the maternity ward. ties are underutilized, raising questions as to like a death trap. But because our funder de- senteeism.” Health Officer) and DEO (District Education Officer) to According to Mr Hassan Mugisha, the chairman, whether both donors and Ugandan taxpayers manded that we make use of it, we do male The day was used to work on transfers of these public servants who have MCL, registration for the run is Shs20,000. got value for money in the investments. circumcision here,” he said. share and celebrate They are also worries of civil servants who over stay in one work over stayed at the health facilities and schools.” “The Masindi and Bushenyi scandals are some of the “What is on the ground as you can see is Efforts to have a comment from the district place. many corruption cases that have health delivery. Most not worth the money? Over Shs200 million officials were futile. The district chairman the achievements the “This has also contributed to poor performance of The locals are also troubled with adequate water sources in the health centers and hospitals are ill equipped and also was chewed,” said Mr Apollo Lee Kakonge, and the town clerk were lip tight. challenges in service these public servants, a case in point is Kijunjubwa district. lack drugs. The little drugs government supplies ends the executive director, West Ankole Civil So- delivery and forge a Health Centre III and Kijenga Health Centre II where “In Pakanyi Sub County, Kihaguzi Village, there is up being stolen by health workers and sold to private ciety Forum. some health workers have over stayed at the place in limited water since the available water sources have clinic while some is exported to DR Congo and South According to Kakonge, the cost for con- THE CASE OF MASINDI way forward. that they have resorted to their personal work and pay dried up due to eucalyptus planted at the water source Sudan. struction of Kasenyi Health Center is Shs45 In Masindi, Shs1 billion was spent on reno- less attention to the patients. This same issue is also (spring well). The village is left with only one borehole million and Nyamiko Health Center and the vating the district hospital amidst fears of staff houses at Shs100 million, the theatre at inflated bids. Shs250 million were inflated. The money was used to face lift the men, A visit to Nyamiko Health Center III, three women’ and children’ wards as well as ma- kilometers from Bushenyi town found the ternity ward. Two private wings were also Health sector funding: are we getting our priorities right? health facility and staff houses underutilized. constructed, however concerns are rife that “Health workers open for few hours and the district tender board connived with the On the 13th of June this year, the Minister of Finance, Planning and Economic Development Hon Matia leave. They claim it is far out of town. The contractor to inflate the cost of the renova- State House Health Monitoring Team were tion. Kasaijja read out the budget speech highlighting allocations for FY19/20. The 40.4tn budget made huge recently here for investigations,” said Ka- Following these concerns President Yoweri Dilapidated staff quarters . Lack of proper housing facilities for doctors and medical allocations to the works and transport sector, security, energy and debt repayment. konge. Museveni ordered Mr Godfrey Nyakahuma, workers has demotivated the outputin many public health centres. Black Monday found the health facility al- the Masindi Resident District Commissioner There is urgent need to ready vandalized with broken doors and win- to investigate the matter. he minister allocated maternal and neonatal unit at Mulago hospi- on treatment of government officials abroad, scale-up prevention mea- dows. The sockets too have been removed. “I am making a report. I will hand it over million,” said Byaruhanga. said. Adding, “We had a security meeting and Ugx2.6tn to the health sec- tal and recruitment of atleast 900 new health yet these resources can significantly trans- The Kasenyi Health Center II constructed to the State Minister for Housing Dr Chris Another allegation that doctors at the decided to arrest these implicated doctors. I am tor, representing a slight in- workers by the Health Service Commission. form our health sector? sures through campaigns with funding from Netherlands is also van- Baryomunsi as soon as I am done,” Nyaka- public hospital charge an illegal fee between going to use my own money to net these wrong crease from Ugx2.3tn allo- Despite these successes and the consid- Why spend on Ugx1.4tn on a specialised on lifestyles to avert a loom- dalised with a bush growing around the huma said. Shs200,000 to 300,000 before an operation is doers. I already have a list of the doctors.” cated in FY2018/19. Nearly erable amount of funding, the sector is still hospital in Lubowa in a potentially fraudu- building. The lightening conductor and some When contacted, Cosmas Byaruhanga, the carried out on every patient. Nyakahuma advised anyone who may be half of the health sector grappling with multiple challenges. The lent project, yet this money can staff, equip ing time bomb caused by windows have too been stolen. The floor was chairman, Masindi District also queried the Mr Nyakahuma said is investigating the on- asked for the bribe to report to his office for budget is still funded by stagnant financing for medical supplies has and capacitate regional and national referral the increasing cases of non- dotted with human waste (feaces). tendering process. going extortions of money from patients by redress. external donors. This budget will be spread contributed to the incessant drug stockouts hospitals to handle the same disease burden? communicable diseases like The theater at Bushenyi District Hospital “The concerned people are sons and doctors. He further explained, “This practice is com- acrToss recurrent wage, non-wage and devel- at nearly all health centres across the coun- Renovation at the national referral hospital, constructed with support from Japan Em- daughters of ‘big’ shots, they are untouch- “I have received several complaints from the mon in most health centers in the district and I opment expenditures. try. In essence, the National Household Sur- Mulago, has stalled due to inconsistent fund- cancers and heart-related bassy is in a sorry state too. able. How do you tell me the walkway from public. I have evidence on this matter and who- cannot tolerate it anymore.” The 6.4% allocation to the health sector is vey 2016/17 by Uganda Bureau of Statistics ing! illnesses. It has ventilators like an ordinary house the maternity ward to the theatre cost Shs45 ever is doing it, stand warned. It must stop,” he still far below what is expected to handle the (UBOS) identified unavailability of medicines/ In a nutshell, Uganda’s heath sector alloca- challenges affecting the sector. Uganda has supplies as a major concern for the citizens. tion coupled with malaise and malfeasance the Uganda Cancer Institute and Uganda consistently failed to meet the commitments Despite an increase in population, currently that has permeated the sector, cannot pro- Heart Institute as well as referral hospitals UGANDA’S CORRUPTION CURVE it made during the 2001 Abuja declaration, at over 40 million, plus the ever-increasing duce a healthy and productive population to handle these cases. Government should where it pledged to allocate atleast 15% of the number of refugees (currently at over 1.2 mil- that effectively contributes to socio-eco- also urgently address the issue of drug stock- Why we continue to struggle with this • Negative influence of politics is 2006-2010 annual budget to the health sector. lion), government has deliberately reduced nomic growth, as envisaged in Vision 2040. outs through increased funding and tackling deplorable, corruption in Uganda. evident in this system. When everything The current health budget allocation is funding to referral and regional hospitals and Failure by government to pass to pass the malfeasance at the National Medical Stores. has been politicized, any attempt to act insufficient to address aspirations in the Vi- specialized institutions. National Health Insurance Bill, 2014 means More support is needed to the Uganda • Too many loopholes existing in the 2016 Todate sion 2040; improving nutrition among chil- Information from monitoring reports by that majority of Ugandans cannot afford ef- Blood Transfusion Services to collect more against a culprit quickly turns into a hot dren, provision of community based Primary civil society organisations also shows that ficient, equitable, accessible, affordable and blood to avert stock-outs. Blood is critical system pave the way for those walking political issue ready for battle on the 2001-2005 Health Care (PHC), establishment of regional the sector is still grappling with malfea- quality health care. to treating expectant mothers, victims of the corridors of power to become corrupt 1.6 tn 2 tn herbs for quality health care provision, estab- sance including; stealing of drugs, absentee- It is important as government plans for road accidents and anaemic patients. Prior- overnight and pass on their ‘tricks’ to partisan political lines. lishment of international and national hospi- ism and extortion. The health ministry has subsequent financial years, to fully opera- ity should also be given to health facilities tals in each regional city and operationalisa- consistently failed to utilise borrowed funds tionalise health facilities that have been up- grappling to high numbers of accident vic- others. The awarding of contracts for tion of a national health insurance scheme. and reports have pointed to blatant wastage graded, through the provision of funds and tims including; Kawolo, Iganga and Masaka instance, and the taking of kickbacks is The National Development Plan II (NDPII) of public resources through procurement staffing. hospitals. 1.1 tn 2011-2015 which is in consonance with the Sustainable of drugs whose shelf-life is short, failure to There is urgent need to scale-up prevention We should harness Public-Private Partner- a real avenue for corruption. Development Goal (SGD) 3 also envisages utilise loans which attracts interest on the measures through campaigns on lifestyles to ships as one the ways of addressing the chal- 1996-2000 9bn 1.8 tn • Lack of any clear-cut official position 2 bn attaining: universal health coverage, sexual Uganda taxpayer and leaving medical equip- avert a looming time bomb caused by the in- lenges affecting the health sector. Emphasis 6 bn and reproductive health, ending malnutrition ment to waste away. creasing cases of non-communicable diseases should be on provision of quality, accessible on corruption presents a problem in our in all its forms, reducing maternal mortality, Having a healthy population is key to at- like cancers and heart-related illnesses. More and affordable health services for all Ugan- Ugandan context. Where gift-giving or ending preventable new born, infant and un- taining Uganda’s development agendas in funding to Primary Health Care (PHC) is re- dans. der-five deaths, ending HIV/AIDS, TB, malaria Vision 2040, NDPs and SDGs. As a country quired to support implementation of preven- receiving is a norm, it can be difficult and neglected tropical diseases and reducing we have to get our priorities right. Why for tive strategies to further reduce the disease The writer works with Anti Corruption to identify where a gesture of ‘thanks’ 1991-1995 premature deaths due to non-communicable instance would we increase allowances for burden. Government should also strengthen Coalition Uganda. exists, and corruption begins. Indeed, 1986-1990 diseases. Members of Parliament by 39%, and reduce referral systems to prioritise diagnosis and 1986-1990 Commendable work towards this endeav- funding to Primary Health Care? Why do we treatment of non-communicable diseases. it is not strange for people to “wet the 1991-1995 1996-2000 our has been done in the sector over the last create new administrative units when several With the medical bill for government offi- ground” in pursuit of a stated agenda. In 2001-2005 2006-2010 2011-2015 financial years. Some of the successes reg- health centres are not yet functional? Why cials seeking treatment abroad ever increas- 2016 Todate istered include; the rehabilitation of some spend a lot of resources on the purchase of ing, government should prioritise funding that case, who is guilty of what? health centres, completion of the specialised vehicles, on conferences and workshops and and staffing specialised institutes such as 1999, 2018 bribe of

bribe of USD 1M

shillings