The government has faced enormous backlash from the wider public for trying to corner medical interns with the threat of obstructing their struggle to complete their studies, if they don’t abandon their strike.
The Minister of Health Dr. Jane Ruth Aceng is quoted as having said: “You are the losers if you want to delay your internship.”
The Minister’s comments confirm the sentiments expressed by the Director General of Health Services Dr. Henry Mwebesa who last weekend authored a stinging letter to all heads of hospitals to close their gates on striking medical interns, if they don’t return to work by December 18, 2021.
The government’s position, as reflected by Dr. Mwebesa’s letter and Minister Ruth Aceng’s cold remark, has angered not only the striking interns but also their senior colleagues, with many observing that the new stance is steeped in arrogance and is a sign of on the part of the government.
The interns were left with two months to the end of their industrial training, without which they are not eligible to be issued with practicing certificates by the relevant regulatory professional bodies.
The President of the Federation of Uganda Medical Interns (FUMI) Dr. Lillian Nabwire expressed disappointment that the Ministry has resorted to under-the-belt tactics, instead of honoring its part of the bargain when it agreed to supplement the pay of interns from UGX750,000 to UGX1.5m per month.
“We were last paid in September but continued working and have been at the forefront of the fight against COVID-19. The letter (from Dr. Mwebesa) is disappointing and unfortunate, said Dr. Nabwire before adding that some hospital directors have already started to implement the directive.
Nabwire said during their negotiations with the Government that ended more than two months ago, the government and the interns agreed on a figure of UGX 1.5m as their monthly salary, from the UGX2.5m that the government had earlier promised.
In his State of the Nation address in 2017, President Museveni promised to raise the pay of doctors from UGX2.5 to UGX5m, and from UGX750,000 for intern doctors to UGX2.5m.
Nabwire noted however that it strikes them that instead of depositing money on their accounts, the government has chosen to issue threats.
Despite the visibly inept strategy, they have stuck to their guns and will not resume work until the government makes good on promise and deposits money on their accounts.
The interns have received strong backing from their senior colleagues under the umbrella (Uganda Medical Association), and the Senior House Officers (those who completed their first degrees and are pursuing masters). They make up 60% of the vacant positions in government hospitals such as Kiruddu, Kawempe, while in the course of their studies. These doctors say they are not obligated to attend to patients but are forced by circumstances. The Intern doctors, SHOs and UMA argue that the government must abandon the ‘arrogant’ stance and instead be proactive and meet the welfare needs of the doctors.
“The Uganda Medical Association stands with medical interns and support their industrial act. Our interns are so poorly paid despite the huge amount of work they do, these freshly graduated doctors get meager allowances,” said Dr. Richard Idro, the President Uganda Medical Association.
Some critics have pointed to the fact that Parliament of Uganda passed a UGX3.8 trillion supplementary budget only last month (November 19, 2021) to purge the government’s revenue shortfall.
The government, in presenting the supplementary budget request, noted that the money was meant to support the country face up to the effects of the COVID-19 pandemic.
Medical interns have been at the forefront of the battle against the COVID-19 pandemic. At some point, according to Nabwire, more than 100 out of the 1000 medical interns, had contracted the disease.
The government’s latest position also appears to contradict President Museveni’s rhetoric of adequately remunerating scientists in Uganda.
The government has so far found it difficult to explain why it has not paid the doctors. This is especially in view of the fact that it has found it more appropriate to spend on what many would consider luxuries – such as sponsoring Ugandan MP’s participation in the East African Parliamentary Games that took place in Tanzania.
The Parliamentary committee last week failed to persuade the doctors to return to work, because they argued that implementing government directives takes some time.
The Secretary General of UMA Dr. Edith Nakku expressed skepticism that once again the government may repeat of what happened in 2019 when the government passed a supplementary budget to augment the pay for doctors only for the money to find other ways.
The strong support received from their senior colleagues (UMA) as well as the junior pre-interns suggest that the government may not be able to sustain its hard-line position against the health professionals.
Lessons from the failed Cuban Doctors’ project
This is not the first time the Ugandan government has taken a hard-line stance against Ugandan healthcare workers. In 2018, the Ministry of Health came up with a proposal to import some 200 doctors from Cuba to fill vacant positions in Mulago.
Back then, the medical fraternity vehemently protested the plan calling and said it went against everything the government claims it stands for.
The Spanish-speaking Cuban doctors, UMA leadership then under their president Dr. Ekwaro Obuku, said would impose a heavy burden on Uganda’s tax payers through extra costs of having to hire translators.
The UMA leaders said the problem was not the shortage of doctors but rather the government’s unwillingness to hire Ugandan-trained doctors.
This event highlights not just the power of solidarity among Ugandan healthcare workers, but also the continued unwillingness by the government to hire more health workers.
The fact that the bulk of the country’s healthcare needs have to be met by intern doctors has continued to be a mark of failure on the government.
Uganda is one of the countries with the highest number of health workers leaving for greener pastures in countries.
The doctors say they leave because of working in abject conditions such as having to buy their own masks, gloves and food while on duty.