Opinion: Support, Don’t Ridicule Medics Responding to Covid-19

BY LUKANGA SAMUEL

KAMPALA: Tuesday, August 10, 2021

If you enter the Ugandan community service, especially at the national level, you understand two things – the media will hold you up to unrelenting scrutiny and the night TV hosts will hold you up to unrelenting ridicule.

This has become a comical tradition in Uganda, more so when politicians are involved. It has long been cited as a sign of what Uganda is said to stand for; a complete independence, democracy and the freedom to publicly mock our civil servants without fear of retribution.

For my case, I prioritized NBS talk shows, one of them, called NBS Frontline. The Frontliners have made their monologue a must-see ritual. This has been the pattern that top politicians and national service executive directors of different agencies’ misspeaks, missteps, even misspells and the jokes fly like flocks of pigeons,  the hosts eager to put in their rightful place every exalted man or woman bronzed by national fame.

Viewing an interactive content on NBS Frontline as of Thursday, August 5, 2021, it is very unfortunate that the panelists lacked facts about the Covid-19 response in Uganda.

As a social scientist, following both the parliamentary and the Ministry Of Health’s public information, I found it patriotic to share some of the facts and responses to the claims raised during this political talk-show;

Dr. Joseph Muvawala, the executive director (ED) of the National Planning Authority (NPA) claimed that the authority was never involved in the planning during the Covid-19 Response.

“In the beginning, we were not essential (National Planning Authority)” he said. The ED-NPA was not aware that Uganda registered her first Covid-19 case on March 21, 2020 when a male Ugandan travelling from Dubai, UAE was detected by the screening measures at Entebbe International Airport. He was detected by strong systems installed by the Ministry of Health during the Covid-19 preparedness phase the country was under from January to March 2020.

The country then transitioned to response mode where several activities were carried out to ensure that the spread of the virus is minimized. Dr. Muvawala missed out the fact that the Government’s response to the Covid-19 pandemic is guided by two costed plans.

These are: The Covid-19 Response Plan (March 2020 – June 2021) and the Resurgence Plan (July 2021 – June 2022)

From the onset, the Covid-19 Response has been guided by key working blueprints which Dr Muvawala needs to consult as the chief government planner who sits in almost all the planning meetings at the Ministry of Finance, Planning and Economic Development.

Dr. Muvawala added: “I wouldn’t prioritise pickups over Personal Protective Equipments (PPEs).”

The ED-NPA never knew it, that health workers have had PPEs ever since the outbreak of the Covid-19 pandemic besides gaps in distribution of these even at facility level. It is important for Dr Muvawala to also note that there is no evidence of a health worker who has died after contracting the Covid-19 infection while working in the Covid-19 treatment unit (CTU).

However, like other members of the community, a number of the health workers who have succumbed due to Covid-19, could have contracted the virus from within their respective communities.

With no evidence of a health worker who has succumbed among those working in the CTUs means that health workers have been protected. It is therefore misleading to link deaths of health workers caused by the Covid-19 to lack of PPEs.

Dr. Muvawala recited another claim, “Is it rocket science that you plan for the pickups, and you don’t plan for the tax?”  Still the ED-NPA was not aware that H.E the President through his regular televised addresses spearheaded a fundraising drive to supplement transport needs within the districts.

And indeed, Ugandans responded to the president’s call and generously contributed sh29 billion through the National COVID Fund from which a decision was taken to purchase 282 double cabin pick-up trucks using   sh23 billion, part of the total donated amount to support transport within the districts. And so far, 121 pick-up trucks have arrived and are undergoing clearance and registration.

The Issue of the taxes for the 121 pick-ups that are already in the country has been well attended to by the Minister of Finance. A tax waiver has been issued and the pickups will soon arrive in the various districts for utilization.

The Executive director of National planning Authority further suggested: “It is important that we develop the ambulance system of the country. What we have are not ambulances but trucks. We are also learning that universal suffrage is also an important area. What is a standard of an ambulance? Does any Ugandan know? Have we put it out there? How do you even plan to buy an ambulance whose standards you don’t understand? Hospitals don’t have to run ambulances that are not their core mandate. I can own an ambulance at a certain standard that you have prescribed and deliver a patient to and you pay me per patient that I have delivered.”

The Executive Director of National Planning Authority came to the show unaware that prior to the Covid-19 pandemic, there were 178 ambulances across the country. However, as part of the response, 116 additional Ambulances have been acquired through procurements by Government of Uganda, external financing and donations.

These have been since deployed according to our policy of regional ambulance system.  This system provides for 20-30 ambulances managed under one call and dispatch center to ease coordination, maintenance, control and accessibility.

This will also change the management of ambulances from health facility based to a regionalized system coordinated at 14 regional referral centers to manage call and dispatch, fueling and maintenance of these ambulances.

So far, two call centres have been piloted at Naguru and Masaka Regional referral hospitals. The funding for operationalization of the Emergency Medical Service policy have not been provided.

However, it is important to note for Dr Muvawala that ambulances that come into the country have classifications.

This plan is to ensure that all Constituencies are covered in terms of ambulatory services as part of the ongoing process of strengthening of Emergency Medical Services in the country.

All health Sub Districts will have at least 1 Type B – Basic Life Support Ambulance Vehicle and all National and Regional Referral Hospitals in addition to a Type B Ambulance Vehicle will have Type C – Critical Care Ambulance Vehicles.

Dr. Wavamala went ahead to claim that “money has not been the biggest problem of this country, we have reallocated the money, every sector has suffered a 40% cut. No workshops, not travels. This is the biggest opportunity to have a better health system as a result of all the resources that we have reallocated to health.”

On this, I accepted the fact that the Government has continuously supported the Ministry of Health through the various budgetary allocations. This can also be explained by the various fast interventions, the Ministry of Health was able to undertake.

It is important to note that Uganda was ranked by the Medical journal, the Lancet, as one of the top 10 best performing countries in the world in suppressing Covid-19 as of August, 2020.

The ranking made Uganda the best performing country on the African continent, a position that Ugandans must be proud of.

The Executive Director of National Planning Authority, after being out of office for some good time, little did he know that at the beginning of the pandemic Uganda had only one laboratory at

Uganda Virus Research Institute that could handle testing of highly infectious diseases like Ebola and Covid-19.

MoH has built capacity for Covid-19 testing from one laboratory at Uganda Virus Research Institute to 23 laboratories in the public and private sector.

In addition to this all Regional referral hospitals have been equipped with GeneXpert machines to support Covid-19 testing. Rapid diagnostic tests have been rolled out up to Health Centre III level and used to diagnose the symptomatic cases.

The MoH established 18 Traditional Covid-19 treatment units (C-19TUs) including Mulago National Referral Hospital, all Regional Referral Hospitals, Adjumani General Hospital and Bombo Military Hospital.

Also six Non-Traditional Isolation Facilities (NTIFs) at Namboole, Moroto, Jinja and Gulu Prisons, Acwa Power Construction and Kyangwali Refugee settlement were established. The total bed capacity at these units is 3,886. In addition to this, a number of private hospitals were assessed and cleared by MoH to treat Covid-19 patients.

Then a legislator in the name of Hon. Abdu Katuntu, a member of the parliamentary Covid-19 task-force also claimed: “we have many ICUs without professional staff to operate them. We spent sh35 billion to purchase them. They are laying idle”

Hon. Katuntu should pen down the fact that by March 2020, the country had only 137 Intensive Care Unit (ICU) beds complete with all the necessary life support equipment in the public hospitals nationwide.

By December 31, 2020, an additional 143 ICU beds and accessories had been procured and distributed to all the Regional Referral Hospitals including St. Mary’s Lacor Hospital and Lira University Hospital.

However, the ICU beds have not been optimally utilized due to challenges of lack of enough space in ICU units in some facilities that has called for remodeling, and lack of enough specialized health workers like intensivists, anaesthesiologists and critical care nurses.

Ministry of Health noted in their responses to Parliament that this remains one of the unfunded priorities and the current leadership has just managed to try and change this by using some of the resources from donor funded projects to offer scholarships for specialist training since 2017.

The other challenge on this is the failure of government to pay specialists better to attract those around to public service, something the President has always advocated for through his struggle to facilitate ‘his scientists’ better.

With all the above information in mind and more yet to be put to the public domain, why would a sober thinking Ugandan belittle such a patriotic leadership that has exhibited such commitment to building an effectively functioning health system that we have never had!!?

The team needs more support to improve, not judgement and ridicule.

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