As thousands of doctors, nurses and other health professionals remain unemployed, Uganda’s government is considering the idea of helping them find jobs in foreign countries after they failed to find employment in the country’s public and private health facilities.
Even when health courses or academic programs some of most sought after in Uganda – not forgetting how President Yoweri Museveni keeps waxing lyrical about how his government prioritizes scientists, doctors, nurses and other professionals face employment just like their counterparts in the humanities (where unemployment is higher).
Yet Uganda’s public health facilities still need hundreds of thousands of health professionals to narrow the doctor/nurse-patient ratio. The country’s doctor-patient ratio is estimated at 1:25,000 while the nurse-patient ratio is said to be about 1:11,000. The World Health Organization (WHO) recommends a doctor-patient ratio of 1:1000.
NO MONEY TO RECRUIT HEALTH WORKERS
Dr Diana Atwine, the permanent secretary of the Ministry of Health told participants at the National Policy Dialogue on the Health Workforce in Uganda at the Kampala Serena Hotel that the ministry was “grappling with gross understaffing.”
The 2023 Health Labour Market Analysis (HLMA), supported by WHO, showed that Uganda needs 342,832 health workers, with overall supply standing at 154,016 health workers.
With government unable to recruit as many doctors as its public health facilities scattered across the country require, some doctors and nurses have been using ‘clandestine’ means to seek employment opportunities outside of the country, silently contributing to the issue of brain drain for a country that trains people and fails to employ them.
The Uganda Medical Association (UMA) has also been helping its members to find better jobs in neighboring countries such as Rwanda, and has also been negotiating with other nations such as the UK for health labour export purposes.
At the Policy Dialogue on the Health Workforce under the theme Investing in and Optimizing Heath Workforce to Achieve Sustainable Development Goals, Junior minister for public service Grace Mary Mugasa emphasized the need to streamline health labour export, making it clear that as government, they “don’t trust some of these agencies that are externalizing labour.”
There have been reports of labour export companies, especially those taking Ugandans to work as house maids in the Middle East, being named in human trafficking cases. Others have fleeced desperate families hoping for a better life of their monies and failed to find them jobs while others have taken Ugandan youth into illegal activities abroad.
GOVERNMENT-TO-GOVERNMENT LABOUR EXPORT DEALS
Minister Mugasa said Kampala is interested in a government-to-government arrangement where Uganda signs a Memorandum of Understanding (MoU) with the country which will have agreed to import health workers, instead of them dealing with labor export firms.
In 2015, a deal to export over 250 public health workers to the Caribbean state of Trinidad and Tobago collapsed after it was opposed in Uganda and the attorney general sued over the same labour externalization deal.
Trindad and Tobago opted for health workers from other countries such as India, the Philippines and Jamaica. In a government-to-government arrangement, Uganda had offered to sent 263 health professionals, including 15 internal medicine specialists, four psychiatrists, 20 radiologists, 15 pediatricians, four ear, nose and throat specialists, 100 registered midwives, four anesthetists, four ophthalmologists, and 40 public health nurses.
Then health minister Dr Elioda Tumwesigye would later tell Parliament’s health committee that government had halted the pan after it emerged that 75 per cent of those who had applied for the Trindad and Tobago jobs were Uganda’s specialists with employment contracts with government.
Although there is no yet any clear plan for the export of health labour, Minister Mugasa said government was interested in deals, which have “clear guidelines, terms of service and benefits.” PS Dr Atwine noted that there should be an arrangement to ensure that the rights of Ugandan health workers working abroad are respected, meaning that protection of exported labour from exploitation must be a top priority – and Ugandan health workers should be treated as other employees in host countries.
She also wants Ugandan health workers to be helped to gain more skills in healthcare provision so that they can bring these back to help the country once their contracts have ended.
Ugandan health workers are among the most paid government employees. In the previous financial year, Museveni’s government increased salaries of scientists, including secondary school science teachers. (See Details Here and There).
Meanwhile, government is recruiting over 1,000 health workers while the army is recruiting scientists. After increasing salaries of scientists, government has also confirmed salary increment for UPDF officers. (Read Stories Here, There and Over There).
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