A call for stronger, united Opposition in 2015

OPPOSITION UNITY

As we enter 2015, there is need to call for a stronger and united opposition to prepare adequately for a reorganized NRMO. Many cynics appear ambivalent in accepting the grueling environment in which Opposition actors operate. Opposition politics is laced with thorns and treacherous hurdles to overcome, requiring lots of resources and meticulous organizing. By nature, the Opposition must be dynamic in ideology to succinctly capture the emerging problems of society with pragmatic responses. Most of our societal problems are generated by instability caused to the 1995 Constitution. 

The Constitution has become the instrument of expression of the aspirations of the dominant group in power. No amount of effort or methods can succeed in advancing alternative ideology using the Constitution given the numerical disadvantage of opposition in the legislature and at local governments. Politics is about domination by ideas and opposition ought to find those sets of ideas to effectively attract the youth population.

Uganda’s Opposition has problems that are similar, but not as galvanizing as those pressed by malignancies of colonialism. These are problems created by stooges and agencies of imperialism whose objectives are driven by innate greed for power. African leaders, like Mugabe and Museveni are setbacks to Africa’s civilization. They have forcefully dominated productive space by maintaining regressive ideologies which have stifled evolution of progressive ideas through generations. Therefore, one can say that the persistent problems of post-cold war African are three; leadership, clarity of independent ideology, and uncritical unresponsive masses.

The case for Uganda’s Opposition is unique, complex and deserving of attention. The dominant Opposition forces in Uganda appear subsumed in ideological aberrations, leading to conflicting loyalties among its cadres, and subsequent intra-organizational confusions. Such a problem makes it difficult for the masses to clearly identify a unique trait that is discernible from the establishment.

For instance scholars have identified that the FDC has retained among its ranks elements that are sympathetic to the bush-era NRM ideologically. And it is problematic in many ways. It compromises the ability to project its own distinctive, enduring and effective mobilizing ideology. Pioneer reformists such as, Rtd Col. Dr Kiiza Besigye and Maj John Kazoora have maintained variedly that the NRM ideology was flawed from its inception. They pointed out that the organization was always characterized by inequities and corruption engendered from within its top leadership right from the bushes into government.

At this stage of its existence, the FDC should cultivate a distinct ideology that is exemplary in all its facets and that whose stance on corruption and obscurantism are concrete. Further, this Party is tested on the ground, has deep roots and should lead in the negotiation for possible single interparty candidates in all elective positions come 2016.

The liberation frontlines have long shifted to a youthful population with better education and technological sophistication. Traditional Parties, such as UPC, DP and CP appears stunted and blunted in ideology to appeal to the liberal mindsets of the youthful generation. I may be dead wrong on this, but unless these Parties accept a political merger, they will remain an obstinate inconvenience in the Opposition politics going forward. In the mind of the youth, these Parties are the caricatures that symbolize the distant past of Uganda, given the 30 years of uninterrupted NRMO misrule.

Most importantly, we can scientifically collect evidences from past elections to demonstrate a growing empathy towards Inter-Party platforms. Trends in Opposition victories from direct and by-elections shows that Inter-Party candidates have had better chances at victory over the well financed NRM machination. It is also true that when Inter-Party candidates prevail, the celebration ignites a national rhythm creating the prerequisite impetus for social change. These patterns are imperative given the numerical and financial advantage of incumbency. The population appears attracted to a stronger, united and mature Opposition that is not obsessed with past glories, internal bickering, betrayals…, but a focus on social transformation beyond NRMO.

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Is the UPDF Impartial, non-partisan and Professional?

Militarism, Civilian Rule

The cloak over Uganda army's (the UPDF) impartiality in civilian politics needs urgent unveiling. Traditionally, public scrutiny of the conduct, character and composition of the UPDF is prohibited by its founder and Commander-in-Chief. I am taking this task out of leap of courage, hoping that it will find an equally a courageous Editor to even consider it for publishing!

I am responding to UPDF Spokesperson, Lt Col Paddy Ankunda’s previous articles (DM: November 7, 2014), and to his deputy, Maj. Henry Obbo’s recent one on this subject of UPDF’s impartiality (See: UPDF is a disciplined, non-partisan force, DM December 8, 2014). In these articles, the UPDF is exemplified as very impartial, non-partisan and professional army that would respect voters’ choices for change of regime; and does not intrude into civilian affairs.

While many of us have been alive long enough to witness the transformation of the NRA from those rag tag revolutionary elements of 1986 to today’s UPDF, we must place caveats when discussing its impartiality. I am inclined to ask, to what extent is the UPDF impartial, non-partisan and professional?

The UPDF may be a disciplined and professional army when compared with other armies in the region or past armies of Uganda. What is known is that the UPDF is not impartial either in their ideology or in dispensation of their allegiance. Given its history, the UPDF is openly still fused with, and as an appendage of the NRM Party. Therefore, to state that the UPDF does not ally with the incumbency is lunacy at best, if not a manifestation of traumatic stress syndrome.

Our most recent history will absolve us. We have been informed from 2001 when Kiiza Besigye contested for the Presidency, that he should not play with the UPDF because it belongs to its founder, the incumbent.

We have also seen the presence of UPDF in previous elections, practically intimidating voters. All of the UPDF commanders openly campaigns for the incumbent, need we mention names? They even use military facilities to compound to the humongous incumbency advantage. To this date, most NRM candidates in constituencies are vetted by, and must be seen to be supported by the army commanders. There is evidence through testimonies, and the voting patterns in most UPDF garrisons, like Achol-Pii, Gulu, Mbuya Barracks, Summit View, etc., where soldiers are mobilized, and ordered to vote for NRM candidates. We can review election results from UPDF barracks since 2001 for coincidence.

Incidentally, Politicians tend not to pursue these anomalies but it does not imply that Ugandans are blind to the partiality of UPDF during elections. If the UPDF were impartial, why should they be allowed to intimidate civilian during elections?

This brings me to the persistence of UPDF in Parliament, which is a civilian platform where an impartial army should not be represented. Now, if Maj. Henry Obbo and his boss need real hard evidence, let us examine voting patterns of UPDF in Parliament from the Hansard as a microcosm of UPDF’s ideological leaning. The UPDF can fool only the naïve about their purported impartiality, whereas they are openly not.

If UPDF were impartial, why did members of the high command assert in subsequent campaigns when Besigye challenged the status quo that they would not salute whoever wins President Museveni? What happened to Brig. Henry Tumukunde when he tried to exhibit independence of thought, wasn’t he forced to resign from his seat as Army MP? There are numerous examples that the limits of this article will exclude.

There are many more questions to ask than answers when it comes to discussing the degree of impartiality of the UPDF in Uganda’s politics. However, we recognize that there is even limited tolerance for public scrutiny of UPDF, especially its internal intricacies. Col. Ankunda could, perhaps, encourage internal dialogue within the army about ideological impartiality so that they exclude the public from such a debate; and to withdraw UPDF from Parliament.

 

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No tears for former PM, Mr. Mbabazi

Mbabazi Vs Museweri

The rift between President Museveni and the Kinkizi West MP, Hon Amama Mbabazi should not excite the youths going to the NRMO Delegates’ Conference. The groups that identify as poor/jobless NRM youths, jobless brotherhood etc should instead hold both Mr. Museveni and Mbabazi accountable for the policies that have diminished opportunities for youths.

These youths know that Mbabazi has been the engine of the system that has alienated them from socio-economic development of this country. If I were a youth, I would shed no tear for Mr. Mbabazi and vote against the NRMO come 2016. In fact, I would dry firewood to roast Mr. Mbabazi, socially and politically to allow him understand the experiences of being marginalized in one’s own country.

Not that I have a “thing” against Hon. Mbabazi, but I have witnessed him evolve through the system, building it into this insensible monster that now rules with impunity and doles out billions of shillings to educate Sudanese, Burundians, and Rwandese youths when our youths lack the requisite skills to access gainful employment. If Mr. Mbabazi gets consumed by this system, it would only teach others of his likes to design political graves for others while taking into consideration that they may require one for themselves at some point. The African soil is red for reasons; it is notorious for consuming those who subvert nature!

In 2005, I wrote an article about how certain elements within the NRM were digging their own graves by entrenching tyranny in Uganda. People like Hon. Mbabazi, Gen Tinyefuza, Maj. Mutale Kakooza, Brig. Mayombo, Gen. Kayihura etc, were legitimizing and consolidating the oligarchic cabal without forethought. Today, none of them is proud of the product of their handy-work. For them, it is too late to undo the damage, so they turn to the youths that they have marginalized and immobilized with fear. Youths should not accept to die in the causes of these evil men. Let them carry their own crosses to crucify themselves. Other zealots within the system may learn from such experiences.

Once upon a time there was the “Yellow Girls” phenomenon. These cheered on as dead bodies of youthful demonstrators piled on the streets of Kampala. Fortunately, most of these people do not see eye to eye with the President anymore. Some of them are not exactly as yellow, maybe cream or even crimson by now!

The youths should learn from how the composition of the NRM is changing very rapidly. What is constant is that the youths always received the short end of the stick. Some misguided youths actively negotiate for such a fate!

Although the National Youth Council (NYC) exists, it is not very inclusive given its limited budget and scope. Uganda today has almost 78% of its population comprising of youths, this is about 27 million young people between the ages of 15 – 30 years. This easily overwhelms the NYC. In addition, the education system has proven inadequate in instilling and honing skills in the youth to generate critical thinkers and innovators. This is why NRM is stuck with “poor” helpless youths who are demanding for employment, instead of creating jobs and innovating. This problem goes beyond Mr. Mbabazi and his rivals; it is the collective policy problems of the NRMO regime as a whole. The youths should hold all of them accountable.

I could be wrong, but clearly what is endearing these youths to Mr. Mbabazi is the myth that the former PM is “loaded”!  People believe that JPAM has stashed away billions of shillings in Israel and China. But when the youths come to debunk this myth, they will discard Mr. Mbabazi from their agenda.

This is where Mr. Museveni says that the youths are a misguided missile. In fact, they should be holding the NRM accountable for their gloomy prospects to fruitful and rewarding life. It is worthless to support feuding leaders when they should be pushed out. I contend that NRM policies as a whole should be targeted for a complete overhaul.

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Changing NRM regime is an inevitable socio-political progress

INEVITABLE CHANGE

One of the problems of Africa is its leaders overstaying in power. The major problem of Africa is its people who tolerate leaders who vegetate in power. They permit these leaders to amass unbridled power, thereby creating predatory political monsters.

Evidences are abounding that no leader, however armed, can stop a people's resolve for change. Egypt, Libya, Tunisia, CAR, Burkina Faso, and others have exemplified a people’s irredeemable resolve for change. These Nations have illustrated that the solution to some of Africa's chronic problems lie with its' critical masses.

Africans should embrace change in governance as an inevitable part of progressive socio-political experience. The fear for change incapacitates our conceptualization of peaceful transition to a just society. Zambia, Kenya, Tanzania and Namibia have all shown us that peaceful transition in Africa is a promising possibility.

Certainly, the Big Man Syndrome is a thing haunting us. But it is a thing of the past. The new elite generation of Africans appear liberal in mindset and yet timid to confront the big men. The increasingly youthful populace are removed from the pursuit of common interests. Most are self absorbed, selfish, unconscionable, ideologically shallow and petty in their dispensations.

In Uganda, nearly 78% of its population is youthful, under the age of 30. Incidentally, the current regime will make 30 years in power by 2016. This makes the imagination of peaceful change of leadership a remote enterprise to this generation. And yet, the stasis, in which only one man dominates the power, is subtly despised. Evidently, the NRMO youth leader, Mr. Dennis Namara, recently scolded their Party historicals for their persistent clamor to power on their bush-war legacies.

Commentators are wondering why the many unemployed youths possess low motivation to spearhead change demands. Underneath this lacklustre attitude towards change, is a desire to experience the change, but not the process of it. Being moderate means exercising more liberty, a fundamental right which draconian laws such as Public Order Management Act have appropriated. But you got to understand the orientation of our young people. Their schooling system de-valorizes critical thinking, hard-work, independence, persistence and innovation.

The bulk of our educated young people are disempowered and uncritical by design. They find no passion in being critical. They are overwhelmed with fear for status quo. Many would rather seek than create; receive than give, consume than produce, praise than criticize. When you are accustomed to the recipient tradition, challenging the Provider becomes subversion. Through an elaborate bribery system, the regime then suppresses critics by simple rewards. Petty jobs and political appointments then becomes bait for political expediency.

Every young citizen is self conflicted with false hope/ fear. They endure the fear of unemployment and its humiliation. They invest with hope in a false system with no guarantees for dividends. To be hopeful means demonstrating loyalty through faith depuration that sustains the tyranny.

In other words, the main problem of Africa is not its leaders who vegetate in power, rather, its vast unresponsive, uncritical masses. The leaders exploit the circumstance of indolence to stay in power. In fact African leaders are some of the weakest leaders in the world because once disposed, they quickly decompose into oblivion. While in power, they accumulate material loot well knowing that a miserable end awaits them. The culture of patronage and the recipient tradition makes African people culpable to exploitation.

Africans must face the fact that they concede too much and way too easily, what truly belongs to them. The entire world has exploited the African people and the continent. Other races have continued to diversely advance in organizing their societies meticulously through technology, industry, value adding... They have taken full charge of their resources.

African people are still shop for foreign investors. Embracing regime change will allow us to occasionally evaluate our true strength as a Nation and to allow us take control of our resources to progress our society.

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Importance of Census data for fight for HIV-Free society

HIV - Free Society

The Uganda Bureau of Statistics (UBOS)'s provisional 2014 census report has revealed that the population of Uganda is 34.9 million. This contrasts slightly with UNFPA’s estimates of 38.8 million. 

We must applaud the government and UBOS for having conducted this census after many years of postponing it. Keeping up with trends in population growth patterns is very crucial for economic planning, and for prioritizing resources to meet the varied needs of the population, especially in the fight against HIV/AIDS.

The significance of this census in shaping the vision for HIV-Free society cannot be underscored. Uganda’s population is one of the youngest in the world. For sub-Sahara Africa, it presents a challenge in youth unemployment and high risk of communicable diseases, including HIV.

In the 2012 State of Uganda’s population report, Uganda’s population under the age of 30 was 78%; those under 15 years were 52%; and those aged 18-30 years constituted 21.3% of the total population. The proportion of this population was projected to reach 7.7 million by 2015.

Research is showing that HIV is dominant among the age group 15-35yrs in Uganda. In 2001, 80% of those living with HIV were in the age group 15 – 34 years. With the current estimated 1.4 million people living with HIV, most of the agencies that provide health services are reporting high turnover rates among expectant mothers at antenatal clinics, and adolescents. In 2011, UNAIDS  reported that young people aged 15-24 accounted for 41% of new HIV cases worldwide, and nearly 5 million were living with the virus.

Studies are also consistently showing that HIV prevalence among girls, and women aged 15-35 is higher than those among their male counterparts. UNAIDS’s figures show consistent patterns of disproportionate infection among females than males. In Sub-Sahara Africa, female prevalence rates of 3.4% compares unfavourably with 1.4% for males.

Another 2002 study by Paul Bennel showed that females had higher prevalence rates until they reached 35 years, then their rates were surpassed by male prevalence rates. This means that the age of 35yrs is a critical age of infection for both genders. It implies that more women under the age of 35 years are living with HIV than male peers, and more males over the age of 35 years are living with HIV than their female peers. In the provisional 2014 census result, women of reproductive age, 15-49 yrs are numbered 7.3 million (21%) of the total population. These are expected to have 1.5 million births by 2015. We could protect these children from risks of acquiring HIV before birth.

Many HIV interventionists have argued that to stop the HIV prevalence rates, we have to focus on behavioural change. Programs such as PEPFAR/ABCs have been implemented. But HIV appears to be a disease that is malignant among the poor, considering that 70% of the global burden of the disease is found in Sub-Sahara Africa.

A robust response to HIV fight must be comprehensively streamlined to include income generation, and equitable distribution alongside behaviour change. A seminal 2007 study by Biddlecom and colleagues shows that 60% of females in Sub-Sahara Africa indulge in sex by the age of 18 compared to 40-45% of males. Among 15-19 year olds who have had sex, only 29-47% of females and 42-55% of males used contraceptives. Among Ugandan teens, one out of five reported that their first sexual experience occurred by force. Moreover, 17-26% of females compared to 6-7% of males have had two or more partners. This also means younger females are having unprotected sex with older wealthier males, 35 years and over. In Biddlecom's cohort of adolescents, 90% had heard of HIV, and yet fewer than 40% could correctly identify ways of transmitting the disease.

Any interested reader can familiarize themselves with two reports: Protecting the next generation in Sub-Sahara Africa by Biddlecom et al., (2007); and Protecting the next generation in Uganda, by Leila Darabi et al., (2008). Both reports are published by Guttmacher Institute. They provide a humbling insight into the magnitude of works required to lay a firm foundation for a HIV-free society.

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Amuru By-Election was a referendum: Implications for the Opposition towards 2016

AMURU REFERENDUM

Amuru has just concluded electing a replacement to Hon. Betty Oyella Bigombe who was seconded to World Bank as Senior Director for Fragility, Conflicts and Violence. Whatever that position entails, Hon. Bigombe secured a respectful position than her pitiful position as Minister of State for Water, considering her seniority in NRMO.

This time, Amuru people switched their position from NRM to Opposition FDC, which could also mean that the 2011 vote was for Ms Bigombe, rather than NRMO’s.

The outcome of the by-elections should not be taken lightly going to 2016. 

Amuru is one of the areas in Acholi that got battered terribly by the two decades of insurgency. Our memories are still fresh with the Atiak Massacre of April 20^th, 1995 in which over 300 lives. Later, the then Vice President Specioza Kazibwe, while visiting the scenes of the massacre, was quoted in the media to have said that the people of Atiak were killed to make manure. With such a dark spot in its history, it was surprising that the NRM candidate, Ms Akilli Amongi could even win at Atiak!

Atiak is relatively an urbanized centre, itself having been a home to one of the largest internment camps where life conditions were described as squalid and unbearable. The hopelessness and powerlessness that shaped the perceptions of the people there could have endeared them to the ruling Party for material gains. Further, it appears that most of the voters in Atiak are alienated from the harshness of rural life characterized by land grabs by soldiers, family conflicts, and forceful eviction for Madhvani plantations.

The other implication is that, the anticipated fortune of the NRM in this region is imaginary. There has been this false perception that NRM has made inroads in Northern Uganda. It appears that these areas tend to vote for individual quality rather than the Party. The regime minders front the various post conflict reconstruction programs such as PRDP, NUSAF, restocking, etc, as a reward or a favor, rather than a right, for the neglected region. 

For the locals on the ground, these programs have translated into fringe benefits for them. The proceeds from these services are evidently benefiting few regime cronies. Take for instance, the unequal distribution of war compensations, including selective cattle restocking, moreover with malnourished breed of animals. These services have compounded the misery of the people and driven them into ambiguity about post conflict development.  Given the fusion of the State with the incumbent political party, people are having difficulties discerning government programs from NRMO’s, and are apathetic to them altogether.

Amuru has been on the political spotlight over a long period of time. From the days of Divinity Union in the 90s to the recent open discovery of potent oil wells, the regime and its elements had eyed Amuru for grabs and they are still fixated on that trophy. Amuru has rich, fertile land, endowed with vast minerals and large rural population. 

The land is what beholds the populace. It is these attributes that the regime so wishes to usurp from the people, to dole out to sham investors whose agenda is to enslave the people of Amuru on their own lands. This by-election therefore was sort of a referendum, to tell Mr. Museveni that the people of Amuru meant business, and that, they value their land above all pettiness of politics.

One of the biggest implications of this by-election is the way it united the Opposition. Ugandans love to see UPC, DP, FDC, etc, working together as they did in Amuru and Luwero. When united, they can deter NRM from blatantly stuffing ballots and multiple voting by aliens to rig elections. Many commentators praised that harmony of interparty coalition in Amuru, claiming that it illustrated a degree of maturity which Ugandans expect, to be able to trust the Opposition with power. While the NRM leaks its wounds, the big questions going forward is; what political fortune awaits a divided opposition in 2016?

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Importance of 2016 for Northern Uganda

2016 ELECTIONS

The elections of 2016 have started attracting attention and this is partly why it is important for Northern Uganda. Many people look to each election time as a window of opportunity to change personal fortune. Elections in Uganda can be treacherous. The cost of democracy is expensive which means that people stake out their votes to the highest bidder. Elections platforms have failed to catch the fragmented interests of the voters who don’t trust politicians.

 One can say that democracy is not for those without legitimate interests to protect. If you have no interest in farming, business, trade, governance, security and industry, then you should not be in politics. Most politicians are naturally sore losers who hold their esteem and interests above that of the Voters. Irrespective of the fact that Ugandan voters are apathetic to the wasteful routine of pre-determined elections, they still value their participation in the process of electing crooked leaders.

The year 2016 marks exactly 30 years of tragedy for Northern Uganda. Out of the 30 years of NRM rule, Northern Uganda has had 8 yrs of peace, and 10 years by 2016. Since The LRA Peace Accord in 2006, some normalcy has returned - the majority of interned Acholi have returned to their ancestral homes, albeit impoverished and disenfranchised.

The significance of 2016 therefore serves to re-invent identity, revitalization and re-entry to the mainstream. The theoretical basis of the 20 years of war in Northern Uganda was to achieve a social transformation in the region. The NRM leadership promulgated that people from Northern Uganda were chauvinists, primitive, killers and therefore deserving of a forceful transformation.

The war was orchestrated and sustained through critical fronts: depriving the region of livestock, mass displacement of people from their natural habitats, destruction of their farmlands and degradation of their environment. Northern Uganda today endures horrifying deficit in land cover as deforestation has left that countryside plain. In fact one can now stand in Gulu and is able to see with his natural sight, the borders of Uganda and Sudan because there are no more trees. Much of the plants in Northern Uganda today are shrubs, thorns and stunted plants. Most of the large trees that once provided canopy, regulated wind-flow, weather, atmospheric water, minimized soil erosion, and provided niche for wildlife, are no more.

The elections of 2016 are significant because it is about post conflict recovery. It will set a new tone for the electorates to choose between a new breed of leaders who are capable of peacetime leadership through social innovation and population based resource mobilization to revitalize the rural and urban economies in the Northern Uganda region, and those stuck in conflict mindset.

The challenges of Northern Uganda are numerous, but the critical ones are associated with the number of young, uneducated, orphaned and sickly young people. Most of them are unemployed or in between menial labor such that they have no time to discover their true identities outside what the regime says of them. The economic magic of peaceful Uganda has not fully embraced Northern Uganda. There are signs of slow reintegration taking place as new buildings are sprouting and low end middle class is emerging. This has illustrated the resiliency of the people, but also reveals a deeper need for a more ideological orientation specifically to tackle post conflict challenges such as pervasive sense of hopelessness, undiagnosed post traumatic stressors, maladjustment leading to self destructive activities such as chronic alcoholism and underclass mannerism leading to sex risks for contracting and spreading HIV.

The 2016 elections provide a potential for the Northern Uganda population to take the stride towards complete recovery. The real recovery and reintegration of Northern Uganda into the mainstream has been predicted to last over 40 years. For now, each election should be utilized to select leaders who have the vision, tenacity and capacity to lay foundation for recovery.

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Public Policy and Fiscal commitment key to achieving HIV-free generation

HIV-FREE GENERATION

 

The debate about a prospective HIV-free generation given the advent of WHO Option B+ attracts attention on the surface. A further probing of the whole idea, however, may reveal a distant utopia. To have HIV-free generation, our communities must come to a convergence on reducing new infections.

There is need for deliberate public health policy and unwavering fiscal commitment to this end. Unfortunately, our national spending priorities deprive the masses of critical social services needed to attain acceptable levels of health.

HIV/AIDS is a disease left to wreck havoc among the destitute of the world. The wealthy and educated are surviving the scourge longer. Their children are able to avoid contracting the disease when compared to the children from impoverished communities. This explains why the global burden of HIV/AIDS is most prevalent in underdeveloped countries like Uganda.

To think about a prospect of HIV-free generation, we have to see the big picture of the structure of governance, the quality of public policies and the distribution of critical resources necessary to secure prerequisites of health.  These forbearing conditions also do shape how society places value on containing the HIV virus spread and caring for those living with the virus. The recently passed HIV and AIDS Prevention Bill (2008) is an example of required policy instruments, which must be accompanied with equal funding commitment

The Ugandan government has demonstrated inability to meet most of the MDG goals including reduction of HIV infections. Scientists now agree that at its current pace, Uganda may achieve some of the MDGs in critical areas such as reduction of new HIV infection, eliminating mother to child transmission of HIV, providing services to reduce child-maternal mortality by 2035.

Uganda is a signatory to the 2001 Abuja Declaration, which committed governments to allocate at least 15% of its annual budget on health services. Uganda has achieved barely 8% since 2007 while only Tanzania has achieved this objective. The ratio of healthcare workers to patients remains staggering and yet the WHO Option B+ remains the most promising opportunity to the achievement of this goal.

It is impossible to effectively implement this HIV treatment regiment when government's per capita heath expenditure is far below minimum international threshold. An audit report in 2013 found that Uganda was spending only UShs 2, 500 (US $1) a month on healthcare, which means it's annual per capita health expenditure is about US$12. This is ridiculously below the 2001 Commission of Macroecomics and Health recommendation of US $ 34 per capita.

The HIV treatment has three parts to it: the biomedical aspect, which includes treatment; the psychosocial aspect, which entails the social needs of persons living positively with HIV; and health promotion, which entails preventive strategies. Each of these aspects is complimentary to each other and yet requires specialized skills, commitments, resources, and funding.

The HIV-free generation, health promotion in the context of maternal child health and HIV infection prevention are crucial. This is where our healthcare system is failing. The 380 people who contract HIV on the daily basis in Uganda are among some of the poorest and yet they endure insurmountable challenges in accessing health information and in economic production chains.

Opportunities for health promotion would mobilize distinctive and progressive cultural resources to enhance the quality, relevance, and efficacy of health promotion and the management of health to prevent new infections. Without bringing in relevant cultural resources, communities will shun important services such as family planning. Social and societal discrimination remains amplified and more so where resources are scarce.

Lastly and most importantly, is the understanding that to create HIV-free generation, we have to realize a reduction in new HIV infections. The WHO Option B+ is effective; however, certain cultural practices and beliefs are still retrogressive, oppressive, and predatory. These undermine opportunities for girls and women making them vulnerable to HIV infection. These conditions will continue to block progress towards achieving HIV-free generation.

 

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Death at Birth is still a reality in Uganda

Maternal Child Death

Death at birth in Uganda is still a daily reality. In fact being pregnant, seeking qualified healthcare services, including Emergency Obstetrics Care (EMOC) are pathways to death.  The UNFPA reported that only 13% of Ugandans actually live in urban areas, implying that Uganda as a whole is majorly rural. And yet, majority of the functional healthcare facilities to support maternal-child health including safe pregnancy and delivery are concentrated in urban areas.

As a consequence of this disparity, only 42% of pregnant women were delivering in health facilities. The figure has improved recently, showing that 57% of women are being delivered by skilled labor in healthcare facilities (according to 2012 data). Uganda’s maternal mortality ratio is 310 per 1000 of live births; 5000 mothers still die at birth annually (from a 2010 source) which has also improved. UNICEF has recently upgraded data which shows some improvements in maternity services consumption. For instance, 93.3% of pregnant women are now attending to at least 1 antenatal visits; 47.6% are attending at least 3 antenatal visits. The WHO recommends at least 4 antenatal visits.

The maternal child health in Uganda could improve if the needed services are taken to rural communities where majority of the women live. This effort requires a political will to commit to the Abuja declaration that government should commit at least 15% of its national budget to health. Currently, Uganda has not fulfilled that commitment as health budget remains staggeringly low while health services expenditures are increasing (Mbonye and colleagues, 2012).

There is also need to increase the density for Midwives, Nurses and Doctors from the current 1.4/1,000 to at least 23 as recommended by WHO, for Uganda to be able to meet its Millennium Development Goals. At the current rate, Uganda will only be able to meet those goals by 2035 or even later.

In my home district of Pader, there has been one doctor for the population of 231,700. Dr Ochaya recently passed on, which means Pader has no Medical Doctor! Given its relatively new status, Pader District is disadvantaged in that it does not have a robust Missionary hospital like its neighboring districts of Kitgum and Agago.

 In Uganda, 42% of functional hospital facilities are in the private hard-to-reach for the poor, the Missionary hospitals and NGO operated health facilities. Most of the government facilities are on steady decline; understaffed with some unqualified personnel attending to medical emergencies.

There are many untapped opportunities in the Ugandan healthcare system. The Village Health Teams offer untapped potential for reach to households in rural communities. This team should comprise of Comprehensive Health Nurses with facilitation to provide instant services in rural hard to reach localities. Instead of employing one Doctor in a rural district like Pader, we should transform the health care system into Public Health Units such that the Doctor becomes the director of various health services with emphasis on preventive healthcare services.

The way sub-Sahara Africa is portrayed in literature is as if it is entirely a place of doom where the males wish their wives and children death. This is arbitrary to the fact on the ground. Every African man strives to have a healthy family and suffers grief when a child or wife dies. Therefore, it is incumbent for us to articulate accurately, those social determinants of health which affect the health of these people in rural communities and work on them collaboratively. We need to pay attention to poverty, rural livelihood and opportunities for earning income, the use of income, investment in communities through functional education to enhance health literacy, transportation, clean and safe water, sanitation, nutrition and security etc.

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Human trafficking discourse is complex

HUMAN TRAFFICKING

I appreciated reading the DM editorial of July 15, 2014 on this subject and the clarification made by  Jacob Siminyu from the Directorate of Citizenship and immigration Control about concrete actions being taken to curb human trafficking at national level.

Understandably, the discourse of human trafficking is a very complex one and it cannot be effectively resolved at the policy level only although such interventions are imperative.  The global human trafficking and trade in humans for labor or any other purposes formed the basis of one of my Global Health studies. Indeed, the common pre-exposing risk for humans to be harvested for trafficking from any society starts with the social conditions in which they subsist. 

To fully understand the complexity of this problem, one needs to undertake a socio-ecological framework approach to systematically unpack the pervasive nature of this lucrative vice. The socio-ecological framework would allow a critical analysis that focuses on individual level challenges, interpersonal (such as relationships, cultures etc), community level loopholes, societal factors and public policies that make human trafficking possible. Another level of critical analysis would be the supranation level where national, regional and international instruments, policies and efforts can converge to curb human trafficking.

However, it is essential to emphasize that poverty, lack of skills and broken social safety nets – simply put; the social determinants of health are also the determinants of vulnerability to being trafficked. In Uganda today, voluntary trafficking is taking place because of nationwide despair among the elites.

The rate of unemployment among youths and the semi-elite Ugandans inevitably makes them very susceptible to being trafficked.  In 2013 62% of the Ugandan youths were reported unemployed and yet 78% of Uganda’s population is under the age of 30 years. Almost half the Ugandan population is below the age of 24 years. The prospect of experiencing unemployment makes the youths to develop interests for future prospects outside the country. The process of fulfilling such ambitions also makes them a very vulnerable group.

A study by Amy Hagopia and colleagues in Uganda which was published in 2014 in Health Affairs Journal revealed that 1 in every 4 Ugandan health professionals aspired to leave Uganda for any destination where they could improve on their professional outlook. But a much more important study conducted among Ugandan Nursing students was published in 2008 by Lisa Nguyen et al. revealed that 70% of nursing students expressed desires to work abroad after graduation and another 24% revealed ambitions to work elsewhere in Africa upon graduation. In all these studies, participants cited poor pay, poor working conditions and not being valued fully for their services.

A group like these, comprising of the country’s most qualified workforce are the primary victims of human trafficking because they are driven away by chronic failures at home. Most of them are not aware that their credentials are not valued in Europe or North America until they get trapped there. Majority of them voluntarily register with agencies to be ferried abroad for menial jobs which subsequently transforms into forced labor and being held in servitude.

While Mr. Siminyu was upbeat in his enumeration of the high level interventions being developed, there are many gaps beneath policy instruments. There is need for a systematic and collaborative interventions designed with various state and none state actors at all levels to stabilize society.

On top of the agenda should be the redistribution of resources, snubbing corruption, creating conducive work conditions, setting minimum wage, affirmative action for young women to build a pathway to employment, providing vocational training to youths and ensuring that diverse opportunity ventures are opened for youths practice innovation.

Lastly, public policies targeting human trafficking should be formulated with the focus on removing inequalities and inequities at all levels of society. Key among these are building individual skills and community capacity, establishing an inter-agency coordination efforts to curb human trafficking.

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US-AFRICA Summit 2014: An empty rhetoric

US-AFRICA SUMMIT, 2014

Listening to Obama make a fool of Africa and its leaders was the most scintillating highlight of the US-African summit being hosted in Washington DC. Obama opined, and I quote “We don’t look to Africa simply for its natural resources. We recognize Africa for its greatest resource which is its people and its talents and its potential”. While many Africans clapped their hands in approval, some few clever ones knew that this is an empty rhetorical that dominate global economic policies towards Africa. Available historical accounts of US-Africa relation shows the contrary as this article shall elucidate.

To contextualize the US-African summit 2014, one needs to understand that this conference is a direct counter to the increasing economic influence of China in Africa. The US and its allies are genuinely frightened of the rate at which China is making concrete investment and control over Africa’s crude oil and mineral resources.

By 2009, China was already Africa’s main trading partner, surpassing USA. In 2012, China’s trade volume with Africa hit US$ 198.5 billion mark while US’ was only $99.8 billion. That is twice as much trading already and yet China’s trade with Africa is only 5% of its total globe trade. It is estimated that more than 80% of China’s $98.3 billion of import from Africa in 2011 were in minerals, raw resources and crude oil.

China’s trade with Africa has been soaring in the last decade or so, while USA has been meddling in Africa for centuries. Why then is Obama misinforming the world about US interests and presence in Africa as if US is a new entrant in exploiting the continent?

For many centuries, the developed West sustained very unfavourable trade relations with Africa best described as bullied exploitation and economic repression. For the most, the current predicament of Africa and its lagged economic progress is mainly attributable to these centuries of exploitative bullying from the US, UK, France and most of their colonial apparatuses that continue to meddle in Africa’s internal affairs.

Therefore, Obama’s claim that the US looks beyond oil and mineral resources should be treated with the contempt it deserves. The basis of any positive economic relationship with Africa has been hinged on crude oil and raw materials. The US has footprints in each and every country in Africa, stable or unstable. They are there primarily and precisely for economic benefit, not to develop human resources or African infrastructure. Otherwise, Africa would not have been as poor and deficient in all internal aspects to compete favourably in the international markets.

Obama offers US$ 33 Billion in new trade partnerships to ensure that US goods and services gain access to African markets. This is another baloney. One only needs to read John Perkins’ 2004 book: “Confession of economic hitman”, Jeffrey Sach’s  2005 “End of Poverty: economic possibilities for our times” and Health Poverty Action’s 2014 report, “Honest Account? The true story of African billion dollars losses”, to unpack the worthlessness of this Obama’s US-Africa trade package.

Mr. Perkins is unequivocal in his narration of how the US has always used underhand methods such as assassinations, cultivating civil unrest leading to regime change, paying bribe to influential leaders and where possible, supplying arms and protection of crooked leaders to manipulate co-operations of all kinds from any country in the world. 

Perkins provides numerous examples around the world where the US is still involved or where it left tragic footprints in pursuit of its interests. According to Sachs, the true value of American foreign aid that reached the person in Africa in 2002 was only 6 cents after all deductions. 

Both Perkins and Sachs show that most of the money that the US offers to Africa, either as aid for cooperation or grants go directly to US agencies, paying off “expatriates”, deduction for debts owed and financing infrastructure that serves American interests in those countries.

The Health Poverty Action report shows that for every US$ 30 billion in foreign Aid that Africa receives annually, it losses US$192 billions. The money is lost through loan and debt repaying of $46.5 billion. Other losses include $35.3 Billion in tax evasion and other illicit financial flows facilitated through tax havens; $17 billion in illegal logging; $3 billion in remittances; $46.3 billion repatriation of profits made by multinational companies; $1.3 billion in illegal fishing and Africa incurs a loss of $36.6 billion as a result of climate change and $6 billion as a result of brain drain.

We conclude that this summit could be fruitful if Obama announced at least 85% of US debt relieve to Africa; expanded US market access beyond existing mechanisms such as AGOA, Power Africa Initiatives, a declaration to respect African autonomy over its resources and removal of Agricultural subsidies and protective mechanism to inhibit Agro-based imports to the US markets.

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Evidence now shows it is Africa donating Aid to rich countries

AID DEBATE

Proponents of aid to Africa will have difficulties convincing the world that Africa really need empathy and financial bailout from rich countries. It has emerged that Africa is indeed the continent that is sustaining and aiding the world with its vast resources and potentials. 

A report by Health Poverty Action released recently shows that Africa is receiving US$134 billion in aid every year and it pays out US$192 billions in return to the wealthy nations. This means every year, Africa donates US$58billions to the West. This is a compelling case which illustrates clearly that donor aid is not meant to develop Africa, but to create favorable environment for mockery and subsequent exploitation.

The situation is made worse by African leaders who are positioned as appendages of these Western government’s mechanisms of securing their national interests. The aid arrangement ensures that African interest is subordinate to the realization of ending poverty and the likes of Prof Jeffrey Sachs should not mislead the world that they have magic formula for ending poverty anywhere using foreign aid. 

Even then, the prevailing aid debate is devoid of a critical assessment of the dynamics of supremacy of foreign control using aid in the realization of foreign interests.

It’s a wonder that Uganda with the highest concentration of NGO per capita in Africa would be presented as a success story by the World Bank and donor community. If the Ugandan economy is indeed growing at 5% per annum, how come Ugandans are not realizing the benefits in critical social services like health care?

Foreign aid is a ploy of hoodwinking the populace so as to soften the ground for resource exploitation. Take for instance that all contracts Uganda signs with direct foreign investors are so shrouded in secrecy and yet Donors are not conditioning aid to foster transparency in natural resource exploitation. 

And, this is surprising given the fact that the British government critically condemned the Chinese- DRC US$6 billion resource – for – infrastructure swap, arguing that it was a bad deal, shrouded in secrecy and in bad faith - claiming that the people of Congo were at the short end of the stick.

To a discerning audience it is clear that the Congolese – Chinese resource deal which truly was similar to the Ugandan - Tullow Heritage oil deal in their lack of transparency was criticized by the British Government because the exploiting parties were not Western based companies.

The report by Health Poverty Action, “Honest Accounts? The true story of Africa’s billion dollar loss - 2014” is a must read.  According to Health Poverty Action, there is unconscionable capital drain to the West from Africa in excess of US $58 billion per year which could service Africa’s foreign debts and bilateral loans sufficiently.  After all, the US aid amounts to only 6 cents per African per year according to Jeffrey Sachs (2005, p.310). 

It is surprising that the so-called economists who claim to be so concerned about Africa are not arguing strongly for plugging these drains.

We may appear too hard on proponents of aid to Africa. But coming from countries benefiting from the capital drain from Africa, they may be fighting not only for their own preservation but for the economic interest of their countries. It is in the realization of Western economic interests that aid is used as bait for compliance of Africans to surrender its resources. 

Certainly, if aid was to develop welfare services for poor communities it is difficult to argue for withdrawing it for political convenience. Why would the aid be withdrawn only when anti-homosexuality bill was passed in Uganda but not the draconian Public Order Management Bill which stifles democratic governance?

A simple conclusion is that the discourse of aid is both racialized and politicized. It is in the political realm that we find strong representation of western scholars blaming all the ills that are associated with Western puppets in Africa on Africans. For instance, President Museveni, with all the numerous reports of gross human rights abuses by reputable agencies such as Human Rights Watch, Amnesty International, the International Red Cross etc, is rewarded with praises and more military aid.

Foreign aid, good as it sounds, has the soft under belly of foreign control and western interests which its proponents tactfully conceal. If the West really itches to give aid to Africa, let them start off by total debt relief for Africa which remains a thorn in the developmental flesh.

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