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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