Why more Ugandans prefer witchcraft than hospitals

 

 HEALTHCARE FAILURES

 

I read Dr. Diana Atwine's speech in the Daily Monitor on May 9, 2023, about the prevalence of Tuberculosis and Leprosy in Uganda. Dr. Atwine is the Permanent Secretary of the Health Ministry. The Health Ministry is a very critical public institution whose role in helping Ugandans cope with ill health and health-related threats is complementary to Uganda's national development goals.

 

In the referenced DM article, Dr. Atwine advised Ugandans that TB and Leprosy were not witchcraft-related diseases. By that statement, Dr. Atwine invites Ugandans plagued with TB and Leprosy to seek healthcare services for proper assessment and management of the diseases.

The problem is, Ugandans fear Dr. Atwine's public healthcare system!

 

In Uganda, the explanations of the causation of "unwellness" have strong roots in personal and cultural health beliefs. Many Ugandans are still semi-illiterate and broke (poor); even those who are learned, health services consumption behaviors are strongly influenced by costs.

The cost and stress of encountering Dr. Atwine's public healthcare system are itself pathogenic.

 

Dr. Atwine and her team must be knowing that witchcraft practices increase in Uganda when the healthcare services run short.

 

The glamorous buildings that emerge randomly to define our skylines during economic hardship like now, probably belong to witch doctors, their intermediaries, and certainly corrupt government officials.

People have turned to traditional beliefs and practices due to fear of confronting the ever-money-sucking healthcare workers, poor services (attitude and skills), high costs associated with buying hospital supplies and drugs that government should provide, and poor outcomes (rigor mortis/frequent deaths) in government hospitals.

 

The health care system, itself a key determinant of health, is simply inaccessible to many Ugandans in the moments of their urgent needs.

 

However, the health ministry is doing some great investments – rehabilitating and refurbishing hospitals, healthcare centers, and so forth. However, a colorful hospital building is not what makes a hospital a hospital. It is the sum total of socialization therein – ethical socialization - to be precise, that makes a hospital a hospital. And, this basic element is grossly missing.

 

The quality of care in government hospitals and health centers is seriously wanting. The unethical conduct within these institutions needs immediate attention if sick Ugandans including Leprosy and TB patients are to seek treatment there.

 

The hospital, however, is a place of extortion that begins for most Ugandans at the gate with the Askaris. Patients and caregivers are milked right from the point of registration to the most sophisticated professional. It is like the government only pays the basic salaries of these health workers such that the ill Ugandan must pay out-of-pocket for supplies and drugs. This is not even cost-sharing as we once knew it!

Most times, you find poor people being charged for gauze, cotton wool, a pint of blood, etc, including a piece of paper to document their care or else their patients are left to die or unattended. What happened to medical ethics and Hippocratic Oath that we once swore with pride?

 

While the fiscal constraints with which the health ministry operates are worthy of our empathy, the idea is to let the care process be functional with some proactive oversights.  Uganda currently allocates a paltry 6.1% of its national budget to health (See DM editorial of May 12, 2023). This is not for the lack of money, given the high cost of public administration. This, precisely, is a neoliberal policy strategy to renege on the state's role in healthcare provision for a perpetually cash-poor population.

 

Further, the poor service delivery at the local government level attests to the collapse of local government functions, and least to the lack of donor support to the health sector. The purpose of decentralization was to bring services closer to the people and empower people to seek direct accountability for these services.

 

Right now, the services are alienating the very people and no one dares provide accountability for the pathetically awful healthcare services.

 

The health ministry itself snubs citizens' attempts at providing direct feedback on these horrendous encounters. Empowering the population means that end-users of the healthcare facilities should provide direct feedback for you to acknowledge and respond to.

 

If the Ministry feels that it cannot accept feedback from the everyday users of the healthcare system, or those rebuffed by the horrible experiences in the system, then why should a local government-run health center be accountable to the people? The Ministry should not shut out civic engagement that empowers its service users else people drift to witchcraft.

 

In sum, Ugandans are turning to witchcraft to "treat" their frustrations and ailments, including TB, Leprosy, HIV, mental illness, and so forth because witch doctors are more accessible, affordable, professional, accountable, and provide some form of psychotherapy, however deceitful to the poor, than our educated experts. People now know that government hospitals are places where their poor loved ones go to die.

End

The Uganda National Examination Board Exam results often alert us to our social inequities

SOCIAL INEQUITIES

The Uganda National Examination Board, commonly known by its acronym UNEB is the statutory body that sets and marks national schools’ examinations at Primary, Ordinary, and Advanced levels of education in Uganda. UNEB filters much of the workforce or tertiary institutions-trained manpower in Uganda. For students, passing the UNEB exam is critical as failing it may also consign one as a societal failure in a culture where a white-collar job is the singular most crucial measure of success.

 The idea of standardized national examinations wouldn't be bad, and it has not been. The real problem is that UNEB exam outcomes have become one of the most reliable measures of social inequality in Uganda. It is also a profoundly reliable predictor of widening gender inequality.

 Children of the rich attend elite schools and pass UNEB exams by any means possible. Children of the poor attend not-so-great schools and fail UNEB exams, with, of course, a few exceptions who may defy the odds to perform well. This pattern of performance in UNEB exams has been the standardized script for decades.

 The aforementioned is not the problem of UNEB.

 UNEB is only a prism through which we are able to observe and analyze social inequities in our country. There are many other robust prisms to measure the materiality of our social inequities, whether in accumulated wealth, income source, employment opportunities, or the patterns of distribution of cultural, social, political, and economic resources.

 Thus, UNEB examination results often remind us that there is a profound endemic societal problem arising from the structuring of our society under this hegemonic social order under the NRM.

 Three decades ago, when UNEB released its examination results, newspaper headlines blossomed with success stories - individually and groups.  Every newspaper would rush to publish reports of best-performing students and schools from around the country. Then the inequities intensified and for two decades, the best-performing schools and candidates were from elite schools where the rich people send their children, in central and western Uganda.

 The best candidates from elite schools filled our front pages and the best performers from remote centers were celebrated as a footnote. Overall, the beaming faces of parents hugging their successful children and celebrating with them often captured the imagination of the nation.

 Until the high school fees' moments come beckoning, of course!

 But now things have changed.

 These days, newspaper headlines scream with the proportion of those students who flanked their UNEB exams in large numbers. 

 Something else caught my attention. For the first time in nearly thirty years, a newspaper headline now revealed to the nation that boys have performed better than girls. 

 Another observation of interest is that Ugandan newspapers are reporting on an exceedingly high number of students whose results were held on suspicion of cheating UNEB exams or being involved in examination malpractices. Leaking exams demonstrate how the fear of failing UNEB makes candidates and parents equally nervous!

 A standardized national exam, however, must have integrity.

 In Uganda's case, failing S4 and S6 defines the life course of many citizens. It is worst for those at the lower socioeconomic margins.  In other countries, there are options for adult education and various arrangements for one to redevelop a career after flanking regular schooling. In Uganda, failing UNEB exams endears one to the bottom of society.  Most progressive societies have abandoned national exams because not all those who fail UNEB are not good. We can agree also that UNEB has excluded some of the most brilliant brains in Uganda from achieving their full potential.

 It is also in Uganda where one has to produce their PLE, UCE, and UACE results even for a lowly automobile driver job or managing director of an organization. UNEB is still very critical and so must its integrity. 

Pay the high cost of school fees while government dances the liberal market trot dance

REGULATIONS

Before 1990, schools in Uganda were affordable. Parents had the means to educate their children through elementary and secondary education, while the government took the responsibility to educate the best-performing students in Universities and other tertiary institutions.

Then that changed when the liberalization of the economy took place. The government sold every asset it had and folded its hands in providing social services under the new socioeconomic formation - the market economy. The government scaled down on its obligation in all spheres of the social life of the citizens and strengthened its military muscles to protect the market.

Private schools started appearing to absorb excess students that the government was no longer paying for. Those students whose academic performances were not good enough for government sponsorship at high institutes of education also got absorbed. The advantage was that every child eventually had hopes of somehow attending school at a cost. The government embarked on withdrawing its full support to public schools and universities completely until the UN Millenium Development Goals convinced us that Universal Primary and Secondary Education are still critical for our civilization.

The street fights of the 1990s with Makerere University over the boom epitomised this radical departure of NRM from its initial ideas. The introduction of cost-sharing in tertiary institutions followed suit. These abrupt changes were nightmarish because most students who could not qualify for government sponsorship at a public university were actually smart kids. Most had studied in humbly remote schools and under very strenuous circumstances. Tertiary institutions were their hub and a stepping stone to rise to better future opportunities. In fact, if you wished to understand how the ordinary Uganda child struggled for success, spending time in teachers' colleges, allied health colleges, business colleges, etc would affirm such. You could see that most of these students were oriented to their facts with a unified vision to exceed the predicament.

Why are we now in this confusion where the government can no longer regulate school fees and standards of education?

Often, we are told to put our mouths where we put our money!

The appealing ideological cornerstones of the NRM faded and became stale somewhere about 1996. At that time, Ugandans had experienced a fundamental change in the NRM character.

Uganda’s resentment of him was the 1996 Paul Kawanga Ssemogerere (RIP), running alongside Hon. Cecilia Ogwal. Clearly, Museveni was at an ideological crossroads which he fully understood but had no shame to relent. He had abandoned his original Pro-Africa or Pan-African economic policies stance and hobnobbed in bed with the West. He had swallowed the neoliberal marketization seed.

We say that there is a forest in every seed. The neoliberal economic policies that Museveni swallowed in 1989 have now produced the forest of inadequacies, corruption, extreme social inequalities, and inequities of contemporary Uganda.

If the government can regulate your life, and even take it away, how can it possibly fail to regulate school fees? The response is that Museveni and his government are trapped in the web of an exploitative global neoliberal economy – the mobile and exploitative phase of capitalism that commands an unhinged liberal market and a reduced influence of government (anti-statism) in the affairs of the market.

For the avoidance of doubt, when the government reduces its funding to schools, most schools fail to meet their basic operational costs. As such, they must charge students more to be able to operate and perform. With the ongoing post-COVID-19 inflation, schools – public or private – will demand more from parents and the government will continue to do the neoliberal trot dance while looking the other way.

Government is helpless and indeed, cannot effectively regulate any sector if it cannot control inflation or doll-out tax-payer money to subsidize gaps in school expenditures. The high burden of school fees is one sign that we, the people of Uganda, are on our own. It affirms further that the government is not the government of the people anymore; it is the government of the liberal market economy. Thus, it is the market economy that regulates it and not vice versa.

END

The Balaalo Surge: Debunking anti-Acholi land appropriation discourses

     ACHOLI LAND GRAB

Acholi land issues are thorny and contentious largely because of many falsehoods or distorted public discourses inspired by sinister motives of aggrandizement. According to M. Foucault, a “discourse” is a historically contingent social system that produces knowledge and meaning.  Discourses transmit, produce, and reinforce power – but also can expose and undermine it.

There have been several discourses sustained about Acholi and Acholi land specifically. For this article, two discourses need urgent redressing; a) that the Acholi land is free and unused; and b) that the Acholi people are sectarian for resisting the surge of Balaalo pastoralists and land grabbers. These two discourses require urgent debunking!

There are opportunistic Ugandans who assume to have better ideas of how to use Acholi land which they consider free and unused and go about propagating discourses to justify land appropriation. These discourses, therefore, afford them the reprieve to appropriate and annex Acholi land as was the case in 2021 with the annexation of Apaa to Adjumani.

Acholi land is not “unused”, “free” or “available” for grabs. Period! Historical facts dispute this discourse and illuminate a plot to perpetrate economic annihilation of the Acholi. For the record, the Acholi people capably preserved and managed their land communally and productively before 1986.  This Acholi region was once wealthy –produced a variety of high-quality food crops twice a year, and cash crops such as cotton and coffee throughout the year. Acholi people are hard-working farmers, hunters, and entrepreneurs like every other group in Uganda.

The pre-Museveni Acholi land relied on cattle, goats, sheep, fowls, and farming for their livelihood. Every Acholi who lived outside Acholiland would return home during public holidays to replenish their own food stocks.  The two decades of war in northern Uganda profoundly disrupted this trend of economic growth and stability. The dispossession of cattle from Acholi and the internment of nearly 1.7 million Acholi people from their homesteads should be prominently illuminated to debunk this discourse. The enduring effects of that war cannot be underwritten in countering this discourse, either.

Honest Ugandans and the Balaalo have no basis to sustain the discourse that Acholi is sectarian. Recently, the surge of Balaalo into the Acholi region gained traction and is generating a lot of tension. The Balaalo are nomadic pastoralists previously known to Acholi in their capacity as kraal attendants – before 1986. Even with their questionable origins, privileges, and consciousness, the Balaalo should be respectful of Acholi and show courtesy. Unfortunately, the forceful ones are university graduates, armed, and most rear their cattle remotely via cell phones.

Key characteristics of this group that are resentful, include indiscipline, arrogance, violence, and a strange sense of entitlement to Acholi land.

Most of the pre-NRM/A Balaalos were paupers who were propertyless with no claim to Acholiland, except for their excessive affinity and care skills for cows as their competency. Most were employees – cattle keepers - that Acholi families treated very well. The short-horned cattle in Acholiland were commonplace and plentifully entrusted to the Balaalos. Every Acholi who owned cattle also employed Balaalos and paid them by agreement, mainly in gallons of milk. This arrangement was amicable as the Balaalo made more money from selling milk than if they were paid monthly wages. They were housed and given land to cultivate food. Some were even married wives and settled as part of Acholi families.

I know this because my father had lots of herds of cattle in Pajule, and my grandfather had almost 250 cows that lurked gracefully at the foot of Atoo hills in Aswa county. There never was a problem of trust or misunderstanding between Acholi families that own cattle and their Balaalo employees. I stand to be corrected on this. On a few occasions, however, some Balaalo tried to accumulate their stock by stealing calves. I never heard of a Mulaalo being mistreated over such, however, we know that most became NRA spies in the heat towards 1986.

Thus, the correct counter-discourse should be such that, Acholi land was dispossessed of cattle and its socioeconomic life potential by means of war, de-stocking, and mass displacement. As such, the NRM/A junta mistreated Acholi on many fronts. The dispossession of its livestock is only one of those, economic annihilation and subsequent protracted violence against the people need to be comprehensively redressed and not perpetrated.

The ongoing surge of the Balaalo with their cattle, however, reminds the Acholi of how treacherous it is to trust your former employees who turned against you, ransacked your home, killed and humiliated your people, and interned your population in squalor. Acholi needs breathing space to recover from the long-term effects of that “social transformation” that Museveni curated for them.

It is shameful that the Balaalo are now returning to grab Acholi land, which they know its potential quite well. In that equation, how will the Acholi person benefit from Balaalo harassment and land appropriation?

It is important to note that, while the Acholi are now caught defending their dispossessed land, there has not been a genuine effort on the side of the government to properly restock the region.

Where you live and work determines your health

MIGRATIONS

Where we are born, grow, play, work, retire and die determines our health. Place, according to the World Health Organization, is a determinant of health and this explains why a built environment is also a determinant of our health. Place matters in everything we do. Place reinforces and validates our identities, and values, and shapes the context of our perspectives.

This article is an abridged version of a speech that View Global Services Inc provided to newcomers in Canada recently. The theme of the event was to motivate and inspire newcomers to make sense of their new immigration status in their new place - Canada.

As we know, it is extremely difficult for ordinary Ugandans to get the coveted Canadian visa, and more so, harder even for those who apply and are denied. Those who make it to Canada, however, have opportunities to succeed in building for themselves a meaningful life through hard work and accepting integration in the multicultural place that Canada offers.

The lesson learned in legal immigration is that changing places has numerous advantages. A person may have limited opportunities and skills to thrive in one place, and yet in the next place, these opportunities become boundlessly useful. Migration is the benefit of globalization.

An analogy using a bottle of packaged water illustrates how value changes from place to place. “The water bottle is probably 20 cents in a Costco supermarket,” he said. When you buy the same water bottle in a convenience store, it is probably $2.00. For the same water bottle brand, you pay probably $5.00 in a restaurant and pay $10 for the same bottle of water on a plane or a five-star hotel. The lesson is that our values change from place to place like that water bottle. It is up to us to find the place where we are valued the most.

Place matters. My high school physics teacher, Mr. Kijjambu, once challenged us to travel around the world to complement our learning – to expand our horizons. He always rebuked those who found themselves born in one place, lived, studied, worked, and died in that same place. Mr. Kijjambu cautioned, such as an unexamined life, and warned us about falling into the grip of poverty. He reminded us that poverty has a way of constraining one’s hands and legs and closing both their mind and eyes to prospects in this world.

Arguably, many people are afraid of change. Migration is energy and resource-consuming. Stability, and settling in a familiar place where one has an established social network and a routinized way of life provide safety and comfort. That, too, is undeniable. Valid. Legitimate.

The limit of such thinking, though, is saturation and stasis. When ideas in society become saturated, such a society can develop. The lack of development also limits prospects leading to a scarcity of resources. How the societal resources in such a situation get distributed or shared among the people becomes unequal leading to conflicts and poor health.

The COVID-19 pandemic has demonstrated that the place one lives matters. Africans and the poorer communities were the last to receive vaccines. Being born in Uganda for instance is not the same as being born in Japan. By being born in Uganda, your life expectancy is set under 60yrs while anyone born in Japan is expected to live to their 90s.

Place matters because it provides context for your material and living conditions that determine your health, and validate your identities and values. Although Africa is constructed as permanently needy, even within Africa, some internal legal migration should be made possible. We share ideas, improve our capabilities, and build a better world if we found better places suitable for us to realize our true potential.

END.

Gen Kainerugaba’s Presidential Ambitions are Infantile and Oedipal

 

Gen. MUHOOZI KAINERUGABA

I can bet with confidence, in this article, that Gen MK will neither be on the ballot as a presidential candidate nor a president-elect in 2026 unless he executes the oedipal method.

Gen Muhoozi Kainerugaba’s (MK) train of presidential ambition has been fired up by tweets and seems now ominously unstoppable. Will he be the first person to depose a dictator over Twitter?

 But wait a minute, has Gen Museveni, the father, a lifelong president, and Gen MK’s Commander-in-Chief declared a position on succession or transition?

The characteristic actions of the President on this matter of succession speak louder than the rancor of Gen MK and his overzealously opportunistic supporters. Clearly, Gen MK’s expectation to replace his father in 2026 is simply infantile, diversionary, and at most, oedipal.

The question that this article raises, is not about the materiality of Gen Museveni handing over power to his cub. This which concerns the conscience of the nation is that with this steam of succession politics, have we, as a country rationalized institutional chauvinism and discarded the foundational ideology that fosters nationalism? Can we state, unequivocally, that the NRM-O and its leaders have arrived at the end-point of their ideological evolution?

I may not have answers to all the above questions myself, however, what is clear is that each time we indulge in this succession debate, the chauvinistic element of Chwezism emerges. The most logical justification of this succession debate is situated in reinventing a Chwezi “historical” might over the East African region.

This chauvinistic tendency is ingrained in the tweets such as the ambitions of capturing Nairobi, the prospects of caving a Chwezi empire to include Eastern DRC, or praises for uncle this and uncle that, including fabricating relationships with Egyptians, Ethiopians and exalting the Russians.

These tweets are not random. They must illuminate repressed knowledge or myth that resulted from being exposed to the power and how that power is mobilized and sustained. Far from those who may dismiss the General’s tweets as misgivings of inebriation, I see in them a pattern of premonition rooted in his father’s myth.

Additionally, the succession discussions feed into the ambiguous theme of transition that Hon. Norbert Mao fronts to justify his transition from opposition to the government. Like Gen MK’s false hope of becoming President in 2026, Mao is also “being driven like a wheelbarrow” to cultivate a false public narrative of a non-existent transition that is otherwise possible only upon God’s beckons.

Previous trends have shown that Gen Museveni says only things he has no intention of doing and effectively does only things he never says in public. For instance, in 1986, he promised never to cling to power, now he is one of the longest-serving presidents. In 1986, he was totally averse to corruption and vowed to end poverty in Uganda, now corruption and poverty, and two leading tourist attractions to Uganda. Somewhere, he promised the return to constitutionalism, rule of law, and securing persons and property, now the constitution is worthless, kondoism is back, everyone is insecure and private properties are being vandalized or appropriated under gunpoint.

Precisely, the contradictions of Gen. Museveni are our motivation to empathize with his son. If his goal is to become President in honor of his mother, then he may as well execute the Oedipal method and we move on!

END

Historia: Musevenism and puppet politics

The claim that opposition leaders strive to become western puppets has pervaded the current Uganda election landscape. Mr. Kaboggoza Kibudde, in the DM of December 20, 2020, penned an article titled: We need leaders who will not be Western puppets”. The article was strange and exposed the author to scrutiny. Mr. Kaboggoza took a swipe at Dr. Kizza Besigye and Hon. Robert Kyagulanyi for seeking and mobilizing foreign support in their effort to ouster the lifelong western darling, dictator Museveni from power.

For purposes of convenience, Mr. Kaboggoza cherry-picked facts and distorted history to support his arguments. First, Mr. Kaboggoza compares Dr. Kiiza’s claims to have won elections that were rigged to the bogus claims that outgoing US president, Trump is making. This is typically comparing oranges with stones.

Mr. Kaboggoza should know that Mr. Donald Trump is an incumbent president who lost an election.

The election that Trump lost was within precincts of a functional democratic institution operated by people of great integrity, the same system which made Trump President.

Incidentally, most of the prominent elected officials in the Trump contested states are Republicans, most of whom Trump recommended for those positions. Mr. Kaboggoza’s comparisons are as fake as Trump’s own litany of cases which have failed to progress in court for lack of evidence.

Neither Dr. Kiiza nor Hon. Kyagulanyi have been Presidents, and none could survive the nexus of global forces in which Uganda must operate. Uganda has long been a victim of neocolonialism, in which Mr. Museveni is the most reliable puppet of the western powers in the region. No one in the African continent has curved in so fundamentally to the whims of the West as Mr. Museveni over the decades.

Mr. Kabogozza may e one of the bazukulus who hardly read history or was too young to have known the evolution of Mr. Museveni from 1986 to date. The Museveni who promised Ugandans a fundamental change in 1986 is not the same Museveni we have today. In 1986 Museveni spoke very spitefully of western powers and imperialism. He preached Pan Africanism and formed various economic blocs, such as the Preferential Trade Area (PTA), and later was instrumental in forming the Southern Africa Development Community (SADC) with a view of enhancing Africa's autonomy and reducing dependence on Western Markets. The 1986 Museveni believed that Africans were cheated in global trades controlled by the industrial west. In fact, at one point, Museveni even proposed that Africa should resort to barter trade to undermine the influence of US dollars.

When Museveni came to government, Margaret Thatcher was in power in the UK from 1979 and Ronald Reagan defeated Jimmy Carter in a US election on November 4, 1980. These two ultra-conservative leaders were ferocious in their single-minded promotion of the free-market economy. The two leaders enacted policies that ignited a wave of global neoliberalism as the solution to the post-1970s economic woes.

Museveni’s early Presidency was faced with mounting foreign debt repayment challenges and the country was faltering on all its debts. The World Bank and IMF were emphatic against such loan defaulters and urged these failed states to adopt a system that could reboot their economies to guarantee debt servicing.

In October of 1987, Museveni flew to an IMF/WB meeting and later met President Ronald Reagan. That meeting whitewashed the Marxist Guerilla in Museveni. Museveni returned a US and western puppet from that time. That visit prepared Uganda for the worst. Museveni was ideologically reorientated to the liberal free-market economy.

By 1990 we had devalued our currency and embarked on structural adjustment programs – retrenchment, radical disposal of national assets, and opening of the private sector while suppressing public service. The rest is history.

Over the years, Museveni has not denounced his links with Sweden, his dealings with lobbyists in Washington DC and the European Union, and the UK foreign office. Museveni’s friendship with Israel, Russia, China, North Korea, etc., remains public knowledge; his rental mercenary business in Somalia to the US and imperial control of DRC and Southern Sudan among others, have paved the way for the perpetual exploitation of resources by his western allies - a public knowledge too!

Mr. Kabogozza, if we are to talk about a western puppet amidst us, no African leader, other than Cameroon’s Biya, who literally lives in Switzerland, can challenge Museveni. For, Museveni’s very hold on power depends on his being an effective stooge managing neo-imperialist wars and a market economy in the region.