Doctor reveals rot in Health
In the book, the former ministry of health official says top jobs at Uganda’s ministry of Health were not awarded on merit but depended on who was closer to the first family and who lobbied best.
The book, released to bookshops around Kampala last month, describes in fine detail the extent to which one’s connectedness determined one’s place. Mbonye, a former acting Director General of Health Services, lifts the lid on how top positions were stuffed with underserving political appointees, killing staff morale and leading to resignations of experienced personnel.
Its insider revelations make for a gripping read which probably explains why copies were allegedly bought off the bookshelves hours after release, probably to limit circulation. It also shows the extent to which intrigue at the top of one of the country’s most critical sectors paralyzed work.
Mbonye, who resigned in January 2018, says the ministry is now grappling with “demoralized staff who feel that the institutional mechanisms to advance their professional careers are no longer relevant.”
“Thus, there is little incentive to work harder since they feel they have little hope for promotion,” he writes.
During his time at the ministry of health, Mbonye didn’t have a good working relationship with the current permanent secretary, Dr Diana Atwine. Atwine was the all-powerful head of the health monitoring unit in State House, which enjoyed the patronage of President Museveni.
He was also not seeing eye-to-eye with then Director General of Health Services, now the minister of Health Dr Jane Ruth Aceng. Often, their disagreements spilled into public view and the media. It is little wonder then that the book picks particular interest into how these officials reportedly wormed their way into the ministry largely as political appointees.
“In 2008, I had met Dr Diana Atwine on a trip to Cape Town, South Africa to attend a conference on cervical cancer, organised by Princess Nicky from Nigeria. She was accompanying the first lady Mrs Janet Museveni to the same conference and it was the first time I had spoken with her.”
“After exchanging pleasantries, she began complaining about corruption in the health sector and poor service delivery…I didn’t take these allegations seriously at the time since I don’t engage in discussion where no valid evidence is presented. Little did I know that she had been spreading this discourse to justify her appointment as the director of health monitoring unit based in State House. Indeed, her strategy seems to have succeeded and she was appointed as its first director.”
Mbonye alleges that the job that was given to Dr Aceng had a more deserving candidate.
“Dr Nathan Kenya-Mugisha was interviewed as the sole candidate for the post of Director of Health Services, and he [had] already successfully passed the interview phase. Given his experience, it was assumed that the president would sign swiftly and confirm his appointment, as had always happened,” he writes.
Instead, Mbonye notes that the whole ministry was left bewildered when a junior officer, Aceng, was announced to the position (Director of Health Services).
“Nobody imagined that a junior doctor, not even a superintendent of a hospital, would apply for the post of permanent secretary and pass the interviews at the Public Service Commission,” Mbonye writes “…Perhaps we had believed in the traditional practice of an open interview and appointing the best officers based on merit.”
“…Dr Jane Aceng from Lira Hospital, after failing in her application for the post of medical superintendent, was accelerated to the post of Director General of Health Services and later minister of Health. She engaged in infighting with staff and fellow ministers.”
He notes that rumours of Aceng’s appointment had been “largely ignored because these were at the time little-known junior doctors who lacked adequate experience, and it was assumed that they wouldn’t pass interviews anyway.”
Mbonye writes that for Dr Christine Ondoa, who was in 2011 appointed minister of Health, there was no rumour but her appointment replacing Dr Stephen Malinga sent shockwaves around the ministry.
“Even appointed officials seemed shocked at their selection,” he writes.
“Dr Ondoa had earlier began calling herself ‘Pastor Ondoa’, and while we were in Oyam district to launch the Prevention of Cancer of the Cervix campaign, she told me and others around her table that she was a prophet! She was a member of the ‘born-again Christians’, and it was said they would go to the State House to pray,” writes Mbonye.
Mbonye writes that the new crop called themselves “The New Team” and they targeted “experienced and more senior officers, initiating a campaign of harassment to have them removed from their posts” as part of their supposed cleaning-up of the health sector.
“During several meetings, they openly abused, ridiculed, and humiliated officers, and in 2012/13 several experienced staff had to leave the ministry.”
“I, then the commissioner of community health, was amongst them and took a sabbatical leave to concentrate on research and teaching.”
He writes that other officials who left included; Dr Paul Kagwa, assistant commissioner health promotion; Dr Rachel Seruyange, the programme manager Uganda National Expanded Programme for Immunisation; Dr Jenifer Wanyana, assistant commissioner reproductive health.
Mr Paul Luyima in charge of environmental health chose early retirement. Mbonye writes that it was when these power struggles at the ministry threatened to completely derail Uganda’s health sector that President Museveni re-assigned some of the ‘New Team’, including Ondoa.
When Ondoa was dropped as minister of health and appointed the Director General of Uganda AIDs Commission, Mbonye recalls that she “set off the same fights and confusion, as had taken place when she was a minister of Health.”
“… her clash with the board chairman at UAC Prof. Vinand Nantulya, again attracted the attention of the president; and to the relief of many, she was again relieved of her position and Dr Nelson Musoba replaced her as Director General,” he writes.
Mbonye also claims that at times, posts would be advertised at the ministry but because the applicants were not favoured by the ‘New Team’, they re-advertised the positions. He gives the example of the post of Director of Health Services (clinical and community) which was advertised in 2012 after Dr Kenya-Mugisha was hounded out.
“I, as well as a number of other commissioners and doctors applied and five of us were short-listed.”
“At 9am when the interviews were supposed to start, the members of the Health Service Commission were summoned at the ministry of Health headquarters for an urgent meeting with Dr Ondoa. We waited until 11am to be interviewed. We believe they were given instructions to fail us”.
The post was re-advertised in 2014 and when Mbonye reapplied again, he says, Aceng ensured that they passed over him.
Mbonye also notes that when Dr Ruhakana Rugunda was appointed premier and left Dr Elioda Tumwesigye, who was then minister of state general duties, as acting minister of Health, some New Team members refused to respect him.
Here, Mbonye pulls out Dr Sarah Opendi, minister for Primary Health Care. Dr Opendi had been a minister before Elioda and “she felt she was senior to him in that sense”.
Speaking to The Observer yesterday, Atwine did not directly respond to the issues raised in the book. She instead said that there are “many things that one can talk about but this book is not worth talking about.”
She said the book was written from “pure hate.”
“That is it. There is nothing more,” she said. “It is okay; let people who want to read it read but someone who can analyse knows it is nothing. I would expect someone who was a professional in the health sector to discuss situational analysis and systems for young people to read instead of being trivial and attacking personalities.”
“There is nothing, really nothing, nothing in that book.”
Let us pursue looters, and not curvy women
Written by Ssemujju Ibrahim Nganda
The reason? We don’t have the required medical infrastructure to carry out kidney transplants, heart and brain surgery as well as decent treatment of cancer. In 2014, we hit a record spending on treatment abroad, which stood at Shs 255 billion ($70 million). It is also estimated that other Ugandans who seek treatment abroad privately, spend about Shs 10.9 billion annually ($3 million).
Minister of State for Finance David Bahati came to parliament last week waving these embarrassing figures. In a 10-page statement, he asked parliament to authorize government to invest about Shs 1.4 trillion ($379.6 million) in a private hospital to be built by an Italian.
This is how this money will be paid, according to Bahati. The facility, to be called International Specialized Hospital of Uganda (ISHU), will be constructed in a period of two years.
For the next eight years after its completion, nobody will be referred abroad for treatment. The money meant for treatment abroad will be included in the budget of ministry of Health and passed on to the owner of this hospital.
Minister Bahati pleaded with deputy speaker Jacob Oulanyah to have the decision on this huge amount of taxpayers’ money taken immediately. He said many agreements with the investor have already been signed. One such agreement is that government will issue promissory notes confirming that it will pay about Shs 1.4 trillion.
Government, Bahati said, “has defaulted on its obligations under the Project Agreements by failing to issue promissory notes within the stipulated time.” As a result, he reported, the investor has issued a Notice of Default on January 30, 2019 and there is a possibility of losing money in this deal.
Both the Constitution and the Public Finance and Management Act require such a transaction to be approved by parliament. What the government did was to get the attorney general pen a legal opinion claiming that since there were mere promissory notes, parliamentary approval was not a requirement.
They had quietly concluded a Shs 1.4 trillion deal involving tax-payers’ money until they hit a snag. That is how Bahati came running to parliament. I think New Vision is the only media house that gave the opposition a spirited fight against this grand theft in parliament prominent coverage.
The rest of the media concentrated on an emotional but worthless debate on Miss Curvy beauty contest. And that, Miss Curvy, is what we have aggressively and emotionally debated as a country. Even people I know to be immoral joined the fray pretending to be defending the integrity of women’s bodies.
David Bahati and other senior government officials are born-again Christians but the things they do, I am surprised the Church has not ex-communicated them. Their boss Gen Yoweri Museveni is extremely vulnerable. If you have a following, he can shield you from anything.
You remember how he offered his chopper to fly Gaetano (Kaggwa) to Soroti for a state banquet on his return from Big Brother in South Africa. Gaetano was with Abbey, the girl he had televised sex with in the Big Brother House. But because many immoral people received him at the airport, His Excellency the President honoured him the way he honoured swimsuit expert Quiin Abenakyo.
If Museveni’s junior minister collects women who have curves all over their bodies, where is the hullaballoo?
Senior editors in all newsrooms should help us frame the right themes for debate. Next week Inshalah, I will be writing about Bobi Wine, Dr Kizza Besigye and the unguided debate about the 2021 general election.
As usual, even this debate is being distorted at an early stage. The 2021 elections are being framed as a contest against Gen Yoweri Museveni yet they are not.
Let us face it, we are all captives. The man captured our country and the state. He dispenses the state the way he likes. He has turned our country into an estate he inherited from his parents. The government is a private company hired to run this estate.
Nigeria’s Electoral Commission can delay elections even to the annoyance of President Buhari. Dr Badru Kiggundu delayed nominations in 2010 because Museveni was still sorting out his internal NRM issues.
Empowering citizens to liberate the state and all her institutions is the struggle we are involved in. All elections organized under Museveni are against the state which he is using against us. That is what we must prepare for and this work requires total commitment.
MP Ssewanyana arrested while trying to close Kiruddu Hospital
Monday February 18 2019
Kampala-
Makindye West Member of Parliament, Mr Allan Ssewanyana is under
detention after his comical attempt to close Mulago Referral Satellite
Hospital of Kiruddu.
Mr Ssewanyana
arrived at the hospital armed with a chain to close the hospital gate
because of management’s failure to construct a better sewage management
system.
He was, however, stopped by police officers who arrested him.
He
had earlier told journalists that he had information government
released Shs3 billion for a sewage lagoon but no work is being done.
The hospital director, Dr Charles Kabugo declined to comment on the issue saying he was attending a meeting.
Dr
Diana Atwine, the health ministry permanent secretary, had not yet
responded to Mr Ssewanyana’s claim although efforts were made to seek
clarification from her.
Some residents alleged that hospital authorities were letting sewage into their homes.
Kiruddu hospital has faced criticism over its defective sewage disposal system.
Last year, Dr Atwiine said plans to improve the hospital’s sewage system were underway.
