Plan to export medics ‘threatens Uganda’s epidemic response’

Uganda’s ability to respond to major epidemics will be undermined if plans to send 263 doctors, nurses and midwives to the Caribbean are carried out, civil society activists have warned.

The healthcare workers are due to travel on renewable two-year contracts to Trinidad and Tobago under a bilateral agreement the Ugandan government says will improve the skills of those who take part.

Uganda suffers from a chronic shortage of health workers – more than 21,000 posts in the sector are currently unfilled – largely because of low pay and poor working conditions. Upon qualifying, hundreds of nurses leave Uganda every year for better-paid jobs in western countries as well as in Rwanda, Kenya and South Africa.

“This dangerous plan should be stopped - a government plan to exacerbate brain drain is indefensible. Unless reversed, this move will undermine the fight against maternal mortality, HIV and other leading killers in Uganda,” Asia Russell, the executive director of Health GAP, a local NGO, told IRIN.

It will also leave communities more vulnerable to the ravages of outbreaks of infectious diseases such as Ebola and Marburg. Governments should be fixing this emergency by increasing health worker pay; instead they want to make an emergency shortage of health workers worse,” she said.
There have been five Ebola outbreaks in Uganda over the past 14 years, which claimed hundreds of lives, and three of the Marburg virus.

“Government participation in the exportation process is retrogressive and thus an indication of failure under its human rights obligations. In the absence of a comprehensive study projecting that the benefits of this exportation outweigh the damage, government has no point to make in such a process,” Moses Mulumba, director of the Kampala-based Centre for Human Rights and Development told IRIN.

He added that international norms required all such overseas recruitments to “be conducted in accordance with the principles of transparency, fairness and promotion of sustainability of health systems in developing countries, which this particular recruitment has not witnessed.”

The United States, whose training and paying of 17,000 Ugandan health care workers makes it the biggest donor to the sector, found the plan “troubling,” according to embassy spokesman Daniel Travis.

“The Ministry of Foreign Affairs’ role in actively recruiting health professionals to work overseas when there is a compelling need for health workers in Uganda undercuts our efforts in the health sector, especially when the Ministry of Health still seeks donor assistance in training and paying for health professionals here in Uganda,” he said.

The mood among those heading to the Caribbean was more enthusiastic.
“We can’t turn down the offer. It’s just amazing and attractive. The remuneration looks so good. We are fed up of being paid peanuts in Uganda with all our expertise,” one of the recruited pediatricians who has been working at a public hospital, told IRIN.

The state minister for primary health care, Sarah Opendi, said the main problem was not a shortage of “health workers in the public sector per se. Our main challenge is the shortage of the resource envelope to recruit them in service.”

Opendi called on civil society activists to pressure the government to allocate more resources to the health sector to enable it to fill all vacant positions.