The sorry state of Soroti Referral Hospital: A proof of prolonged mismanagement from the state!

That suddenly the Members of Parliament (MPs) was visiting the Easter Region and the Referral Hospital of Soroti. Yesterday, on the 7th September 2018. This happens suddenly, maybe, because of the added pressure, as they want to prove that the Hospitals and Medical staff in great shape. They need to show the President that his lack-luster work on the Health Care has been worth it. However, the MPs was disappointed, as the public should be too. This is something that has been in the works for ages!

MPs on the Parliamentary health committee visited Soroti hospital yesterday Friday 7th. The committee expressed disappointed on discovering that the hospital disposes infectious waste into toilets and that a number of medical equipments are broken down” (Parliament, 08.09.2018).

Because if they are surprised and about the state of how the hospital operates. This sort of activity has gone of for years at Soroti Hospital, as the lack of medicine was even stated in the performance of the hospital until September 2015. As the NMS had only delivered 63 % of the needed medicine in that given calendar year. In that given budget year, one of the smallest posts was for maintenance, meaning the reason for the sorry facilities at the Hospital has been going for years as well.

As the budgets for 2014/15 and 2015/16 shows alone is that the Parliament didn’t put in any money for rehabilitation or any significant construction in the Hospital. Except for the wards or the housing of staff. Which means, that is deliberate acts of not offering needed funds for the upkeep of the hospital itself. The MPs should be able to look into the back-log before walking on a field-trip to Soroti.

The Auditor General wrote an report in 2017 called: “REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF SOROTI REGIONAL REFERRAL HOSPITAL FOR THE YEAR ENDED 30TH JUNE 2017”, Auditor General Muwanga published this on the 11th December 2017, where it states this about the hospital:

Medicines and medical supplies worth UGX.11,211,866 were not accounted for at the main store and user departments as shown in appendices i & ii. In addition, 8000 kits of determine were issued without supporting documentation as shown in appendix iii. These shortcomings may be a result of mismanagement or poor record keeping. This may have led to rampant medicine stock outs which hamper service delivery and occasion widespread public outcry” (Muwanga, 2017).

Therefore, what the MPs found in September 2018, was well known if they just looked a hot-minute into the paper-trail left behind. I didn’t even have to put in work to find these factors and mismanagement. Not even a field-trip to Eastern Region to figure that out. The MPs who has access and ability to gain the documentation before voting budgets. Could go into the paper-trail and configure the need for maintenance and general support of the buildings. Not only support funds for staff quarters/wards. Which is important in itself, but the hospital needed proper facilities to heal the sick.

Even a HURINET report from 2012 explains this:

The lack of space in most hospital wards was evidently the main cause of overcrowding. In the female surgical ward in Soroti for example, the in-charge said patients are admitted up to the verandas and the equipment sterilization room is not spared either. The records department head expressed similar concerns when he said: “because of lack of space, I have scattered documents which should have been in one place so if I need a file I have to create time in my busy schedule to move around to look for it” (HURINET-U; the state of Regional Hospitals in Uganda; November 2012 The report was produced under Economic, Social and Cultural Rights projects with the generous support of Democracy Governance Facility (DFG) Uganda and DIAKONI).

When, we can back in time and finds this lack of issues and with the near past lack of financing, the state of the hospital has to bad. As the Referral Hospital of Soroti haven’t been an priority and the NRM only comes for a PR Stunt. Not for deliberate change. Then would have done it already, as they have had the years to do so, if they really cared. Alas, that is not the case. The OAG, the Budgets proves the lack of care for maintenance and upkeep.

If the NRM had cared about the state of Health Care, maybe they had cared before, not only sending VIPs and MPs abroad for medical services themselves. Peace.

Opinion: If the Cabinet scraps NMS and UNRA, what about the weird expenditures at the Presidential Affairs?

As the giant Cabinet of the Republic are planning to scrap Uganda National Roads Authority (UNRA) and National Medical Stores (NMS), that these are going back into their ministries. Because of how these two organizations has supposed wasted government funds and spending. The National Resistance Movement (NRM) knows the ordeal and the reasons for that, but they are instead scrapping the organizations, to keep the deals in-house and not as sole organization doing the operations as expert organizations for the government. That is why this will go back to Ministry of Works and Transport for UNRA and Ministry of Health for NMS. I have one more vital idea for the Cabinet members, but don’t expect them to so.

Today’s news:

The Cabinet has taken a decision to scrap Uganda National Roads Authority (UNRA) and National Medical Stores and transfer their mandate to the mother ministries to reduce wastage of resources. According to a source, the decision was taken in two meetings with the first held on August 20 and the last one on Monday last week. The source said President Museveni was unhappy with the UNRA performance, especially in the rural areas where roads are impassable yet it is where majority of votes for his NRM party are” (Andrew Bagala – ‘UNRA to be scrapped in merger of government agencies’ 03.09.2018 link: http://www.monitor.co.ug/News/National/UNRA-to-be-scrapped-merger-government-agencies/688334-4740804-qvrsbnz/index.html?utm_medium=social&utm_source=twitter_DailyMonitor).

As these ideas are noble, but we know the reasons in itself. More direct control and cannot use the organizations as faults for the corrupt, graft and embezzlement anymore. The Cabinet are thinking this will stop this, but they are just making sure the deals and agreements made with tenders and buying, will be happening in-house and not by experts in the same regard as today. That is the real reaction to what is happening with this.

My advise would be find ways to merger and move responsibility from the Office of the President, State House and Office of the Prime Minister. As these could be moved to their representative ministries, as the Youth Livelihood Programme should end elsewhere. The budgets for the Residential District Commissioners are put under the President, this should be put Minister of Local Government and not under the President.

Like what does the budget of Internal Security Organization and External Security Organization lay under neath Office of the President, as this should be under the Ministry of Internal Affairs or Ministry of Foreign Affairs.

As well as all the development expenditure that is parts of the Office of the President and Office of the Prime Minister. Both of these should have been put under fitting expertise of certain ministries, as the Ministry of Agriculture, Ministry of Education and Sports, Ministry of Works and Transport and so on. As well, as the ones fitting Ministry of Internal Affairs and Ministry of Internal Affairs. All these ministries could have connected these projects under the State House, Office of the President and Office of the Prime Minister.

Like what does the Uganda AIDS Commission does under the Office of the President, shouldn’t this be under the Ministry of Health? Why does the Office of the Prime Minister have the Disaster Preparedness and not the Ministry of Internal Affairs or the Ministry of Local Government?

This is just what I wonder about, because, if the Cabinet is serious about scrapping UNRA and NMS, why are not the government looking into the weird expenditures at the Office of the Prime Minister, State House or even the Office of the President?

They should really ask and wonder. If they are not doing this as a political stunt, as we know how corrupt these enterprises are, but will it make a difference to cut out the middle-man? Peace.

Uganda Cancer Institute Press Release glitches in the radiotherapy machine (30.08.2018)

Uganda: Ebola in DRC – Ministry of Health Issues prevention guidelines (10.05.2018)

Permanent Secretary of Ministry of Health Dr. Diana Atwine letter to Secretary of MOFPED Keith Muhakanizi on “Operationation of Hope for Humanity Rehabilitation Centres in Amoro and Kitgum District” (12.03.2018)

Mzee complains today about waste, however he haven’t rehabilitated sugar industry or revamped pharmaceutical industry either!

“In this regard, we need to learn and apply lessons from emerging economies such as India, whose total healthcare industry revenue is expected to increase from US$ 110 billion in 2016 to US$ 372 billion in 2022 in response to deliberate investments in telemedicine, manufacturing of medicines and health technologies, medical tourism, health workforce training and risk pooling/health insurance, among others. In order to achieve this, we need to plan in a harmonized way. In Uganda, for instance, we, indeed, have a nascent pharmaceutical industry producing Aids/HIV, Malaria, Hepatitis-B, pharmaceuticals, etc. drugs. These are, however, still using imported pharmaceutical grade starch and imported pharmaceutical grade sugar. The pharmaceutical grade starch and sugar are crucial for making tablets and syrups for children’s medicines. Yet, the starch is from maize and cassava and the pharmaceutical grade sugar is from sugar. I am told the drugs would be 20% cheaper. Moreover, apart from helping in the pharmaceutical industry, more refined sugar is also needed in the soft drinks industry. Uganda is squandering US$34 million per year importing refined sugar for the soft drinks, about US$ 20 million for importing the pharmaceutical grade starches not including the other raw materials, US$ 77million for taking patients to India etc. Africa is incredibly rich but wasteful” (Yoweri Kaguta Museveni at THE OFFICIAL OPENING OF THE JOINT EAC HEADS OF STATE RETREAT ON INFRASTRUCTURE AND HEALTH FINANCING AND DEVELOPMENT, 22.02.2018).

Seems like the 1980s World Bank loans to restart Kakira Sugar Works hasn’t done enough, since the Ugandan state did right after the National Resistance Army takeover of the state. They went into an arrangement with the World Bank getting loans for the company, to restart. That deal was done 8th March 1988. As the documents said back in 198:

“Uganda currently imports US$15-20 million worth of sugar annually, which ranks second only to petroleum imports. Import substitution through restoration of domestic production capacity is therefore a high priority and eminently justified given the considerable comparative advantage Uganda enjoys as a result of its landlocked situation. Conditions for sugar production at Kakira are highly favorable. Cane growing benefits from excellent soils, good rainfall distribution (requiring only limited sunplementary irrigation) and relatively low levels of inputs of fertilizers and pesticides. The project brings back to the Kakira complex the original owners who have a demonstrated ability to manage sugar operations at Kakira and elsewhere” (SUGAR REHABILITATION PROJECT, 08.03.1988).

Therefore, what the President said today, the Sugar Rehabilitation Project, which was done to stop the heavy imports of sugar and for consumption, has clearly not worked as projected. Since his own state is squandering their resources and not even following the loans to make the project work. That is my take on it. The president of 32 years has clearly mismanaged this and not finished his job. Since he hasn’t been able to rehabilitate the industry.

When it comes to pharmaceutical industry there massive challenges, not just the sugar starch for medicine coverage of the pills. Nevertheless, the whole arrangement, since the technology to operate these machines are imported, as well is the parts. Not only the sugar starch, but also the ingredients are imported too, than you have few companies who has automated manufactures, which makes hard to make medicine on a larger scale. It is also high operation cost, because of use of back-up generators because of blackouts and shortfall of electricity. Because of this, it is expensive to have cold storage of the medicine and have a storage for the final products.

So the Idea from Museveni that it is simple, it is the whole system around it, that makes it more profitable to import ready made medicine, than actually produce it. Even if the added value of production would be there, but with the circumstances put by United Nations Industrial Development Organization, seemingly it is from 2009. However, the state of affairs hasn’t changed that much.

We can really estimate, that the adjustment and the needed organization to pull forward both industries during the years of NRM hasn’t been totally fruitful. If so, why would he complain about the imports of sugar and medicine, when he hasn’t been able to make it function with his 32 years of reign? Someone who has 3 decades, should have the ability and time to find the information, finalize plans and execute as seen fit. That is if he cared about the industries in question and their possible engines for growth and riches of Africa. Nevertheless, he hasn’t cared and haven’t used the time wisely. He has used the time bitching and not acting. That is just the way things is and it isn’t becoming better either.

He could have made sure that the pharmaceutical industry had energy, had the sufficient organization behind it to make the medicine, not only import and assemble certain medicine, he could have made sure the sugar industry was profitable and had the equipment to make the refined sugar used in the pharmaceutical industry. However, both is a lost cause, because it takes money and time. Both, is something he doesn’t have, since the narrative isn’t making him wealthy.

Alas, he we are at the status quo, with a President running for life and complaining about waste. When he has wasted 32 years and not made effort to change it. It is all talk and no fire. Peace.

Uganda: The Medical Interns Executive Committee letter to Ministry of Health – “Re: Concern about the Payment of Allowance for January” (02.02.2018)

Why did Dr. Tedros Adhanom bill the Ethiopian government for his Hospital Bill in Singapore in September 2016?

We know that the new World Health Organization Director Dr. Tedros Adhanom Ghebreyesus, who has already did some controversial assignments since become the Director there. Dr. Adhanom has a history as Ministry of Health in Ethiopia. You should think a man who represent his own nation and in cabinet cared about the Health Care there. However, he himself went for treatment abroad and billed the Ethiopian government for it.

Dr. Adhanom had an official meeting with officials from Singapore on the 9th September 2016. This was the story of the Ministry of Foreign Affairs on the 13th September 2016:

Dr. Tedros Adhanom meets Dr Mohammed Maliki Bin Osman, Singapore’s Senior Deputy Minister of Foreign Affairs and Defense Minister at his offices today (Sept. 9, 2016). Discussions focused on strengthening bilateral ties between Ethiopia and Singapore, in areas including industrial parks development, tourism, education sector and inter-parliamentary diplomacy” (The Ministry of Foreign Affairs of Ethiopia, 13.09.2016).

Even if the Ministry of Foreign Affairs has deleted this on their web-page. Still, it is still online and can verify this. Therefore, that the billing of a hospital bill of Dr. Adhanom was billed with $986,50. It isn’t a big bill, but still instead of paying it himself. The Ethiopia-Beijing Embassy was asking the Consulate General of the Federal Democratic Republic of Ethiopia to cover this. This was asked for by the Embassy of Ethiopia-Beijing, who covers Singapore and dozens of other Asian nations. We can just imagine what else he has gotten covered during his stay in Singapore in 2016 as a dignitary. Since, this is the one document leaked. This document asking for a payment directly to an account at United Overseas Bank Limited, Singapore on the 6th September 2016. This is just days in advance of the meeting with Deputy Minister of Foreign Affairs Dr. Maliki Bin Osman.

So seemingly the Minister of Health of Ethiopia did a routinely check-up or something. Since the bill isn’t big. But its the principal of making a good health care system back home and secondly, also putting this on the taxes of your citizens. When your the Minister of Health. That he is representing the whole Health Care in his Nation, but he still uses the state reserves and bills it on the public.

Dr. Adhanom misused it and got the Embassy of Ethiopia-Beijing to refund his visit at a Health Care facility days before having a meeting with the Deputy Minister of Foreign Affairs. Seemingly, it could be a coincidence, but its a bit to good to be true. Though in the scheme of things, a grand of US Dollars are pocket change. However, it is the principal of good governance. If he has done with this small one, what has he done one the budget funding yearly as a minister from Addis Ababa. Would he care or is he careless, since he knows the state will takes his bills and he will eat?

We can just wonder if he has done similar stunt and misused bigger funds for personal profits, because this is just a proof of a minor incident. Where he used a 1000 USD for personal health. We don’t know what he has done with the budgeted funds for the Health Care Ministry, but if we cannot trust you in the minor things. How will you act when your supposed to control the bigger things?

Peace.

It was a late birth for the New Cancer Machine at UCI, Mulago Hospital: The Saga lasted from 2013 to 2018!

Yesterday was supposed to be celebrated, but however, I can’t. Not honestly, not, no, not knowing that this process of procurement and knowledge of possible unnecessary demise of dozens of cancer patients, while waiting between March 2016 to January 2018 for possible treatment. It is insane.

Therefore, when I read crap like this yesterday, when the Machine was launched by Prime Minister Ruhakana Rugunda, I don’t celebrate:

“The Prime Minister Ruhakana Rugunda has commissioned the new radotherapy machine at the Uganda Cancer Institute Mulago. This follows the purchase of a new radiotherapy machine after the old one crushed in April 2016. According to Dr Daniel Kanyike the head of the radiotherpay department at Mulago, 80 patients are attended to per day and they suspect the number will increase after the commissioning today” (Sudhir Byaruhanga, 19.01.2018)

Because, I have a letter dated back to IAEA from Dr. Byahagaba from 28th May 2013, where the funding of 325,297 Euros was deposited to the UniCredit Bank, Austria, Vienna on the 22nd May 2013. To start the procurement of a new Cobalt 60 Cancer Machine to Uganda Cancer Institute at Mulago Hospital. However, this has been lost in the story, that suddenly NRM moved swiftly in 2017 and got it ready for 2018.

It might be true that old one from 1995 – finally gave way and broke down in April 2016 before the General Election, the same fall. However, that doesn’t mean, they started procurement and facilitating the funds for a new one. They used longer time and awaited the destruction of the old one, before getting a newer model that actually worked.

They didn’t act quickly or swiftly in this affair. They moshed it together in a stew and hope to get gold, instead they are boiling bones and hope to taste the real deal. It is a mess and was a mess.

Because I still remember this:

“Cancer patients receiving radiotherapy treatment at Mulago hospital may have to wait until next year when the new cobalt 60 radiation machine will be installed, after the old one broke down three weeks ago. According to Dr Jackson Orem, the director of Cancer Institute at Mulago hospital, it may be difficult to repair the radiotherapy machine, procured in 1995, to render efficient results” (EA BIZ INFO, 08.04.2016).

Secondly, when NRM says April 2016, well, Dr. Orem speaks about three weeks before April, that means it broke down in March 2016. So the NRM cannot hold one piece of the story correct. Not even when it breaks down!

Therefore, the promise waited on results because of hardships to make a new space and have a new machine in where the old one was. The Uganda Cancer Institute had to wait and secure funding for a new one, even if they had already started procurement in 2013. Something they should have focused one, before making sure the old one crashed. This has clearly cost lives, since the Cancer patients have not been sent in drones in Kenya. They got some promises to Aga Khan in Kenya, but that was only for a few lucky ones. We can imagine how many cancer patients lost their ability for treatment between March 2016 and January 2018. It is insane, but also the structure and carelessness the National Resistance Movement (NRM) is known for.

So this has been a long await, which could have fixed before and was already in the making. Who knows why the authorities and the NRM didn’t fix it in advance, when they already paid partial payment in 2013. Years before it broke down. It is foolish and nonsense, when this is the only type of this machine in the whole Republic. Then, not being able to for-see its demise.

Well, NRM can think of this a propaganda victory, since no-one is questioning much and just is happy. The public shouldn’t be, because why didn’t they fix it earlier and made sure for a transition from one machine to another? Peace.

Ministry of Health: “Stock Situation for Antiretroviral Drugs in Uganda” (04.12.2017)