April 25th should have been a special day in Uganda. A day to celebrate, but also a day to pause and reflect; and perhaps cry a little? It was World Malaria Day. It was a day on which the policy makers should think deeply because despite efforts, malaria still accounts for the highest number of outpatient visits in our health facilities.
But let’s step away from the numbers-in-the-book, because April 25th was a day of strange news. I was lost in reading and tweeting about malaria figures. I was reading about reduced deaths and the uncertainty of prevention and treatment projects due to the slump in donor economies, when this and this came in.
That people were using mosquito nets to catch edible ants wasn’t the strangest mosquito net misuse story i had read. Years ago, there were reports of people turning these bed nets into wedding gowns, and even fish nets. But according to this article from February 2012 that too is not a story of years ago.
Besides such practices harming the fishing industry and bringing more would-have-been mosquito net users to the hospital wards, those practices may not necessarily make you wish that you don’t get a patient (or be the patient) that needs a blood transfusion one of these days. Imagine. Your trusted doctor, running across the street to buy a 300ml bottle of Mirinda Fruity to transfuse into your blood stream. The case in which this happened may not necessarily have been malaria. But it could also have been, considering the illness figures.
So i ask myself, what is the link between mosquito nets, white ants and soda? A poor health system. A health system that has been branded sick time and time again.
It is a health system in which even attempts to window-dress and cover the shameful inside, always fall short. Even in cases where a facility or two are in place, many times they become white elephants. Because the planning thread in our public service system, the one that should link equipment to electricity and air-conditioning for proper functionality, seems to have been gnawed at by rodents.
We have a Medical and Dental Practitioners Council, which licenses private clinics and other facilities, but is too thin on the ground to ever cover the country with a watchful eye. As such, a quack doctor flees the wrath of a family mourning a relative for a transfusion gone bad, and opens a new clinic in the next district.
You want to be hopeful sometimes, and imagine that if the regional blood bank had been adequately stocked, perhaps said doctor would have done the right thing. A quick internet search on blood shortages gives you a hit on almost every referral hospital.
When we hear the mosquito net misuse stories, we laugh, at the residents of Oyam, or Bugiri. Because the uncomfortable truth, when it is happening miles away from you, gives you a distance comfortable enough to laugh. But we should be laughing at ourselves.
One will argue that the mosquito net gospel has been preached, complete with radio adverts accompanied by a scary-sounding drum-roll and mosquito characters. So why don’t those people in Oyam get it? In Ugandan speak; why don’t they just stop being ‘villagers’? The question should be, whether the people that claim to run this health system have, instead of laughing, tried to find out why the message doesn’t sink in.
The question should be why the Medical Council and the National Drug Authority are not empowered enough to do continuous checks on the medical practitioners. Even in cases where checks are done, the phrase “You are guilty until proven rich”, most times comes into play.
Recently, a friend wondered why public departments are always crying about being understaffed, when we have very high unemployment levels. There are many sides to this story, but one of them is systems failure. So the other question should be, with the high number of medical sciences graduates, why we never have enough gate-keepers in the profession.
Sometimes when the questions have been asked, they have been met with evasive answers. Sometimes these questions are not asked; and we join the laughing lot. But we shouldn’t stop asking; we can’t afford to, it would be disastrous.
Some refer to them as diseases of the rich and old, but non-communicable diseases should be a concern to populations across the board.
Talk of hypertension, cancers or diabetes; these diseases are slowly creeping into lives of younger people. They are also a growing concern for the public health system in developing countries like Uganda.
Our public health system, which was designed to treat rather than prevent disease, has been caught off guard by this surging epidemic. Health centers, in some parts of the country don’t have the simplest equipment to diagnose high blood pressure.
And when one is diagnosed with a disease like diabetes, it is a disease to deal with for the rest of their life. So how do such people cope?
For an insight into Africa’s new epidemic and how you can keep yourself safe, tune in to a radio station in your area to listen to this edition of National Perspective.
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