#OutToLunch Subsidize charges for patients in ICUs in private hospitals

By Denis Jjuuko

There is a hospital in my neighborhood that is usually not very busy. Over the last few days, you can see people getting their intravenous treatment in the parking lot. The hospital is near a popular bar, if you are not a keen observer, you may think that the vehicles parked alongside the road are for the bar patrons. Yet the bar is closed. The cars belong to patients and their caretakers.

Another photo trended over the weekend over a guy on oxygen as he sat in the car. I am not sure where the photo was taken but I wasn’t surprised. Pharmacies in Wandegeya have queues that rival those of young people lining up at offices wherever they have heard of a job opening!

The real COVID-19 wave is finally here. Every day, you hear of somebody you know who has died. It is gloom everywhere. However, I believe this is the time the government should take the bull by the horns.

Vaccinations
There are very many people right now who are interested in vaccines and the government officials must be working the phones to find them in the required quantities. We made some mistakes by ordering a few the last time out. It is time to have them now available in the required quantities. And when they are available, they should have them available everywhere just like those of polio and measles. Members of the G7 meeting over the weekend pledged to give out a billion vaccines to developing countries. The Ugandan leadership should ensure that we are on the priority list with the right quantities. It is time those responsible for managing the country showed what they are made of. Those responsible for communication need to double their efforts too to ensure that the right messages are widely available.

Tests
On average, on the fliers I am seeing, the cheapest COVID-19 test in Kampala is Shs70,000. Assuming the average Kampala household has six people, that is Shs420,000. This doesn’t include the transport to the facility or the transport for the health worker to come to your home. Some facilities are charging Shs200,000 for a PCR test! That would be Shs1.2m for a household. These amounts are out of reach for most people. This means that many people who need to be tested will not go for tests. They will resort to taking each herb that is being circulated on social media. The health cost of steaming and taking all sorts of stuff people are selling in the name of a cure of COVID-19 is going to be very high. Yet last year, people like Alibaba founder, Chinese billionaire, Jack Ma donated lots of test kits. What happened to them? The government should come in and subsidize the cost of tests so that those who need them can have them. They can also widely offer them for free by setting up testing centres everywhere. COVID-19 tests shouldn’t only be for those going to attend parliamentary meetings.

Home based care
The Ministry of Health has come up with a treatment regimen that people can order over the counter in pharmacies for those suffering from mild COVID-19. Such drugs include azithromycin, amoxicillin and zinc among others. The cost of these drugs is high. In some of the pharmacies in my neighbourhood, a 20-tablet pack of a combination of zinc and vitamins D and C is being sold at Shs45,000 while a dose of azithromycin is at Shs12,000. I saw people paying upwards of Shs200,000 for their COVID-19 patients. I must admit that the cost might be lower in some parts of Kampala such as downtown Kampala but you get the drift. Again, government must show leadership and subsidize these drugs they are recommending people to take at home. They can also make them widely available for free. A simple database linked to the national ID can be created to ensure that people don’t take more than at least one dose to ensure equity.

Subsidize ICU charges in private hospitals
Without the private hospitals including those owned by religious institutions, Uganda’s healthcare system wouldn’t be worth the ink of this article. Intensive Care Units in private hospitals are charging an arm and leg. I wouldn’t call them greedy like most people are doing because the owners instead of investing in apartments like most Ugandans with money, they went into healthcare. Without them, we wouldn’t do much. Some acquired loans at more than 20% per a year to get the beds and equipment. So as businesses, they want a return on their investment. Who would blame them?

Government however can subsidize what private hospitals are charging COVID-19 patients and even those suffering from other diseases.

The beds aren’t too many and government can easily pay some of the bills for such patients. The same can be done for those in High Dependence Units. Government can pick the allowances of healthworkers in private ICUs and HDUs, supply medical oxygen, and such other stuff.

The government cannot watch as families sell all their assets to clear bills for people who have even died. Sometimes the assets sold aren’t even enough to clear the bills.

The writer is a communication and visibility consultant. djjuuko@gmail.com

Tags: COVID19, COVID19 testing in Uganda, COVID19 Vaccination in Uganda, Denis Jjuuko, ICU, Out to Lunch, Private hospitals in Uganda

Health

#OutToLunch: Unless we do something, we shall soon be sent to the villages to die

By Denis Jjuuko In the years when HIV/AIDS was wreaking havoc to the country, it was not uncommon to hear that somebody who is sick has been sent from the city to their village. Whenever you heard about it, tears simply rolled down. It was a metaphor for death. Everything has been tried and there is nothing else to do. Chronical illnesses leave many families in poverty and since there was nothing else the family could do, they decided to cut expenses, one of which was the transportation of a dead body. Transporters always charged a fortune. They understood that we may abandon people when they are alive but show immense love to them when dead! And that was before funeral management became a professional service. One could have thought that we had turned a corner from those devastating years of the 1980s and 1990s. That falling sick didn’t mean death but we seem to be slipping back to those dark days. At least two recent cases provide a reminder of where we are. It all started with a senior judge detailing the difficulties she faced when her now late husband was admitted and ended up describing the national referral hospital as “a monument” to the chagrin of its administrators. Before that dust could settle down, the country woke up to a crowd fundraiser for a heart transplant for one of Kampala’s highflyers who unfortunately died before the money could be raised, raising another spotlight on Uganda’s healthcare challenges. The two cases above were public figures hence the publicity they raised. People were bitter that we have neglected our healthcare by outsourcing it to private and foreign hospitals. If you have some money, you run to a private hospital in Kampala. If you have real money, you run to Nairobi or other foreign capitals outside the continent. The majority of Ugandans have no money to run to a private health facility in Kampala or any town in Uganda for that matter. They resort to witchdoctors, fake pastors and prayer to survive. And probably we are about to start seeing families sending back the sick to their villages to die like it was in the late 1980s and 1990s. We many times get obsessed with economic growth and transformation, rolling figures off our tongues. And as the national budget is being read this week, such numbers will be making headlines once again. If we really want to put money in people’s pockets, we must think about social services such as health and education. The cost of healthcare goes beyond what we pay to buy the drugs and pay for consultation fees. There are many lost hours when one falls sick. The sick person and the caretakers are unable to work and are spending money on transport and medicine. Given who we are, others are spending money to check on the sick. It deters economic growth. There is a need to improve our healthcare services as well as promoting health seeking behaviours among the population. If people are healthy, they will be able to attend school or get involved in productive work that leads to economic transformation. Although one of the cases mentioned above involved a heart transplant and many people called for establishment of such facilities, it is probably something that we can do in the future. The doctors who can do heart transplants and such high skilled procedures exist in Uganda but if we are still dying of malaria and such other diseases, our focus should be on primary healthcare services. Lower-level health centres should have well trained personnel who are motivated to work and given the tools they need to diagnose and treat people. The majority of our people seek services at such facilities but many times when you visit, you see despair. From people suffering from simple diseases such as malaria or women getting complications while giving birth. Many times, the health workers are very frustrated. They see their patients die who shouldn’t be dying. When such patients die, we convince ourselves that it was God’s plan. It wasn’t at all. We simply failed at the basics. One of the basics we have failed at as a country is health insurance for all. We know the cost of healthcare. We also know that the benefits of health insurance for all can offset the costs of healthcare but we do nothing about it. Unless we do something about healthcare for all of us, we shall return to the days of being sent to the village to die. The highly connected may laugh at this. But I have heard of some who have been sent back from Nairobi and India to die from here. The writer is a communication and visibility consultant. djjuuko@gmail.com

June 23, 2025

Out to Lunch

#OutToLunch: Canadian visas and what Africans must do to avoid humiliating rejection

By Denis Jjuuko I recently applied for a visa to Canada to attend a Rotary conference in Calgary and thereafter visit a few of their attractions like the Niagara Falls and return to Kampala. The application was rejected on grounds that I didn’t have enough assets and therefore I might not return. I thought that the visa officer had missed something, so I appealed and I attached some more assets. I thought no sane person would have such assets, get a visa to Canada, fly for 2-3 days, reach an airport and then disappear into mountains of snow! But the Canadian visa officer sent back my application rejected with the same reason. I believe they never read anything I attached. I don’t know anyone entrepreneurial like myself who would spend nearly Shs10m on an economy class air ticket to Calgary and then decide to disappear into thin air instead of returning home. I am also too old, lazy and highly educated to directly wash cars, clean airport bathrooms and such other menial demeaning jobs the majority of people who disappear in Canada do to survive. Some of my friends urged me to appeal again. I refused. I am not desperate to fly for a few days to Calgary or anywhere in north America, western Europe or anywhere anyway. I thought I could invest the money I would have spent in Canada on starting a new business venture whose profits could pay for the next Rotary convention in Taipei in 2026 or even donate it to charity. I actually donated some of it last week. Anyway, I hadn’t realized that I had become a statistic until I read a recent story by CNN that Africans lost nearly US$70m in 2024 in denied visas. That is a lot of money. If the US$70m is the annual average, in just a decade, the continent has lost US$700m. If you think of the interest that could have earned when compounded, it is in billions of dollars. Since the release of that report, many Africans have taken to social media platforms such as X to argue that the continent should become reciprocal. Charge westerners same rates they charge us and then give flimsy reasons to deny them access after all many that travel to Africa have no real assets to talk about. The argument is popular but lacks thorough thought. African countries actually are as discriminatory only that they do so to fellow Africans. Many people from the west can fly to any airport and access a visa on arrival with zero chance of rejection. Africa’s richest man, Aliko Dangote, says in a popular TikTok video that he needs 35 visas to cover the continent while most Europeans don’t need any. Why doesn’t the African Union copy the European Union and ensure that there is no need for visas to travel anywhere in Africa by a citizen of any member state? That would spur a lot of growth when Africa becomes borderless like Europe is. Also, why do Africans go to the west? It is because we have failed to put in place facilities and create jobs that we need here. With all the coastline we have, why would anyone fly to resorts in Europe, America or the Middle East? Africans fly there because there is nothing at home to write about. We can sing about lions and gorillas but we can’t even build an airfield where planes could easily land. Ssese Islands or Buvuma can be as beautiful as Bali or Ibiza or Santorini. But the infrastructure is lacking. That is why even when the visas are nearly free for Americans and Europeans, Africa still struggles to attract tourists. You don’t want to fly into Entebbe and then drive on the Mityana-Kyenjojo section of the road to catch the elusive lions in Queen Elizabeth National Park. Hotels are too expensive and poorly done. You can spend a night in a European resort paying only EUR160 or less inclusive of an endless flow of meals, beers, champagnes and whiskeys. Here? Somebody charges US$1,000 a night for a hotel room with a floor made of uneven stone slates! Our universities still teach stuff that one can easily find online and hospitals are in a mess. Can we host international conferences like the one I had wanted to attend in Canada? Only a handful of countries in Africa can. But African countries have money for the shiniest military hardware and rigged elections. No ministers fail to get the latest Landcruiser to go launch a pit latrine built with funds from western donors. We must build the kind of countries that we love to see otherwise Canadians and other westerners will continue rejecting us without any care in the world. The writer is a communication and visibility consultant. djjuuko@gmail.com

June 23, 2025

Out to Lunch

#OutToLunch: Farmers are willing to do the hard work, government must do the same

By Denis Jjuuko Agriculture has been for long touted as the answer to the poverty that is exhibited everywhere you turn in Uganda and in most parts of Africa. A recent study by Global Right Alert even confirmed that Uganda can get UShs10 trillion (nearly US$3 billion) annually from coffee. Our much-heralded oil revenue is estimated at about US$2 billion annually. When I read snippets of the report, I was at first tempted to ask where should we put our money? I quickly remembered that developing a country can’t be one directional. Extract the oil and get that cool US$2 billion every year and work on the coffee to get that US$3 billion too. Although many people have been focusing on coffee given the recent increment in quantity of production in central Uganda and elsewhere and the resulting high prices that have turned peasants into shilling millionaires, there is a lot that still needs to be done. The majority of farmers depend on unpredictable rainfall yet we are experiencing irregular seasons and changes to the climate. It is no longer guaranteed that it will rain during the months we all knew as rainy seasons. And sometimes when the rains come, it is very little or too much. No farmer wants to experience either. We still depend on the hand hoe to till the land to the extent that it is one of the most distributed items by candidates seeking support in the upcoming general elections. Although many farmers have small plots of land on which they grow food and cash crops, a hand hoe is 19th century stuff. Luckily, the Chinese have been kind enough to invent petrol powered ones that can help a farmer till the land faster and easily. The traditional hand hoe is a back breaking tool. One of the reasons many young people would rather sell the land, buy a boda boda, which they turn into a bed for daytime napping due to lack of passengers than spending the day in the garden. Inputs are expensive and fake. There is a need for the Uganda National Bureau of Standards to do their job to ensure only genuine fertilizers, pesticides and other inputs are on the market. It shouldn’t be very difficult to find who makes or import fake inputs. We can’t always blame everything on the impunity of some individuals with high political and military connections. If such people found a serious officer desirous of doing their job, they would back down. A certain government entity that owns a printery always refuses to print campaign posters of highly connected individuals on credit. The individuals usually curse the managers and promise to teach them a lesson but return with cash and pay. If they had found weak managers, they would abuse the system. A public officer who fails to reprimand the so-called Gamba Nogu (people with military and political connections) is just weak and wants to use the system to enrich themselves illegally in many cases. The other problem for Ugandan farmers is transportation. Some are able to grow significant amounts of produce but transport is a very big cost to bring the goods from the farmer to the market where the prices are not laughable. Agricultural produce can be rotting in a garden less than 100km to the market where there is a high demand. It was thus refreshing to read in newspapers last week that there is a project, at least for the northern region, that is working to change this narrative. With support from the Germans, the Ministry of Local Government is implementing the Rural Development and Food Security in Northern Uganda (RUDSEC) project. This newspaper reported that more than 1,300km of roads connecting farmers to markets will be rehabilitated and upgraded in Acholi, Lango and Teso regions. I regularly travel across the country and including these regions. Sometimes you find farmers with vegetables being sold at giveaway prices. One of the challenges they face is transport. The rundown Sahara or Isuzu can’t manage the roads many times. Yet we should know that an improved transport and market infrastructure would allow year-on-year accessibility. The cost of inputs would reduce because it wouldn’t take one so much to buy them. Ideally that should lead to increased inputs. Many farmers are willing to do the hard work to increase production. Entrepreneurs will set up the processing plants for value addition. The government should do its part too. Pay road contractors on time, make genuine inputs affordable, provide technical expertise and access to the market. Poverty would be history for many people. The writer is a communication and visibility consultant. djjuuko@gmail.com

June 23, 2025