Health

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

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Health

#OutToLunch: Should every newborn baby be subjected to a DNA test?

#OutToLunch: Should every newborn baby be subjected to a DNA test? By Denis Jjuuko In some African cultures, when a baby was born, the parents took it to its paternal grandparents to be given a clan name. It was never a big event even though the birth of a child has always been a cause for celebration in this part of the world. The grandfather of the newborn baby would summon his sisters to come to the naming event. It was the duty of the sisters, the baby’s paternal aunties or ssengas in Luganda to look for body marks that confirmed that the child belonged to their family or not. They checked the ears, the fingers, the toes, any birth marks that would give any clues. They would pass on the results to their brother, the grandfather of the child. If they doubted that the child belonged to their nephew, the grandfather would give the child a universal name that doesn’t necessarily belong to any clan. In some rare cases, grandfathers outrightly refused to give the child any names. But this usually caused havoc so many avoided it. In many families, “paternity doubted” children were known to exist. But divorce was rare so people carried on with their lives and kept what they thought were family secrets. The Baganda even coined a saying that you only knew your biological father after the death of your mother. As long as you mother lived, she could at any one time introduce you to another man as your biological father. And her word was final. Women many times introduced adult children to other men they had had casual or secret sexual relationships with as the biological fathers. In such cases, some children changed names and acquired those of the new clans where they now belonged. Advancements in technology led to DNA (Deoxyribonucleic Acid), cheekily written in full by many today as Ddala Nze Amuzaala to literally ask if you are the biological parent of the child. In Uganda, the stories started largely by some local TV stations providing this as a service where two men or more claimed to be the fathers of the child. Some of these stations created popular programs where a series of late night shows were done, interviewing the claimants and the mother. The TV stations ended up paying for the samples to be ferried to South Africa to establish the paternity of the child. In one famous example, DNA samples showed that a pair of twins belonged to two brothers. Eventually, technology got here and labs were established in Kampala that offer DNA tests at a fraction of what was being charged by the labs in Johannesburg. Today, many people who doubt the paternity of the children take samples so they could establish whether they are the biological parents or not. But it wasn’t just parents, also siblings in bitter quarrels of how to manage their late parents’ estates frequent these labs. This has led to increased stories of DNA tests and some people have argued that the results will lead to breakdown of families and a dysfunctional society as children are subjected to severe psychological effects. And in a country where psychosocial support is almost alien, one could understand the argument. But decreasing resources also dictate that most people wouldn’t want to take care of other people’s responsibilities. In the years gone by, children especially in rural areas contributed to their school fees by working on their parents’ coffee shambas or matooke gardens. Some elements of social welfare worked. But as Uganda continues to urbanize, it becomes increasingly difficult for many people to look after children. So the burden, the argument goes, should go to the biological parents or people should know which child belongs to them and decide to either look after them or not. Some women on social media platforms have argued that they have been looking after children that aren’t biologically theirs and therefore men shouldn’t complain today. The difference, however, is that women get to know that the children men bring to their homes sired outside marriage aren’t presented as their own. For the men it is different, the children are presented as biological children of the man until doubts either emerge or through some misunderstanding the facts start presenting themselves. DNA tests are then done to confirm or deny the allegations. So if we want to protect the psychological well-being of the children, shouldn’t it be better that every baby born is subjected to a DNA test before the mother is discharged from the maternity ward? This would also help in addressing cases where a baby could accidently be switched by health workers during birth. The writer is a communication and visibility consultant. djjuuko@gmail.com

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