Helpless: A woman waits to be assisted by a midwife in the delivery room of a hospital in Uganda. Ugandan health workers tend to move abroad because there are no jobs at home.
A court ruling on the controversial “export” of nearly 300 Ugandan doctors to the Caribbean was postponed as the Ugandan government defended the move, bizarrely claiming it was simply trying to help prevent those seeking greener pastures from ending up in trouble.
Uganda’s government drew flak after it recently advertised posts for 283 local health professionals to apply for jobs in Trinidad and Tobago.
A Ugandan think-tank, the Institute of Public Policy Research (IPPR), is asking for the final preparations for the “imminent” deployment of the health workers to be halted, in what it says is one of the first public interest litigation cases on medical “brain drain”.
The IPPR say the exodus would prove “fatal” for Uganda, which already has too few doctors, nurses and dentists, and has a much weaker health system than Trinidad.
A judgment on an injunction sought by the think-tank, which stresses the case could set an important precedent for countries in Africa and elsewhere affected by brain drain, was expected on March?2 but was adjourned to an unknown date.
Uganda’s foreign ministry defended itself against the accusation by activists that they were “shipping out all the health workers”. The foreign ministry reiterated claims made by a health ministry official last month that Ugandan medics had drowned in the Mediterranean while trying to go abroad, and that by “regulating” those leaving they could help prevent this.
“You pay money thinking you’re going to get a job in Europe, only to find that you’ve been picked up by some crooked hands,” said the permanent secretary at the ministry, James Mugume. “They take your passport. You find yourself on a raft cruising the Mediterranean. Here we have a structure that is legal, we have a framework.”
Bilateral agreement
Mugume said the export of health professionals was part of an “existing bilateral arrangement under the South-South co-operation and within the context of the G7 and United Nations, also known as the Technical Co-operation for Developing Countries”.
“We are requesting Cabinet to approve [it], then we can go ahead and finalise the memorandum of understanding,” he said, alluding to the strengthening of relations between Uganda and Trinidad.
A Caribbean team is expected in Uganda to conduct interviews once the agreement, which includes oil and gas training and financial support for the Ugandan police from Trinidad, has been finalised.
“The problem is not the absence of health workers, it’s the budgets for districts and councils,” Mugume told the Mail & Guardian, stressing the “absorptive capacity” of the public service was limited.
“People just assume we’re taking [medics].” He said they were “leaving anyway” and also denied any had paid to be shortlisted for the scheme.
Justinian Kateera, IPPR executive director, said he was surprised by the claim that the transfer was facilitated under the auspices of the G7, as neither Uganda nor Trinidad were members. In relation to the claim about South-to-South Technical Co-operation for Developing Countries, Kateera said Trinidad was no longer a developing country.
“Why should we give technical assistance to Trinidad, a country with 38 times the per capita GDP, and 10 times as many doctors?
“It is absurd, if not tragic, to claim that government-facilitated medical brain drain combats human trafficking or prevents doctors from drowning in the Mediterranean.”
The United States has criticised the plan publicly and Belgium is said to be withholding funding for Uganda’s health sector because of the scheme, but this could not be confirmed. Activists have asked the UN special rapporteur on the right to health to intervene.
Johnny Muthahi Muhindo, head of the Americas department at Uganda’s foreign ministry, said the medics’ export was part of a “wide exchange” between the two countries. “Tomorrow we may be taking teachers. The [next] day engineers,” he said.