By Dr Samuel Odongo Oledo & Dr Herbert Luswata
The Uganda Medical Association (U.M.A) brings together over 7000 medical doctors in Uganda and the diaspora. Our vision is to see that “All the people in Uganda have access to quality health and healthcare”.
The mission of the U.M.A is to advocate for improved quality of healthcare and improved welfare of medical doctors in Uganda. We have 15 regional branches across the country.
Referring to the 2017 Industrial Action by the Uganda Medical Association, U.M.A., which was suspended following an agreement between the Government of Uganda and U.M.A.
This agreement followed the continued neglect of the Health Sector, specifically the human capital development/health workforce and aimed at addressing a recurrent shortage of medical supplies, employment of doctors, salary enhancement and better conditions of service for Intern Medical Doctors and Senior House Officers.
U.M.A has over the past 4 years engaged the relevant Government Ministries, Departments and Agencies to discuss these critical health systems gaps including human capital development and other emerging issues especially the challenges visited upon us by COVID 19 that has affected more than 120,000 people and claimed over 3200 including over 80 health workers.
These engagements have been with little success.
Notably, U.M.A met His Excellency the President at State House Entebbe on 1st June 2021 who re-echoed specific directives to address these gaps with special note on improved welfare for scientists and health workers.
Today, the U.M.A presents the first press conference edition focused on the National Industrial Action by Medical Doctors phase 2 for the following reasons;
1. Chronic shortage of medical supplies and technologies.
a) We acknowledge the effort by the government to invest in health infrastructure, equipment, ambulances especially during the COVID-19 pandemic. Government has also invested in COVID-19 vaccines and we call upon all Ugandans to embrace the vaccination exercise.
b) However, there are still major gaps in availability of medicines and supplies within the health facilities that we have raised since 2017 including;
i. PPEs like gloves, masks that are critical for all health workers especially in this COVID-19 crisis.
ii. Lack of functional High Dependency Unit (HDU) and Intensive Care Unit (ICU) (bed, oxygen, ventilator, monitor, critical care medics), that left Ugandans in desperation and catastrophic expenditures in the private hospitals.
iii. Lack of enough medicines and other supplies for continuation of care for non COVID-19 conditions.
2. Unemployment of medical doctors amidst plenty.
Today, Uganda produces over 500 new medical doctors annually and another 150 Medical Specialists in the various Medical schools. Despite these numbers, approximately, 60% of the approved posts for doctors in public service are vacant including 75% for senior cadres of Consultants and Senior Consultants.
a) In our recent survey, at least 1,113 doctors were found unemployed. This is estimated to rise to over 1900 upon completion of the current lot of medical interns and SHOs.
b) Yearly, funds meant to pay for salaries are returned to the Treasury due to the posts being vacant yet the specialists to fill these posts are there. In many hospitals specialists are working as Medical Officers and earning less pay since they are not appointed.
3. Delayed salary enhancement as per the Collective Bargaining Agreement (CBA)
On 30th September 2019, in a letter Ref PO/12, H.E the President of Uganda directed the Ministry of Public service to conclude the issue of paying scientists, university lecturers and health workers to the agreed levels. An entry level Medical Officer is to be paid a monthly salary of Uganda Shillings Five million and a Senior Consultant Seventeen million monthly, with the rest of the cadres increased accordingly.
a) Although this directive was implemented in universities and some parastatal organizations, health workers in Public Service have to date been neglected.
b) Over the past 18 months, H.E the President repeated this directive multiple times in his public addresses but to no avail!
c) The conditions of service of our Intern Doctors, Nurses, Midwives, and Pharmacists have further deteriorated with a large number now dwelling in unsafe accommodation including peri-urban slums and where a number have been attacked, robbed and suffered physical and sexual abuse and severe bodily injuries while returning from work especially at night. The presidential directive to have interns paid half the salary of their senior cadres is yet to be implemented.
d) U.M.A and the Federation of Uganda Medical Interns met with H.E the President at State House Entebbe on 1st June 2021. Among other resolutions, the meeting resolved that the Government employs all unemployed doctors, expand posts for doctors down to Health Centre III and that revised salaries be paid effective July 2021 but this has not been implemented to date.
e) H.E the President repeated this directive publicly to the Rt Hon Prime Minister and the Hon Minister of Health while speaking after the reading of the 2021/2022 national budget at Kololo Independence grounds on June 10th 2021: Employ all doctors at the revised salaries starting July 1.
On the 6th August 2021, we issued a 90 days’ notice of Industrial action to the Ministry of Public service if the above issues are not handled. This ended on 6th November 2021 with an unsatisfactory response.
Therefore, we have decided to launch phase 2 of industrial action with the following demands.
1. A supplementary budget to boost the medical supplies and other technologies including PPEs (gloves, masks), ICU equipment, oxygen in all health facilities.
2. Employment of all Doctors
a. Fill all vacant positions as approved in the public service structure.
b. Include Medical interns and SHOs in the public service structure.
c. Revise the current structure to have more positions including a Doctor at a health centre III as per the presidential directive.
d. Automatic promotion of Doctors depending on years of service and additional qualification.
3. A supplementary budget for salary enhancement as per the presidential directive with immediate effect.
4. Compensate families of all health workers who have succumbed to COVID-19 in line of duty as per the workman’s compensation act 2000 with immediate effect.
5. Prioritize welfare improvement for Doctors outside of salary; medical insurance of doctors, tax-free vehicles, tax-neutral building materials as promised by the President in 2017.
Until all the above demands are met, Industrial action will be our only form of negotiation as per the 1995 constitution and relevant labour laws.
Dr Samuel Odongo Oledo is the President of Uganda Medical Association (UMA)
Dr Herbert Luswata is the UMA Secretary General
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