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A frank memo to our elite

OPINION

Why we should downplay anecdotal evidence by looking at scientific data that gives a broader picture

So last week the cancer machine at Mulago Hospital collapsed, causing uproar in mainstream and social media. Every newspaper columnist or television/radio pundit of any heft weighed in. Daily Monitor devoted its whole Thursday opinions page on this subject. Pundits outdid each other in over-stating how this is a sign that the entire health sector “has fallen apart”. Yet cancer is not a major killer, not even among the top 20 killer diseases. So why all this self-righteous indignation?

I think it is because cancer is a disease the elite pay attention to – because it can kill them. So the outrage is not about the ordinary masses but the interests of those that control weapons of mass propaganda.
The eight most common killer diseases in our country in order of their killing rate are maternal mortality, malaria, tuberculosis, pneumonia, kids dying during child birth, injuries due to motor accidents, cardiovascular diseases, and HIV/AIDS. How often does the punditry address them? Hardly!

The thing I admire about Ugandan elites is our self-indulgence. We write in holierthan-thou tones, appealing to public emotions domestically and perhaps for recognition among the donor elite. We denounce those who have “failed the public trust” insinuating that if we were in their positions things would do better. Our audiences applaud us in silent (sometimes loud) admiration. This is the political point-scoring and public grand-standing we hypocritically indulge in to deceive ourselves that we care more about “the common man” than those who are elected to serve him.

Our health sector is not managed by people from England or Chad but by our alumni, friends, relatives, relatives of friends, neighbours, in-laws etc. They are not mean, cruel and heartless people out to destroy the country and harm its citizens. Besides the people who die are their friends, family and fellow citizens. It is true some are corrupt, others negligent and many incompetent and this causes myriad dysfunctions in our public health sector. But equally many public servants try to do a good job.

Secondly, Uganda is governed largely by elected public officials. Our citizens have a very high anti-incumbency bias – over 65% of incumbent MPs including ministers and powerful opposition figures – are not returned in every election. This is the opposite of countries like USA where only about 10% of incumbent congressmen and women lose their seats in an election. Hence we cannot say our country is saddled with entrenched politicians who are resisting reform.

So what have been the implications of elections on health policy? There has been a massive shift of focus from high-value elite based clinical medical treatment (like for cancer) to low-value mass-based preventive health and clinical medicine strategies. This has gone unnoticed by our elites because it addresses the needs of the common man. Democratically elected politicians can be corrupt and selfish but at least their bread is buttered by voters. So they cannot ignore the majority interest.

75 comments

  1. The president of the South African Medical Association trade union, Phophi Ramathuba, has blamed poor management for a power outage at Chris Hani Baragwanath Academic Hospital earlier this week, which left doctors with no choice but to operate on a patient using only the light provided by cellphones and iPads.

    “In the early hours of Tuesday morning, doctors were operating on a patient with a ruptured ectopic pregnancy but there was a power outage during the surgery,” said Ramathuba.

  2. “The generator failed to kick in – luckily the anaesthetic machine had a spare battery. But doctors had to use cellphones and iPads to light the theatre while performing the surgery.”
    This is in ‘heavenly’ South Africa some of whose citizens say “they have never been to Africa” because they take themselves to be overseas due to their vanity.

    Hear more below if you think Uganda is unique or incompetent.

  3. Doctors and lawyers The Times spoke to said the crisis in Gauteng hospitals was due to:

    *Poor management, with incompetent leaders at hospitals and cadre deployment;
    *Nurses who were unable to perform simple tasks such as putting up a drip;
    *Poor ethos among nurses and some doctors;
    *Burnt-out healthcare workers, exhausted by the huge patient load;

  4. *A chronic shortage of doctors and nurses;
    *Most patients arriving at a hospital when severely ill;
    *Broken equipment including CAT scan and X-ray machines;
    *A constant shortage of supplies, including antibiotics, painkillers, drips or gloves; and
    *A lack of discipline and accountability of nurses.

    Gauteng is the equivalent of Kololo,Muyenga and Bugolobi but most hospitals and clinins there are called ‘killer hospitals’

    • Mr Rwasubutare, Gauteng is one of the 9 provinces of RSA, comparable to Central Uganda. It’s made up of Soweto, Joburg, Pretoria and several very poor black townships and slums! I’ll enlighten you more about the so called ‘killer hospitals’ in Gauteng and the status of health care delivery SA at a later time. I’m afraid it will make your arguements and those of Mr Mwenda pedestrian.

      • If you were a bit slow to reply, you would have realised I get my facts from South Africans themselves; not Mwenda who I in fact don’t trust without verifying. You too get all most of what you post from reading what others have written because you are human and cannot be omnipresent. even if you were in all places, still what you would say would be your opinion; not necessarily the thusness of things.To put your mind at ease however, I lived in the place for a long time and frequent the place even now as we talk. For medicare however, I would any hour of day or night go to India other than South Africa.

      • I guess you are one of those Ugandan Sangomas or the like visiting or living in SA, and perhaps haven’t had resources to experience the affluent life in SA. I have trained and worked both at Indian and South African hospitals and I can assure you my brother, overall, the level of medicare in SA public hospitals is way above that of Indian public hospitals! The acclaimed medicare the ‘rich’ Ugandans receive in India is found only in a few teaching and private hospitals.

        • Power outage and failure of back up power at Baragwanath hospital was indeed such an unfortunate and unusual incident, but nothing compared to actually what happens at Ug hospital theatres, including Mulago National Referral Hospital. I have had, on more than 6 occasions, to operate on patients in the main operating theatres of Mulago Hopsital without lighting, either because of power outage with failed backup or dead bulbs. Such incidents are very common and almost ‘normal’ in Ug. In SA such incidents call for thorough investigations and immediate rectification. And for your information, I have got reports of such power outages in operating rooms in Canada, USA, the UK and Japan! However in such countries the hospitals and governments ‘pay dearly’, unlike in Ug it is business as usual.

  5. The reason is simple to understand. Those hospitals used to cater for ‘whites only and the elite’ in the apartheid era. When independence set in, all people were admitted to the services and overwhelmed them. Mwenda labours ceaselessly to make readers understand that ‘quantity undermines quality’ a la UPE, USE etc…
    Uganda health sector works round the clock and as Mwenda put it, out there there are many patients and even foreigners/beneficiaries who have been treated and cured in Uganda. As for besigye visiting Abim, he wanted to blackmail the government like the devil he is. How many people has he treated in Kasangati, he being a medical doctor? He deals in petroleum and pigs which everyone can do. But he goes shouting that medicare is lacking while he, a medical doctor is wandering day in day out plotting against the government.

  6. Has this man aver treated even a single hurt rioter?

    • You don’t need to be a doctor to physically or medically treat a rioter. Any Ugandan can play a role in ameliorating the effects of rioting; prevention, provision of emergency medical services (first aid, transport to hospital, inhospital care), rehabilitation of the injured, good policies, etc etc. You too, just like Besigye, can play a role at different levels of care.

  7. AM give us statistics of the poor cancer sufferers who are just waiting to meet their creator.
    How many of the well to do Ugandans use Mulago and how many go to the state of the art hospitals abroad. You have some facts right but your conclusions are sick because in the first place, cancer kills everyone rich or poor and unfortunately majority of the people in Mulago are the poor.

    Leave the statistics you are availing us here from your comfortable chair, walk down to Mulago and first gain reliability of your facts.
    Ohhh and by the way, on a more selfish note, these few alarmists make noise because they can and because they sweat more for the resources.

  8. ejakait engoraton

    It is a simple analogy which says “you do not have to be a chef to know the food tastes bad” or indeed to be a food critic.The reason M 7 went to the bush and many people got killed with a lot of property destroyed was on the promise that they would make things better.People pay taxes and expect that the government will deliver the requisite services – how – is none of their business.If a person in the village is unhappy about the services , do you tell him/her to try and be a minister and see if they can deliver the services.People have a right to complain about the services and they do not have to know the solution to make the services.It is like I go to a restaurant and do not like the food and the owner tells me to go the kitchen or why I did not prepare the food in my own house.

    • Why do you talk of the government as though it is a colonial one? Mwenda started by reminding you the people who run these institutions as “…. our alumni, friends, relatives, relatives of friends, neighbours, in-laws etc. They are not mean, cruel and heartless people out to destroy the country and harm its citizens. Besides the people who die are their friends, family and fellow citizens…..”
      ejakait, leave your stupidity at home when you come to this forum. we shall chase away fools from this forum…. if they don’t want to learn. This is last warning

      • Rwasubutare wrote: “Why do you talk of the government as though it is a colonial one?” Can we say it is a neo-colonial government?

  9. Talking about missing the point. Mwenda doesn’t get it. The machine simply become a metaphor to talk about and address widespread failures prevalent in all Uganda’s corrupt institutions: The Cancer Machine Allegory.

    • Fools talk because they have to say something; Wise men speak because they have something to say.
      Now Ocheto, what did you want readers to hear?

      • Mr, I’m worried that your foul language is characteristic of our current leaders, or may be it is just in your genes. You can actually convince people in a more civilised tone and language. It is unfortunate that our generation has learnt and perfected, from our leaders, a rude and foul (may I dare say, uncivilised) language that you are deemed not smart and man/woman enough if you don’t speak like them. School and university kids at all levels have developed this uncivilised demeanour and are proud to display it. No wonder there are now ‘tough-talking’ politicians and public officers in every corner of Uganda. It’s sad but fashionable! Impact: anger and highly charged emotions dangerously stocked up in our bellies. I shudder at what will happen when these bottled-up anger is eventually unleashed in this country.

      • My point is very simple. Mwenda with his so called scientific-based analysis dismisses the legitimate concerns by all citizens for widespread institutional failures. Scientific analysis isn’t the be all and end all. It is narrow-minded scientism run amok. What about peoples aspirations? What about their imaginations and re-imaginations – more superior to scientific analysis, that relies on recycling, re-purposing, reinventing and repackaging. People are free to look at issues in as many possible ways as they are capable. Africa lacks or down plays imagination not scientific analysis.

  10. Hmmm…big question “besigye visiting Abim, he wanted to blackmail the government like the devil he is. How many people has he treated in Kasangati, he being a medical doctor? He deals in petroleum and pigs which everyone can do”.

  11. SHAAA, Mwenda so who told you that we expect 100% perfection in our health care system. All we are asking for from your gov’t is at least a tiny paltry 40% . Please just that and no more.

  12. ejakait engoraton

    MUSINGA – with all due respect, it does not take your argument to make the likes of MWENDA et al pedestrian. Once you start to trivialize peoples lives and death related thereto then you are indeed pedestrian- what I have said time and again the Banyarwanda call OBUTINDI (OMUTINDI) – this is life in its lowest form.A slogan in insurance says “it always happens to others until it happens to you” so M 9 to say the % age of deaths from cancer are so low they do not merit the outcry is SICK.So on his “top of the pops” , what %age and what number on the list does it have to make before we cry out.Why do we scream when accidents claim lives ,yet those who die in accidents are the one who can afford cars or travel in them.That is why there was outrage when KALYEGIRA tried to suggest that AMIN did not kill as many people as claimed- tell that to someone who lost a dad, brother, sister, one death is a death too many.

    • It is just the nature of our current leaders, not to value quality. I’m afraid this kind of mentality might be in their genes. They highly value quantity and strongly abhor quality and excellence. They would rather bribe, concoct figures, disparage those who aim to excel, with the sole purpose of getting votes.

  13. 1. Mr Mwenda, cancer is ranked number 7 or at least among the 10 (depending on your source of info) causes of deaths in Uganda. Please reconcile your data with that of Uganda MoH, CDC and WHO.

    2. Cancer deaths in Uganda concern the poor as much as they do to the rich/elite in this country. You need to visit Ugandan hospitals and also interview rural communities to ascertain the cancer burden in Uganda. The poor are very much affected by cancer deaths, especially those cancers related to infections.

  14. 3. Ugandan elite is not self-indulging!!! Their level of education equips them with skills to notice and complain about preventable problems in the nation. It is just a natural human behaviour among the educated even in the developed world. Unless of course you are suggesting that we sit back and watch as social services delivery goes to the dogs. Remember we can’t all become social services managers and directors, just as not everybody is an MP or government minister. Someone some where must do their assigned job, be it our alumni, friends, relatives, relatives of friends… (to borrow your words). We’ve got to do our jobs perfectly, and we’ve got to complain and reprimand those who don’t perform to the set standards. No short-cuts, brother!

  15. 4. The high ‘anti-incumbency bias’ in Uganda is NOT something to celebrate about. It is just a result of our people not seeing an improvement in their livelihood at every 5- year term expiration. Their solution: vote the incumbent out. This situation for the elected political leaders in Ug is even made worse by the incumbent president who keeps blaming the local leaders for poor performance- remember, it is never the fault of the president for poor social services- so says M7! I sincerely pity our politicians.

  16. 5. Come on.., Mr Mwenda! It is the 21st century and every country, rich or poor, is faced with an increasingly high burden of non-communicable diseases afflicting both the rich and the poor. It is a fact of modern life that despite all ‘low-value’ mass-based preventive health and clinical medicine strategies, our people even in rural communities will always remain affected by diseases that require ‘high-value elite based clinical medical treatment’. Even with the best primary health care, our people will always require treatment and rehabilitation for various ailments. Thus, in equal measure, or even a lot more resources must be availed to promote the development of centres of excellence for medical treatment and research in Ug. Investors or tourists- I understand these are the most respected ‘citizens’ of Uganda- worthy their name (the likes of Bill Gates) can only visit and invest in Ug if they’re assured of high quality medicare for their acute heart attacks, strokes, hypertensive crises, RTAs, etc, while on a visit to Ug. Otherwise, get used to dealing with low level investors and tourists.

  17. 6. Mr Mwenda, the widespread health centres in Ug are ‘white-elephants’ in most instances. That really is not healthcare!! The ingredients for real healthcare are well trained health workers, good physical infrastructure, equipment, medical consumables, research and effective supervision. A better arrangement would have been to build fewer HC3 and HC4, well facilitated enough to liaise with Village Health Teams to carry out public health awareness campaigns and outreaches, supplemented with effective referral systems thorough out the country. Disjointed and ill-equipped but numerous HCs in every corner of the country will not take us far. That’s the reason a number of such centres have been turned into police-stations and storage facilities of some sort.

  18. 7. The costs of massive increase in access to health care in Ug is inevitable (your words), but very preventable. What do you expect to happen to the quality of health care when the president of the country encourages families to produce more children, well aware that there’s no commensurate increase in capacity of well facilitated health facilities? Perhaps, the president should be a little more specific and discourage Ugandans in the more over-populated areas of the country (such as Kabale, Mbale and most districts of Eastern Uganda) to tightly control the birth rates. In these areas the population has outstripped the economic usefulness of the fragmented pieces of land, and further population increase does a lot more harm than good to the under facilitated HCs as well. Perhaps people in the more sparsely populated areas of Luwero, Masindi, Karamoja, Kiruhura, among others could be cautiously encouraged to produce more kids, but more importantly educate their kids and do more mechanised commercial agriculture.

  19. 8. Mr Mwenda, HC4s that can perform caesarean sections have grown from 24% in 2010 to 51% in 2014 solely because the Uganda Medical Association lobbied, lobbied and lobbied government to pay an extra 1.5M per month to medical officers as a ‘retention allowance’. But why not increase rates to 100%? One of the core activities of HC4s is to manage emergency obstetric care in the districts. Half of the HC4s performing C/S is not something to be proud of. It is total failure, considering that so much money has been sank into their construction. Once again, it would have been better to construct fewer but well facilitated HCs with effective referral systems in the country.

  20. 9. Thirty years under NRM, and with relative peace compared to most countries in SubSaharan Africa, this country should have developed and nurtured medical centres of excellence in the various specialities of healthcare. These centres would act as ‘role models’ to lower health centres, empowered to delivered primary healthcare from informed point. Currently this has fairly been achieved in the area of HIV/AIDS care

  21. 10. However, so many years in a more stable political environment and with a population of 35 million, we still struggle to train medical specialists such as neurologists, cardiologists, neurosurgeons, cardiac surgeons, nephrologists, gastrointerelogists, to mention but a few. Whether you like it or not, these so called medical super-specialists act as role models for the lower health cadres, and the effects of their expertise trickle down to the communities. They generate core and specific pieces of knowledge for a 21st century health system and inform health policy. If you really want real investments, growth, and to be respected as a country, invest heavily in medical centres of excellence. It is expensive in the short-run but long-term dividends are real and palpable.

  22. 11. Mr Mwenda, you need to tone down on your attacks on the so called elites in Uganda. You are one of them. Please stop bashing them! The overwhelming majority, if not all, of these elites still have their roots in the villages, they are the bread-winners for their poor rural siblings, they (we) all feel the same pain and the financial costs when our relatives fall ill. If you don’t hear voices of the rural folks complaining about the state of health in the nation, it is because they have no access and capacity to use the social media, like the elite do.

  23. 12. Unfortunately, the ‘current’ Andrew Mwenda seems to know better which side of his bread is buttered! No wonder articles presently are so opinionated, seem to be written in such a rash, with uncalled for emotions, and without much sought. Anyway, we all are culprits of this kind of behaviour, but Mr Mwenda being a professional journo, is expected to be more sober and analytical. Such is the unfortunate state of affairs and effects of our struggles to survive in Uganda. Elite or not, we are all ordinary masses in Uganda. Don’t divide us, we go to the same markets in Uganda!

    • Mr. W. Musinga, i think Mwenda should copy your researched info save it and recite everyday if he is to come back to his senses.
      We need Ugandans who have right thinking minds.

  24. Excellent informed response, Mr Musinga, to Mwenda’s almost diabolical piece. Mwenda is such an intellectually dishonest analyst, it is shocking. He masks his dishonesty with selectively applying statistics that will prop up his arguments but anyone with a keen eye can look through his schemes.

  25. ejakait engoraton

    I posted a comment which seems to have been conveniently edited out, in which I questioned the issue of quantity v quality or in some cases where it is claimed the numbers have completely overwhelmed the system.My question was ,if MWENDA has 2 kids and is able to buy them shoes , is he justified in not to buy shoes when he has 5 kids.Populations always increase and any government worth its name should plan accordingly.At every opportunity M 7 has trumpeted his thoughts on why we should have a large population.The Ganda say “babi kulya…..” which is the story of a not so clever person who is happy to have many hands when he has work, but when it comes to feeding the mouths, they are too many.M 7 sings til the cows come home about how he has increased the tax collections so many fold, is it not partly because of a large population.Happy to collect taxes but not to provide services.

  26. Musinga, then, use your intellect and know-how to talk to the powers-that-be and suggest attainable solutions.
    Sincerity has a way of burning through steel I assure you. But riots and sabotage, insults and lies, abetting crime and incitement of rebellions will always get us the results we saw in Ruwenzori recently.
    Musinga your presentation of facts attracts whoever wants the good for and of Uganda and that means everybody. Please start a blog and figtht for change using a pen(keyboard) and your effort will not be in vain.
    You will also along the way realise that you get more supporters than opposers.

  27. The reason we resist the ejakaits and ochetos with all force is because they talk tough and promise mayhem and vengeance. It is the only language they understand…else we can find the nation engulfed in fire if we don’t pre-empt these historical mischief-makers. Otherwise Musinga we are a very civilised lot in NRM otherwise how have we managed to move on and on and grow and grow? Look at our good side and of course suggest some remedial deeds like the good medic you are and we shall be grateful to follow suit. NRM does not know everything admittedly.

  28. ejakait engoraton

    RWASUBUTARE – when f**ls and id**ts( sorry for the language but have tried to look and failed to find a better word) have been made to look pedestrian and do not have any viable arguments to put forward , they try to extricate themselves by making all sorts of allegations and trying to pass the buck – mbu ejakait and ocheto bla bla bla- .Mbu you know what happens in South Africa first hand and are always there.Now a man has come up who has made what ever you said look the rubbish it is.M 7 has time and again said he takes no advise from anyone , not even his late mother(RIP).Do you think we do not have people who have the kind of expertise that MUSINGA has and who are in a position to tell M 7 what is going on and how to put it right.It is not that the NRM does not know it all, they know absolutely NOTHING.Mbu “has this man treated a single rioter”.How do you start to reason with someone like this and then now you start to applaud MUSINGA.

  29. ejakait engoraton

    I have said it before that M 7 looks at everything including the provision of services in terms of investment and only provides those services that seemingly have no direct returns as a last resort.He can see what it means to buy guns because they can be used against those who threaten his livelihood, he can see the returns from the tear gas etc.Where are the direct returns on a road or in a hospital.That is the reason we had mass privatisation so that his cronies can provide the services and make money. That is why he provides/ promises roads, hoes , sanitary towels etc in return for votes and support.If a hospital is built, especially in an area that does not support him, then it will treat his enemies – what he refers to his opponents as.He wants to retain the power to decide life and death.He can decide that CAROL(or Kategaya,Byaruhanga etc) is given money to go for an operation or not.

  30. 1.I pray that no one gets cancer.
    2. I am sure that after the fundraising most guys contracted some diseases coz a typical weekend for a Kampala guy is spent in bars & lodges.
    3.Most rich people and govt officials are in a comfort zone coz govt was forced to adopt the Structural Adjustment Programme under WB & IMF e.g Govts r supposed to buy brand new car this is not by mistake its meant to get ready market for Toyota,Nissan cars.
    4.At times we expect too much from people once a govt offical gets perdiem,allowances,a free car chances are that he will not take his/her job seriously.

  31. 5.The decision made by M7 to have the oil pipe line pass thru TZ was brilliant can you imagine we will supply the whole of Southern Africa e.g Zambia,Malawi,Botswana,SA,Zimbabwe,Nambia etc meanwhile the Kenyan route is;(i) Too expensive (ii) The Terrain is bad(iii)Northern Kenya has many hostile neighbours e.g Somalia&Eritrea(iv)Most oil producing states are in Northern Africa e.g Libya,Sudan so we would have no market.
    6.Prof.Mamdhani is a real gentleman i wonder why police wants him to make a statement Mamdhani is not KB all he required from the Kimansulo Grandma(Nanyanzi) was to lecture(I dont know why most Kimansulo is performed by women from Buganda)

  32. 7.It means that each time an MP is elected He/She must buy a new car courtesy of govt?Cant they afford to buy cars by themselves? with this kind of arrangement an MP who has served 10 terms in parliament will have 10 cars who sells to govt such crazy ideas?
    8.You guys CEO’s are too comfortable to think of our problems do you expect someone who has entertainment allowance,holiday allowance & a fat pay cheque to think for poor people?Over the weekend i had a Business meeting with a Top CEO in his office at about 12.00 noon he told me had some wine in his office being the only lady in the meeting, i was made to serve wine.I asked the CEO whether he had a wine opener he told me oh yes this left me wondering do these guys do serious work?by the way he had different brands he even had the guts to say that work without plays makes… a dull boy don’t be surprised that our leaders take this “play”too far.

  33. Very poor attempt Andrew. It is shockingly inappropriate to say cancer is not a top killer disease in Uganda. Cancer is among the top 10 killer diseases in Uganda. In fact there are many cancer related deaths but we are unable to pick them because of our poor diagnostic capacity. We should be doing more to prevent and treat cancer instead of spinning the facts. And please note that maternal mortality is not a disease; it refers to death of a woman from a pregnancy related cause. Also check the ranking of the top killer diseases; HIV/AIDS, malaria, airway diseases, and diarrhoeas rank top. Maternal mortality is actually a rare event; that is why we express it as a ratio per 100,000 live births. In most of Sub-Saharan Africa, only less than 0.5% of pregnancies end in maternal deaths.

  34. ejakait engoraton

    DIANE and MUSINGA – M9 writes his articles aiming at people like Rwasubutare and Winnie; people who are not capable of any critical thinking, people who argue for the sake of arguing without having the relevant facts.I read some of M 9 s arguments and do not know whether to laugh or cry, but then again I realise that he probably laughs all the way to the bank.Someone who argues that one can not win a presidential election basing on results of the parliamentary results, not realising that they each have different criteria.An MP can and they do win seats with minority votes and could win with even as low as 20% depending on how crowded and close the field is.A presidential candidate can win in a constituency yet his party candidate does not win the seat, this happened in some opposition seats especially those of DP and UPC.

    • poseur to boot. how does your calibre liaise with medical professionals? thought you were (by your own unintended revelation) in catering. if and when medicas are talking of cancer, you and I should at least listen and at best ask questions for further enlightenment. but you attack Mwenda pretending that you have similar opinion with the said professionals; yet I bet you don’t even know how and where food passes from mouth till it makes body muscle. your type did not reach the level where such a fact is imparted.

    • Now Diane, it is incumbent on you knowledgeable guys to suggest ways to get us out of this dilemma. second-best-thing sort of. while thanking you for your enlightenment on things we took less seriously than they deserve, take us a step further and suggest a crisis-management step ( first-aid sort of) until we reach where and when we shall have the situation in control. cancer we are made to understand is not terminal if the correct machinery and personnel are available. Once more thank you Diane and Musinga for the knowledge (though brief) imparted….. proof that real education such you got is like the sun from which we all bask and benefit.

    • DP and UPC are indeed your role model. no wonder you are irretrievably lost and incorrigibly misguided. you are the cause of backwardness because the speed of a caravan is dependent on the slowest camel.

  35. You are blind to the importance of cancer probably because it has not struck closer to your home. But come and I give you a guided tour of the hospital I work in. If you go back home unchanged thereafter, then you are less of a human being.

  36. ejakait engoraton

    DIANE – your exercise will be futile.You are dealing with a bunch of hardened heartless people.YES maybe they have not had the misfortune of someone close to them die from cancer or the many deaths that are needless and preventable but sometimes it does not have to happen to you personally.A one AKUTCH SUSSLEY once when I pointed out the fate of CAROL , all he said was “bambi” and for him life went on as usual. Rwasubutare yowesha simply because I make reference to catering, that makes me a person in catering, and what is wrong with that , was not your mum a caterer for the family- mine was.I do not have to be a doctor( nor anyone for that matter) to know the impact of our failed system and though they are talking from a medical perspective, most of the things they say are common knowledge and common sense to boot.I know so much about cows and other animals it does not make me a “muliisa”.

  37. ejakait engoraton

    I have not at any one time claimed to be at the level of DIANE and MUSINGA but rather than put your tail between ………. like those dogs do and admit that your pseudo ” facts”have been put to shame because you had hoped that all the people on this forum are half baked like you and M 9.That you get your facts from people who live in South Africa, then the gentleman comes out with concrete facts ( not wolokoso),he has worked in SA and India, and I can even say that what you tried to tell us was not what you were told because I doubt you have the capacity to understand a paragraph with more than 2 sentences.There is no need to talk tough or to promise mayhem, the mayhem is already there and some of us have a stake in this nation called UGANDA and that is why we are concerned and in so much pain over what is happening, the likes of you are “mercenaries” and will go where the wind takes you.Here today, gone tomorrow.

    • chicken memory ejakait, who alluded to owning a restaurant with a (dead) man in Kigali some time back? wouldn’t one safely guess that that is money-laundering in that Kampala has more customers and facilities to set up business than Kigali? who is vilifying the powers-that-be hourly wishing them ill? is that patriotism? who spews tribalistic animosity like ‘bantu’ and other vocabulary calculated to provoke anger among a certain community? isn’t it you? who pretends to side with the civilised lot in this forum whenever sense gets the upper hand?

    • the Winnie you denigrate is and will always be better than you now and ever even after death. remember your anger and animosity is because you were promised to vandalise and loot others’ hard-earned property at libersty (early 80’s luweero all over sort of) and the security organs (which you rabidly detest) stood guard.
      one simple question: if you are as brilliant and cleverer as you ‘believe’; and the present leadership is as ‘incompetent and mediocre’ as you believe; why do you mr clever man and your other clevers howl and bark instead of using your ‘wisdom’ to dislodge them? ” Wisdom is vindicated by its (tangible) results”
      Jesus Christ in LUKE 7:35.

  38. ejakait engoraton

    WINNIE-I would never in a million years ask someone who comes to a meeting in my office to serve wine to other people ,woman( lady) or not. Even in my house ,if I have guests around I would never ask my wife to serve drinks or tea – I would do it myself.This shows the calibre of “CEO” you had your meeting with, if at all it was a meeting.Or it shows the calibre of person you are ,or what the CEO and the others in the “meeting” thought of you.ME thinks it was not a meeting but rather an audition to see whether you make a good bartender with the hope of giving you a job in some bar in Bwaise or some such place.
    Either these people had no respect for you or you have no self esteem.Can you imagine Kagina going to a meeting and she is asked to open the wine mbu “being the only lady”- what an insult to your fellow women(ladies).YOU are only worth as much respect as you give yourself.

  39. So Winnie did you play yourself? Hope not with the bottle but with the “boss” himself? I hope the message is sober enough for your interpretation.

  40. ejakait engoraton

    DIANE – if you think that taking some of these people around a cancer ward and they see the suffering of the patients will faze them , then you have something coming.These people can not become less of human beings than they already are. Do you think blood fazes a tick or a flea? These people are perverts and sadists who take pleasure ( and probably get orgasms)from the suffering of others.After you take him through the ward, he/she will probably go to his/her watering joint, order an ice cold beer to wash down a plate of muchomo, get in his Pajero and go to his/her fraaaaat in Bugoroooobi and sleep like a baby that night without the slightest care in the world about your winging CAROLS and their bloody cancer, he will probably say , just like Engoraton and the Ochetos and Rajabs , and the wise acre Musingas, these people deserve their fate for some alleged sin, maybe they did not vote the visionary and his party otherwise they would be on the first plane to a foreign hospital.

  41. ejakait engoraton

    WINNIE – I know this is the topic at which you are an expert , and you blurt that the Ganda women are the ones who most practice “ekimansulo”!!!!!!! Really? The word “ekimansulo” is a relatively new word in the context it is used but which people have it as their standard vocabulary, the word , at the risk of offending LOKODO, is “okunyaaza”.CHECK.
    MUSINGA – our leaders as you say have the “quality defect” in their DNA – or GENES , because these are people who believe in “MIVUMBA”- hope you know the origin of the word.Our textile industry was killed in preference for second hand goods.I watched a documentary in which AMIN visited the UGIL factory, and I remember this factory used to make YAMATO shirts in addition to undergarments.Then you bring AGOA and make it appear as if it is the best thing since sliced bread.

  42. ejakait engoraton

    RWASUBUTARE – you need help and very soon.AS I said before , a rabid dog always goes back to its vomit.Tell this forum now that EZRA BUNYENYEZI the husband of Chantel, father to Nshuti, brother in law to DOUDOU, who had a green SUBARU Legacy Estate left hand drive and formerly owner of UTB was dead in 1995. Is owning a business in a foreign country “money laundering”. If you own a restaurant, does that make you a chef. So ROMAN who owns Chelsea is /was a footballer. Even the INDEPENDENT posted your comment as an afterthought because they saw it as an embarrassment.Do you think wisdom is used for only one thing.Was EINSTEIN a person in government or a politician, is BILL GATES in politics or involved in trying to change governments.You talk like those school waiters when pupils complain about the food “why dont you go and cook”.I have no desire to be like WINNIE, why would I want to go to a meeting only to end up being the barmaid.NO THANKS.

    • I see you are angry now and that drives my point home. you are free to and at liberty to destroy all breakables you wish as long as they are yours and in your own premises. Elsewhere we deal with you conclusively.

  43. ejakait engoraton

    WHAT makes you think I hate any particular tribe as you suggest simply because I used the word BANTU.What if I told you I have relatives and friends from all corners of the country.And what if I told you that the late CHEF ALI(ERIYA MWINE) was first cousins with my father.Like I told you, I have no desire in seeing UGANDA going up in flames , because chances are I have a far much bigger stake in it than you have and I am sure that if push came to shove, you probably have somewhere else where you could run to and call home.I have only this place called Uganda to call home, a place where my grandfather , father and all other relatives are buried and would like from time to time visit their graves and lay flowers.All we want is a country that is enjoyed by all irrespective.IT is as simple as that.

  44. You lake a lot of pride in calling yourself (the only) Ugandan as though others are your tenants. everyone you fool (including migrant Indians) are stakeholders in Uganda. A congolese in Bukavu to who my FUSO truck delivers dried cassava from Kizibu in Kigumba (after driving a distance of 1,000 kms)is a stakeholder. The youth who peacefully sells roast meat to my driver is a stakeholder. The night-ladies who comfort my driver and turn-boy along the journey are stakeholders. All those have no wish to see Uganda going up in flames even if you think you are capable of even igniting the fire. To prove to you how inconceivable it is, none in the whole of FDC was among the 27 pioneer Kabamba attackers so you may as well know you are following followers and no leaders.

  45. And to be truthful, do you know your father, let alone knowing where he is buried? as for a grandfather, it is like attempting to trace you genealogy to Adam. so man your rage is all air-filled balloon and no substance. and ejakait, the more we exchange ,the more I psychologically dig that you are one of those who are feeding on others sweat; so pray for stability man. your type are the first to perish when adversity strikes….. and most likely to be the first casualty in looting spree ; either by owner,fellow looter or security forces that are usually summarizing matters.

  46. I badly miss Kakyama and with his copycat obsolete text-book nonsense and historical data that had been overtaken by other truer versions, posted wikipedia wrong facts and other poison that sadly would corrupt the young minds save that they do not read much. Kakyama would spew irrelevantly:
    “…..The materialist doctrine that men are products of circumstances and upbringing, and that, therefore, changed men are products of other circumstances and changed upbringing, forgets that it is men who change
    cirumstances and that it is essential to educate the educator himself……”

  47. Then Omeros would pick from there and attempt to outdo him with even more poppycock thus:
    Both Marx and Engels left comfortable bourgeois families to pursue a life of revolutionary scholarship and struggle. Meeting in Paris with Engels in 1843, Marx began studying economics and associated himself with communist groups. When communist artisans form associations, education and propaganda are their first aims. simply means of bringing people together. Company, association, entertainment which also has society as its aim, are sufficient for them; the brotherhood of man is no empty phrase but a reality, and the nobility of man shines forth upon us from their toil.
    Truth be told, these two raised my antibodies by 2 because I would laugh until tears welled and ribs ached.

  48. 1.@Ejakait: Generally,Ugandan men have poor etiquette e.g you hardly find them holding their ladies’s hands while walking(obaa its coz they have many women),they walk ahead of ladies,they sit with their jackets buttoned,they don’t close their mouth while yawning,they doge paying fees, they cant open the car door for a lady(mbu those r for movies)any way it cost me nothing to serve the wine besides that it was an informal meeting.(You expected me to protest like Nanyanzi)
    2. So you think when Kagina or Musisi r told to led the opening prayer in a meeting they would feel offended?
    3.@ Rajab so u give your lady a push with the bottle i really dont need a push to get started. I Read Charles Oboo’s article where he wrote that they needed to 1st hear Barren White’s voice before they got started.

  49. 4. I really pitty my generation what is going to wipe us all is AIDS you find Ejakait(65 years of age) moving out with a 18 year of lady then that lady meets Ejakait’s son of 22 years infects him and the cycle continues.These days When our parents are giving in our hands in marriage you really see tears in their eyes these are not tears of joy but tears of worry,pitty & sadness.

  50. ejakait engoraton

    SO WINNIE – to you LEADING(LED)( a word you chose to use) a prayer and opening wine for a bunch of men ( certainly not gentlemen) are the same.SO to you opening wine is leadership.There is no way you could have refused to open the wine because in the first place , just like you have equated it to leading a prayer, you thought it was an honor, and also the man who asked you to open the wine knew very well you could not refuse.SO no protest Nanyanzi or any other way.
    YES you say generally, but not all, but it goes to show the kind of company you choose which is the standard by which we are judging you.I have got used to your generalisations about Ugandan and African men, but have said it before that just because your father has gone out with a woman younger than you , you think Ejakait does the same.

  51. ejakait engoraton

    WINNIE – for once I agree with you and think you are right.They say even a broken clock tells the right time twice in a day.My father(rip) told me to always listen to people no matter how stupid, foolish or mad I may think they are because they may say 99 wrong/mad/stupid things and then say 1 very intelligent thing.As you say it cost you/you lost nothing.What did you expect to lose.What did you have to lose.YOU lost nothing because you had nothing/ nothing to lose.You went into the meeting with no dignity, no self respect, no esteem and came out the same way.The CEO knew all along that he was going to serve wine and that he was not going to serve it nor would he be asking any of the other men to so he invited the hapless WINNIE who was so naive she could not question why she was the only female in attendance.

  52. ejakait engoraton

    You say Ugandan men have poor etiquette simply because they do not hold their womens hands. Do you realise that it is the women most times who do not want to have their hands held.You are the type who copy everything the whites( who I assume are your clients) do as gospel.Do you ever question why they do and do you realise some things are embedded in ones genes.Why do cats bury their poop yet dogs and indeed other cat family members do not, why do goats eat thorny shrubs yet sheep and other ruminants do not. The reason whites hold hands is because of the cold weather where they pass heat to one another.Just like it is a fact that black men are “big” where the Japanese are “small”.BUT the ape the WINNIE is just because the whites do it , it must be cool and right.Opening doors used to be in the era before we had central locking!!!!!!!!!!!! and EQUALITY.You are stuck in the stone age.

  53. Ejakait :(i)On earth,there is no lawyer nor Briton with low self esteem.(ii)There is a difference between a command,request,honor, and acting in a primitive way once told to do something(iii)For us young people we dont feel offended once told to do something especially when it costs us nothing(iv) Rich people take a glass of wine when they are happy or after a meal for purposes of digestion may be you are mistaking wine for kweete(baaba ndeeka) (v)So your understanding of the central locking system in a car is that its meant to lock ladies out of men’s cars right?Does the central locking system of a car stop the doors from opening or you are taking the natural meaning of lock? you sound like one who overheard people conversing about the central lock of a car coz clearly you cant explain how it works.

  54. ejakait engoraton

    SO Madam WINNIE – what does the central locking system of a car do. Can you open the doors of a car if they have used the central locking system to lock them without using the key.
    WINNIE – even if you live your life two times or convene all your clan to challenge me about cars or vehicles for that matter, you will never know as much as I know about the subject.That I say with all the confidence I can master.

  55. Tema a circo é lítico porque ele por si mesma já remete para alegria, risadas e
    também diversão.

  56. i am very grateful for Mr. Musinga for a well informed response. It helps us discount M9 s and the like who have a flexible relationship with reality. I also lament being his almuni. I loved him when he was a young man informed the nation uncovered secrets which would of concern. Heonce had the country at heart. I guess he wants to survive. And I respect that but it would not help him in pedalling propaganda on the like of Musinga and others with concrete facts.
    The elites or middle income earners who can pay the taxes are not treated in Mulago for Mwendas information. They go to case and paragon. They complain about Mulago because they pick the bill for services other poor folks never recieve. These are the poor this young man who calls himself oldman pretends to care about. This is outrageous and false thanks Mr. Musinga for putting him where he belongs.
    Our quarrel is not out of hate or blackmailing the government like they have sent their propaganda champion M9 after us. Ours is based on a belief that our country can do better in these services and care for our own. On these m9s speaking falsehoods to make people content with the status quo. Besigye brought to light the inconvenient truth. The propaganda machine sends M9s to put people to sleep for the next five years how cruel can this man get.
    Mind you M9/7 the EA federation is on course and every Ugandan should look to it with fear. Free labour movement targets these elites who have the know how upsetting these folks and insulting donors can not be away to start a very controversial presidential term.

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