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COMMENT: Understanding the doctors’ strike

Doctors show their dissatisfaction during a meeting with PM Dr. Ruhakana Rugunda

 How it reveals impact of the state undermining workers’ organisations and unions

COMMENT | MORRIS KOMAKECH | Ugandan doctors opted to strike over poor remunerations, which they say compromise their work ethic. The doctors’ plight is understandable. Doctors in public facilities earn, on average, about US$300 per month. This level of abuse is unheard of anywhere in the world. In Kenya, the recent doctors’ industrial action ended with a decent settlement where interns earn US$ 1,900 and the highest consultants earn about US$5600 a month.

The Ugandan state’s insensitivity to income inequality and widespread rent seeking signifies deliberate undermining of labour and Unions.

The doctors are seeking equitable pay and improved work conditions. Public resources should not only fund political expedience. The decaying public institutions need fixing, henceforth. Too much politics of self-aggrandisement has left critical social services to deteriorate.

Ugandans are dying too often from conditions caused by social inequities.

Generally, industrial action is commonplace these days and is perceived to target the state actors, more than the private sector employers (corporations and businesses).

This is largely because the Ugandan liberal market is under-developed, and atypical. The market-labour relations are equally atypical due to patrimonial indulgences by the state and sub-state actors who constantly distort the markets.

Researchers David Booth and Frederick Golooba-Mutebi studied the formation and influences of developmental patrimonialism in Rwanda where the state’s legitimate interests in the market help to shape the direction of the economy, reduce devastating rent seeking tendencies, and spur real economic growth as measured by reduction in poverty rates. How does patrimonialism shape Uganda’s liberal market?

Interestingly, Uganda’s market economy is not the main employer of the fledgling youthful labour force. Therefore, externalities (concentrated political interests), rather than the market, regulate and moderate labour- capital relations In Uganda. According to the 2016/17 Uganda National Household Survey (UNHS), the general unemployment rate was high, 9.5%, to signify that the economy was probably liberalising fast without expanding, or diversifying in proportion to the growing labour force; and, about 60% of Ugandans are employed informally.

The high-end investors in manufacturing, agro-processing, Information technology, banking, energy, tourism, infrastructure development, and mining avoid chaotic Uganda. The local or crooked investors have come and run out of business due to political patronage, pervasive rent seeking, restricted liberal rights and freedoms, making Ugandan market highly risk-prone. The political instability signals high potential for large-scale disruptions of the market; risks that investors avoid.

Today, the major institution of the economy is not the market – rather, it is the state – the Presidency and political class who live off rent seeking. In this way, the Ugandan economy is atypical in the real sense of a liberal economy as those shaped under ideologies of neoliberalism.

Incidentally, the Uganda state tends to distances itself from social spending, especially in critical areas of childhood development, education, health, agriculture, and social securities. For instance, the budgetary allocation to social sector has declined from 37% in 2002/2003 to 19% in the 2017 budget. This expenditure if far below the global and emerging marketing standards where health social coverage remains as low as below 3.0%.

The striking civil servants fall in the social sectors where the state has reneged on its fiscal obligations. The state wishes to cede social service obligations to the private sector or liberal market.

Evidence shows that working and living conditions are far better in economies with high labour union densities. Where unions thrive, pay inequities and poverty are reduced, and the sense of social justice supersedes that of economic justice. However, where the market is the dominant force, liberal rights are enforced but labour unions are suppressed. The objective of the capitalist class is maximisation of profits by paying low wages and limiting benefits.

The 2014 Uganda Labour market profile identifies 40 workers unions, covering only 440,000 workers, or 3% of the labour force, constituting 13% of workers in the formal workforce.

This is an indicator of how much the state deliberately undermines labour and their unions, and every means of social and political organising.


Morris Komakech is a Ugandan Social Critic and Political Analyst. Contact via

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