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Doctors get offers they can’t resist

By Ivan Rugambwa

Healthcare workers are the heart and soul of healthcare delivery systems, says Ambassador Scott DeLisi

Every two days, at least one doctor heads to the airport of a poor African country and flies off to work in Europe or America. Up to 2000 doctors have left in the last 10 years; leaving Africa with the highest disease burden in the world and the lowest number of health workers.

Now, universities in 12 African countries have come together to try to stop prospective health workers fleeing as soon as they graduate.  Grouped under the Medical Education Partnership Initiative, the universities want to offer the health workers pre-graduation conditions similar to what is available in the developed world.


The universities want to give them better education, better opportunities to do research, and better technology and infrastructure to ease their training and work.

The whole deal is covered under five-year US$130 million (Approx. Shs325 billion) programme funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) together with the U.S. National Institutes of Health (NIH).

Health workers to benefit are from Uganda, Kenya, Tanzania, Mozambique, Zimbabwe, Ethiopia, South Africa, and Botswana. Launched in October 2010, it is already working in Nigeria, Ghana, Zambia and Malawi.

U.S. Ambassador to Uganda, Scott DeLisi says the new programme is critical.

“These health care workers are the heart and soul of health care delivery systems,” he told a meeting of MEPI beneficiaries at the Serena Conference Centre in Kampala on Aug. 6.

He pledged more support but said the ultimate responsibility for the transformation of healthcare systems lies not with the U.S. assistance and international donor funding, but with African governments, using their limited resources.

“It must be shaped by you and your fellow citizens,” he said.

Former US ambassador to Uganda and now Assistant secretary in the US department of Health Services, Jimmy Kolker, said MEPI could help stem the renewed threat from HIV/AIDS which Uganda appeared to have conquered in the past but has relapsed.  He was supported by the U.S. Global AIDS coordinator, Eric Goosby, who said his government through PEPFAR was willing to support partnerships like MEPI.

DeLisi said the MEPI money is an addition to over US$ 428 million that his country spends on health projects in Uganda. He said under this arrangement, this nation’s oldest university, Makerere University, and  Mbarara, Gulu, Busitema, and Kampala International universities have a running collaboration with Johns Hopkins University in the USA.

Grouped under the Medical Education for Services to all Ugandans (MESAU), they also aim at improving service delivery.    Health service delivery in Uganda is often rated among the worst on the globe. Although the government has built health facilities across the country, most are ill-equipped, lack staff and medicines, and are placed among the most corrupt by local and international surveys.

In a bid to change that, MESAU is to add 1,400 students to participating universities, has supported 22 staff to get Master’s degrees in biomedical sciences, and another 17 faculty members have received research grants, according to Prof. Nelson Sewankambo, the Principle of Makerere College of Health Sciences.

As a result, Prof. Sewankambu, who is the President of the Council of Principal Health Investigators, says Makerere University is now ranked number two on the African continent after University of Cape Town in terms of research.

The new Health Minister, Dr Ruhakana Rugunda, told the MEPI meeting that the government was also adjusting healthcare workers’ salaries upwards to try to retain them and attract others to fill the gap left by those that leave. He said 7200 health workers have been hired and another 1200 are to be offered scholarships to study abroad.

The World Health Organisation (WHO) reports that despite Africa carrying 24% of the global disease burden; it has only 3% of the global health workforce.

Sub-Saharan Africa has the lowest workforce density of approximately two doctors per 1000 people.  Uganda has one doctor for every 18,000 people.   Education Minister Jessica Alupo says this is unacceptable and that her ministry, which received the biggest chunk of this year’s national budget, was prioritising health education in universities.

She told the MEPI meeting that money has been allocated to build a new medical school in Busitema University. Another medical school is planned for Soroti, she said.

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