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The White Ribbon Billboard
A White Ribbon Alliance Uganda
Newsletter, February 2015
Vol.3 
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Connecting partners and members
POLITICAL SUPPORT: Members of Parliament Hon. Dr. Lulume Bayiga (L) and Hon. Sylvia Namabidde endorse citizens' participation in the Post-2015 agenda


'Nothing About Us Without Us'

 

The Citizens’ Hearings on health matters beyond 2015 are around the corner. They will give citizens an opportunity to participate in dialogue about priorities and deciding on accountability mechanisms for the new development framework (Sustainable Development Goals), which will replace the current Millennium Development Goals (MDGs) that expire at the end of this year (2015).

We know that important decisions on health and other matters are made in international fora where citizens are hardly present, yet these decisions concern the citizens and greatly impact their lives. So this time round, we are saying ‘Nothing About Us Without Us,’ and as part of the International Women’s Day activities, White Ribbon Alliance Uganda (WRA-Ug) is working with districts and national level stakeholders to hold Citizens’ Hearings, under the theme: 
Citizen-led accountability is key in the Post 2015 Health Agenda. 

As part of the International Women’s Day activities, White Ribbon Alliance Uganda is working with district and national level stakeholders to hold Citizens’ Hearings, under the theme: Citizen-led accountability is key in the Post 2015 Health Agenda.
The events will bring together the civil society and citizens in Uganda with interest in health to develop a strong voice for setting people-centered health priorities and advocate for citizen-centered accountability for sustainable development. During the hearings, WRA-Ug and partners will solicit views of the citizens on their priorities regarding Reproductive, Maternal, Newborn and Child Health (RMNCH) on the Post 2015 health goal and also engage and discuss with citizens about appropriate citizen-centered accountability mechanisms for the Post 2015 health goal. 

Together with the district local governments, WRA will hold Citizens’ Hearings in Kabale and Lira districts as part of activities for marking Women's Day. The Citizens’ Hearings will be held on March 6th 2015 in Hamurwa Sub-county (Kabale) and Amac Sub-country (Lira) shortly before the National Women’s Day celebrations. Recommendations from the hearings will be presented during the Women’s Day events on March 8th 2015. Above right: WRA members in Lira meet with Amac Sub-county leaders to plan for the citizens' hearing.

 While the global theme for this year’s International Women’s Day is ‘Make It Happen,’ Uganda has adopted: ‘Empowerment of Women and Girls is Progress for All: Three Decades of Gains for Ugandan Women and Girls,’ as a national theme. At WRA, we believe nothing can be done without good health. Empowerment of girls cannot be achieved without good health – the reason we are advocating for improvement in health service delivery by empowering citizens to demand better services from their representatives.  
Recommendations from the citizens at the district will be taken to the national level for discussion with decision makers as they prepare Uganda’s priorities to be discussed in international negotiation forums such as the World Health Assembly and the United Nations General Assembly. 

The Citizens’ Hearings will involve WRA members, local community, district leadership (LCs, MPs, CAOs, etc), district health professionals (representatives from all levels), CSOs working on women’s, children and newborn health, the ministries of Gender, Labour and Social Development, Health, Foreign Affairs, Finance, religious leaders, Members of Parliament, health workers, VHTs, grassroots women, men, the media, etc. WRA-Uganda and Action Group for Health, Human Rights and HIV/AIDS (AGHA) Uganda will facilitate the hearings.

It's your right to be involved in the citizens' hearings. Give your views on reproductive, maternal, newborn and child health. 
Remember, 'Nothing About Us Without Us.' Become a citizens' reporter on social media using the Citizen Reporter hashtags #CitizensPost #Commit2Deliver #ActNowToSaveMothers on Facebook, Twitter and Instagram. Follow what's happening in citizen hearings in different countries on a dedicated website citizens-post.org created by WRA-Global.
Recommendations from the district citizens' hearings will be taken to the national level for discussion with decision makers as they prepare Uganda’s priorities to be discussed in international negotiation forums such as the World Health Assembly and the United Nations General Assembly.

Increase investment in motivation and retention of health workers instead of 'exporting' them –CSOs in health


The media has been awash with reports about the exportation of health workers to Trinidad and Tobago. Civil Society Organizations (CSOs) in Maternal, Newborn and Child Health have been central in engaging stakeholders on this issue. When the CSOs read adverts by the Ministry of Foreign Affairs seeking applications for 263 professional medical personnel in different specialties to work in Trinidad and Tobago, they were perturbed by this irrational move by the government. Professional health workers are the drivers of the health system and if the government of Uganda facilitates this medical brain drain/‘exportation’ of health workers, it would adversely affect health service delivery and deprive citizens of an already limited resource – health workers.
 

Debating medical brain drain

WRA-Ug was invited by Wizarts Media to participate in a TV debate about the ‘exportation’ of health workers to Trinidad and Tobago. On the panel were Hon. Chris Baryomunsi (MP Kinkinzi West and also now State Minister for Health), Ambassador John Muhindo representing the Americas and Mr Justinian Kateera the Executive Director of the Institute of Public Policy Research (IPPR), the think-tank that sued government over the ‘exportation’ of health workers.
Watch WRA-Ug’s Faridah Luyiga Mwanje challenge Ambassodor Muhindo on whether the Ministry of Foreign Affairs did a risk-benefit analysis to understand the impact of this medical brain drain on the health work force.
Below are links to the full debate organized in 6 parts:
Part 1: https://www.youtube.com/watch?v=DRntxk0852o
Part 2: https://www.youtube.com/watch?v=fZJYm5beKJE
Part 3: https://www.youtube.com/watch?v=_y4J7zXbC6A
Part 4: https://www.youtube.com/watch?v=iKQC_YdsD04
Part 5: https://www.youtube.com/watch?v=ynf_xuGp-cg
Part 6: https://www.youtube.com/watch?v=Z1lwromRbWs

CSOs issue statement on exportation of health workers to Trinidad and Tobago


CSOs advocating to end mortality in Uganda met and issued a statement calling on government to abandon the plan of facilitating the brain drain of our treasured medical personnel. The statement was released at a joint press conference hosted by AGHA Uganda. Health workers were represented by the leaders of their professional associations who added their voice, calling onto the government to increase funding for motivation and retention instead of 'exporting' them. Click here to read the full statement . The media has amplified our voices by report extensively about this, and below are some quotes from the stakeholders about this.

Quotes from stakeholders on medical brain drain

How can government export doctors when...


“Imagine 90 senior medical cadres from Mulago!  How can government export doctors when Parliament has on several occasions complained about shortage of senior medical personnel?”
Dr. Chris Baryomunsi Kinkinzi East MP wondered. 

This is basic economics


“The government should be ashamed,” said Sam Senfuka of White Ribbon Alliance Uganda. â€œThey are supporting the export of our most prized resource — our health workers, who are in scarce supply in the health system. “Export should only be considered if a country has a surplus; this is basic economics. We have thoroughly analyzed this plan; it is wrong-headed and must be stopped."

Uganda has an acute shortage of health workers


“Uganda should stop defying its own evidence, and substantially increase investment in the health workforce so that citizens seeking health care do not face a death trap,” said Asia Russell of Health GAP. “Trinidad is a tiny, oil rich, high income country with only 1.3 million people and no health worker crisis. Uganda has an acute shortage of health workers that can only be fixed through investing in better pay, better working conditions, and better management. Exporting health workers is dead wrong.”

Who will treat you when you get heart failure


Dr. Merdad Bitekyerezo (MP Mbarara) amused MPs when he asked State Minister for Regional Cooperation Asuman Kiyingi who will treat him in case he suffers heart attack. “If there are no good doctors in Kamuli, who do you think will treat you when you get heart failure?” he said, sending MPs into laughter.

We find this irrational


“We are seeking a judicial review of the decision because we find it irrational that a government that is presiding over a health system that is short of human resources should be at the centre of efforts to export these scarce resources,” IPPR-U Executive Director Justinian Kateera told The East African.

Our people are suffering here at home


“The shortage of health workers is killing Ugandans, particularly the most vulnerable and the poorest,” said Dennis Odwe of AGHA Uganda. "...how can they [government] spend hundreds of billions on VIP care abroad when our people are suffering here at home?” 

There are many unemployed Ugandans to fill the positions


“There are many unemployed Ugandans to fill the vacated positions,” Ministry of Foreign Affairs spokesman Fred Opolot said.
 

It's a good thing if these people go out


Dr. Asuman Lukwago, the Permanent Secretary at the Ministry of Health echoed Mr Opolot's position. Lukwago said there were many unemployed medical workers who would fill the gap. “The reason why we have many unfilled positions in health facilities is not because of a lack of qualified people as such but rather because of budgetary limitations that don’t allow us to recruit and retain workers in the sector. So it is a good thing if these people go out because it will create opportunities for others,” he said.

Lukwago added that the decision to export health workers is aimed at arresting the scenario where most of them have drowned in the Mediterranean while trying to cross to overseas in search for green pastures.

“We don’t know how many health workers have died in the sea trying to cross to Europe and other developed countries. What government did was a formalization to make sure that things work out for them legally instead of them risking their lives.”

We have a heavy disease burden


“Uganda’s health budget is between 8% and 9% of the total national budget, which is way below the Abuja Declaration standard. We have a heavy disease burden but government is not investing in the health sector. Uganda’s current doctor to patient ratio is 1:15, 000; nurses to patient is 1:7, 000 and midwives to patient ratio is 1:9,000. This is against the World Health Organisation’s (WHO) required ratio of one doctor to 1500 patients, one nurse to 700 patients and one midwife to 1000 patients,” said Janet Obuni, President Uganda Nurses and Midwives Union (UNMU)

Our duty bearers are defying their own evidence


“Government should be increasing health workers’ remuneration, improving working conditions and increasing the wage bill so that our clinics are finally saturated with motivated health workers. Instead, our duty bearers are defying their own evidence and want to actively support health workers to leave. We will not allow this to happen,” said. Joshua Wamboga, the Executive Director of Uganda Alliance of Patients Organization (UAPO)

Parliament discusses the exportation of health workers


WRA-Uganda sparked off the issue of exportation of health workers to Trinidad and Tobago in the Parliamentary Committee on Health meeting when we provided information about this plan to Hon Bitekyerezo, who tabled the issue before the committee and read the advert by the Ministry of Foreign Affairs. Watch a video of Hon. Bitekyerezo presenting the issue to the health committee. He committed to take the issue to Rt Hon. Speaker and implore her to intervene. Indeed, he immediately took the issue before the Speaker who acted and included it on Order Paper for that day. Hon. Bitekyerezo presented it on the floor of Parliament. The Speaker asked the ministers of health & foreign affairs to present an explanation to Parliament in a specific time frame. Click here to read an article about this.

Advocates meet with MPs to draw action plan


WRA-Uganda and AGHA Uganda together with CSOs in MNCH convened a meeting with MPs to address motivation and retention of health workers in FY 2015/2016 and stop government plan of facilitating the brain drain of medical personnel. The CSOs made an economic analysis of the export of health workers to show gaps in the decision to export 263 specialists. CSOs called onto government to abandon this illogical move completely and also adopt strategies Trinidad and Tobago is using to attract, motivate and retain health workers such as increase in salaries and improving working conditions. The MPs committed to support the issue tabled in Parliament by Hon. Bitekyerezo. Above, Hon. Sylvia Namabidde talks to CEHURD's Noor Nakibuuka Musisi.
 

NRM should commit to deliver on its health promises to citizens


At the time of the NRM Parliamentary caucus retreat in Kyankwanzi, CSOs lead by Health GAP, WRA-Ug, AGHA and CEHURD wrote a memo about NRM’s performance/delivery on health promises in their 2011-2015 manifesto. The memo was shared with MPs and Hon Sylvia Namabidde, a maternal health champion asked the State Minister for Health Dr Elioda Tumwesigye (Now Minister of Health) to explain why government was spearheading brain drain of health workers. We tweeted about the story here, but you can read the full memo here
POLITICAL SUPPORT: L-R: MPs Rhona Ninsiima (Kabale), Lulume Bayiga (Buikwe) and Sylvia Namabidde (Mityana) show support for citizen involvement in Post-2015 Health Agenda.
ECONOMIC ARGUMENT: Patrick Ojilong presents a CSOs' economic analysis of the 'exportation' of 263 health workers to Trinidad and Tobago during a meeting of CSOs and Members of Parliament. Below are more photos of the meeting.
L-R: WRA-Ug's Robina Biteyi & Faridah Luyiga and PATH's Ashley & Kristy pose for a photo after a meeting in Kampala.
Upcoming events
  • Women's Day: March 8th 2015. National celebrations in Kabale District
  • District Citizens' Hearings: March 6th 2015
  • National Citizens' Hearing: Date to be determined
  • Annual General Meeting: March 27th 2015
We hope you enjoyed reading The White Ribbon Billboard. Give us feedback through info@wrauganda.org or fluyiga@gmail.com
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