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Uganda is a landlocked country in the Great Lake
Region of Africa and lies astride the Equator. It has
an area of 241,139 sq. Km of which 18% is open water
and swamp. According to 2000 estimates, Uganda¡¯ population
is 22 millions.
The Medical situation of Uganda
During the 1960s Uganda's health delivery network
was regarded the best among sub-Saharan countries. However,
since the declining of socioeconomic situation started,
the situation changed drastically.
Communicable diseases have been increasing and became
predominant and still continue to reflect the prevalent
pathology in the country. Current estimates indicate
per capita expenditure on health for Uganda, of US$
9.8 (1995-1996); This is below the per capita amount,
recommended by WHO, of US$12, (and even below the SSA
per capita average of US$19) which would be sufficient
to provide health for all.
Major causes of Morbidity in Uganda are Malaria (19.2%),
respiratory infections (18.2), intestinal worms (7.4),
Diarrhea (5.2) and Trauma (5.0). The 5 major causes
of mortality are infectious diseases that might be treated
properly if there are good facilities.
Uganda is estimated to have an infant mortality rate
which is about 9% higher than the SSA average and 70
% higher than the average for low-income countries.
According to the data from Tuberculosis association
of Uganda in 1996, the cure rate of sputum AAFB(+) tuberculosis
in Uganda was only 36.9%. The mortality rate of patients
in medical ward was 19% at 1997. Such high mortality
is somehow resulted from high prevalence of HIV in Ugandan
people, however, we must confess that many patients
who could have been saved with proper treatment died
due to various reasons.
There are 98 hospitals in Uganda. 55 of them belong
to government, 39, to NGOs and 4, to private. There
are total 23,717 beds including Maternal units
and AIDS post. This means 1.18 per 1,000 population.
There were about 20,000 health professionals in the
country in 1996. 70% of them are in government service,
28% in NGO service and the remaining 2% in private practice.
There are about 1000 medical doctors (20,000 people
per doctor) and as many medical assistants. The country
counts 41 schools of which eleven operated by NGOs.
In general physical assets, as well buildings as
equipment are in deplorable state. Most of the health
care infrastructure is in a major stage mal-or non-function
because of the lack of maintenance. Many buildings have
reached the stage where repair would be more costly
than the construction of new facilities. As far as the
equipment is concerned, there is hardly any equipment
available and when it is, it is provided by NGOs or
other bilateral aid programs. In cases where new equipment
has been provided, there is a lack of supplies to make
the equipment function which makes the investment of
the "gift" useless.
The government knows such situations and has been
trying its best to improve this situation, but still
most problems have not been solved partly due to lack
of finance, partly due to low morale of medical staffs.
At this setting, while many poor patients are dying,
the rich usually go abroad to be treated spending a
lot of money.
Most importantly, the most miserable problem in medical
field is lack of sense of responsibility in medical
persons. Those who care for patients lost pride as medical
persons. Therefore, proper treatment could not be given
to desperate patients. There are many problems to be
corrected. However, the most urgent thing to be corrected
is lack of commitment of medical persons.
We do not have enough number of medical person or
medicines, but such things can not be corrected in a
day. So at present, the most important thing we must
try is to motivate medical workers. Because of collapsed
medical system, they have lost morale and do not do
their duties properly. In turn, their uncommitted work
demoralize others again. We must cut this vicious cycle.
Therefore, the education of medical person should be
emphasized and given properly to them.
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