In early February, Speaker of Parliament Jacob Oulanyah flew to Seattle, Washington in the US, for cancer treatment. His means of transportation—a private flight on a Uganda Airways jet – cost the Ugandan taxpayer roughly half a million US dollars.
Members of the Ugandan diaspora gathered to protest what they saw as a waste of precious resources by a country with some of the world’s worst health statistics. In a bid to deflect criticism of the government, some Ugandan elites, including MPs from Oulanyah’s Acholi ethnic group, disparaged the activists as disgruntled National Unity Platform (NUP) supporters and accused them of tribalism, regionalism and sectarianism.
In fact, this demonstration, like many others, was organised by members of the diaspora from the entire political spectrum who are sick of watching their people back home die in Uganda’s dilapidated health centers, sick of the theft of their money by corrupt elites, and sick of the indifference of government officials, aid agencies, donor governments and the entire international community to their plight.
Uganda allocates roughly 5% of its national budget to health—one of the lowest fractions in the world, and far lower than 15% the country pledged to spend on the sector when it signed the Abuja Declaration in the year 2000.
As a result, Uganda’s health system barely functions, with often absent and abysmally underpaid staff, stock outs of drugs that should be free, broken down equipment, crumbling buildings and many other problems.
Uganda’s women and children succumb at staggeringly high rates to easily preventable or curable diseases such as measles, malaria, and malnutrition, which afflicts one third of children and kills roughly 80,000 of them each year. In a country of 40 million people, there are only 500 pediatricians to care for these children. Every day, 20 Ugandan women die giving birth—one of the highest rates of maternal death in the world.
In order to meet international standards, even for a low income country, Uganda needs four times as many skilled health workers as it currently employs. The national referral hospital largely relies on interns to provide essential medical care, but they recently went on strike because they weren’t being paid even the meagre salaries they were owed, a strike that lasted several weeks.
The combined result of malnutrition, disease, maternal death and a similarly underfunded and dilapidated education system is that, according to the World Bank, only 17% of Ugandan children can read and understand a simple text by the end of primary school. This data was collected before the nearly two-year education hiatus due to COVID-19, so the situation is undoubtedly worse now.
The reason for this disgraceful state of affairs isn’t hard to find: Uganda’s power elite has, for decades, been stealing every shilling that isn’t nailed down. The scandals—thefts of money from the Global Fund for AIDS, TB and Malaria, the Global Alliance for Vaccines and Immunisation and countless other donor and tax payer funded programmes are far too numerous to list, but according to one NGO probably amount to billions of dollars over time.
If anything, the scandals have accelerated in recent years. In 2019, Parliament allocated $379 million for a new hospital at Lubowa, a Kampala suburb, but it is still at foundation level. Ugandan taxpayers are now paying that borrowed money back anyway.
Shortly before the brutal November 2020 crackdown in which at least 52 Ugandans were shot dead in the streets by security forces, the government appears to have diverted a $300 million World Bank Covid-19 relief loan to those same security forces.
Activists alerted the World Bank and the US government, which lavishes roughly $1 billion annually in foreign aid on Uganda, and also supports the World Bank, to this and other scandals, but they’ve turned a blind eye to them all, probably because the US Defense Department works closely with the Ugandan military.
So, the corruption continues, at the cost of countless Ugandan lives. This, and not tribalism or petty political point scoring, is why Oulanyah’s expensive flight to the US sparked outrage. Cancer is one of the leading causes of death in Uganda, and all citizens—not just the ruling clique—have a right to treatment for it, and to all their basic health needs.
The political elite must stop rushing to the defense of the predatory networks that are the cause of so much suffering and wake up to the plight of the Ugandans they are supposed to represent.
Nsereko is a Ugandan living in the US. Epstein is an American professor of human rights and public health, with a special interest in Uganda.