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Government priority setting has undermined the health sector in Uganda

The recently concluded 43rd session of the Commission on Population and Development (April 12-16, 2010), had an intensive debate on Health, Morbidity, Mortality and Development. Uganda was represented at the meeting, participated actively in the debates and made a statement at the plenary.

It was recognized that while commendable progress had been made in health over the last ten years, much more remained to be done in many developing countries especially the least developed ones to address the ‘double burden’ of infectious and parasitic diseases, emerging and re-emerging communicable diseases, and increasing non-communicable diseases such as hypertension, stroke and diabetes. Maternal and child health had made the slowest progress in the last decade. It was stressed that poverty, inequality and vulnerability have had far-reaching repercussions on the health of many people within and between nations.

The commission stressed that improving health will need to go beyond constructing hospitals and clinics and providing medicines, and adopt a multi-sector approach that includes health education, nutrition, safe drinking water, hygiene and sanitation, environmental protection, reproductive health, training and retention of staff.

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Denying the existence of ethnic differences in the Gt. Lakes region is absurd

I have used the word ‘absurd’ after careful reflection. According to Webster’s New Universal Unabridged Dictionary the word ‘absurd’ means “clearly untrue or unreasonable; ridiculously inconsistent with reason, or the plain dictates of common sense; logically contradictory. An absurd man acts contrary to the clear dictates of reason or sound judgement. An absurd proposition contradicts obvious truth”.

Because some African leaders believe that ethnicity, tribalism or divisionism – be it religion or race – is the root cause of political instability and conflict, they have decided to deny that ethnicity exists or to legislate against its use in public discourse. In Uganda there is a law against ‘sectarianism’; in Rwanda the word ‘divisionism’ is the equivalent of sectarianism in Uganda.

At a workshop in New York about Rwanda some participants who had gathered to talk about post-genocide progress singled out the disappearance of ethnicity as the most significant achievement. They stressed that Rwandese had decided to put the past behind them and move on as one nation. They added that ethnicity was a colonial creation which should not be carried into post-genocide Rwanda. They emphasized that in pre-colonial days Rwandese not only spoke the same language, went to the same church, lived on the same hill but also practiced complementary economic systems as one people. These symbiotic relations were shattered following the arrival of Europeans and the imposition of divide-and-rule methods that favored one group over another.

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History has been unkind to Bahutu people

Until 1994 Rwanda – and its Bahutu and Batutsi people – was relatively unknown in international relations. The country is small, not endowed with resources, and until 1994, had no strategic value. It was first colonized briefly by Germany and after World War I and until 1962 – when it became independent – by Belgium under the United Nations trusteeship mandate. The ‘social revolution’ of 1959 resulted in Bahutu replacing Batutsi that had ruled the country since the 16th century. Batutsi went into exile in neighboring countries and immediately started an armed struggle – which intensified from 1990 with external support – to reestablish their hegemony over Bahutu who constitute up to 90 percent of the total population with 9 percent Batutsi and 1 percent Batwa.

In 1994 the shooting down of the presidential plane and the death of Bahutu presidents of Rwanda and Burundi set off the killing – by Bahutu extremists who feared losing power – of moderate Bahutu and Batutsi who opposed Habyarimana government in Rwanda. After hesitation the international community decided that these killings constituted genocide. The Bahutu government was replaced by Batutsi-led regime thereby restoring Batutsi minority hegemony over Bahutu majority in Rwanda.

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What would be his legacy if M7 retired today?

When the president came to power in 1986, Museveni had a clear vision for Uganda and he conveyed it with a simple message. He wanted his presidency to be remembered inter alia by the eradication of poverty, hunger, disease, illiteracy, subsistence agriculture, dependency on foreign aid and raw material exports, sectarianism and corruption. Above all he wanted to eradicate Obote’s record by performing better. This vision was conveyed in his speeches delivered at home and abroad. I have read most of his major speeches and heard his statements delivered at the United Nations General Assembly Hall in New York.

President Museveni was convinced that he would eradicate poverty in Uganda because the country has what is necessary to do the job – fertile soils, good rainfall, natural resources and resilient people. With good leadership and a clean government the job would be easy. Since he was convinced he would eradicate poverty, Museveni refused to use the word “reduction”.

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The curse of resource abundance in DRC

The abundance of resources in DRC – elephants and their tusks, rubber trees and their latex, vast and varied minerals, fertile soils and adequate rainfall, rivers suitable for navigation that also have waterfalls in sections essential for the production of hydroelectric power, and resilient people – should have turned the country into a first class industrial nation with rich people enjoying a high life expectancy. Instead DRC has been ruthlessly exploited, has suffered keptocracy (government of thieves), wars and massive loss of lives and displacements, and human rights abuses including sexual violence with impunity thereby turning the country into a third class pauper with the majority of Congolese among the poorest on earth. How did resource abundance turn into a curse? But first, let us briefly review the situation before plunder began.

Before the Congo basin became a part of the global community, the Congolese had developed strong kingdoms like Kongo and Luba. Economically they engaged in mixed farming growing a wide range of crops and herding cattle, goats and pigs etc. The foodstuffs were supplemented by hunting wild game, gathering wild fruits and vegetables and catching wild fish. Together they provided adequate and balanced diet in quantity and quality for a healthy, active and productive life. Because they ate well, they developed resistance against disease, had relatively low death rate and rapid population growth.

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The trouble with NRM double standards

Since 1980 when the Uganda People’s Congress (UPC) won the general elections and the National Resistance Movement (NRM) began a guerrilla war in 1981 to unseat the UPC government by force since the Uganda People’s Movement (UPM) had failed to defeat UPC at the polls, I have followed NRM’s policy statements to the present day in 2010. NRM’s statements before 1986 are contained in two publications – Yoweri Museveni (1985), Selected Articles on the Uganda Resistance War; and Mission to Freedom (1990). I have had the opportunity to read the contents of the two publications.

NRM’s policy statements since 1986 are found in many publications or hard copies that have been distributed at conferences and summits. Since 1986, I have had the opportunity to attend major conferences and summits at the OAU/AU and United Nations in New York where these statements have been delivered by senior civil servants, Ambassadors, Ministers and the President.

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Structural adjustment and violation of human rights

Because of the tremendous suffering during the two World Wars and the interwar economic and social hardship, world leaders decided – when they adopted the Charter of the United Nations in 1945, the Universal Declaration of Human Rights in 1948 and subsequent instruments including the binding Covenants on economic, social and cultural rights, and political and civil rights in 1966 – to introduce safeguards against violation of human rights like the right to work, earn a remunerative wage in a decent environment, access adequate and balanced food, healthcare, quality education for all and equitable sharing of the benefits of economic growth etc.

From 1945 to 1975, the world enjoyed a period of relative peace and security and the golden economic environment resulted in the overall improvement in peoples’ welfare. In Africa and other developing countries, the benefits of peace and economic growth manifested themselves in falling death rates and rapid population growth.

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In Africa colonialism is still alive – and well

I have heard many times including at the United Nations commentators warning Africans to stop blaming colonialism for Africa’s ills. They argue that colonialism ended many decades ago and Africans must begin to take responsibility for their commissions and omissions. Before we decide – definitively – whether or not colonialism has actually ended, we need to examine what colonialism was all about and how colonies were administered.

Western countries colonized Africa in order to obtain cheap raw materials for their expanding industries, cheap foodstuffs for their growing populations, markets for their increasing surplus manufactured products and – to a certain extent – a home for their exploding population. Because European powers wanted to run colonies cheaply, they hired local agents through the indirect rule model. The agents had to be loyal and follow instructions from the few European colonial officers like the governor and district commissioners.

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What can Uganda learn from Europe’s development experience?

Ugandans and their governments have attempted – since independence in 1962 – to transform their economies and societies to improve the quality of their lives, live in peace and security with one another and enjoy their human rights including the right to elect their representatives and hold them accountable. They have attempted development planning, ugandanization – by expelling foreigners – nationalization and privatization of the economy, have worked abroad and diversified exports to earn adequate foreign exchange to import technology and modernize the economy. On the political front they have attempted multi-party and no-party political systems with a view to finding a formula appropriate to Uganda’s diverse interests and past experience.

After nearly 50 years of experimentation, Ugandans are beginning to feel they have been riding on a wrong bus. They are at a crossroads wondering which turn to take as they enter the second decade of the 21st century. Against this background, it may be worthwhile to review Europe’s development experience and adopt lessons – if any –relevant to Uganda.

The development of Europe was driven by many factors including the emergence of the middle class and revolutions in agriculture, population, industry, commerce, transport, politics, scientific thinking and western values.

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Population explosion: Africa is sitting on a time bomb

A response

Mr. Peter Mulira – a lawyer by profession – has written an article on Africa’s demography with the above title which appeared in New Vision (Uganda) March 31, 2010.

I would like to offer the following observations.

First, Africa’s fertility is declining albeit slowly thus lessening the scare of a ‘population bomb’ – an expression that entered the demographic discourse in the 1960s.

Second, Africa has the potential to feed many more people than it has right now given its arable land, water supplies (surface and underground) and idle labor force. The problem is that much of the food is wasted through storage, transport and processing constraints and much of the balance is exported to earn foreign currency as required under the Washington Consensus, thus leaving little for domestic consumption – pushing up prices which many households cannot afford. At the same time Africa’s agricultural productivity is very low.

Third, instead of addressing these shortcomings, a new idea has developed: Africans are being urged to sell or lease land to foreign countries and/or companies to produce food to feed people in their home countries – an arrangement if implemented will reduce food supplies in African domestic markets. The case of Madagascar is too well known to be repeated here. The reduction of food availability to African consumers will then be erroneously interpreted as population growing faster than food supplies.

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