They are the dudes that make tough decisions. (and yes, I mean TOUGH DECISIONS). They are adored by the communities where they come from. They are gods and goddesses in the face of the common man. To him, they decide on who lives and who dies! They have all the rights to promise, deliver or not deliver! In the developing world, they are even above the law (that is, until they are toppled and killed). Whatever happens, they are, without argument, the cement very much needed in making a strong basement to policy planning, implementation and evaluation. Their name is #PoliticalLeaders.
Whether you are from hell or heaven (read South, East, West, Centre of Northern Africa), surely you must have heard about the rope pulling platform between education sectors and health sectors vs the rest of the players. The African human resource in those 2 fields has successfully failed to be sustainable often moving from one country to another, at times changing the continent. The reason, simple, the terms and conditions for one to work in the education or health arena in Africa are soooooo unbelievably turbid! If you think am lying, lets go statistical!
The Ministry of Education in Uganda says 1 primary school teacher is responsible for 200 school pupils. In the Sunday vision dated 26th February 2012, a report on universities of Uganda by an Irish team, notes that there is a terribly high poor staff-student ratio, lack of finances and low teaching standards. Makerere and Kyambogo had a 1:33 ratio while Nkumba had 1:32, which are far below the recommended level. Makerere University Business School was at 1:47. Such has been the trend for the last two years. The ideal ratios, according to the National Council of Higher Education (NCHE), are 1:15, good at 1:20, acceptable at 1:25, can be improved at 1:40 or unacceptable (1:50 and above). Of the 1,728 academic staff, according to the report of the visitation committee on public universities, in the entire public university system, there are 53 (3%) professors and 80 (4.6%) associate professors. You can see the whole article at: http://www.sundayvision.co.ug/detail.php?mainNewsCategoryId=7&newsCategoryId=134&newsId=750793. On the health part of the story, 1 doctor is responsible for 15,000 patients! Now, for those of you who are not doctors or nurses or something close to that and have not been in a hospitals, you should consider having your honey moon in these hospitals. Trust me, you will learn a lot ranging from hearing heart breaking stories of how patients have spent 1 week looking for a doctor, how patients have been asked to pay money where they are not supposed to pay, neglect, delays in receiving treatments. Others will tell you of how they have been punished by health professionals…I mean, A LOT! When it comes to the road safety arena..eish…we know the story of helmets, seatbelts and speed governors.
On the right hand side of history however, you will notice that all this mess is can be sorted out by our leaders who have the POWER to say YES or NO! By putting strong policies and implementing them (because those are 2 totally different words), a lot of lives could be saved! But what have our leaders done? In Uganda, our top decision makers have been blending in the hood and putting on a deaf ear mask despite calls from the masses! In S.Sudan which is the birth place of the infamous nodding disease, the decision makers did not do much as regards this condition. They (I think) thought, it was another cry-of-a-poor-man! This disease has migrated and successfully established itself in Northern Uganda. Have you heard about the interests of these decision makers? In the developing world, they are the guys that drive the MOST expensive cars, they own a lot of property that would feed 400,000 hungry mouths in a day, …should I add more? You know…
As public health leaders in our lovely developing continent, I suppose it’s the time for us to change tactics in order to have incremental and realistic changes for the betterment of our communities. This tactic ( I hate to say this) is rather painful and am afraid, even lives will be lost. But the economic evaluation of the after-effects, I think will be worth the move! All Public Health Leaders In Developing Countries Will Make Health Programmes In Their Community Fail In The First Year Of Implementation So As To Spur The Interest Of Policy Makers’. The mid term review of such programmes and projects will show that they WILL FAIL if they are not re-designed or given a facelift to answer the question of sustainability and community acceptance!
I know a lot of questions are already running into the reader’s mind but one thing is certain! For how long shall Africa continue to run poorly planned and evaluated programmes? I know the Brian’s Law has a serious implication on the health and dignity of the human person but what the hell…do we still have any alternatives? It really sucks especially on when we are supposed to be at the same level as countries like Singapore yet we are here still talking about diseases like jiggers, malnutrition