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.