Uganda’s health ministry shamelessly exploits, abuses and dump its employees. I derive this considered opinion from the experience of about 80 nurses and midwives who have approached me for assistance in handling their salary grievances against the Ministry of Health, which hired and deployed them to work in various parts of the country for one year, but did not pay them even a single cent for their services.
Briefly, the sad story of the said nurses and midwives is as follows:
The Government of Uganda, represented by the Ministry of Health, established a Private Not For Profit bursary pool fund, in partnership with its development partners, and the Uganda Catholic, Protestant, and Muslim Medical Bureaus.
Under this arrangement, the Government was to sponsor selected students in nursing and midwifery. The students were to undergo training at centres known as Health Training Institutions (HTI), availed and operated by the medical bureaus, at a cost of Uganda shillings two million per year, per student.
Formal bonding agreements were entered into in 2011 and 2012, between the beneficiary students and the Government, represented by Ms Kusasira Edith, who signed for the Permanent Secretary of the ministry. The agreements were witnessed by the Principals of the HTIs, and the Head of Personnel at the Ministry, Ms Birungi Rachel Asiimwe.
The students undertook studies and completed training in 2013.
On 23 June 2014, they were offered a Non-Pensionable Contract Appointment as enrolled nurses and midwives, for one year, as arrangements were made to regularize their appointment in the mainstream public service, subject to their performance. This offer was made in a letter signed by Ms Kusasira Edith, signing for the Permanent Secretary of the ministry, stating, among others, a monthly salary (for example, each midwife was to earn Uganda shillings 365,627/= per month, inclusive of PAYE and 5% employee’s contribution to NSSF), and that acceptance of the offer should be made in writing. It was copied to the Executive Director of Mulago National Referral Hospital, Dr Byarugaba Biryabareba.
The nurses and midwives accepted the offer in writing on different dates, expressing their gratitude for the deployments, and promised to abide by the rules and regulations of their work stations. Henceforth, they became employees of the Ministry of Health.
On 27 June 2014, the substantive Permanent Secretary of the Ministry of Health, Dr Lukwago Asuman, issued posting instructions to the nurses and midwives to various work stations across Uganda, including Mulago National Referral Hospital, effective 1 July 2014. The letter was copied to the Executive Director of Mulago hospital, Dr Byarugaba Biryabareba, instructing him to inform Permanent Secretary Dr Lukwago Asuman as soon as the employees start working, for him (Dr Lukwago) to start processing their salaries.
On 1 July 2014, the nurses and midwives started working at their duty stations across the country. During this time – around 3rd and 4th July 2014 – they also filed their Personal Record Forms with the Ministry of Health, indicating their particulars (like names, date of birth, nationality, sex, districts of origin, places of work, religious denomination, bank account details, educational status and qualifications, and next of kin).
On the instruction of Mr Louis Tugume, acting for the Permanent Secretary of the health ministry, they were examined by Government Medical Officers, to ascertain their medical fitness for appointment to the public service. After examination, they were found to be medically fit and cleared for appointment. The clearance was copied to the Permanent Secretary of the Ministry of Public Service.
The employees worked for one year, up to July 2015. During this whole time, not even a single shilling was paid to them!
It is said, however, that Ms Kusasira Edith, who I gather is the Deputy Permanent Secretary of the Ministry of Health, made a verbal communication to some still unknown people, in September 2014 (only three months after the employees’ assumption of work), that the Non-Pensionable Contract Appointment was terminated. This, of course, was very irregular of Ms Kusasira, especially, considering that everything from the start was in writing, yet she now purported to terminate the contract by mere word of mouth, and given her close and personal involvement in this matter.
Nevertheless, the employees continued working at their duty stations, mainly because of strong and repeated assurances and encouragement from their superiors that their money would come in bulk. At Mulago hospital, for example, the Executive Director, Dr Byarugaba Biryabareba, told them confidently that their money was there, and warned that whoever didn’t work as per the agreement, would not get it. On basis of such reliable assurances and encouragements, the nurses and midwives continued working tirelessly, faithfully and loyally, serving their country and people diligently.
By God’s grace and mercy, I undertake investigation and resolution of this matter, with a view of helping the affected employees obtain justice; but some disturbing thoughts come to my mind.
It is highly possible that the nurses’ and midwives’ salaries were released, but misappropriated and stolen by officials either at the Ministry of Health or the duty stations. In the likely event that this hypothesis is true, then it would be very absurd and unfortunate for this country. I promise that whoever is found culpable in this matter will be held accountable before God, all the responsible authorities in Uganda and beyond, and definitely, the people, in whose name all public work is done.
Then, one cannot help, but pity the health workers of this country, who have to deal with insensitive, callous, exploitative, corrupt, and inconsiderate superiors. Many times I hear members of the public complaining that they are mistreated by harsh health workers especially, nurses and midwives. While this is wrong and should be condemned in the strongest terms possible, it is also important to appreciate the plight and hardships of our healthcare system personnel. Take, for instance, the nurses and midwives involved here, who worked for a full year without pay at all! They have to look after themselves, their families, and other dependants, plus a host of other financial obligations to cater for. How on earth are they expected to survive? I think it is due to such great or immense difficulties that some of them vent their deep-seated anger and frustration on their patients, although, as I have clearly said, unjustifiably so. As the saying goes, ‘A hungry (wo)man is an angry (wo)man.’