By Denis Jjuuko
Uganda has one of the fastest growing populations in the world. I recently read a report from Uganda Bureau of Statistics, which indicated that the population grows by 3.3% per a year. If we are 40 million people, that puts the number to 1.32m people every year. This is an explosion that is probably at the same level with countries that have grown their population massively. China, India, and Nigeria come to mind.
Yet our policy makers found it important to spend borrowed money on building an allegedly state of the art sperm bank at the new private wing of Mulago Hospital. If you need a sperm injection, you will part with Shs14m. Our policy makers are more concerned about having more kids produced in a country that is producing a lot already! Don’t get me wrong. I think anybody who needs a child should get them but that can’t be a priority for a poor country that is grappling with an uncontrolled population explosion. Besides, private facilities already exist in the country where anybody who can afford Shs14m to have sperm injected into them could go.
In privately owned clinics, senior consultants charge about Shs40,000 as consultancy fees for antenatal care. At Mulago, in a hospital refurbished by pubic debt, it will be Shs50,000. So it is more expensive to go to a public hospital than a private one.
For the investment in Mulago to make any sense, they should be charging about Shs15,000 and offer a service that is unrivaled by privately owned health facilities. This is because the doctors at Mulago are paid a monthly salary and will earn pension for the rest of their lives when they retire. The other day, they were demanding V8 Land Cruisers!
If Mulago’s “out of this world” private facilities charged well under what privately owned clinics and hospitals are charging, the forces of supply and demand would force them to be reasonable. This is because patients won’t be lining up at private facilities like they are now. Instead of losing more clients, privately owned health facilities will become more professional and charge reasonable fees. If Mulago is charging more than them, they are simply going to increase and make a terrible situation worse.
As I was writing this article, I saw a story of a health facility in West Nile, which after many years, it got lit up. Health workers were no longer going to use torches while treating patients at night. We also know how badly off we are when it comes to diseases like cancer. Yet our planners are more concerned about Uganda having more kids!
‘Ultra modern’ sperm banks and fertility centres are for countries that have already taken off. In a country where mothers can’t afford Mama Kits and the health system depends almost entirely on donor money, we shouldn’t be going for fancy stuff. We should be ensuring that basics are in place. Sperm banks should be left to entrepreneurs until after the country’s most immediate health needs have been addressed.
Having children in Africa is fanciful because we are still a really backward society but it is not a matter of life and death. We shouldn’t be competing with entrepreneurs in that field. We should be leaving that sector to them at least in the time being. I heard that Mulago spent USD50m on the private wing — building rooms probably at standards of fancy hotels where the elite could be treated. Great but the majority of Ugandans will never afford the private wing. They will still die because of lack of oxygen in the public wing.
Mulago could maybe have done away with the public wing actually and ensure that everyone pays but an affordable fee. Everyone who accesses Mulago would then have an insurance policy. That way, we could easily have everyone in the country insured. Adults would pay Shs30,000 a year or Shs2,500 a month. People under 18 would pay Shs10,000 a year (their guardians would pay for them). If we had just 10m people paying Shs30,000 every year as health insurance, that would be Shs300b annually. And if we had another 10m kids paying insurance, that would be another Shs100b every year. And if we managed to ensure people get national IDs, we can use same methods to ensure everyone pays their health insurance.
If this money is not accessed by the thieves in government, it would be more than enough to provide health care to all Ugandans. Those who now want hotel service in the ostentatious hospital private wings, could top up. The privately owned health facilities would be put in line or they would go for sperm banks and fertility centres.
The writer is a communication consultant and visibility. firstname.lastname@example.org
*Internet photo of the the specialized maternal hospital at Mulago