Date: Thu, 12 Mar 2015 00:19:53 +0100
Plan to export medics ‘threatens Uganda’s epidemic response’
The healthcare workers are due to travel on renewable two-year contracts to Trinidad and Tobago under a bilateral agreement the Ugandan government says will improve the skills of those who take part.
Uganda suffers from a chronic shortage of health workers – more than 21,000 posts in the sector are currently unfilled – largely because of low pay and poor working conditions. Upon qualifying, hundreds of nurses leave Uganda every year for better-paid jobs in western countries as well as in Rwanda, Kenya and South Africa.
“This dangerous plan should be stopped - a government plan to exacerbate brain drain is indefensible. Unless reversed, this move will undermine the fight against maternal mortality, HIV and other leading killers in Uganda,” Asia Russell, the executive director of Health GAP, a local NGO, told IRIN.
It will also leave communities more vulnerable to the ravages of outbreaks of infectious diseases such as Ebola and Marburg. Governments should be fixing this emergency by increasing health worker pay; instead they want to make an emergency shortage of health workers worse,” she said.
There have been five Ebola outbreaks in Uganda over the past 14 years, which claimed hundreds of lives, and three of the Marburg virus.
“Government participation in the exportation process is retrogressive and thus an indication of failure under its human rights obligations. In the absence of a comprehensive study projecting that the benefits of this exportation outweigh the damage, government has no point to make in such a process,” Moses Mulumba, director of the Kampala-based Centre for Human Rights and Development told IRIN.
He added that international norms required all such overseas recruitments to “be conducted in accordance with the principles of transparency, fairness and promotion of sustainability of health systems in developing countries, which this particular recruitment has not witnessed.”
The United States, whose training and paying of 17,000 Ugandan health care workers makes it the biggest donor to the sector, found the plan “troubling,” according to embassy spokesman Daniel Travis.
“The Ministry of Foreign Affairs’ role in actively recruiting health professionals to work overseas when there is a compelling need for health workers in Uganda undercuts our efforts in the health sector, especially when the Ministry of Health still seeks donor assistance in training and paying for health professionals here in Uganda,” he said.
The mood among those heading to the Caribbean was more enthusiastic.
“We can’t turn down the offer. It’s just amazing and attractive. The remuneration looks so good. We are fed up of being paid peanuts in Uganda with all our expertise,” one of the recruited pediatricians who has been working at a public hospital, told IRIN.
The state minister for primary health care, Sarah Opendi, said the main problem was not a shortage of “health workers in the public sector per se. Our main challenge is the shortage of the resource envelope to recruit them in service.”
Opendi called on civil society activists to pressure the government to allocate more resources to the health sector to enable it to fill all vacant positions.
Sudan: The Prospects for “National Dialogue”
Africa Briefing N°108 11 Mar 2015
AFP PHOTO/ABDULLAH DOMA
OVERVIE
Read it in PDF attachment below:
Prospects for an inclusive national dialogue President Omar al-Bashir promised in January 2014 are fading, making a soft-landing end to Sudan’s crises more doubtful. Sceptics who warned that the ruling party was unwilling and unable to make needed concessions have been vindicated. Peacemaking in Darfur and the Two Areas (Blue Nile and South Kordofan) and potential merging of these negotiations with the national dialogue were dealt a blow with suspension of African Union High-Level Implementation Panel (AUHIP)-mediated “parallel” talks in Addis Ababa in December. A separate German-backed initiative has elicited a more unified and constructive approach from the armed and unarmed opposition, but no breakthrough yet. The government still holds many cards – including formidable means of coercion – and has little sympathy for the increasingly unified demand of the armed and political opposition for a really inclusive process and true power sharing. Unless both sides give ground, a continuation of intense war and humanitarian crises is inevitable.
The offer of national dialogue was prompted by a series of events – partly due to unaddressed consequences of the 2005 Comprehensive Peace Agreement (CPA) and South Sudan’s 2011 independence – including large, violently repressed nationwide September 2013 protests in Khartoum and other cities, followed by a costly, unsuccessful and unpopular military campaign in South Kordofan. But almost as soon as the government’s offer of dialogue was announced, there was a crackdown on opposition activists and the media. The recently-formed paramilitary Rapid Support Forces (RSF) reportedly were deployed in Khartoum to quell protests. The Sudan Armed Forces (SAF), alongside the RSF, have since renewed their “hot dry season” campaign against the Sudan Revolutionary Front (SRF) rebel coalition in the southern peripheries and Darfur.
Opportunism and divisions within the civilian and armed opposition have given the ruling National Congress Party (NCP) a respite. While other parties refused to participate in or withdrew from the preparatory National Dialogue Committee (NDC), some Islamist, traditional and smaller parties remained, looking to maximise their share of government posts in return for lending credibility to planned April elections that other major parties will boycott, further polarising the country. The December 2014 “Sudan Call”, which reflected a growing unity of demands from the political opposition, civil society and armed groups, came too late to influence the NDC’s discussion in August of the parameters for the dialogue and was immediately rejected by the government. However, the opposition’s more sophisticated approach at subsequent meetings in Berlin has improved prospects for an inclusive preparatory meeting before the election.
The NCP has reason to believe Sudan’s vulnerable regional and wider international position has improved. The International Criminal Court (ICC) decision to “suspend” its Darfur work gives the president more confidence he will not be prosecuted. Pressure from anti-Muslim Brotherhood Arab and Gulf states has eased somewhat. Meanwhile, the civil war in South Sudan has distracted the SRF, an increase in gold exports has relieved economic pressure, and the steep drop in oil prices has been weathered, because Sudan now imports much of its fuel, and its substantial income from oil transport fees is fixed. But this betterment of the government’s political and military position is fragile and reversible; fundamental, dangerous weaknesses remain.
As Crisis Group has argued in previous reports, a peaceful, political solution through an inclusive national dialogue would be a vital step toward ending the violent protests at the centre and wars in the periphery that could otherwise lead to Sudan’s further fragmentation. The NCP, and the military-security apparatus in particular, are unlikely to submit to another “CPA” process requiring them to share power in Khartoum with a still-armed opposition, but might accommodate greater regional administrative autonomy if they can continue to dominate the centre.
Western donors’ influence is much reduced, and the responsibilities for mediating the fighting, encouraging recommitment to inclusive dialogue and bearing the burden and cost of instability now mostly fall to the AU (especially the AUHIP, which is mandated to mediate the proposed national dialogue); immediate African neighbours; Arab friends (collectively the Gulf Cooperation Council); and China, given its huge investments. These actors could exert greater and coordinated influence for remedial actions that would improve the chances for more talk and less war by:
- pressing the opposition and government to participate in an inclusive preparatory meeting for the national dialogue, hosted and mediated by the AUHIP prior to the national elections, to forge clear terms of reference and common positions to which all parties are fully committed;
- urging the AU Technical Assessment Mission to consider the impact an AU observation mission to a controversial election might have on the AUHIP’s mandate in the national dialogue process;
- encouraging opposition parties and civil society to develop further a common position on the national dialogue through trusted third-country facilitation (eg, the German-sponsored initiative);
- pushing the government and opposition to re-engage with the AUHIP’s strategy for a parallel and loosely synchronised process of talks on the Two Areas and Darfur; and
- consideration by China of how its economic investments can better address regional inequalities that are fuelling continued wars.
Nairobi/Brussels, 11 March 2015
Plan to export medics ‘threatens Uganda’s epidemic response’
The healthcare workers are due to travel on renewable two-year contracts to Trinidad and Tobago under a bilateral agreement the Ugandan government says will improve the skills of those who take part.
Uganda suffers from a chronic shortage of health workers – more than 21,000 posts in the sector are currently unfilled – largely because of low pay and poor working conditions. Upon qualifying, hundreds of nurses leave Uganda every year for better-paid jobs in western countries as well as in Rwanda, Kenya and South Africa.
“This dangerous plan should be stopped - a government plan to exacerbate brain drain is indefensible. Unless reversed, this move will undermine the fight against maternal mortality, HIV and other leading killers in Uganda,” Asia Russell, the executive director of Health GAP, a local NGO, told IRIN.
It will also leave communities more vulnerable to the ravages of outbreaks of infectious diseases such as Ebola and Marburg. Governments should be fixing this emergency by increasing health worker pay; instead they want to make an emergency shortage of health workers worse,” she said.
There have been five Ebola outbreaks in Uganda over the past 14 years, which claimed hundreds of lives, and three of the Marburg virus.
“Government participation in the exportation process is retrogressive and thus an indication of failure under its human rights obligations. In the absence of a comprehensive study projecting that the benefits of this exportation outweigh the damage, government has no point to make in such a process,” Moses Mulumba, director of the Kampala-based Centre for Human Rights and Development told IRIN.
He added that international norms required all such overseas recruitments to “be conducted in accordance with the principles of transparency, fairness and promotion of sustainability of health systems in developing countries, which this particular recruitment has not witnessed.”
The United States, whose training and paying of 17,000 Ugandan health care workers makes it the biggest donor to the sector, found the plan “troubling,” according to embassy spokesman Daniel Travis.
“The Ministry of Foreign Affairs’ role in actively recruiting health professionals to work overseas when there is a compelling need for health workers in Uganda undercuts our efforts in the health sector, especially when the Ministry of Health still seeks donor assistance in training and paying for health professionals here in Uganda,” he said.
The mood among those heading to the Caribbean was more enthusiastic.
“We can’t turn down the offer. It’s just amazing and attractive. The remuneration looks so good. We are fed up of being paid peanuts in Uganda with all our expertise,” one of the recruited pediatricians who has been working at a public hospital, told IRIN.
The state minister for primary health care, Sarah Opendi, said the main problem was not a shortage of “health workers in the public sector per se. Our main challenge is the shortage of the resource envelope to recruit them in service.”
Opendi called on civil society activists to pressure the government to allocate more resources to the health sector to enable it to fill all vacant positions.
- application/pdf attachment: Sudan-the_Prospects_for_National_Dialogue.pdf