I’ve been in Zambia and Uganda over the past two weeks, and have had some experiences and encounters that really make me wonder about governments and their priorities.
In Zambia, I was in a minibus taxi, and one of the passengers was handing out photocopied letters, explaining that he had had to come to Lusaka, a long distance from his home village, to get medicines at the government hospital — only to find that the medicines were out of stock. This wasn’t the first time, either. Now he was asking for contributions from fellow passengers, to help pay his transport fares back home.
In Uganda, the New Vision newspaper of January 23rd contains a letter to the editor, by a father telling the tragic story of the death of his new-born son. He had taken his pregnant wife to a private hospital to be tested for malaria. The hospital supposedly tested her and gave her a clean bill of health. The next day, his wife’s waters broke and he rushed her back to the hospital where she gave birth two months prematurely. After he discovered the hospital had no incubator, and the nurses had left the baby for dead, he decided to take his wife and baby to the government hospital. The ambulance took over an hour to get going. When they eventually arrived at the government hospital, instead of rushing the child to emergency care, the receptionist berated them for first going to a private hospital. The child died that afternoon after receiving no treatment.
The same newspaper has another letter, complaining that MPs were apparently each given a large sum of money to buy ‘pot-hole proof’ cars. After reading this letter, I was taken on a very bumpy ride by a friend of a friend who is a motor mechanic. He told me he always has plenty of work, since cars and taxis in Kampala regularly need new shock absorbers and related parts, because of the terrible state of the roads. I asked him why the government doesn’t invest in Kampala’s roads. He tried to explain the politics to me, and then shocked me by saying that if ordinary citizens even try to fix their own patches of road in their neighbourhoods they face arrest!
All of these stories are shocking. They tell a story of neglect and abdication of authority by those we trust to provide us with protection and essential services. According to international undertakings they have signed, all governments are supposed to have a list of essential medicines, that are supposed to be available at all times in government health facilities. But research (as well as personal stories – such as the one I came across) shows that these drugs are frequently out of stock.
When governments fail to fulfill their most basic obligations, people turn to privatised solutions. If they can afford to, they go to private hospitals (which it seems are also often failing to do their job!), and they buy expensive 4×4 cars to cope with the awful roads. Nobody tallies up the cost of this, as it is borne by private individuals. But how much money would be saved, and how much wider the benefits would be spread, if people could rely on public hospitals, and could depend on the government to keep the roads in good order!
If the state health facilities were good, rich folk would go there too, and since they could afford to pay, their money could be ploughed back into the facilities so that poorer people could benefit from them too.
I found the stories in Uganda particularly disturbing. If MPs really are getting pot-hold proof cars, that is outrageous. Instead of voting money to improve the roads so the entire economy could benefit, they are siphoning off funds so that they alone don’t suffer the ill-effects of their own neglect. This kind of politician, we just don’t need.
And to punish citizens when they show enough public spirit to take matters into their own hands and repair what roads they can, is just perverse. If you don’t want to help build your society (despite being elected to a position where you’re expected to do just this), then at least stand aside when others voluntarily step in to fill the gap. Do do otherwise is to damage the very social fabric we all depend upon.
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