Until his appointment as minister of state for Health (General duties) last month, Kinkiizi East MP, DR CHRIS BARYOMUNSI was an outspoken liberal-minded NRM MP who closely worked with the “rebel MPs” before they were expelled from the party in 2013.
Baryomunsi himself got prosecuted by the state for his role in pushing for an independent parliamentary post-mortem report into the mysterious death of Butaleja Woman MP Cerinah Nebanda. In an interview with Sadab Kitatta Kaaya soon after he took the oath of office last month, the minister insisted he is still the same Baryomunsi who holds liberal views despite his elevation. Excerpts:
How do you feel being appointed to an “election cabinet”?
I don’t think the [appointments] had anything to do with elections because there were some vacant positions and the president was bound to fill them.
It [appointment] rather had [a lot] to do with filling vacant positions so that government at the executive level can be full in order to deliver services as pledged in the NRM manifesto and as the president pledged to Ugandans. It is not about elections but delivery of services.
As to how I feel, well, I am grateful to the appointing authority for having picked me from among many people, and I have that sense of duty that I now have responsibility to deliver as a minister of state for Health, particularly to ensure that I work with my colleagues in the ministry both at the political and technical level to deliver health services to Ugandans.
You were so instrumental in schemes that brought down former Prime Minister Amama Mbabazi because of his perceived interest in the presidency. Was your appointment to cabinet therefore a reward?
Well, your statement is unfortunate. I don’t think you can substantiate that I have been instrumental in fighting Mbabazi. How? I have never fought him, and we have been colleagues. He is the MP for Kinkiizi West and I am the MP for Kinkiizi East.
So, it is not true that we have been fighting or that I have been fighting him. Don’t see my appointment as having anything to do with Hon Mbabazi, no. That is just a figment of imagination by some people.
What I can say is that it is correct I have been appointed to fight, but to fight ill health, poor maternal health, the burden of disease, and to fight so that Ugandans can have better-quality services as far as health is concerned but not to fight individuals.
I am sure that Hon Mbabazi is not a health challenge I think Ugandans should not believe that nonsense that some of us have been appointed because we have to fight some individuals.
In the public eye, you were appointed to make up for Mbabazi’s sacking since you both come from Kanungu. And because of the growing pressures on the president. Baryomunsi had to be appointed to kill off some of that pressure…
Under the constitution, the president has the prerogative of appointing anybody he wishes provided that the [appointee] has the necessary qualifications and competencies. I think he must have looked at Ugandans and identified me as somebody with the qualifications and capabilities to serve as a minister.
So, with or without Mbabazi’s politics, I think I have my own competencies to be a minister and I am sure whether Mbabazi was in government or not, I could still have been appointed. I think Ugandans should judge me on my own merit. But relating my appointment to the so-called political fevers in Kanungu is not right.
The health docket is one of the underfunded sectors in government and you seem upbeat about your new role. You are setting your own goals fighting ill health, maternal health, etc. How do you hope to achieve all this?
The good thing is, I will be working with a competent team of political and technical leaders in the ministry, and I believe through teamwork, we are going to constitute a formidable force that is going to provide leadership and guidance to the sector.
We shall continue to aocate for better funding. It is true the health sector in Uganda remains underfunded and we shall continuously aocate for increased funding. Two, I also believe that with the resources the sector is receiving, there can be administrative re-organization within the sector to attain more efficiency and better results.
That is where the issue of political leadership, supervision and guidance come in. I will start by ensuring that we reorganise the effectiveness of the ministry of Health headquarters so that all public servants there are accountable and are results- oriented.
I also intend to ensure that there is a g linkage and a live umbilical cord between the centre and the local governments in as far as provision of health services is concerned. In my view, decentralisation has to some extent de-linked the lower local governments from the centre.
We want to ensure that there is quality assurance, monitoring and supervision of the district health services we are going to institute a mechanism where the leadership at the ministry’s headquarters regularly interacts with the leadership of health services at the district level, particularly the district medical officers and superintendents of health facilities so that there is that regular interaction and technical backstopping.
We are going to institute a number of reforms in the interventions being carried out particularly I will be preoccupied with the issue of making health centres at the health centre level, especially health centre III, IV and district hospitals functional.
Government has invested a lot of resources in constructing health centre IVs for instance [with] facilities such as theatres and posting medical doctors at the centres. We would want these health centre IVs to carry out surgical operations especially emergency caesarean sections to help mothers who come with complications.
In a number of health centre IVs, this is not happening. In the next months, I am going to devote a lot of energy and time in giving support to these health centres to ensure that they can be functional and can be able to provide a service to Ugandans.
This looks like an ambitious plan and considering the time to the next elections, you may not even spend a year in the ministry. How do you intend to do all this?
It is true we have little time to the end of this term but I will use the available time to do as much as I can. Of course the work involves doing political mobilisation in my constituency as well as do the national duty as a minister, but I will devote more time in the field.
I will be able to visit the different parts of the country, assess the situation in our health facilities, interact with both the political and technical leaders in the local governments and try to appreciate and understand better why there are these challenges in the health sector and be able to find possible solutions.
Of course I am not saying that within the next few months we shall attain 100 per cent perfection, but we should be able to make serious progress in the coming months. The other issue I intend to address seriously is the attitude of health workers towards work. There are both moral and professional degeneration among health workers.
Absenteeism is a very big problem latecoming, etc will have to stop. We shall have to institute measures which will require the use of both the carrot and stick to ensure that we restore the glory of the health profession. I would want to urge health workers that when a patient comes to you, you are like his or her God.
Even when the pay may not be very adequate, we have a cardinal duty as health workers to provide care to patients who come to us. We are going to institute measures to ensure that health professionals take their work seriously and must be able to report to work in time and must be at the health facilities all the time.
What is happening is that instead of working through shifts, they just agree that you work on Monday and Tuesday, me I work on Wednesday and Thursday, etc which is wrong. The whole team of health workers should be there because one person complements the other. We have a nurse, a midwife, a lab technician, a dentist, a dispenser, etc.
All of them have different tasks, and the way a health centre functions, all of them have to be there all the time but can agree to work in shifts so that they create some space for resting but not to just abandon work. We are going to restore sanity in the health sector so that Ugandans can feel comfortable getting a service from a public health facility.
But most of the government health facilities are understaffed…
There has been some reasonable improvement, the figures we have indicate that the staffing levels have risen up to about 70 per cent although we still lack some critical cadre of staff in a number of health facilities.
For instance, a number of hospitals and health centre IVs are unable to carry out surgical operations because they lack anaesthetists a person who does anaesthesia before you conduct a surgical operation. We intend to work on the human resource in terms of numbers and build their capacity, so that their quality is also enhanced.
One area I intend to address with my colleagues is to review the policy of decentralisation because my belief is that we need to re-examine the issue of recruitment and deployment of health workers particularly medical doctors and senior medical professionals.
Maybe we need to recentralise some of these cadres like district medical officers, doctors, senior nursing officers, etc so that they are recruited and posted by the centre rather than the local governments because under the current arrangement, there is no chance for them to grow both horizontally and vertically.
What is your view on the proposal to export doctors to Trinidad and Tobago?
I don’t think that government should be involved in exporting health workers at this point in time because, we have not yet attained the health worker – patient ratio that is recommended by WHO [World Health Organisation]. We still rank very low in terms of availability of health workers in Uganda.
Therefore, if doctors have to be exported, they should [go] on their own or if it is a private entity doing it, I would have no problem, but for government I think government should withdraw from that [scheme].
We [government] need to concentrate on how we can motivate our health workers and also attract more health workers into the public sector, and also persuade those outside the country to come back and work in our country because one of the key challenges we have in the health sector is the shortage of health workers…
About two years ago, you had a run-in with the state over the mysterious death of Hon Cerinah Nebanda. Assuming a similar scenario came up again, on which side would Baryomunsi, the minister, stand?
The Nebanda case shows you that when I am given an assignment, I take it very seriously, and I do it. That time, I was a Parliamentary commissioner, and I was tasked to work with other health professionals to [investigate] the cause of our colleague, Hon Cerinah Nebanda’s death.
Although the whole issue was misunderstood and some people wanted to put politics into it, for us, we were doing professional work because as a medical officer, I speak for the dead as well, and [fight] for their rights. We tried to defend the rights of Hon Nebanda who had died.
It is unfortunate that the whole issue was misunderstood by some leaders but luckily enough, when we were taken to court, [we] were cleared of the criminal charges [that had been brought up against us].
My prayer is that no one dies in such circumstances, but if, God forbid, it happened to anybody, I would still play the same role because I would still be interested in knowing the cause of death. That is a basic practice in the medical profession that you always [ascertain] the cause of death of an individual. So, my being a minister does not change something which is provided for in the profession.
Many people like you who speak freely go silent when appointed ministers. Are we about to see a new Baryomunsi?
The Baryomunsi of yesterday is the Baryomunsi of today and will remain the Baryomunsi of tomorrow. Give it time you will discover that Baryomunsi will remain the same, both outwardly and genetically.
Probably the only difference which sometimes people don’t appreciate is the way we debate in Parliament as a backbencher and a frontbencher. When I was a backbencher, I could stand on the floor and ask why Kambuga hospital in Kanungu district is not functioning well.
It will not be wise now for me to raise the matter in a similar way because as a minister, I am supposed to make it function and also to explain to Parliament and Ugandans why that hospital is functioning that way.
So, you don’t expect me to raise such an issue in Parliament the way I have been doing because my responsibility has changed. But I know in cabinet, we discuss freely. As to whether I will speak for Ugandans, definitely, I will. I will do that even with more energy, more enthusiasm and more vigour.
Source : The Observer