Uganda’s social safety net is torn the politician likes it

Last week’s major moving story, was the one about the popular NTV news anchor, Ms Rosemary Nankabirwa, who finally lost the battle to cancer. Her former workmates at NTV put up a fundraising drive and within a week, they were able to collect more than Shs100 million to save Nankabirwa.
There are so many positive things about this sad story. First, you have to give a lot of credit to the kindness, selflessness, endurance and generosity of human beings. Here we mention the people at NTV, several Ugandans and other people from all over the world who dug into their pockets and said prayers for this cause.
The most important and enduring aspect is that Rosemary being a known popular figure with a considerable following, has given us an opportunity to think about the state of the social safety net, particularly the delivery of health services.
Under normal circumstances, a government should collect taxes then use the money to provide social services to all irrespective of tribe, creed, colour or political affiliation.
There must be proper systems and policies that enable one to walk into a hospital, school, court of law, police station, etc., and be served unreservedly. That is what happens when a State is functioning properly.
In Uganda today, the State is absent in most of the social set up. There is always a claim of a ‘meager resource envelope.’
The reality is that there is a lot of corruption and profligacy that eats up most of the taxpayers’ money. The end result is that the State has gradually relinquished its role as the provider of the social safety net.
This has increased pressure on the individual and their resources. For instance, you cannot afford the ‘luxury’ of going for a medical checkup to detect cancer early when there is school fees to pay or your father is battling hypertension. You do first things first. What we now have by way of a social safety net are donations from individuals and non-governmental organisations (NGOs).
Trouble is that individuals and NGOs have their own motives and intentions. As such, their service is selective. For instance, if an NGO is faith-based, it may favour those of one religion over others. As for the individual, it is mainly for patronage.
Where there is no political mileage, there will be no service. So the wife of the bare foot grass cutter in Mutukula is likely to die without help as opposed to a popular musician with a huge following. The politician will calculate that their help to the musician will endear the musician’s many fans to the politician.
It is important to know how we got here. Besides the issue of greed manifested in the stealing of public funds, the break down in delivery of social, especially health services, is a result of the creation of a cynical power relation.
Autocratic governments motivate citizens through fear. They are better feared than loved. Health services are made to be expensive and out of reach for the ordinary citizen. You have to go to Nairobi or India to get treatment at a cost well beyond your means.
Citizens become scared for their lives. We have to ‘be good’ and ‘show respect’ to our leaders knowing very well that in our hour of need, they are the ones with the ‘economic potential’ to come to our rescue. At such times, there is no space for being philosophical. You have to take what the politician who has presided over the very situation that denies you the service you are entitled to as a taxpayer. You thank him and ask the people to give him ‘another term.’
The alternative is dying in a dysfunctional hospital without drugs and motivated personnel. That is the dilemma we face. The very hand that has robbed you is the one that saves you. It is a system that works for the politician and they will not want to change it even with the enduring voices that urge the citizens to demand their rights. It is very sad and scary.
Mr Sengoba is a commentator on political and social issues.
Twitter: @nsengoba

SOURCE: Daily Monitor


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