Vol. 1, No. 3
ugandahealthcom@yahoo.com
July 4, 2008
In this issue… Focus on Health Insurance A Special Forum: Mark your calendars: UHCA is sponsoring a special forum on national health insurance on Wednesday, July 23 from 9 a.m. to 1 p.m. The session will examine the thinking behind the government’s plans to launch a national health insurance system next year. In many countries, insurance is the primary tool for protecting people from financial ruin when they become sick and incur high medical-care costs. It also is a way of controlling health care costs, and establishing uniform standards of care. Some countries also use it as a device to subsidize care for the poor. In Uganda’s plan, who will be covered? Who will pay? How much will it cost? What health services will it finance? And will it make Ugandans healthier? Featured speakers who will address these and other questions include: Dr. Juliet Nabyonga, World Health Organization: What are the issues, and what are the challenges? Dr. Robert Basaza, Senior health Planner, Uganda Ministry of Health: The Emerging Uganda Plan. Dr. Ian Clarke, Chief Executive Officer, International Hospital Kampala: The private sector perspective on the Uganda plan.
Journalists and Partners Journalists are supposed to be the independent eyes and voices of the community. But that can be a tall order in warravaged northern Uganda, as Chris Ocowun, Gulu bureau chief for the New Vision, explains. –– Much of Ocowun’s concern revolves around the relationship between journalists and nongovernmental organizations. But relations with the private sector also can be problematic. Eve Mashoo, a reporter for the East African, describes how corporate support for journalism – in the form of funds to facilitate reporting trips – often comes with strings attached. –– When the Uganda Health Communication Alliance was established last year, it brought together journalists and communications professionals from NGOs. We reasoned that the two groups stood a better chance of forming a strong and sustainable organization together than they would separately. But while we all seek to serve the public and promote better health, journalists and NGO employees each have our own self-interests. Can we overcome them, and work together in the same organization? UHCA is developing a statement of principles that we believe can unite us. ––
Dr. Francis Runumi, Commissioner for Planning, Uganda Ministry of Health (tentative): Can Uganda achieve universal coverage?
Key Players
The workshop, to will be moderated by radio commentator, columnist and UHCA coordinator Gayawa Tegulle, will be held July 23 from 9 a.m. to 1 p.m. at Makerere University Department of Gender and Women’s Studies, First Floor Conference Room (Pool Road, opposite the swimming pool)
District Health Officers manage Uganda’s health system at the grassroots. They gather data, supervise lower-level health facilities, and oversee the activities of nongovernment organizations. They are ideal sources for health journalists who want to understand what is happening on the ground. We provide a complete listing of who they are and how they can be reached.
We hope to see you there!
Health news highlights… Family Planning Network: Are you interested in sharing ideas with journalists who cover issues related to family planning and gender-based violence? A group of journalists have established The East African Family Planning and Gender-based Violence Media Network to share information on these important health topics. The journalists created the network during a training program organized by the Regional Centre for Quality Health Care and Makerere University’s Institute of Public Health. Funded by USAID, the two-week program brought 28 journalists from Uganda, Kenya, Tanzania and Rwanda to Mokono to discuss ways to cover these issues. For information, contact Patrick Ogwang, a reporter for New Vision/Rupiny at 0782 559 638 (pogwang@newvision.co.ug).
Hospital Woes. Congratulations to the Daily Monitor’s Kakaire A. Kirunda for his six-part series in Uganda’s ailing hospital system (May 31, June 7, 14, 18 and 28). Kirunda’s richlydocumented reporting describes how countless individual problems combine to create a system in crisis: how regional referral hospitals are flooded with patients who can’t get the treatment they need at Health Centre IV’s, how deficient housing aggravates the severe lack of staff, how medicine shortages are worsened by patients who insist on getting drugs they don’t need – and how poorly trained hospital employees are all too willing to accommodate them. Kirunda notes that while the system is chronically under-funded, money alone won’t solve its problems without major management reforms. HIV/AIDS Fatigue? Not Here. In 2006, the International Federation of Journalists warned that “fatigue” in African newsrooms and taboos about public discussion of sensitive issues like sex and homosexuality were undermining HIV/AIDS reporting. Not in Kampala. New Vision covered the HIV/AIDS Implementers Meeting in Kampala June 3-7 extensively, with stories on AIDS in the military and among sex workers and homosexuals; new approaches to preventing mother-tochild transmission of HIV; tensions between donors and recipients over HIV/AIDS funding, and more. It capped its coverage with a news analysis by Raymond Baguma on June 9 that asked a tough question: “Why is AIDS on the increase despite increased funding? (http://www.newvision.co.ug/D/8/426/632590/raymond%20baguma%20HIV/AIDS%20implementers ) The Discussion Continues. If you want to follow up on the implementer’s meeting, check out an online discussion on the Global Fund’s “e-Forum 2008.” It focuses on “overcoming obstacles and sharing best practices when implementing programs,” and will remain online until October 3. (www.MyGlobalFund.org). Tips for next time. The Science and Development Network, a non-profit organization that provides information about science and technology geared for the developing world, has on its website an essay on how to cover technical conferences like the implementers’ meeting. Among its suggestions: don’t expect scoops because researchers rarely break news at these mass gatherings; study the program and line up interviews with prominent speakers in advance because they are hard to corner once the meetings begin; stay after presentations to listen to the discussions since that’s when some of the best story angles emerge; don’t neglect poster sessions, which can be a great source of story ideas; and focus your efforts because it’s better to produce a few good stories than lots of half-baked ones. (http://www.scidev.net/en/practical-guides/reporting-from-scienceconferences.html). The Truth About Fat Cells. They are a lot more than the villains that give us oversized abdomens and big bottoms. A fascinating Los Angeles Times article – a good example of quality explanatory journalism -- tells how these much maligned cells also “enrobe internal organs, cushion the eyeballs, lubricate the lungs and serve as shock-absorbing pads on fingertips and toes.” They may complicate our wardrobe choices, but they also regulate hunger and fight off infection – and when they misfire they increase our risk of heart disease, diabetes and some cancers. (http://www.latimes.com/features/health/la-he-fatcell2-2008jun02,0,373778.story)
Reporting in the North: Reforms Needed By Chris Ocuwon Reporting on health in war-ravaged northern Uganda is a lot more difficult than it should be. For one thing, it’s a huge challenge to cover nongovernmental organizations (NGOs). Northern Uganda has the highest concentration of international, national and local NGOs in the country. All claim to be working to improve conditions for people who have suffered for more than 21 years from the conflict. But many are just using the suffering of the people to accumulate wealth for themselves, and others are more concerned about protecting their own images than about helping journalists inform the public. Most of the NGOs in the north are not transparent. They don’t want to reveal their budgets to journalists or any member of the public. The few who do declare their budgets inflate the figures and hide how much they spend on huge salaries, “risk” and housing allowances, and posh cars. NGOs often call journalists to go along with them in the field when they are delivering some used clothes and relief items. They want us to show their donors that they are working. NGOs that are in trouble plead with us not to report their problems. But the majority of the NGOs shun us in their day to day operations. When we need information, they refer us to their head offices in Kampala. When journalists are led around by NGOs and told where to look, whom to interview and what to think, we are not able to establish the truth. When we are sent to Kampala to get information about our communities, we get farther from the facts on the ground, not closer to them. Many medical doctors, like NGOs, believe journalists want to report only negative things. So they shy away from talking to journalists, or actually hide information from us, for fear of being misquoted or misrepresented. In Lira regional referral hospital, medical workers recently grabbed a camera and detained a New Vision journalist who had gone to take pictures of a child who had been knocked down by a truck. Other times, medical workers give information, but decline to be quoted and to let us take their pictures to give more strength and authenticity to our stories. Often, even getting to the scene of a story is difficult in northern Uganda. It is especially hard to reach village health centers. Most journalists working in the north have no means of transport, and few drivers will take us to remote places for fear that they may be ambushed by LRA rebels. We can’t help the search for solutions to the centers’ problems because we can’t report what is going on. We cannot see, and hence report adequately on the problem of self-medication in our communities, for instance, or the fact that some health centers have no drugs and are being manned by nursing assistants rather than medical officers and clinicians.
What is to be done? First, NGOs need to become more transparent in their operations, and more willing to work with journalists – even when they aren’t seeking publicity. Second, journalists and medical workers in rural health centers both need more training on basic health issues and common diseases in the north, their symptoms, causes and how they can be prevented. Training the two groups together would help change negative attitudes, and encourage health workers to look at journalists as partners who can cause change in the community for betterment. Third, journalists need means of transport and equipment such as digital and video cameras and recorders to document conditions in rural areas and in internally displaced peoples' camps. And finally, journalists need to become more professional themselves. We need to stop ambushing medical doctors on the streets, and we have to work hard to dispel fear that we will misrepresent them on serious health issues that concern the life of many Ugandans.
UHCA: Seeking Common Ground In August 2006, somewhere on the top floor of World Health Organization building in Kampala, six health communicators sat intently listening to Gawaya Tegulle, a veteran Uganda journalist and radio commentator, as he related a sad story he had heard during a cancer conference in Washington. Mariam, a 13 year old from Tanzania, the story went, had just died of cancer, while Seth, a 72-year old Harvard professor, had been cured of the same disease. The reason for the discrepancy? Information – or, to be more precise, the lack of it! In Uganda, well analysed, thoroughly researched and timely medical information is hard to come by, especially in the media.
Where is Our Journalism Headed? By Eve Mashoo
It was against this backdrop that the Uganda Health Communication Association (UHCA) was born. Its mission: to empower, train, and support journalists and other health communication experts. A five-person steering committee, headed by Dr. Charles Wendo, the editor of Saturday Vision, was put in place, and in March 2007, with support from the World Health Organization, UHCA acquired legal status to pursue its objectives. UHCA brings together journalists and communications experts from other walks of life. One of the difficult issues before us now is how to unite our diverse constituencies. We don’t always have identical interests, as Eve Mashoo, a reporter in the East African Kampala bureau, testifies in the box on this page. Such experiences lead some to believe journalists need their own organization. “It is important that journalists keep their independence,” says Anne Sizomu, training manager for the German Foundation for World Population (DSW). “It is of paramount importance that NGOs are oriented about the benefits of this independence. Otherwise a situation may arise where NGOs set the health agenda instead of the journalist reporting about the real issues.” Journalists, of course, have their failings, too. Among other things, they can let commercial interests get in the way of serving the needs of the public. They also are chronically underfunded, and sometimes have notoriously short attention spans.
“Where is my story?” It’s a question that journalists are used to hearing from their editors, but in this case it wasn’t coming from an editor. Rather, the insistent speaker was a public relations officer for a private company that financed a trip for me and a group of other journalists to northern Uganda to write about the company’s programs. The company paid us 100,000 shillings per night, presumably to facilitate our travel so that we could write an important story. However, as the urgent question revealed, the money came with strings attached. In this case the company expected in return for its financial support a favorable story on its activities. Sadly, Ugandan journalists frequently face this situation. Media managers often don’t pay us enough funds to go out and report stories independently, so we have to choose between staying home or becoming dependent on companies and NGOs that want publicity. This is not a choice I expected when I got into journalism. I got into journalism to inform my readers, not to write stories for private organizations. Media managers need to work hand in hand with their reporters to provide logistical support so they can avoid being humiliated, exploited and used by the companies or NGO’s. Then we can come out and write meaningful stories, not necessarily ones shaped by sponsors hungry for publicity. Sponsors don’t understand why I took up the pen. They don’t even care. Once, I came back from a reporting trip only to find a sponsor waiting with the “story” already written for me. This is so demeaning.
Is this where is our journalism is headed? The challenge is to find a way our different constituencies can set aside our individual self-interests to achieve our common, overriding goal – namely, to inform and empower the public about health. Christopher Conte, Knight International Health Journalism Fellow, drafted a possible set of principles around which journalists and professional health communicators might be able to unite. It is based on a “Statement of Shared Purpose” developed by the Committee of Concerned Journalists in the U.S. (http://journalism.org/resources/principles), but adapted to UHCA’s circumstances. It appears on the following page, and will be considered for official at a future meeting of the UHCA.
Proposed Principles for UHCA The Uganda Health Communications Alliance seeks to improve the quality and quantity of information about health that is available to the public. This includes information concerning such matters as disease, medical care, and personal behavior that affects the health of individuals, as well as information about political, economic and social conditions that shapes the health of the entire population. Our ultimate goal is to empower people, both individually and collectively, to make informed decisions. To achieve this mission, we pledge to pursue the truth in everything we do. The journalists among us promise to assemble and carefully verify all the facts and perspectives our readers need in order to make informed decisions. Those of us from other fields of communication pledge to adhere to high standards of honesty, and refrain from misleading others. And all our members pledge to be as transparent as possible about our sources and methods of information gathering, so that others may assess the reliability of the information we provide. We do not advocate any particular set of policies. While our members serve diverse constituencies, the first and only obligation of the alliance is to citizens. This commitment requires us to report the truth without regard to whether it represents our personal views or serves the interests of the organizations that employ us, advertisers, employers, funders, political leaders or anybody else. Further, we recognize and seek to promote the unique and vital role of an independent press in society. In particular, the journalists among us pledge to defend our independence and to avoid conflicts-of-interest – especially financial arrangements – that might compromise our independence or lead others to doubt our objectivity. The communications professionals among us pledge to support the independence of the press and oppose information strategies or other actions designed to compromise it. Collectively, we all pledge to work to improve the professionalism and elevate the working standards of health journalists. In our commitment to the free flow of information, we promise to do all we can to foster healthy public discussion concerning health issues. In particular, we pledge to give all relevant stakeholders an opportunity to have their views reflected in the matters we cover. Among other things, we encourage research, and if we report information about particular individuals or groups, we pledge to give them an opportunity to respond or comment. Finally, we recognize that we must strive to make the information we provide both interesting and relevant to the public. This involves reporting information that is important to our readers as individuals and citizens, and exercising the craft of storytelling to ensure that such information is provided to them in a compelling and meaningful way.
Please let us know what you think. Send your comments to ugandahealthcom@yahoo.com.
Uganda’s District Health Officers Source: Ministry of Health, June 2008
NO 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54.
NAME Dr. Bernard Otim (asst) Dr. Betty Apio (acting) Dr. Rabbin drabu Dr. Kababa. L. D Dr. Mulwani Elisa Dr. Emer Mathew Dr. Awanyo James Dr. Anguzu Y. Patrick Dr. Pande Stephen (acting) Dr. Wakooba Peter Dr. Kiirya s. B Dr. Oluka Charles Dr. Francis Engwau (acting) Dr. Nyakoojo Francis Dr. Sikyewunda Dr. Twesigire Ben (acting) Dr. G. B . Oundo Dr. Mweru k. H Dr. Robert Oremo Dr. Onek A. P Dr. Ruyonga Joseph (acting) Dr. Bamwine Julius Dr. Muwanguzi D Dr. Nyehangane W Dr. W. Kitimbo Dr. Kisambu James Dr. Joa Okecho John Dr. Malinga Thomas Dr. Onyige Dr. Bitakaramira H Dr. Shaban Mugerwa Dr. David Tigawalana Dr. Kasewa Sarah Dr. Sebudde S Dr. Boyo Mashandich Dr. Mukobi Peter Dr. Musisi Diriisa Dr. M. Mubiru Dr.Kyamanywa Dr. Muruta Allan Dr. Assay Ndizihiwe Dr. Olwedo Alex Dr.Zirabamuzaale F. Dr. Driwale Alfred Dr. Okio Talamo Dr. Ocom Felix Dr. Balinda J Dr. Kusolo Dr. Okware Joseph Dr. Katumba Dr. Wamasebu Gideon Dr. Musisi Stuart Dr. Turyaganuka J Dr. Waako james
DISTRICT Abim Adjumani Amuria Amuru Apac Amolatar Arua Budema Bududa Bugiri Bukedea Bukwa Buliisa Bundibugyo Bushenyi Busia Butaleja Dokolo Gulu Hoima Ibanda Iganga Isingiro Jinja Kaabong Kabarole Kaberamaido Katakwi Kalangala Kaliro Kamuli Kamwenge Kanungu Kapchorwa Kasese Kayunga Kampala Kibale Kiboga Kisoro Kitgum Kiruhura Koboko Kotido Kumi Kyenjojo Lira Luwero Lyantonde Manafwa Masaka Masindi Mayuge
TELEPHONE 0772-884574 0772-473945 0772-359189 0772-455254 0772-930244 0772-406695 0772-614354 0772-696200 0772-483633 0782-308719 0772-432918 0772-858862 0772-527572 0772-479077 0772-534149 0772-472840 0772-507510 0752-581025 0752-497016 0772-602947 0772-611467 0752-338417 0772-436474 0772-514940 0782-867284 0772-927164 0772-482106 0712-465167 0782-308689 0782-691061 0782-701525 0772-400248 0772-553408 0772-900138 0772-984947 0774-408225 0772-447832 0772-454893 0772-490345 0772-460297 0772-665948 0772-959647 0772-455997 0772-515222 0772-381451 0772-605145 0772-589588 0782-726199 0772-664776 0772-412710 0772-642431 0772-368491 0782-268196 0772-642809
NO 55. 56. 57. 58. 59. 60. 61. 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. 73. 74. 75. 76. 77. 78. 79.
NAME Dr. Amoti kaguna Dr. F. Abwaimo Dr. Lwasampijja Dr. Edele Omere M (assistant) Dr. Seraphine Adibaku Nassanga J. R Dr. Mubiru Wilson Dr. Kkonde Anthony (assistant) Dr. Muyinda Mark (acting) Mubiru Frank Dr. Kasibante Godfrey (acting) Dr. Kiirya James Dr. Jakor Oryema Dr. Kalikwisya W Dr. Okello Anam S (acting) Dr. James Oola Dr.Mayanja Robert Dr. Karyabakabo Z Dr.Andrew Namonyo Dr.Binta Monica Dr. Okwana Nicholas Dr.Wabende Peter Rogers Dr. Okumu David Dr. Mukisa Emmanuel Dr. Hassan Nassur
DISTRICT Mbarara Mbale Mityana Moroto Moyo Mpigi Mubende Mukono Nakapiripirit Nakaseke Nakasongola Namutumba Nebbi Ntungamo Oyam Pader Rakai Rukungiri Paliisa Sembabule Soroti Sironko Tororo Wakiso Yumbe
TELEPHONE 0772-521846 0772-415913 0772-454143 0772-459050 0712-607245 0772-503088 0772-670556 0772-402784 0772-429586 0752-405061 0772-428184 0772-457614 0772-619018 0782-521787 0772-565645 0772-689392 0772-664776 0772-681785 0772-441522 0772-507310 0772491418 0752-818474 0772-457360 0772-408885 0772-473179
Final Thoughts NGOs and the Internal Brain Drain. A group of international health and development agencies that met recently in Washington D.C. pledged to refrain from creating "internal brain drain" by hiring scarce government employees, such as doctors and nurses, away from the public sector in the countries the groups are trying to help. It could be a small step toward a code of ethics designed to ease the drain of health professionals from developing countries. For background, see Raymond Baguma and Anne Mugisa’s “Brain Drained States Seek Compensation” in the March 9 New Vision, (http://www.newvision.co.ug/D/8/13/615747/raymond%20baguma%20brain%20drain%20code%20et hics). What is Fairness? It’s as simple as A, B, C (D and E)… William Recktenwald, a senior lecturer and Fulbright Senior Specialist from the Southern Illinois University School of Journalism, offered this simple formula for fairness in a recent lecture at the U.S. Embassy in Kampala: “A” is for Accuracy, “B” for Balance, “C” for Completeness, “D” for Detachment and “E” for Ethics: Add them all up and you have “F” for Fairness.
Here’s to your health – and to the health of all Ugandans!