I recently attended a private meeting in which medical officers in Mbale in the eastern part of Uganda were asked to reflect on their welfare and what impact this has on service delivery in government aided hospitals.
Due to the complexity of this matter I will not mention the names of the medical staff who spoke in this meeting.
In a room packed with doctors, consultants and nursing officers, a nursing officer heatedly spoke out saying medical officers were struggling to survive on low pay from the government while the cost of living in Uganda keeps rising.
In 2009/10 the monthly salary of a newly recruited medical officer in the public sector stood at USD $320 and the starting salary of a senior doctor at USD $420. The entry level salary for a registered nurse was USD $177, while the take home pay of midwives was as little as USD $50 a month.
The women noted that these financial worries add to other stresses faced by staff in government aided health facilities. Many work long hours, putting in twelve hour shifts everyday with little rest as they struggle to cope with overwhelming patient numbers. They also face the frustrations of a lack of medical supplies and a lack of appreciation in the workplace.
Another nurse complained that uniforms were no longer supplied by central government. The nurse said many had been attracted to the profession by the smart appearance of nurses and were aggrieved at being forced to now buy their own uniforms.
“If you pay very well a nurse that person will work with any number of patients with love and care, knowing that the rent and other domestic needs are catered for,” another nursing officer said.
Someone who operates from a rural health facility said that, despite long working hours with little chance to rest, staff work over weekends and on public holidays for the sake of the patients. They added that they even volunteer unpaid on top of their regular work out of commitment to patient welfare, for instance in HIV clinics.
Low salaries were of course a huge and widespread concern. However, it was striking that, when asked what needed to change to make things better, health workers emphasized improvements in care and treatment for patients.