By Julius Mugaga Tukacungurwa/Umoja Standard.
HEALTH: As elections for Federation of Medical Internees (FUMI) draw closer, Umoja Standard‘s Reporter had a one-on-one interview with Dr. David Mugyema, one of the Candidates eyeing the seat for Presidency.
Our Reporter had 14 key questions to put across to him and to see how he will help take FUMI forward and below are the questions and how David Mugyema attempted them.
Question 1. *Who is David Mugyema?*
Answer: I’m a Ugandan born again Christian, a born of Masaka city, currently a pre-internee doctor (Bachelors of Medicine and Surgery), a leader throughout my life. In primary-(head boy), secondary (head prefect) and University (medical association vice president, health minister and senior presidential advisor and strategist ). I sit at the national youth council of Uganda, East African youth parliament (vijana assembly-Arusha).
I head the health team for literacy of love, a community based Non-Government Organization in Mpiji, central region. I’m currently running for President of Federation for Uganda Medical interns.
I’m a fellow of Julius Nyerere leadership institute, a fellow of the educate program USA, a fellow of Ecoarse4 under the Michigan state foundation and PYPA (Participation of Youth in African politics). I have won two silver medals in the National medical Quiz representing my university.
In my free time, I watch action intelligence/detective movies, I read books about leadership and governance, warfare and economics. I come from a family of 7, 6 girls and I am the 3rd born. I’m an interactive and down to earth person.
Question 2. When did you join the University?
Answer: I joined university in 2014, signed for a year off (2015) and went abroad, I then returned in 2016 and along the way, covid had us twice, but thank God we are finally done with medical school and we are currently pre-internees.
Question 3: *What is your Agenda for FUMI?*
Answer: To see a FUMI that regains trust in its leadership, to have a leadership that will bear fruits and will be inclusive to all young health workers of this country (preinterns). We want to break the barriers and build a future together. We want to have serious pending work done! We tailored this in our 6 point program in our manifesto like we shall have it broken down.
Question 4: *What are some of the challenges do you meet as Medical Interns and how do you expect to solve them? *
Answer: We are faced with challenges like lack of Personal Protective Equipment, we want to work with both government and Non-Governmental Organizations to get medical supplies at a low cost. These include: Stethoscopes, scrubs, clinical coats, even gloves since some of these aren’t adequate where we practice from.
We want to engage many other Well-wishers to give us a hand to run FUMI activities since we don’t have a strong pool or external source of income as an association to run all fumi activities.
Besides, we must have a Secretariat according to the constitution, it must be operational but u find that it’s the interns leaders doing secretariate work, even when they must attend to the patients and do the learning.
*Question 5: *And what about Funds?*
Answer: We need funds to hold press conferences, media activities, workshops, orientation programs and induction. When one of us passes on or contracts an illness or accident in the line of duty, we must contribute to burial arrangements of our colleague, contribute to medical bills while we advocate for an insurance cover.
The money we get from subscription is very little compared to the challenges the intern leadership faces. Less than 5M was collected in subscription last year yet the current interns are 1700 plus. This would be 17M. So, you can imagine. Whereas this is small money, interns expect services including reports from parliament, PM office, MoH, cabinet resolutions, site visits in emergencies, so on and so forth.
Question 6. *Tell us about the voting pattern and issues of sending delegates to participate in this exercise?*.
Answer: At the moment, voting is both physical and online (virtual), all interns released on the list by the ministry of health and posted in legally recorgnized intern hospital sites pay ugx shs.10,000 each according to the constitution to both become a member and have voting rights.
There have been proposals in the FUMI constitution that institutions send a certain percentage of delegates for the election process, this will settle bias on who’s sending bigger numbers takes the day! All this can be agreed upon during General Assemblies.
Strict laws against making this federation partisan should be put in place. If unions front political parties, they create sentiments and the whole objective of welfare loses meaning.
Question 7. *There have been demands for salary enhancement in the profession and many directives issued by the President of Uganda to that effect but in vain. How will you change the narrative?*
Answer: In the meantime we are going to continue to engage relevant stakeholders of this country to solve the salary discrepancy among nurses midwives and pharmacist. Only Doctors are getting what the president directed (half the salary of their professionals)
Again, in the 2nd last UMA meeting with the president, he tasked the Ministry of public service, Attorney General and URA to devise means to reduce the taxes on allowances from 30% to 10%
This will increase our take home package and we solve challenges like extortion done by unpatriotic interns.
Question 8. *I understand that there have been proposals about Preinternship examinations to eliminate some quacks what do you say about this?*
Answer: Yes, it’s true. This year a pilot study had to be done but because the procedure is unclear, institutions dropped out of this arrangement at last minute. A consensus between Uganda medical and dental practitioners council, and institutions teaching doctors ought to be reached . In the same manner, we must focus on screening the admission process from year one and let’s say give a national exam while crossing to clinicals from biomedical sciences and the UMDPC must be involved in this process of quality assurance and not only back up national council for higher education. So, accepting this exam comes from all stake holders appreciating the process and not it to be seen as a blackmail strategy against certain institutions.
Question 9. *Tell us about the fights between the former FUMI and current one? How does this affect you?*
Answer: There has been a rift between the former leadership of Dr. Nabwire and the current of Dr Lumumba that resulted into a faction of Dr Mutebi called UMIU.. this whole mishap was due to failure of interpretation of the constitution on who is a FUMI member and whether or not subscription is mandatory.
Yes!, according to the constitution it is. Like any other association, funds are needed to carry out activities unfortunately the leadership of Dr Nabwire allegedly refused to hand over to Dr lumumba and means to have an amicable solution are underway.
Like I said, it’s in our interest to pursue a review of the constitution to suit the whole FUMI fraternity and we hope the predecessors’ misunderstandings don’t spill over to us. Throughout our campaigns, we have preached unity and chosen to harmonize both groups and we are certain all the aspiring candidates are under FUMI and have come from the same institutions that had recently got a divergent opinion. So, this is a plus to us as a pre-intern force.
Question 10 . *In a less than a month, we have seen and reported in news six medical personnel who have died mysteriously. What is killing your brothers and sisters in the profession?
Answer: We first lost Dr nturagye rashid from mbarara university, he was a candidate in this race and is said to have been murdered in Ibanda, we dint get a detailed report on what transpired or whether Justice has been served to his family.
We got a report of a Kiu medical student who was strangled by his workers-we thank the bushenyi police since these have been arrested and it was due to a misunderstanding in their payment according to the video police recorded on the suspect killers.
Another Kiu preintern pharmacist was found in his house dead. We haven’t got details from police,
We have just lost Dr Polla who had just finished his internship in fortportal and had just been employed in kalisizo-masaka. It’s alleged he hit his head, reports remain scanty! Not only medical students, kyambogo lost a student to iron bar hit men in the same last month.
The rate at which students and young people are mysteriously dying is worrisome. I want to ask all interns to be security cautious. Move with a friend, don’t be in places where you’re new and alone. Introduce yourself to authorities in a new area so that u can get immediate assistance, contact police if there is anything unusual that happens around your environment. Again; we must take mental health serious.
Medical school studies consume much energy, some times this leads to stress and precipitates depressive episodes. Some young people escape this reality with drugs and this is how we have lost some of them. We must encourage them to seek for help from colleagues or seniors and we need to end the stigma about mental health.
We also task govt to provide accommodation in places that have security. This calls for good pay for us to manage safe places. It’s in otherwords collective responsibility! May the souls of our colleagues rest in power, lastly, we want to trace if they’ve left any children and we ask the parliament and the cabinet to give them assistance in form of education since the lost health workers intended to serve this country and its people.
Question 11: We saw your elders in Uganda Medical Association-UMA bitter over the decision by Dr Oledo their president to endorse General Yoweri Kaguta Museveni for another term of presidency. What’s your opinion on this?
Answer: Dr Oledo is a known NRM Carder and it’s not a crime for him to show love in whatever form to his party Chairman in this case the President. It’s true the President has been of assistance in improving the welfare of interns especially allowence increment for interns and salaries of our senior health workers. We do appreciate him. Where we draw the line is Dr. Oledo dragging the clinical coat in dust while in activities that seemed politically motivated and selfish. That was unbecoming and unthinkable.
That was not a resolution by UMA and FUMI. He had all the right to remove the clinical coat and adress the President as Oledo, the NRM Carder. These associations are non partisan, imagine the next leader belives in DP, UPC or NUP! Should they endorse their flag bearers as well while in association attires? We have never seen Uganda Law society drag their fraternity and so forth. Let’s work with government but not cause professionals to question our motives.
We also don’t agree with the idea of volunteering for one year after internship as fronted by Dr Oledo. Where is the guarantee that after this, absorption in public service is automatic? How about those who won’t have been recruited? Do they spill over to another year? How about those that will be fresh for that year?
I thought we were discussing absorption of health workers into HC3 and HC4 after their upgrade? How then did we get in the position of promising volunteering?
Besides, how will those who obtained loans from higher education students financing board, and other bank loans pay off this money yet the grace period given is a year after internship?
Are they going to rewrite the MoU?, the loan scheme being a revolving fund, won’t this fail to meet the intention of government ? Where is the return on investment If those that are supposed to pay back are volunteering?
We must think through before we make these conclusions out of excitement..
Question 12 *There are cuts in the yet to be read budget regarding funds for the Health Sector*
Answer: Our health budget in the coming financial year 2023/24 has suffered a cut of Ugx 430.1BN according to the national budget framework paper. This has affected regional referral hospital infrastructural development, medical supplies by National Medical stores, the none wage Bill among others.
We ask government to reverse these budget cuts otherwise we shall have shortages in supplies of anti malarias, TB medicines, ARVs, reagents needed in labs, immunization supplies and etc due to NMS Ugx 298.5BN funding gap!Low budget execution and wastefulness further diminishes available resources for health. Low government spending hurts citizens the most and results in high out-of-pocket spending and an inequitable health system that only guarantees access to those who are able to pay.
This is quite absurd. We should interest ourselves in international chatters like the Abuja declaration that give priority to the health dockets of the countries, this proposes that 15% national budget should be allocated to health. A healthy country is a productive one hence a wealthy one..
Question 13: I understand there is an issue of Brain drain in this country. But then what about unemployment of health workers?.
Answer: We have more than 2000 unemployed/underemployed Doctors and many health workers. The head of state promised to elevate HC3 and HC4 to community hospitals and this is yet to be realized especially that the budget has instead been reduced in the FY2022/2023.
We are going to engage the cabinet, parliament and public service to absorb in installments a number with in this small budget. Not only should we be deployed but also equipment should be put in these community facilities, the restructuring should be fundamental. We still have a low doctor to patient ratio and yet we have many unabsorbed health workers loitering on streets.
This points to a gap in administration and priorities
Question 14: *Any other thing to say? *
Answer: We want to ask government to work with hospital/site administration to get us fair accommodation at low pay in secure places. Some of the areas we are posted are not safe and we have continued to lose young health workers by hitmen and local thieves. We deserve safe accommodation at a sizable cost which is manageable by the interns.
Lastly, I request anybody who wants to support my cause to contact or WhatsApp me on (0706305343) and we see how to take forward FUMI.