Kampala — Realising the vision of health for all is still a distant dream. Many of us are familiar with the challenges of access to public health services, particularly for the rural poor who form the bulk of our population.

There are heart rending stories of rampant thefts of drugs by health workers with the resultant adverse effects, especially for the poor who cannot afford to buy drugs from private clinics and drug shops.

Adding to theft of drugs, is the negative attitude of some of the health workers, especially nurses, towards patients. This has forced some expectant mothers in rural areas to shun health facilities and continue having unsafe deliveries at home.

There is also the lack of proper supervision of health workers, resulting into chronic absenteeism from duty, with some upcountry health units closed during working hours.

A case in point was on December 26, 2009. Acting as a Good Samaritan, I drove a victim of mob justice to Bududa Hospital in Bududa district. To my consternation, other than a night watchman, there was no single health worker on duty.

The sight of patients lying in agony in dark wards, some with empty drip bottles hanging over them without anybody to remove or change them, was horrible. While still pondering what to do next, a motor vehicle accident victim was rushed in, but there was nobody to attend to him. I checked on the notice board and from an old (July 2009) doctor's duty roster, I got telephone contacts. I called one of the doctors who promised to send someone to help us, but we spent more than two hours at the hospital and left without being attended to.

Before that, on December 23, 2009, my wife drove to the same hospital with a convulsing child.

She left at midnight without being attended to because there was no staff on duty. She resorted to a clinic five kilometres away to save the child's life.

These and other undocumented experiences reflect the poor quality of services in Uganda's hospitals.

While I fully accept that resources are finite, there is a big problem of accountability of time and financial resources availed to deliver services in health centres. There is also lack of political and administrative accountability in running public institutions.

In the absence of efficient state institutions and reliable administrative systems, service delivery will continue to be poor. Some disturbing questions that require urgent answers from the concerned officials are:

• Why should it take President Museveni's personal efforts to arrest thieves stealing drugs in hospitals?
• What have the responsible ministers, accounting officers, management and local leaders done to stop this anomaly and ensure efficiency in service delivery by health workers?
• Can they justify their continued stay in offices given this gross inefficiency and incompetence? Is it just about occupying time and space?

To shut one's eyes to the gravity of this abuse and negligent of duty or to pretend that all is well when people continue to get lip-service, is to bury our heads in the sand.

I feel a profound sense of frustration that public health service delivery seems unresponsive and insensitive to the needs of those who are unable to fend for themselves. Our health system denies many people and their families the opportunity to live their lives with basic human dignity.

In my opinion, the country cannot achieve sustainable wealth without health. Therefore, the responsible officials must urgently take steps to address the loopholes.

The writer is an accountant and works with the World Food Programme