Uganda: How Quack Health Workers Are Putting People's Lives At Risk

In the densely populated slums of urban areas around the country, several private clinics and drug shops are run by unqualified health workers, an investigation by Daily Monitor has revealed.

Some of the clinics are often closed when district health officials in partnership with Allied Health Professionals Council (AHPC) and other health bodies, conduct their routine crackdown.

Some clinics, when closed over lack of licences and lack of qualified staff, reopen a few days later, reportedly with authorisation from the district health officials.

Daily Monitor found out that most nurses and midwives employed in the private clinics and drug shops are trained but are not licensed to practice by the government.

Residents blamed the mess on corruption by district health officials.

"They closed the clinic here and arrested the health workers but after two days, it was reopened. The same health workers were working again," Mr John Musamali, a resident of Link Cell in Mbale City, said.

"I asked myself how the health workers were able to get the requisite academic documents within two days," he added.

Mr Yasin Wabomba, the deputy speaker of Mbale City Council, attributed the mushrooming unlicensed clinics and drug shops, especially in rural areas, to rampant unemployment and poverty.

Mr James Magomu, a resident of Bulweta village in Bukonde Sub-county, said in order to fight the vice, the government should ensure the presence of adequate and well-equipped facilities to match population demands in all areas.

"We cannot get rid of quack health workers and their establishments if the government has not equipped health centres," he said.

The Mbale District Health Officer, Mr Jonathan Wangusi, however, said they have tried to get rid of quack health workers in the district.

"We did a thorough operation and chased away the quack doctors. I'm sure the health workers operating now have working licences and are professional doctors," he said.

The Bulambuli District Health Officer, Dr Vincent Natega acknowledged the challenge posed by quack health workers.

"When we close the clinics, they wait when we have left and they reopen. It is a big challenge to our profession and to the people's lives," he said.

Dr Natenga explained that quack health workers give wrong prescriptions to patients.

"For one to practice as a doctor, dental surgeon, nurse or midwife, they must be trained. Then they have to register with the relevant professional council/body to get a license," he said.

For example, doctors and dental surgeons register with the Uganda Medical and Dental Practitioners Council and must renew their registration every year.

Clinical officers and laboratory technicians register with the Allied Health Professionals Council and must also renew their practicing licences annually.

Registration bodies

Nurses and midwives are registered under the Uganda Nurses and Midwives Council and must renew their practicing licences every three years.

In Tororo, the district health officer, Dr David Okumu, said despite the sustained efforts to get rid of non-qualified health workers, they have not yet succeeded.

Dr Okumu said in rural areas, the challenge is big because local people have more faith in such health workers. "The quacks are trusted and the locals follow them blindly," he said.

Mr James Okello, a businessman in Tororo Municipality, said local governments should sensitise the public on how to identify quack health workers.

"There is a need to educate the public so that they appreciate the danger of the quacks. Short of that, people will continue trusting them with their lives," he said.

In rural Ntungamo District, unlicenced clinics that employ unqualified workers are common.

"It's a big challenge. You will find someone running a shop, then admitting sick people and cooking from the same place, and people trust them," the district health officer, Dr Richard Bakamuturaki, said.

In Rukungiri, the district health officer, Dr Akasiima Mucunguzi, said they have worked tirelessly with the National Drug Authority (NDA) to get rid of quack health workers.

"The NDA and my team have tried to do close monitoring. Currently, there are no known cases of masquerades," he said.

In Bunyangabu, the district health officer, Dr Richard Obeti, said in the financial year of 2018/19, they registered a case where an impersonator claiming to be a drug inspector from NDA was collecting money from drug shop owners, promising to give health licences.

"When I got that information, I immediately acted and the impersonator took off. Our attempt to arrest him were futile," Dr Obeti said.

In central region, the situation has not been any better. Mr Fred Oyesigye, the Allied Health Professional Council supervisor for the central region, said since the year started, they have arrested six quack health workers from Masaka City, two from Kinoni in Lwengo district and five from Kayunga District.

"Lwengo is one of the challenging areas in the region since they have many traditional healers but we have always warned people against seeking medical services from unregistered units," Mr Oyesigye said.

Recently, a survey conducted by AHPC, a body licenced to regulate and monitor health professionals in the country, revealed that Busoga Sub-region has the highest number of quack doctors in eastern region.

"During on-spot survey, the results indicated that there are more illegal clinics that were being operated by quack doctors in Busoga compared to other sub-regions found in the region," Dr Patrick Mpiima Kibirango, the chief executive officer of AHPC, said.

Dr Kibirango reiterated the need to enforce operations to root out unprofessional health workers.

WHAT NDA SAYS

Mr Fredrick Ssekyana, the NDA spokesperson, said the agency has been fighting hard to protect the population from fake medicines. A total of 4,387 drug outlets were surveilled, leading to closure of 1,526 and effecting 56 arrests in the first half of the last financial year, according to Mr Ssekyana. The World Health Organisation (WHO) estimates that every year some 100,000 people across Africa die from taking "falsified or substandard" medication.

Compiled by Fred Wambede, Alfred Tumushabe, Alex Ashaba, Mudangha Kolyangha, Joseph Omollo, Robert Muhereza, Phoebe Masongole & Malik Fahad Jjingo

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