NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Wednesday, April 1, 2015

The decision by Uganda to send nearly 300 medical professionals the Caribbean has sparked a controversy that extends beyond the East African nation. Belgium says it will make cuts to the €11 million in aid it sends to Uganda. The United States has criticized the plan, as has Human Rights Watch, and activists in Uganda.

All say it is a form of state-sanctioned “brain drain.”

An advertisement posted by the Ugandan government in 2014 offered jobs for 283 health workers in the Caribbean country of Trinidad and Tobago. It quickly sparked controversy as people noted that Uganda’s 1 doctor per 24,725 people is below the guidelines set by the World Health Organization, and much worse than the 12 doctors per 10,000 people in Trinidad.

Ugandan government officials defended the program by saying it supported bilateral relations with the country. It also provides earning opportunities that allow expat medical professionals to send money home through remittances that then is taxed and spent in Uganda. The Institute of Public Policy and Research (IPPR), a Ugandan think tank, was not convinced. It launched a lawsuit to stop the practice.

“While the government is bent on exporting health workers, thousands of Ugandans are dying daily. Sixteen women die daily giving birth, but the government can’t see that as problematic. This [Ugandan case] is going to set precedents on the continent. We want governments to know that it is their responsibility to retain key professionals,” said IPPR Executive Director Justinian Kateera, to the Guardian in Feburary.

The IPPR argues that the government’s recruitment of health workers is a violation of the constitution by limiting access to health care. It hopes a court injunction will stop the program in its tracks and allow for a legal case against the government to proceed. Kateera is not alone. Janet Obuni, president of the Uganda Nurses and Midwives Union, also expressed concerns about the effects of sending away trained health workers on health care in Uganda.