By Patrick Odongo
It all begins with us and certainly must end with us if we choose to first, we look into the background as we attempt to answer some of these questions.
I) What if anything matters today?
II) Where is our moral and ethical obligations to humanity?
III) Must we monetize or marketize everything?
In todays’ dynamic and turbulent environment where we face high burdens of epidemics, you realize before concluding lessons from one a new one emerges, the best example being the COVID-19 pandemic.
It is important for us as a country to adopt evidence-based global strategies to enable us prepare and respond with resilience in combatting new diseases including the current health problems like HIV, TB and malaria, it also requires renewed commitment and strong political will from government through both its political and technical leaders, hence, surreptitious actions from key people in authority and policy position has to be well accounted for, refined, reviewed and approved by the very people who confront far-reaching effects of their decisions.
It is worth noting that a policy on health training, education, and practice is a key public health concern not just for the trainees, educators, institutions, consumers of healthcare (patients/clients), but a much wider population and a national agenda since everyone is bound to experience ill-health at any given time.
Recently, a shocking policy directive emerged from the ministry of health affirming waiver of internship for upgrading nurses and midwives trained at the university with either bachelor of science in nursing or bachelor of science in midwifery (BSN/BSM). Nursing and midwifery professionals form the majority of health workforce worldwide thus their training, competence and practice must be well grounded and regulated in the interest of public safety.
World health organization has acknowledged in its state of global health report that this health profession is critical in guaranteeing populations’ health and has continuously emphasized on improved standards of education, training and practice for nurses and midwives.
Several studies further highlighted that a well- trained, supervised and mentored nurse improves patients’ safety and health outcomes, (cite). In spite of these full awareness, the PS-MOH (Dr.Atwine) on selfish-grounds, without trace of moral and professional conviction impulsively endorsed an evil policy placing the lives of millions of vulnerable Ugandans at great danger.
So let me go head to explain why this policy is evil, immoral and a great danger to the public.
When you don’t invest in skill development of health professionals through supervised internship training and mentorship, in essence, there is no way one can justify matching competence with quality service delivery, instead you will be the same person crying out that you have half-baked and incompetent healthcare workers who you blocked them from enriching their skills through the translation of theoretical knowledge into practice (hands-on) more so to a very critical service personnels that literally run the healthcare in Uganda.
Waiver of nurses and midwives as well as other healthcare professionals from internship because there is a huge backlog, limited funds, and other remote assumptions completely deviates from the principle of altruism and beneficence long embedded into medical practice.
By favoring this policy, we are imposing harm and risking the safety of our patients’ and the society and this raises a serious moral concern and culpability from a renown medical practitioner and permanent secretary.
Of course, medical errors do occur but are much less common today, due to progress in medical science, technology, teaching methods and practice.
As a country, we should not accept to be dragged-backwards to the dark times through reckless decisions and action from misinformed technical people and leaders who continue to ignore our real priorities as the people and instead focus on their very own interest as a standard when choosing programs and policy.
Too many times, the government and ministries are trapped into wasteful spendings in terms of travels, exorbitant allowances, health tourism, failed vaccine trials, poorly-negotiated contract deals, and yet become happy to compromise the quality of training and the health of our people.
It is again important to note that; we in the profession aspire to attain and compete at the acceptable global standards set out by both the international council of nurses and the international council of midwives to which we are a member and as a matter of fact so many of our nurses trained here are in high demand from foreign recruitment agencies and many have by far excelled beyond expectations across the region and globally yet here we continue to grapple with chronic shortage of nurses and midwives in every public hospitals; where do we place our priorities, are we working for our people or we care only about ourselves instead?
Last but not least; Iet me draw to your attention that internship for healthcare professionals particularly nurses and midwives needs to be streamlined, reinforced and improved through direct dialogue and engagement with nursing professional bodies and associations, regulators, educators, technical groups, union of nurses, stakeholders with the clear agenda of improving healthcare delivery, personnel training and competence through effective internship training with focus on; upgrading training centers, creating new ones, recruitment of supervisors/mentors for interns (nurses and midwives), equipping training sites, provision of Infection prevention and control supplies , improving working environment, structure and designs.
Finally, Truth be told, money is not everything. There are things that money of any amount can’t buy.
Human life is one such example but there are many including ofcourse our time, values and belief systems.
So, if we know and also understand this concept, then there is no reason why a reasonable person such as permanent secretary should take a stand that compromises and undermine the set-standards of an autonomous profession instead of promoting empowerment for a multidisciplinary approach in service delivery.
It is therefore, a call for her to restrain from pursuing this misconceived policy before we start experiencing its effects as highlighted in the article
Patrick Odongo is a clinical and research nurse- leader.
