Thursday, 15 December 2011

Health services collapse as officials eat big

A struggle over power and on who gains from big money deals has derailed the delivery of services at the Health ministry after senior bureaucrats split into two antagonistic groups.
The acrimony has attracted the attention of State House that has directed that thorough investigations be done.
My investigation reveals that instead of fighting to revitalise the collapsed health care delivery, the officials engage in drafting projects and seeking financing for activities which most often were not done.
The result of the factionalism in the ministry is that projects meant to deliver services to the public unravel even before they kick off while money meant for them is swindled.
Already, some officials have refunded Sh450million out of the Sh600million they had reportedly obtained to implement yellow fever awareness campaign in the North, a project, senior bureaucrats say was a rip-off.
The officials did not conduct the yellow fever vaccination and awareness but instead colluded with district health inspectors to mobilise villagers who were given Sh10.000 each for attending “a workshop.”
“They had created an activity which is fiction,” said Dr Asuman Lukwago, the permanent secretary, “the principal officer, Mr Kafuko, who generated the requisition was suspended and some were warned.”
But some insiders allege that the project unraveled because some big shots needed a cut which they didn’t get.
The suspension of the said officers has fed into the mood of mutual suspicion in the ministry with Commissioner for planning Dr Francis Runumi reportedly leading a faction of the old staff while Dr Lukwago commands the new entrants.
It now obtains in the ministry that neither group relies upon the other to function correctly thus increasing the already poor delivery of health care services. In some health units, the medics receive drugs and tack it away instead of dispensing to patients, a move seen as sabotage of the new officials.
Dr Lukwago said on Wednesday that the new staff could be perceived negatively because “what we need is to interrupt wastage and improve service delivery.” However, some staff believe they were victims of Dr Lukwago’s autocracy.
Dr Runumi said: “In any organisation, when there is change, those who are in the system want to study new people and the new people do the same. But we have adjusted and things are beginning to work well.”
Dr Achieng, Dr Lukwago and Dr Christine Ondroa, the minister, are some of the new faces at the helm.
The permanent secretary is accused of colluding with the Director General of health services, Dr Ruth Achieng and the head of the Drug Monitoring Unit in President’s office, Dr Diana Atwine to intimidate and injure reputations of officials noncompliant to their personal interests. Both deny the allegations.
“They are just branding us but we insist that whatever little money gets to health from government, let it do something,” Dr Atwine said.
As a result of internal strife, some staff have separately petitioned the Inspectorate of government and President office to investigate Dr Lukwago and other officials’ work methods. They allege that fight over lucrative contracts and kickbacks define work at the ministry and shifted the doctors’ focus from clinical and public health work to fixing deals.
According to letters, copies of which this newspaper has seen, Dr Lukwago is accused of bullying other technocrats while invoking the powers of State House.
“I have received the letter [from State House] and we have replied to it,” Dr Lukwago said, “Some of the complaints in the letters were known to us.”
Incompetence or theft?
Dr Runumi, is accused of failing to account for Sh1.5billion he received to prepare the health insurance bill. Sources say State House has asked that within two weeks, the accountability must be presented to the PS but Dr Runumi said on Wednesday that he had nothing to account.
“Accountability is held centrally by the office of the PS. No Shs1.5billion was associated to the health insurance bill; we used to get Shs800 per year,” he said.
Dr Atwine, however, said the ministry reeks poor accountability.  “For instance, out of Sh1.4billion meant for car repairs, they have only accounted for Sh199million,” she said.
She also disclosed that while initially money was sent to districts to buy drugs but was diverted, the schemers have also learnt to divert drugs and forge accountability.
“ In Mubende, a medical officer took a book for drugs to his home and forged names of patients,” Dr Atwine said, “He told us the drugs had been taken to a private clinic by his bosses yet he had to account; he said sorry and let us to the clinic where we recovered the drugs.”
While the bureaucrats fight for the control of projects, the ministry is planning to demolish hundreds of theatres it constructed in health center IVs because they were unfit for medical operations. Sources say the theatres are substandard because the ministry’s engineering unit took big cuts from the contractors who then compromised the standards and design of the theatres.
“Some theatres were constructed 10 years ago but have never been used because they were built poorly. We are going to demolish some,” Dr Lukwago said.
Sources told this blogger that several officials in the ministry were on rampage picking anything that gives them money.  And at the ministry’s mechanical workshop in Wabigalo, Kampala, at least 18 car engines were stolen as government vehicles were vandalised. Dr Lukwago has also had to forcefully recover vehicles parked in officials’ residences yet several health units had not means of transport.
The health ministry commands the largest fleet mainly four-wheeled fuel guzzlers. Some officials assigned them to their spouses.
Although Dr Lukwago confirmed the theft of car engines, he said: “We are building up cases before prosecuting the culprits.”
Because of the cocktail of issues in the ministry, several government agencies including the IGG have opened up investigations. On forgery of receipts, some drivers have so confided in the investigators that their bosses often sent them to pick receipts at Nkurumah Road, a commercial printing center in the city, to help in the false accountability. Effectively, this would mean most activities were never conducted.

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