"Are we surprised by the increase of witchdoctors who sacrifice our children?"

August 24, 2006 -- Today the New Vision site (Uganda) posted "Why does MUK admit few nursing students?" by O.E. Bukabeeba. Bukabeeba is the "former secretary for mass mobilisation, Mbarara District." The opinion piece objects to the recent admission of only 18 students to study nursing at Makerere University, and it argues forcefully for more resources for nursing education. Bukabeeba wants Uganda to train more nurses not just to address the nation's own desperate health care situation, but also to exploit the huge market for nurses in developed nations, which could increase much-needed foreign remittances. Whether those goals fit easily together is an open question.

Bukabeeba expresses outrage at the government's training of so few nursing students, and at its apparent decision to charge them high fees, when "[t]he most urgent task facing Uganda and Africa as a whole is producing enough Human Resource for Health." Bukabeeba points to Uganda's distressing health indicators, including an under-five mortality rate of 152 per 1,000 live births. Bukabeeba also notes that the nation faces "high levels of poverty, illiteracy, poor nutrition, poor hygiene and unemployment." However, the nation has "a deficit of 30,000 nurses," and most of the ones it has serve the central region, to the detriment of the great majority who live in rural areas. Thus, Bukabeeba asks, "[a]re we surprised by the increase of witchdoctors who sacrifice our children?" The writer suggests that 70% of the disease burden in villages could be handled by nurses.

Bukabeeba goes on to observe that Uganda receives over $1 billion (we assume each year) in "remittances from Ugandans in the diaspora"--more than the $730 million it gets from donors. At the same time, Bukabeeba notes, the U.K. needs 250,000 nurses, and the U.S. over one million, to meet projected shortfalls, with U.S. nurses able to earn "as much as $40,000" yearly. Bukabeeba argues that "[w]ith high unemployment, even among graduates, why has Uganda Investment Authority (UIA) ignored developing such a market?"

This is an impassioned plea for more resources for nursing education. It makes some good points about Uganda's need for nursing care, particularly the note about how much nurses can do for villages, and the warning that in the absence of nurses, unqualified practitioners step in. Bukabeeba seems to be arguing that the government should train more nurses not just for domestic needs, but as a valuable export to developed nations. The point that the nation gets more money in remittances than aid is a telling one.

However, given the experience of other developing nations, some might be skeptical that a nation like Uganda could train enough nurses to meet both its own needs and those of other nations. In the absence of greatly increased funding for clinical nursing, the likely result of increasing the number of nursing graduates may be a greater flow overseas. It is also unclear whether the remittances such nurses send back are a good investment relative to the resources the nation expends on their training, and the costs of the poor health that results from insufficient local nursing resources.

We thank O.E. Bukabeeba and New Vision for this strong piece on behalf of nursing education.

See the article "Why does MUK admit few nursing students?" from the August 24, 2006 edition of The New Vision.

You can send comments to The New Vision at letters@newvision.co.ug (and please copy us at letters@nursingadvocacy.org, thank you).

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