Why in Uganda, Ebola and Aids have always been very political diseasesBy CHARLES ONYANGO-OBBO | Wednesday, August 1  2012 at  10:49

So the deadly Ebola struck Kibaale killing 14, and before anyone could blink it was in Kampala. President Museveni quickly issued an alert, and cautioned people to avoid touching, touching.

The Ebola news came while the country is still struggling to come to terms with the mysterious “nodding disease” in northern Uganda. The Kampala government has been accused of “not doing enough” to get on top of the “nodding disease”.

According to a doctor who knows these things, the state of the health sector in Uganda today is worse than it was during the rule of military dictator Idi Amin. And indeed nearly all State-owned – and several private ones like Nsambya – are a shamble and disgrace to the nation.

That said, one of the most fascinating things about diseases in Uganda is that they are strangely political. Today Uganda is fairly open and the world’s do-gooders – the Americans, WHO, Bill & Melinda Gates Foundation, etc, – are throwing some money into the health sector even if the government is delinquent.

However, during Amin’s time Uganda was largely isolated. The strange thing is that Aids, major cholera outbreaks, and nodding disease didn’t strike then. If they had, thousands, if not millions, would have been killed. There was something else.

If you were Amin’s governor or minister, you did not want to risk having a major crisis in your area of responsibility. Because if something happened that annoyed Amin, he could very easily send his boys around, pick you up, finish you off, and dump your body in Namanve Forest. The price of failure in Amin’s time was higher than in Uganda today, so officials feared.

Hospital officials would steal and sell 60 per cent of the medicine, and leave 40 per cent to cover their tracks. Today they steal 101 per cent.

Death

Diseases and other disasters stayed away until Amin fell in 1979, and from 1980, we had a famine in Karamoja and West Nile. The fact that diseases stayed away at the time when Uganda was so isolated and would have been unable to cope was important. The people felt like a higher power was looking after them, and therefore their spirit and faith did not collapse.

Fast forward to recent years. In 2000, northern Uganda was ravaged by a particularly bad wave of Ebola. My friend, and as wonderful a Ugandan as they get, Dr Matthew Lukwiya, who was working at St Mary’s Hospital, Lacor, became the face of the war against that Ebola attack. On December 5, 2000, Lukwiya himself died from Ebola and, in death, became an international celebrity.

At that point, the war against Joseph Kony’s Lord’s Resistance Army was still on, and anti-northern sentiment was still high in most of the rest of the country. The north was suffering horribly, but most of the rest of the country really didn’t want to know.

Ebola changed that, because it made the point that if the rest of us didn’t pay attention and get interested in what was happening in the north, a disease that could consume the country could start from there. So the rest of the country sat and took notice.

Also, the death of Dr Lukwiya, and the way his life was celebrated, offered a counter-narrative to the popular and sectarian view of the time – that the north produced mostly people like Alice Lakwena and Kony. Ebola, you might say, is what eventually re-united northern Uganda with the rest of the country.

Politics

Aids, which ravaged the country mercilessly in the late 1980s through the 1990s, had the same effect. Again, Aids waited when Uganda was a more open country, allowing many international groups to come in, chronicle the mayhem the disease was causing, and get involved in fighting it. Aids challenged the relatively new NRM government, and knocked the smugness out of it. The first result is that the God complex that was developing in the triumphant NRM/NRA died down, because it confronted a problem it could not overcome easily.

Also because Aids threatened the rich, mighty, and poor and humble equally, the government adopted both national and reasonably egalitarian social and health policies to fight the disease.

Once the threat of Aids receded, and ARVs came on the scene, we saw the end of these egalitarian policies. The absence of a collective threat led to the current gulf between the haves and have-nots, and the inequities where the chiefs are sure to get treatment on tax-payers’ money abroad, while the taxpayers are condemned die at home in some hell hole of a hospital.

The present Ebola outbreak that seems to have started in Kibaale, terrible as it is, has forced the Kampala privilegentsia to look over their fences once again. Many years later, in a bizarre sort of way, disease is still the glue that holds Uganda together.

cobbo@ke.nationmedia.com
& twitter@cobbo3