Fighting for healthcare reforms in Uganda

In order to understand Betty Nangira's interest in healthcare, we have to go back to the very beginning, to the moment of her birth. In many African communities, children are named after the time of day or season in which they were born, or after their ancestors so that they may continue to live on in spirit through their grandchildren.

In Uganda, the Basamia and Bagwe ethnic groups have a unique naming tradition — if a baby is born on the way to the hospital, it is called Wangira if it is a boy and Nangira if it is a girl.

Scholar Betty Nangira is no exception to this rule. "I was born on the road while my mother was on her way to a health center," says the young researcher at Makerere University. "She couldn't get there on time. So that's why she called me Nangira."

The circumstances of her birth inspired Nangira to look for ways to ensure greater accessibility to proper healthcare services — especially for people living in rural areas of Uganda.

Although, on paper, medical services in Uganda are free in all government health care facilities, the unfortunate truth is that patients often have no other choice but to foot the bill themselves. Many families are forced to spend huge sums of money on health services, contributing to a spike in poverty levels.

Lack of political will

Nangira plans to investigate various issues relating to health matters in Uganda in order to come up with proposals on how they can be addressed. Among these is the government not setting aside enough funds for the health sector, despite evidence that it is crucial for economic growth. Nangira says that public funds are often allocated to security at the expense of citizens' health.

She puts some blame on regional leaders for failing to address the problem by not expressing their grievances to the national government. "A mother from a poor family cannot pay for health services," she says. Although she left her village to pursue her PhD studies at Makerere University, Nangira vividly remembers her early life and the daily struggles of the people around her.

Frequent strikes by healthcare workers — with many demanding a pay rise as well as better working conditions — also reflect a dissatisfied workforce and contribute further to the deterioration of the health sector. Some staff members even steal medicines from government healthcare facilities, which they sell to patients at their private clinics or pharmacies.

Betty Nangira is well aware of the challenges ahead if she wants to bring about change. "Most health workers are demoralized because they are paid peanuts," she says. "I know what I'm pursuing is somehow political and it will be difficult to easily get the information that I need from those in charge of various health facilities. Most of them will evade my questions or keep on postponing our appointment," she predicts.

Putting trust in traditional medicine

Many people in Africa still rely on traditional medicine as their primary source of healthcare. Traditional healers and local midwives are trusted by their communities but face increasing opposition from the government. Betty Nangira wants to investigate their work and better understand their contribution to African society, especially in rural areas.

She knows it will be hard work to get the information she needs. But she hopes that her research, which is supported by the Gerda Henkel Foundation in Germany, will pave the way for meaningful reforms in Uganda's health sector and improve access to healthcare for everyone.

This article is part of a special series "African Roots" investigating historical dimensions of Africa, a project in cooperation with the Gerda Henkel Foundation.