Janet Anyango: unaffordable healthcare

26 July, 2008

“Janet Anyango’s son Yuventino suffers from cerebral malaria, and Janet has faced a constant struggle to care for him. But with little or no income and six other children, it’s been virtually impossible for her to cope. As Janet recounts her story, further tragedy strikes” See this video on the Guardian Katine website.

This video is gutwrenching…there is no other word for it.

It must prompt some hard (evaluation) questions in the minds of many visitors to the Guardian website. Such as:

  • Why are the necessary drugs not available in the health centre?
  • Why cant AMREF help her directly, with the money the Guardian has raised?

In the field of maternal health it is common to carry out a detailed analysis of the causes behind deaths during childbirth (called maternal mortality audits) and in cases of “near misses“, where the mother almost dies. This makes a lot of sense – if some one has died, when they should not have, then every effort should be made to learn as much as possible from this tragedy, so it will not happen again. Their lives deserve respect.

Janet Anyango’s story deserves the same kind of attention. While here in Uganda on my second visit to Katine I will be discussing Janet’s story with AMREF and others. AMREF staff in Kampala have already pointed out to me that there are a number of points in Janet’s story where good decisions could have made a big difference. And where AMREF’s support to the health services in Katine could increase the chance that such good decisions will be made in the future. For example:

  • the distribution of treated bednets. Did the family receive any from the health services?
  • the availability of early diagnosis. Early treatment is better than late
  • the correct diagnosis of malaraia, versus a fever of another kind
  • the appropriate prescription of drugs
  • the availability of those drugs
  • the correct use of those drugs

All this considered, it is still hard not to feel angry at someone for the empty shelves in the health centre. More hard questions need to be asked about what is wrong with the supply chain. There are likely to be both local and national reasons. I will follow up the local reasons next week, in Katine. Some of the national level reasons have already been explored by others in Uganda, incuding recently by the mass media (see the weblink at the end).

The video has already prompted me to ask how AMREF is responding at the national level to this problem of lack of availability of essential drugs. One of the criticisms that has been made of area-based projects like the KCPP is that they ignore the importance of national policies and practices. That is where changes are needed, it is argued. From my discussions with AMREF staff in Kampala yesterday it is clear that AMREF are engaging with national health policies via a number of channels, including on the issue of malaria drug supplies. I have encouraged AMREF to document that strategy and publicly report the progress being made (by AMREF in association with other important actors in Uganda). That work needs to be seen, including all the difficulties involved. Because this is a public issue that needs continuing public visibility.

On that theme, I hope to include some links here on related actions already being taken by others in Uganda. Here is one


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