Day: March 10, 2009

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Cabinet Reshuffle: Votes > Performance

I know, this should be obvious. The point of Museveni reshuffling cabinet was not primarily to ensure that the most qualified people become ministers of their respective ministries, but to secure votes for the not-so-distant 2011 presidential election. I know, but does government have to blatantly admit it?

In a recent interview with Uganda’s Independent magazine, the Vice President of Uganda, Professor Gilbert Bukenya gave the following response to the following question:

Q: How do you regard the newly appointed cabinet; is it the best the President would produce?

A: This [cabinet] is a perfect combination which is going to lead us to the next general election with developments that will help us generate more support as the NRM party from the masses. The new cabinet has people whom I think are great performers and this is what the President needs as we move toward the elections in 2011. This does not mean that the previous cabinet did not have performers but I think these are vote winners.

And there you have it. Votes > Performance. No shame, no beating around the bush.

My other favorite part of this interview? In regards to his supposed shenanigans as reported by the Ugandan media:

“What these reports have done to me is denying me a chance to dine and mix with people in open places because during such times stories are made up, actually it’s because of that that I decided to construct gyms and saunas in all my homes so that I work out privately.”

Oh, really? Phew. Gyms and saunas in all your homes? Thank goodness, I was worried.

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Who Cares About Cancer?

Cancer is not captivating. Or, at least, in sub-Saharan Africa it doesn’t seem to be when compared with, say HIV/AIDS or malaria. Why is that? Is it the sheer numbers? The assumption that you are more likely to die of a communicable disease before you will ever develop cancer in this region? Or maybe, like global warming, it’s a scary topic that it is easier to put off thinking about until tomorrow. Or the next day…Or the next day…

It seems like a lot of friends of friends are dying or have died from cancer recently in Kampala. On Sanyu FM this morning, a caller asked for advice on how to handle his relationship with a girl who had terminal cancer. While I have long been interested in health and healthcare in Uganda, I have never looked much into cancer prevalence or treatment. I assumed, at any rate, that treatment was prohibitively expensive for most people when available at all. But do we even have accurate figures on who has cancer and where? I went circles around the WHO Uganda site to find any figures. At best they have projections for 2005, based on 2002 burden of disease estimates. Not exactly what you might call up-to-date or very accurate.

I next went to Uganda’s most recent Demographic and Health Survey, from 2006. I was shocked to find that in searching “cancer”, there was a SINGLE result, out of 501 pages! It was a note on reproductive organ cancer made in reference to the Sexual and Reproductive Health Policy Guidelines that had been developed in 1994.

According to WHO’s stats, cervical cancer is the most common form of cancer in women, followed by breast cancer. In men, the most common is prostate cancer, followed by esophageal cancer. Lung cancer is surprisingly low on the list (9th for men, not even ranked for women), given the number of people I see smoking around Kampala (of course this is not indicative of the rest of the country, but still, Kampala-ites are more likely to be diagnosed anyway I would imagine).

Uganda does have a Cancer Institute, which is almost definitely underfunded, understaffed and ill-equipped, though I haven’t done much in-depth investigation of the place. While cancer may not yet be killing as many Ugandans as malaria or diarrheal disease (which primarily affects children), I have a strong suspicion that it is much more prevalent and pernicious than meets the eye. It may not be captivating, but it is killing. More on this to come…

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