Dying to be President

Meles Zenawi of Ethiopia is only the most recent of a series of African leaders to die while in office. Prof. John Atta-Mills of Ghana passed away in July, and Malawi’s Bingu wa Mutharika before that. Rumors continually swirl about the health of other current presidents, including Zimbabwe’s octogenarian, Robert Mugabe. The health of leaders is often veiled in secrecy, which can make it difficult to plan for potential transitions.

In the days immediately following the death of Atta-Mills, many of those I spoke to in Ghana were sad, but also a little angry. How could he dance and jog on his return from a medical check-up in the US when he knew he was so sick? Former president Jerry Rawlings gave a frank, if rather callous, assessment on the BBC: “I think had he been advised and done something wiser, you know, earlier on, he could have probably survived, you know, for, I don’t know, for another six-seven months…” There was a feeling expressed by some people I spoke to that Prof. Atta-Mills should have taken time off, and taken care of himself. This calls to a more general problem — the secrecy enshrouds the health of leaders sets up governments for moments of crisis. Fortunately, Ghana and Malawi have both managed to pull through with successful transitions, but others may not be so lucky.

Songwe and Kimenyi examine this issue in their op-ed, “The Health of African Leaders: A Call for More Transparency” at Brookings:

As the number of ailing presidents increases, three major issues are emerging: First, the continent demands more transparency regarding it’s leaders’ health; second, democracies need clear term limits; and third, successful democratic transitions require transition processes outlined in the constitution, that are understood and familiar to all. With these safeguards in place, the risks of administrative paralysis, political tension, internal conflict and instability that characterize situations in many African countries could be mitigated. Unfortunately, in many African countries today there is a general lack of clarity around term limits and even less clarity and agreement on succession: Term limits are changed on a rolling basis, and constitutions are amended frequently.

Rwanda’s next president

Published online January 16, 2011.

There was quite a kerfuffle following President Kagame’s last visit to Uganda in December 2011. The hoo-ha that played out over the airwaves, news pages and Twitter had nothing to do with the trip per se – relations between Presidents Kagame and Museveni have been warming over the past six months and such visits are becoming the norm – but rather with repeated questions about presidential term limits in Rwanda. Amending the constitution to lift term limits is a relatively new trick in the handbook of institutional manipulations. President Museveni, together with the Ugandan parliament, steamrolled right through term limits in 2005, paving the way for a 30-plus-year reign for the former rebel leader. By the time Uganda marks its Jubilee in October of this year, just a few months after Rwanda’s 50-year celebration, Yoweri Museveni and the National Resistance Movement will have held power for over half of the post-independence period.

Whether or not Kagame will attempt to follow in the footsteps of Museveni and lift term limits in advance of the next presidential elections in 2017 is a tired argument. Personally, I doubt that he will do so, but neither do I think it would be at all a difficult task. But that is neither here nor there. Just as there will be a South Africa without Nelson Mandela, there will be a Uganda without Museveni and a Rwanda without Kagame. Though there will undoubtedly continue to be discussion regarding Kagame’s candidacy up until 2017, ultimately the more productive debate is the extent to which promising and talented individuals have opportunities today to become tomorrow’s leaders.

I’m not going speculate who the next president will be, but I’d like to float the idea that Rwanda’s next head of state will be a woman. Rwanda has led the way in bringing women into politics and positions of power, and women around the world are making inroads every day into politics, business, academia, and beyond. As in Uganda’s National Resistance Army and Movement (NRA/M), women have held key positions in the government and party of the Rwanda Patriotic Front (RPF). The presence of women in politics has been steadily increasing since 1994, and in 2003 Rwanda joined Uganda, Namibia, Mozambique, South Africa, and several other countries in implementing a gender-based quota for legislative seats. In the 2003 election, women won nearly half of all seats in the legislature.

Women have also been well represented in other areas of government and civil society in Rwanda, and have played key roles in rebuilding society in the aftermath of the genocide. Many women have been elected gacaca judges, and women groups have worked to address a wide array of issues, from health to microfinance. As of 2008, Rwanda is home to the only majority female parliament in the world. Women today hold several key ministries, including the Ministry of Foreign Affairs (Louise Mushikiwabo) and the Ministry of Health (Agnes Binagwaho), as well as senior management positions in institutions such as the Rwanda Development Board (RDB). And regardless of your view of her, Victoire Ingabire has emerged as the figurehead of the official opposition in Rwanda.

While women representatives do not alter policy or the playing field overnight, research suggests that women’s participation in politics has the potential to affect both policy and perceptions about women’s abilities. Studies in India found that local politicians invest in public goods that are most important to their lives, and that types of investment differ by gender and location. For example, women tend to invest more in drinking water than their male counterparts. In Rwanda, women parliamentarians have been credited with pushing for the reform of laws regarding issues such as inheritance, discrimination against women and sexual assault.

In addition to the possibility of affecting policy outcomes, some research shows that the presence of women in politics helps to alter perceptions and prejudices about women’s ability to lead and govern. A group of researchers from the US and India found that where women in India held elected positions in local government, initially with the help of gender quotas for these positions, men tended to hold less negative stereotypes about the efficacy of women in positions of authority.

Additionally, exposure to female leaders tended to increase people’s perceptions of women’s abilities over time. Although community members may rate poorly the first woman elected to a position, her successor would generally be rated more favorably. Exposure to women in politics, at least in some settings, appears to reduce negative stereotypes about women’s abilities to govern, and will likely encourage more women to enter the ring.

In Rwanda, many women have had opportunities to develop the skills and experience to lead. While the debate on term limits rages on, it is important to think beyond personalities—however formative or influential—and focus on the processes through which leadership is reproduced. Rwanda’s political system, its many flaws notwithstanding, has allowed women to participate in government and policymaking to a greater extent than in many other countries. These opportunities for leadership will help shape the next generation and next era of Rwanda’s history. It would not be surprising, therefore, if Rwanda’s next president comes out of this network of powerful and promising women leaders.

Women’s leadership in Rwanda has evolved alongside the innovative approaches the country has tested in its recovery from conflict. Like other challenges Rwanda faces, both general and gender-specific, from poverty to maternal mortality, it is to processes and not individuals that attention should be paid.  Despite urgent challenges, real opportunities exist for ordinary citizens, men and women alike, to grow up in good health with a good education. The impact of public health and education policies on Rwanda’s political development may not be obvious now, but will eventually become evident. The democratic space in Rwanda is still being tested and shaped, discussed and critiqued, pushed and pulled. Ultimately the future lies not with an individual, but with a system that allows the next generation of leaders to emerge.

Researching Nodding Disease

Nodding disease is a syndrome that was first reported in Tanzania in 1962, has been spreading in South Sudan and Uganda more recently. The number of cases in northern Uganda appear to have increased at a particularly fast clip in the last year. Nodding disease sounds made-up, but it is very real and often fatal, and is becoming a growing problem in the region. Most problematic is that the causes of nodding disease are still unclear, although there appears to be a connection with a parasitic infection from Onchocerca Volvulus, which causes river blindness.

Adult Onchocerca volvulus worms (WHO)

The Daily Monitor ran a story on December 23, 2011, quoting director of health services in Uganda, Dr. Jane Achieng, as saying that there are around 2,200 reported cases of nodding disease in Uganda (most in Acholi sub-region) and that the first case in the area had been reported in 2009.

A letter to the Daily Monitor written by Dr. Ddungu, of the Uganda Programme on Cancer and Infectious Diseases, notes that a similar phenomenon was studied in Kyarusozi sub-county as early as 1991. A 1992 study by E. Ovuga et al. on this topic was published in the East African Medical Journal.

Nodding disease appears to afflict children between the ages of 5 and 15 and is usually diagnosed by the characteristic nodding it produces in children. The head nodding (HN) is often triggered by eating or seeing familiar foods, or when a child becomes cold. Winkler et al. (2008) write:

HN represents a repetitive short loss of neck muscle tone resulting in a nodding of the head, sometimes associated with a short loss of muscle tone of the upper extremities. Loss or impairment of consciousness may be present, but not always. To date HN is not mentioned in any classification and it remains unclear whether it represents a seizure disorder and if so, whether it belongs to the group of generalized or partial seizures.

Nodding disease appears to be a growing problem that warrants serious attention from the government. The CDC and WHO have been involved in investigating its causes, but there has been relatively little information available to the public about this illness. I’ll be posting information on the published medical literature on nodding disease, as well as news updates and commentary as they become available.

Sedition is no more!

Time to break out the champagne! Uganda’s archaic sedition law has finally been scrapped, in a much awaited decision made today by the Constitutional Court. This means that a number of Uganda’s journalists will have court cases and charges dropped (though many other charges still remain). Among them include those who have been charged with sedition for likening the Museveni regime to that of Ferdinand Marcos, for discussing Uganda’s role in  the death of John Garang, and for discussing Uganda’s role in the July 11 Kampala bomb attacks, among many others.

The petition to the Constitutional Court on the issue was originally filed in 2005 by the Independent’s Andrew Mwenda (formerly of the Daily Monitor), who was quoted today by AFP saying of the ruling, “Today is not just a good day for journalists. It is a good day for all Ugandans.”

Amen!

free and fair elections…or else?

“Uganda’s past elections have been marred by reports of fraud, intimidation, and politically motivated prosecutions of opposition candidates. If these upcoming elections follow that same pattern or worse, it will put the United States and our relationship with Kampala in a very difficult position. We might have to consider restrictions to our assistance and limiting our engagement with Uganda’s security forces.”

That is U.S. Senator Russ Feingold writing in today’s Daily Monitor. While the political process is by no means completely free or fair, and while journalists regularly report to the Orwellian titled Media Crimes Department of CID (Criminal Investigations Department), I find Mr. Feingold’s op-ed pretentious.

“Divisions and upheaval surrounding February’s elections could undermine the country’s unity and potentially its stability. It could also weaken the government’s international reputation and partnerships. Therefore, it is critical that the government take steps now to build public trust in the election process and the country’s democratic institutions. As a true friend to Uganda, [USA] should press them to take these steps and provide support as appropriate. The stakes are too high to ignore these issues.”

I think many Ugandans are quite aware of the high stakes. Living through decades of political upheaval and violence, which occasionally still rears its ugly head, leaves memories and losses that are not easily forgotten. In any case, people certainly do not need a U.S. senator to tell them how high the stakes are in their own country. Feingold’s thinly veiled threat to pull back U.S. military support of the UPDF is more likely to annoy the country’s leaders than send them running for political reforms. I do not disagree with the substantive points he raises, but his words come across as those of a parent warning his rebellious teenager that bad behavior will result in an a reduction of pocket money. And that’s annoying.

NYT Uganda coverage

Denise Grady explains how a woman who caught the Marburg virus in Uganda has become a medical celebrity. And Uganda tourism takes another blow. Damn.

“Michelle Barnes never imagined that her vacation to Uganda would make her a medical celebrity.

Ms. Barnes, 44, became ill in January 2008, a few days after returning home to Golden, Colo. At first, she seemed to have a typical case of traveler’s diarrhea, but she soon worsened. She broke out in a rash and developed abdominal pain, terrible fatigue, weakness and confusion. Blood tests found her white-cell count low and her liver and kidneys beginning to fail. She was hospitalized, still deteriorating. Her blood was taking too long to clot, and her pancreas and her muscles were inflamed…”

Not to mention, while demonstrating much concern for the doctors and staff in the US, there is zero discussion of the spread of the virus in Uganda from what I can tell.