In June this year, 52-year-old, Dr Emmanuel Mukunya was employed at Nakaseke Regional Hospital as a general physician. He died of COVID-19 on July 19th, 2021.
Another doctor Charles Kiggundu, an Obstetrician and gynaecologist who advocated for reproductive health and rights and talked to us as journalists consistently under the HEJNU umbrella also died. Dr. Kiggundu was born on April 17, 1965, in Luwero District, and died from COVID-19 complications on Dec 29, 2020, aged 55 years.
Family and friends describe Mukunya as a man who was dedicated to his job. His wife, Rosette Mukunya says her husband’s life revolved around home and work. As journalists we remember Dr. Kiggundu as a human rights voice and as an educator who consistently educated us about unsafe abortion and always found time to explain to journalists anything regarding reproductive health and we wrote this tribute about Dr. Kiggundu.
Dr Mukunya and Dr. Kiggundu are out of the 65 doctors that are believed by the Uganda Medical Association (UMA) to have succumbed to COVID-19 between 2020 and 2021. Mukunya left behind three children, the eldest who did their Uganda Certificate of Education examinations in 2020.
According to the country’s workman compensation law, families of doctors such as Mukunya and Kiggundu are supposed to receive the equivalent of his monthly salary for a period of 60 months. This can be paid in a lump sum or in a periodic way.
Family members of deceased doctors can get as much as 180 million shillings or even more depending on the cadre level of the deceased. While this money cannot resurrect the deceased, the families can pay for some expenses and help them get back on track. The money can be a game-changer for the families, unfortunately some might not be able to get it.
“We are struggling financially. I need to look after the children but also pay their fees. Schools are supposed to start next year but I don’t know where I will get the fees from. Life is not been the same since the doctor passed away. Before I never used to worry about such things but now I do. I need that money because it will help me look after the children,” she said.
Ministry of Health officials and their counterparts in the Ministry of Gender, Labour and Social Development argue that only doctors who worked on COVID-19 treatment wards and came into contact with known COVID-19 positive cases deserve the compensation since tracing where they were infected is possible.
The minister of health, Dr Jane Ruth Aceng has on more than one occasion insisted that the majority of COVID-19 health worker infections took place within communities. “Many of these infections took place outside health facilities. We have not registered any infection in the COVID-19 treatment wards,” she said.
Mrs Mukunya says when her husband was not at home, he was at work. “He always spent most of his time at work. Even on Sunday, you would find him at the hospital. He enjoyed his work.” Towards the end of June, Dr Mukunya developed a cough on a Friday. When he went back home, his wife, concerned about the coughing and asked whether he had gotten.
“He told me that he had gotten treatment but the cough seemed to worsen. On Saturday night, I had to wake him up because he was coughing too much. He reassured me he was getting treatment but promised to go and maybe change the course of treatment the next day,” Mrs Mukunya recalls.
On Sunday morning, Dr Mukunya left his home early that was located within the hospital premises and went to work. He was still coughing. Unknown to him and his family, those few moments before he left his home would be his last. “When he went to work he was still coughing. They tested him for COVID and he tested positive. They didn’t allow him to return home. He was sent to Mengo and later referred to Mulago where he passed away on July 19,” Mrs Mukunya said.
Since Mukunya was working in the general ward of the hospital and not the COVID-19 treatment ward, tracing where he got infected with COVID-19 might be next to impossible due to the nature of the disease. As such, his wife and three kids might not get his workman compensation.
The government during its response to COVID-19 prioritized the availability of PPE on treatment wards. Doctors treating persons infected with COVID-19 at designated treatment facilities always had gloves, full-body suits and even facial masks. In a day, these health workers would wear as many as three bodysuits and change their facial masks every three to four hours.
However, their counterparts in other wards were not as lucky. In a story published by URN in June this year, an intern doctor working at Mulago National Referral Hospital narrates how she is forced to use a disposable facial mask for more than one day because the country’s biggest hospital did not have enough PPE on other hospitals wards.
Doctors under the Uganda Medical Association are now up in arms demanding the compensation of their colleagues who succumbed to the disease. They say on many occasions, doctors in other wards were not provided with personal protective equipment which exposed them to COVID-19 infections that led to death.
Dr Samuel Odongo Oledo, the President of UMA says health workers on other wards were exposed to the disease by asymptomatic patients. In an earlier interview, Dr Charles Olaro attributed the lack of PPE to poor planning of health facilities. Olaro when asked why some health facilities lacked PPE he said, ” Ideally all health facilities are supposed to have enough makes for all members of staff but shortages may be experienced when health facilities are not able to order for masks on time.”
The lack of PPE and the resulting deaths of health workers in other hospitals left patients stranded with no health workers to treat them. In June 2021, COVID-19 wards at some hospitals in Jinja and Gulu had no health workers. Many feared for their lives.
Dr Florence Tumumisirize, the Director of Jinja Regional Referral Hospital says that they were facing a human resource problem because the staff was scared of working on COVID-19 wards. “Someone comes and tells you that their family refused them working on a COVID-19 ward. What can you do? You cannot force them to work if they do not want to,” she said.
The UMA leadership says the government failed to protect all health workers despite their dedication to treating Ugandans. Dr Herbert Luswata, the General Secretary of UMA says it’s more than a year since these health workers succumbed to the disease while doing their jobs. Luswata says the government’s silence on the issue of compensating their colleagues is concerning.
Dr Luswata says the government is using an old law to deny the families of doctors what should be there’s. He suggests the law be amended to cater for all health workers. According to Dr Luswata, if the government can afford to compensate the families of the victims of the Machete killings in Masaka or even set aside more than 20 Billion Shillings for the former leaders like the Vice President and Prime Minister who are still alive, then doctors need to be catered for too.
The compensation of deceased health workers is one of the demands the doctors under UMA want the government to respond to in their ongoing strike. Now in its third week, Dr Luswata says the strike will not be called off unless those who died are compensated.
“Some of these doctors collapsed during ward rounds and died due to COVID. We cannot pretend that they didn’t die serving their country. It is only fair that their families are looked after. We have met the president and several government officials but unless these monies are released or an understanding reached, we shall not call off the strike even if our other demands are met,” he said.
Despite such threats, some government officials maintain their position that only health workers who can prove how they were infected with COVID are entitled to compensation.
Martin Wandera the Director in charge of the labour directorate at the Ministry of Labour, Gender and Social Development says compensation applications for deceased health workers will be handled on a case by case basis.
“These cases are all unique and will be handled on a case by case basis but as the law states, only health workers who can prove that they were infected at the hospital can apply for compensation, he said. According to Wandera, the burden of proof of infection lies on the health worker or their family in this case.
However, Stanley Oketcho, a labour law expert with GEM Advocates, says in the case of COVID-19, the burden of proof lies on the employers and not the employee. He says the Workers Compensation Act of 2000 provides that compensation shall be payable by the employer who last employed the worker during the period of twenty-four months.
The burden of proving that the disease was not contracted while the worker was in the employer’s employment instead squarely lies on the employer. Oketcho says that due to the nature of the disease, all health workers should be entitled to be compensated if they are infected with COVID-19 or succumb to it.
“The health worker by nature of their work need not prove that they contracted covid while at their duty stations like Hospitals. To me, it is occupational. The law in fact places the burden on the employer to prove otherwise. Sober governments have specifically legislated specific laws to cater for such instances. I wonder why the Minister of Health has not yet scheduled Covid 19 under the Act. This delay three years into the Pandemic is inexcusable,” Oketcho said.
Following their meeting with President Yoweri Museveni, a committee has been set up to look into the compensation of health workers.