Senior house officers (SHOs) deployed for post-graduate or specialist training at various hospitals across the country have declared a nationwide strike effective Sunday over salary arrears.
The specialist doctors held a press conference at Mulago hospital on Saturday, saying that while they are entitled to a monthly allowance of Shs 2.5 million, they haven’t received the money since October and their calls for payment to the ministry of Health have gone unanswered.
According to Dr Robert Lubega, chief resident at Makerere University college of health sciences, the government is in a habit of not remitting allowances to first-year students for the first 3-6 months of reporting to work-study training.
“Most recently, the current second-year lot of SHOs based at Mbarara Regional Referral hospital missed their payment for the first 6 months without any explanation as to why the allowance didn’t come when they were in the first year,” he said.
Currently, the doctor says first-year officers based in Mulago, Kiruddu, Kawempe and Mbale Regional Referral hospitals have not yet received their allowances since they reported to the work-study sites in October last year. Those in Kabale hospital haven’t received theirs since August 2022.
“We give our notice of a national senior house officers and fellows industrial action. SHOs are senior medical officers, newly registered with the Uganda Medical Practitioners Council who are undergoing post-graduate study training to become specialists in various specialities of medicine. These specialities include orthopaedic surgery for bones, neurosurgery, internal medicine to become physicians, paediatrics to treat children. So those are the ones we call senior medical officers, and they are actually very experienced medical doctors who have come back to upgrade and become specialists. They are indeed the workforce of all super-specialised government facilities. An SHO is the people doctor [whose] typical day starts at 6 am with ward rounds, the head to the theatre to perform life-saving procedures on patients that they had to prepare the previous day,” said Lubega.
According to a statement signed by four representatives of SHOs based at the different universities, prior negotiations with Dr Diana Atwine, the permanent secretary in the ministry of Health last year only resulted in partial payments for some.
It should be noted that strikes by medical workers have become a perennial procedure – laying down tools whenever salaries delay or are not enhanced as promised, affecting the operations of hospitals across the country since they majorly rely on doctors in training to run health facilities considering the very low doctor-to-patient ratios in the country.
Dr Hebert Luswata, general secretary of the Uganda Medical Association (UMA) says striking is their last resort as healthcare managers tend to pay a deaf ear whenever they raise their concerns in a cordial way.
He now says that apart from paying the SHOs arrears, the government needs to employ those who finish training as senior medical officers as this will have them get a fixed wage rather than allowances. He notes that there is already a 70 per cent gap to fill in as only 30 per cent of vacancies for specialists in regional referral hospitals are filled.
“They need to provide housing near hospitals where they work. SHOs work 24 hours a week and are the first line of specialists. This is why the first doctor to die in the recent Ebola outbreak was Dr Mohammed Ali who was an SHO of KIU working in Mubende Regional hospital,” he said.
The resolution to pay senior house officers a monthly allowance was birthed in 2016 when President Yoweri Museveni while attending the UMA general assembly said that not paying these graduate doctors was an act of modern-day slavery. Payment of SHOs would then start in July 2021, giving them a monthly allowance of Shs 2.5 million.
Countrywide, there are 692 SHOs deployed in different parts of the country. While one might argue and say this is a small negligible number and may not affect the daily operations of the hospitals, Luswata says SHOs supervise medical interns and their absence means the junior doctors will work unsupervised creating a risk of mistakes in healthcare.
Atwine didn’t pick up her calls to respond to these concerns when contacted. The SHOs strike comes at a time when broke government has announced no borrowing in the next financial year, no salary enhancements or budget increments for all government ministries and departments according to ministry of Finance permanent secretary and secretary to the treasury Ramathan Ggoobi.
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