small comfort

At least Bundibugyo is not alone  . . it seems there is a nation-wide crisis of medicine supply.  Link to this article from the New Vision (national paper)  http://www.newvision.co.ug/D/8/13/675331   in which the districts blame the National Medical Store for inefficiency and the NMS blames the districts for corruption.  From our perspective both are true:  not enough money to buy the drugs, not enough supply within the country, obscure paper trails, hands dipping into the till at every point along the supply chain, lack of accountability.  But the effect is this:  at our local health center, the only medicine available right now was purchased privately by our donors through us, and is locked in a store which only I access.  So the peadiatric ward is overflowing, while frustrated outpatients increasingly abandon the effort to get care.  Any glimmers of hope?  Small ones.  A national consortium has formed to address the issue.  Locally, in our weekly staff meetings I ask hard questions bout money and how it is spent, and our staff is becoming more politically sensitive, wondering who benefits from the current messiness (the first step in understanding why a non-functional system persists).  The young World Health Organization doctor who has been appointed to help the district seems to be struggling to get a hold on the situation, and if he does not give up that may bear fruit.  Scott talked to the Chief Administrative Officer again yesterday and he still strikes us as a person who is moving within the system in the general direction of justice.  Meanwhile a kid with malaria (number 1 killer in Uganda) will be sent away from the hospital without treatment and told to forage in the local private drug shops, where the recommended first-line treatment goes for the equivalent of several days' pay.  What will happen?