Saturday, August 13, 2011
The short film "Empty Handed," produced by Population Action International, addresses problems of access to contraception in Uganda. The film highlights the fact that women know about contraception, and want it, but due to weak distribution systems and poor government support, it is often unavailable at health posts when they make the effort to seek it out.
A few weeks ago, there was an article in the New York Times about maternal mortality in Uganda. The two issues go hand in hand. Contraception prevents not only unwanted pregnancy, but also pregnancy-related deaths.
While both stories focus on Uganda, the problems they describe exist all over the world. Especially poignant is a comment by a warehouse manager that somehow Coca-Cola is able to restock distant villages with its product in a matter of days, while the government health system delays distribution of medications for months. It´s not that it can´t be done, it´s that multiple pieces of the distribution system are broken.
The film and article both address the fact that donor money could be part of the problem. The warehouse manager informs us that 95% of the medications are paid for by donors and only 5% by the government. The NYT article reports that the Ugandan military recently purchased fighter jets. The more donor money received, the less responsibility the government takes for its own health care system. Donors may pay for medications, but are often not allowed to pay government workers´salaries or assume control over distribution systems. Donor agencies cannot and should not take the place of government run ministries of health. But if the government moves funds from the health budget to the military, assuming that outside help will cover the health care of its citizens, then maybe the donation is hurting more than it is helping.
In my experience, I have seen beautiful, new health clinics with no staff, I have seen boxes and boxes of medication with no transportation to the clinics, and I have met skilled health staff who do not have all the tools they need to use their skills to save lives. Women know how to prevent having more children than they want, but when they go to the clinics, they come away empty handed.