By Roy William Mayega
The person in this picture is Dr. Musiitwa Michael Mugwanya. He was the person who immediately succeeded me at Bukomero Health Center IV in Kiboga District. I worked in Kiboga District as a Medical Officer from 1999 to 2005. When I left, he took over. At the time, the district was extremely rural. These crop of doctors was the most dedicated group you can ever imagine. They came into the wilderness that was Kiboga, right from Medical School, with their very young families.
They were the pioneers of the Health Sub-district system. They worked in deeply rural health facilities, no mobile phone network, extremely rough roads, extremely under-staffed, in the land of ‘Nakawunde’. You could only send an SMS to a loved one at a specific point, facing a specific direction, phone-raised, perched on top of an anthill in the bushes overlying Bukomero Health Center, and it had to be at 8pm! They worked with utmost dedication, with the conviction that a health system had to be built from the grass-roots.
They worked with budgets of 250,000/= for a HCII, 750,000/= for a HCIII, 4,000,000/= for a HCIV PER QUARTER from the PHC Conditional Grant at a time when cost-sharing was abolished. They built the Health Center Level IVs (Bukomero and Ntwetwe) from the scratch. We did the first surgeries to ever be done at Bukomero HCIV with him and the visiting surgeon Dr. Jose Jombwe, in a Surgical Camp organized by the Association of Surgeons of Uganda. “Abo na bashaho ababaaga abantu”, shouted a cattle keeper from ‘Lukoola’ (the flat grasslands to the north of the district) we strolled by with Dr. Musiitwa.
The theatre came to life and has not relented since. With funding from Irish Aid (thanks to the excellent support of the fearless Connie Nekessa-Ouma and her team), we worked with Dr. Musiitwa, Dr. JB Serebe and the late Dr. Mugenyi Kizito to lead the location planning and construction of at least 8 new health centers in the most rural areas of Kiboga, building on the strong work of our predecessors, Dr. Moses Mutebi Nganda, Dr. Emmanuel Batiibwe and Dr. HDW Megere. Places like Kisala, the extremes of hard-to-reach, infested with deadly serpents and witchdoctors.
With Dr. Musiitwa, we partnered with World Vision to increase immunization outreaches from the 4 that were traditionally supported by PHC to 12 per month. A few months after the Surgical Camp, I handed over to Dr. Musiitwa. When several of us left to work in Kampala and beyond, this crop of doctors stayed on, fully dedicated to health care in the rural areas. He was later to grow in the system and become the Medical Superintendent of Kiboga General Hospital, and later the District Health Officer.
He survived a Kidney transplant undertaken over 10 years ago – and went back to Kiboga. He later became my student, at the Public Health training program at Makerere, and on completion, went back to Kiboga.
One time, I told him that there comes a time when one has to grow and move, but he was not the type to listen to that – he stayed on in Kiboga – he said the people there needed him. Extremely focused on his work and always on the ground.
He has passed away die to COVID-19. May the Lord touch his family in this time of utmost grief; may the Lord write him in his book of life, as well as all the front-line health-care workers who have soldiered on in this very fragile health care system, some losing their lives. And may the Lord deliver us from this deadly pestilence. People like Dr. Musiitwa are the giants of our epoch, the unsung heroes of the overburdened health care system.