Uganda

Ridiculous Tax Coming

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So I hope you had a great day today. I also had a bad day, after learning that all my insurance policies are going to incur an extra 0.5% for the flimsy excuse that the Insurance Regulatory Authority needs money to carry out training for the masses. This is the verbatim, released September 10th 2012:

The Insurance Amendment Act 2011 provides for an Insurance Training Levy (ITL) that shall be imposed on the Gross Direct Premium charged for all policies issued by Insurance companies. In consultation with the Minister of Finance, the rate of the Levy has been set at 0.5%.

The levy, which is effective 1st October 2012, shall be charged on all new policies issued, renewals and endorsements, for as long as these attract an additional premium. 

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When life (almost) cost 12000 UGX

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I put this off for a long time, Chris is since well recovered, but i think it needs to go on the record. My apologies if you have read/heard this story before. The exact time frame for this blog was about June of this year

We call it helter skelter – when you shake up a bee hive or throw a snake in a room, or have a patient roll their eyes as they struggle for their last breath. Some are premeditated, but others are purely a result of sheer negligence, bordering on incompetence. This was the scene at Nsambya Hospital’s St. Gonzaga ward – as 25yr old chris mpanga suddenly suffered a bout of piercing pain in his chest.

He is admitted for the 3rd time this year, second time in this ward, no wonder a few of the nurses call him by name. This particular day, might be the last to say his name.

Chris suffered a fracture in his femur, after a boda boda RTA (Road Traffic Accident). 2 months later, he is making progress on the fracture, and has mastered the use of clutches. But this is not why Chris is re-admitted. Chris is just over 100Kg in body weight, and for the whole first month of recovery from the accident he will be at risk of Pulmonary Embolism – a condition where blood clots develop in the blood vessels, and if not treated, could end up flowing into the heart and/or lungs.

As healthy as he looks, his “silent killer” condition could result in sudden death.

Pulmonary Embolism is feared in almost all cases of RTAs where there is a significant amount of bleeding (internal), and/or deep or large open wounds. It’s advisable that victims be placed on Clexane – or any drug that thins blood, just enough to disintegrate any clots. However, Clexane may not be administered without regular follow up – and as such, all patients under this treatment have to undergo a regular (as regular as every half hour, in extreme cases) INR test, which tells medical practitioners whether or not there is too much thinning happening to the blood, otherwise it (blood) would lose the ability to perform its normal functions. Too little Clexane, would not be effective against the clots, and as such a fatal embolism could find its way to the heart and lungs.

For Chris, his 3rd admission is a result of wrongly prescribed Clenaxe medication. Granted, he is over-weight for his height, but he has taken varying dosage of this medication, from as low as 40mg to as high as 120mg. With every admission, there is a sad realization, that he was “under-dosed the last time”.

The nurses attending to Chris are not allowed to have any say, until a doctor does, and sure indeed, the last 3 doctors have given varying conclusions on his state, one even signing for his discharge! Every re-admission has been preceded with sharp pains in the chest cavity, sustained pains with every deep breath, not to mention a Doppler test that confirmed 3 large clots in his left lower limb (had a deep open wound following the accident).

This time however, Chris cant get his INR test – a worth of 12,000 UGX- because he got re-admitted at short notice (death, as a result of PE doesn’t give much notice, does it?). To think that a nurse would idly sit by, with a patient on Clexane, but with no INR test for 3 hours, as she awaits a Doctor on ward rounds to tell her what to do – is, at the very least, disturbing. After making the nurse on duty see the folly in a re-admitted patient failing to get a regular observation test over a prepaid bill that is less than 10% what we paid the last time we got wrongly discharged, I asked her, what information the almighty Doctor would use when he finally arrived, other than the usual.

Ofcourse, we both responded with a cold rhetoric stare.

Whereas surgery for Chris was successful, and whereas subsequent tests were informing, its surprising to note that there was not enough follow up in terms of treatment given and neither was there adequate dosage of any follow up medications he might need.

Of course these symptoms were more visible when Chris was still Bed-ridden, but as he got better, and started to walk on clutches, and get more angles on his lower limb joints, he has gotten better. Its a very painful realization to think that had we not been vigilant on re-admitting him, Chris might not be here with us today. He simply refused to give up, as did so many people in the family, who decided to go against all odds, to make sure Chris would get the right attention whenever he needed it.

I wonder, what that nurse would have said, had Chris succumbed to PE – that she was waiting for the doctor’s instructions? Then what would the doctor say – that had not arrived for duty? What would the hospital say? That the family failed to raise 12000UGX? Really, for a patient re-admitted because he was, admittedly, wrongly discharged twice?

Chris is a dear brother to me, and we are thankful to his surgeon, Dr. Okello, who demonstrably went out of his way to give him a good chance at recovery. Chris is since fully recovered, even dropped his clutches, retains a slight limp in his step.

Stanbic Bank, Where is My Card?

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On Friday 27th July 2012, an authorized person used my card at the ATM on Kampala Road, next to Fido Dido – on the second attempt, the machine responded with something to the effect of “Card Issuer not available” – something i took to mean, a network connection with this machine’s parent server was not established, as as such it could not proceed to identify the card holder. The ATM did retain the card, providing no receipt as is the case with other card retain experiences. This person called me immediately, to which i immediately drove to my branch, in Mulago. While there, i was advised, that a service team visits the ATMs in Kampala regularly and they would collect captured cards. Because my card was retained at a “stand-alone” ATM, it would be taken to the Main Branch, sorted, and delivered to my branch right away. I was told, if I had a photo-id on me, it would not be a problem to get my card, had it been captured at an ATM machine, annexed to a branch.

Still My Bank? I wonder….

This had been clearly described by the non-authoritative guard at the ATM on Kampala Road. It was comforting to receive the same information at the branch. So i supposed i could pick up my card on Monday, since the guard had said the cards were to be collected that same Friday afternoon, as he expected a scheduled service team to come to the ATM machine.

On Monday 30th July 2012, I went to my branch in Mulago, first thing in the morning,  where i was told they had not received any cards. This time, i was told it would take 4 working days, and that I should check on Thursday. I was assured that my card, would by Monday evening have been picked from the ATM on Kampala Road, and it would take only 2 days to sort it out of the large pack and deliver it to my branch along with any other captured cards from various ATMs.

On Thursday 2nd August, 2012, I went back to my branch in Mulago, and i was disappointed to find my card had still not arrived. It was evident on the faces of the banking officers that they too did not know why my card had not arrived. But it was also clearly said to me, they had not received any pack of cards from the Main Branch. I was advised to go to the Main branch and ask at the Inquiries Counter. I did this immediately. Upon presenting my case at the inquiries counter at the  Main branch, i was asked to see a gentleman with a white sash presumably, and ironically reading:  Customer Satisfaction.

I explained my case to this gentleman, who asked me to wait as they checked the dispatch lists for captured ATMs, to check what the problem might be. After about 30 minutes of waiting, there was no clear response as to the whereabouts of my card, and having been deprived of banking services for nearly a week, i resorted to dealing via the counter, certainly at exorbitantly extortionist rates.

A few hours after i left the bank, i received a call, from a lady – it sounded like customer care – and she asked me to explain my case to her which i did.

On Friday 3rd August 2012 – exactly 2 weeks since the card first got captured – i received a call from (presumably) the same customer care lady, who called to ask me what Branch i belong to. The call didn’t last a minute, and she said she was going to follow up.

Today is the 9th of August, and tomorrow, it will be exactly 2 Calendar weeks since my card first got captured. I have no new information about my card, nor about the steps being taken to trace, recover and return my ATM Card.

I would like to know what it really takes to get my card back.

Bank of Uganda’s Consumer Protection Guidelines(June 2011) state, in paragaph 3(a) that ” Where a financial services provider gives advice to a consumer, the financial services provider shall ensure that: (i) the advice is suitable, taking into account the circumstances and needs of the consumer;  (ii) any product or service which the provider recommends a consumer to buy is suitable for the consumer; (iii) there is no other product or service available to the financial services provider that would be more suitable for the consumer; (iv) the provider keeps sufficient records of each piece of advice it has given to a consumer to enable it to demonstrate that it has complied with paragraph 6(3)(a)(i), (ii) and (iii); and  (v) it clearly informs the consumer of any actual or potential conflict of interest.”  I would like to take issue with section (iv) of this paragraph. I wonder if my bank has a record of any and all the advise i have been given since raising my case, as required by the law. I need not mention the services that i have been deprived of since my card has been captured.

Paragraph 6(1)(b)(ii) that ” A financial services provider shall not: mislead the consumer.” I believe that i have been misled by the Bank, on how long it actually takes to get back my card and also, where exactly to pick my card from.

Paragraph 7(2) states that ” A financial services provider shall ensure that where Automatic Teller Machines (ATMs) or other self-service banking channels are offered, the ATMs and selfservice banking channels shall be available both day and night to serve a consumer; except that the machines may be temporarily inaccessible: (i) due to an emergency which is beyond the control of the financial services provider; or (ii) when they undergo regular servicing and maintenance. ” It is my belief that there was a breach of this paragraph when the ATM became unavailable, at a non-scheduled hour of service. Perhaps the processes that led to its unavailability were beyond the Bank’s Control – but what steps did the bank take to ensure that an unsuspecting customer does not become the victim of a failed ATM machine? If the ATM was programmed to recognize a failed connection, and as such display a message to say it was not advisable to use the ATM at that point, perhaps the person with a card would not insert it into a machine that would potentially capture it.

Paragraph 5 of the same document states that ” (a) A financial services provider shall: 

(i) assess the training needs of its staff when they take up a new role and at appropriate intervals after that (including if their role changes);
(ii) ensure that its staff receive sufficient training;
(iii) satisfy itself, on reasonable grounds, that its staff are competent to carry out their roles;
(iv) review at appropriate intervals the competence of its staff and take steps to ensure that they remain competent for their role; and
(v) arrange for its staff to be appropriately supervised.
(b) Paragraph 7(5)(a) above applies to the extent necessary to ensure that the financial services provider complies with all other provisions in these Guidelines.
(c) A financial services provider, in determining how to ensure that it complies with paragraph 7(5)(a) above, shall take into account such matters as:
(i) technical knowledge and its application;
(ii) skills and expertise; and
(iii) changes in the market and to products, legislation and regulation.
(d) A financial services provider shall consider the level of relevant experience of a member of staff when determining the level of supervision required.

I have every reason to believe that there is a significantly devastating lack of training, incompetence, supervision, and/or a health mix of all 3. This is exhibited in the fact that neither the Main Branch nor my local branch know where my card is, neither have given updated information of what is being done to locate my card.

Paragraph 8(1)(a) states that “ A financial services provider shall: a) ensure that any information given to a consumer whether in writing, electronically or orally is fair, clear and transparent; ” There is a breach of this section here, considering that it has taken more than “4 working days”.

Paragraph 9(5)(a) states that ” A financial services provider shall, on receiving a complaint, provide the complainant with a prompt written acknowledgement that it has received the complaint and is dealing with it. However, a financial services provider need not send a written acknowledgement where it resolves the complaint within three business days of receipt of the complaint.” I believe there is a breach of this section in my case. Tomorrow will be the second calendar week, a complete 10 working days, since i first raised my complaint.

On these grounds, i find that my bank has not kept its word towards myself, has breached many guidelines and has caused me unnecessary stress and distress as well as financial loss, considering the amount of times i have had to drive to the different branches back and forth.

I insist that Stanbic Bank is liable for this, and they should return my ATM Card, as well as redress all complaints raised herein.

Why bring Ebola to Kampala?

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I know it was done in good faith. And i know it was to try to save “one of us”, but I am very disturbed by the decision to bring an Ebola Patient to the National Referral Hospital.

First of all, Ebola is striking Uganda for the 4th time – Gulu, 2000; Bundibugyo 7 years later, Luweero only last year and now Kibaale! Surely its disturbing that the 4th time, we have not picked lessons from across the country and shared them across the healthcare systems and channels.

The President said, ” About three weeks ago in the village of Nyanswiga in Kibaale district, some people become very sick. Initially the health workers did not realize what it was.  This was apparently because the people who were sick had many other problems….malaria etc. And apparently the bleeding which normally accompanies Ebola did not take place initially among these patients. That is why Ebola is part of what they call hemorrhagic fevers – this is because of the bleeding which takes place.”  See Full Statement Here.

3 whole weeks – and yet it takes 4 hours to go from Kibaale to Entebbe (if you have test samples for a disease that you don’t seem to recognize) . Far less, if you fly there with an M15 jet…

Secondly, There were many other cases being treated at Kagadi Hospital, of regular people. How is it that a “well-trained” and “well-equipped” health worker did not have the mind to perform her duties with protective gear? Sadly, the driver who might have been tasked to deliver her to Mulago did. Why then was that “vote of no confidence” cast on staff and services at Kagadi Hospital? Or, i dare say, was it a case of “one of us” has to go to a better facility? Some of the people who stayed at Kagadi are now recovering, which means there is ample treatment and every reason to stay put. Why did someone bring Ebola to Kampala?

Thirdly, since Ebola had been confirmed, i wonder, do all hospitals have some kind of routine? Say like immediately setting up isolation facilities and quarantine zones? Identifying personnel to man these? Prepare and avail safety kits for these personnel… When they brought the patient to Mulago, what this kind of routine stuff done already? If so, why the stampede that is requiring 7 doctors among other people to go on quarantine – for “coming into contact with the patient”? What about the families of these 7 doctors, or any other patients they might have seen that day, and their families too… Did someone not do their job? Who might this be?

Kampala has the complexities of density – and for a disease that thrives on contact, this is the ideal breeding ground! Money Exchange, Fake Spontaneous hugs, Boda Bodas, Pioneer Buses, lazy walkers on the street, the 2 old taxi parks, Kimombasa in Kawempe, Chicken in Wandegeya – migration style Walk-To-Work and Walk-From-Work.

Who really drives a patient into this madness….? And why?

 

Facts on Ebola:

http://www.webmd.com/a-to-z-guides/ebola-hemorrhagic

http://ebola.emedtv.com/ebola-virus/the-ebola-virus.html

1 Million US Dollars

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This is a big figure, whichever way you want to look at it. If you still doubt it, lets get some context going…

At 2455 UGX for each benjamin, that’s a whooping 2,523,740,000UGX – in words, Two Billion, five hundred twenty three million, seven hundrend forty thousand Ugandan shillings. 50,475 notes of 50,000/= each.

That’s my gross salary for 1009 and half months – just over 84 years! Considering that I started earning this gross salary only a few months ago, I have to live close to 120 years to ever make that money – and still, almost 40% of it would remain black holed into PAYE and NSSF!!!

Simple – I will never live to make that kind of money, atleast while still at my day job!

This figure will go down in books of history, as the first donation of its kind by a sub-saharan african church, to 3 churches outside of the boundaries of its own country! Watoto Church has just given away over 1 Million USD to Israel, Burundi and SouthSudan, for the purpose of building the church in the 3 capitals.

In a country where 64.5% of the population live on 2 USD and below – source – how is it that some 20,000 or so faithful givers have the means to raise 1 Million USD? In a country where there is no money, or atleast we have come to believe it, where do these christians get this much?

My Miracle Missions Offering

So it was a miracle missions offering – interesting! This money was all given as individuals, men women, husbands and wives, parents and children, companies sought to give an offering to missions, for a miracle.

Ok here is why this is mind boggling. If these christians would do it, imagine if 10 churches in Uganda, gave 500,000 USD in miracle offerings – imagine what that would do. To the spirit of Generosity, the breaking of the bonds of greed, and for Ugandans to learn to give – selflessly give.

Imagine what a challenge that would place to the government, to know that a community could mobilize to stock a hospital’s drugs for 1 a whole year, or a church would single-handedly fund a school, for the sake of the children getting off the streets and getting into classrooms. Imagine the challenge it presents to governments and authorities if a community of believers bought a ferry, and reconstructed a landing site?

You might say, that’s the church getting into politics -but what about the problems of the society. It would be great for christians to give 10,000 USD to Bududa Victims. You see the church is not just about the spiritual stuff. The church is very much community. Small groups meeting in a home, iron sharpening iron, small groups praying together, meeting each other’s needs. These small groups were first seen in the early church – read the book of The Acts. These small groups meet once in a week to encourage each other, and to celebrate their Christ. These small groups form a large unit. This Unit raises 1 Million USD. For that amount of money, which church shouldn’t be involved in politics?

Anyhow, What would you do with 1 million USD?