The Medicine Man Deserves His Due

Greetings. The Ugandan medical professionals went on strike last week, a practice they have done countless number of times. The health sector, just like education, is a cornerstone of human capital development that will deliver the government's desired middle-income status. You can't be productive when your health is found wanting, and it's partly through skilled medical personnel (as well as their availability) that our longevity can be secured. With a country whose life expectancy is at 63, the government is so casual about the guardians of our health system going on strike.

The current crop of medical doctors at the age of 30 years have been practicing for approximately 4 years. Revisiting their HSC class set up a decade ago can help understand their demands for an increment in remuneration.

PCB/Maths

Back in 2011, there were four medical schools in the country, with government scholarships only available at Makerere University, Gulu University and Mbarara University of Science and Technology (students at Kampala International University, a privately-owned institution, are not eligible for government scholarships). The essential subjects for an admission to a medicine program are Chemistry and Biology. Therefore, for students preparing for the Higher School Certificate with an eye on a career in the medical field, their subject combination must include these two. The most common combination at the time was Physics, Chemistry, Biology and Mathematics, colloquially known as kalamba (full set).

It is in the Mathematics classes that PCB/M brigade rubbed shoulders with students whose career paths are targeted outside the life sciences of Medicine, Pharmacy and Dentistry. Students interested in Engineering could opt for PCM/Economics or PEM (while stroking Fine Art or Technical Drawing), whereas for those interested in Quantitative Economics and Statistics anything with Mathematics was good enough.

For students who didn't pursue the path of sciences, the options in Humanities included History, Christian Religious Education (Divinity), Islamic Religious Education, and Geography. Subjects like Economics, Fine Art and the languages (French, German, Luganda) were open to both science and humanities specialists. The kalamba for humanities was HEG/D. University courses for humanities students included the law, social sciences, history, mass communication, business administration, and languages. Whereas Medicine was only available at three universities, Architecture at only Makerere and Engineering restricted to Makerere, Kyambogo and Ndejje, humanities courses were available at all 31 universities in the country at the time. With limited university vacancies available, the race to become a doctor was more competitive than the other career paths.

Upon reaching the university, Medicine - which comprised of two undergraduate degrees (Bachelor of Medicine and Bachelor of Surgery) - has a duration of five years. Architecture is the only other undergraduate course that requires five years of study. Of the Humanities courses, the longest duration is reserved for the Bachelor of Laws (4 years), with the rest of the courses having a three year duration. 

Therefore, as the medical student commences his/her fourth year of study,  majority of his/her HSC classmates that opted for a path in the Humanities are commencing their job hunt. It is during the second semester of this year (sometimes the year before) that the big four audit firms reach out to university students that are likely interested in a career in accounting/auditing. These firms have an inclination to hire people with a background in Engineering, Economics, Mathematics and Statistics, believing that the quantitative background in these courses gives them a leg up when completing the chartered courses in accounting. 

For a student fresh out of campus, the audit firm presents a very enticing career starter. The net salary ranges between UGX 700,000 and UGX 1,000,000/=, along with health insurance and a scholarship to study the chartered  accounting course. For the class that joined university in 2011, by the time the doctors signed their first professional contract their counterparts in the auditing career path already had two years of experience and were on track to complete their professional courses. 

As the years progress, the gap between the doctor and the rest only grows wider. Considering that the individuals in the audit path can opt for careers in financial management as well, the humanities career paths advancement is often not that quick. One has to obtain a postgraduate education to become more competitive in the job market and this comes with its costs as well. However, for those that don't choose that path the option of a side hustle can bring their monthly earnings to a respectable level. The time available for people in this line of work is not accorded to the doctors. A doctor has to establish their reputation and specialisation in their formative years before they can branch out and establish their own practice, which is often a very expensive venture.

The Medicine Man and the King

The government's treatment of the medical professionals, and the health system for that matter, leaves a lot to be desired. The 2018 decision to hire doctors from Cuba rather than raise the Ugandan doctors remuneration,  was a major slap in the face to the medical profession. Along with the police's aggressive efforts to quell the doctors' demonstrations, these events are reminiscent of the ancient arrangement between the witch doctor and the king. The excerpt below from Matthias S.M. Kiwanuka's book sheds light on the relationship between the medicine man and the king:

"The relationship between the king and the medicine men depended very much on the character and personality of the former. If vexed, a man of a violent nature treated them violently. King Tebandeke, for instance, executed very many of them, burned down all their temples, and looted their estates with impunity. During the eighteenth-century King Kyabaggu treated them in the same fashion."

The medicine men doubled as diviners and physicians. Like their modern successors, they spent their apprenticeships at the temple learning the skills necessary from the old guard. However, in contrast to their modern successors, the ancient medicine man determined what he charged for his services. One had the liberty of charging ten bulls for treating the king's boil whereas charging the peasant a domestic fowl for treating a more serious ailment. 

Perhaps our doctors that have chosen to pursue a career abroad can charge the President's acolytes - considering they get their treatment outside these borders - exorbitantly when they seek treatment. But our president is easily vexed. And the equivalent of an academic temple (read Makerere's Ivory Tower) already burnt down a few years ago. The looting of the doctors' meagre earnings will long continue.

Ceteris. Paribus.

MILESTONE: This is the 40th article posted on this blog. In commemoration, we should all remember to wish the medical professionals a happy festive season because majority of them will be on call.

References

Abet, T., (22nd December 2021). "Medical interns, doctors call off strike," The Daily Monitor.

Aboneka, J., (15th May 2018). "Cubans won't fix our healthcare," The Daily Monitor.

Kiwanuka, M. S. (1972). A History of Buganda from the Foundation of the Kingdom to 1900. Holmes & Meier Pub. pp 178.

Rigby, P. (1975). Prophets, Diviners, and Prophetism: The Recent History of Kiganda Religion. Journal of Anthropological Research, 31(2), 116-148.

When Robert Seguya Refused To Conform

"When you have the will to do something good, nothing can stop you."

 [LONG READ ALERT]

Greetings. A few days ago, Robert Seguya passed away. An icon of the game of rugby, the 42-year-old succumbed after a year-long battle with leukaemia. He will be remembered for his long service to the game. Since 1992, he has played and coached at school, club and national level. It is in one of his coaching roles that the full measure of his impact has not been fully appreciated. Seguya's coaching tenure at Hana Mixed School needs to be studied more closely for the impact it did in the social outlook of the game.

The Game Before Seguya

Robert Seguya began his sports journey at Namilyango. At the time of his admission, boxing was no longer the venerated sport from the 1960s. The pugilists were disposed to the youthful avarices of smoking, drinking and bullying the young ones. In a few years of his admission the sport was scrapped from the College's cocurricular offering. However, Seguya had already taken an interest in rugby.

Rugby at Namilyango was introduced in 1964. Places like Namilyango and Nsambya TTC provided a platform for native Ugandans to try their hand at the sport. The 1958 Ugandan team that played in an international against Kenya had no native Ugandan on it, despite Sepiriya Mukasa being a member of the Kampala Rugby Football Club at the time. A photo of the Kenya Schools' XV that toured Uganda in 1964 is an all-white line-up. Considering native participation in other sports, boxing in Uganda had registered two commonwealth Games medals (F. Nyangweso and T. Kawere) at the time, and there were thriving local football tournaments including the Kabaka's Cup, with the topflight league to be formed before the end of the 1960s. Rugby's race problem in Africa was not only confined to apartheid era South Africa.

The sport of rugby peaked at the college in the 1970s, but it went on the wane in the following decade, only being revived in the early 1990s. Interhouse fixtures were regularly contested. In the absence of a schools' competition, Namilyango played in the nascent Ugandan League, contesting against teams like Heathens, KOBs, Makerere Impis and ANC.

For much of its history, rugby has been an amateur sport. The game only went professional in 1996 and this birthed the urgency to grow the game beyond its traditional hinterlands. Uganda joined the International Rugby Board (the forerunner to World Rugby) the following year, and an inter-school competition was introduced that same year. By the time Seguya left Namilyango, the Schools' Championship had been split between Namilyango and King's College, Budo.

Since the creation of the Uganda Rugby Union, Namilyango, Budo and St. Mary's College Kisubi have dominated the sport of rugby, both on and off the field. The institutions have provided all past presidents of the URU, the current head of the referees' society, the two most recent Head Coaches of the Rugby Cranes, several club chairmen, the founders of Pirates RFC and Eagles RFC, sports columnists at both leading papers of the country, as well as the brains behind Kratos rugby media. Six starters of the 2007 Africa Rugby Cup final were from Namilyango, with a further two on the bench. The position of Chairman of Uganda Schools Rugby alternated between the rugby patrons of Namilyango, Budo and Kisubi.

Not by some conspiracy has this dominance been manufactured. It rests solely on the merit tradition and availability of resources at the institutions. Despite Namilyango being the only school with a dedicated rugby pitch, the other two schools have each converted one of their many football pitches towards rugby purposes. From their early years, as the pioneer schools in the country, the trio competed for academic supremacy and this moved into the sports arena as well.

The Typical Namilyango Rugby Player

Namilyango has horned a reputation as "the rugby school". A good number of the students have partaken in rugby in one way or another, despite the fact that new students rarely have rugby experience from their previous primary schools. It is from watching the evening training and the interschool games that they garner their interest, and the absence of rugby balls has never deterred them. Former Cranes flyhalf Edmond Tumusiime, who joined Namilyango in Seguya's final year, described how he and his classmates in Form One finished "our Quencher bottles, slopped down the pitch and used them as rugby balls."[1] The drive in these thirteen-year-olds never goes unnoticed and the Form Three class is tasked with teaching them the rules of the game, preparing them for their maiden game.

At its peak, each class boasted of a first XV and a second XV. In the early 21^st century it was tradition for the incoming Form One class to participate in their first official rugby game against the second XV of Form Two. When they reach Form Two, they will contest a game against the Form Three class. When one reached Form Three, training to the Anchors was open to them and one had a chance to prove oneself. The very ambitious would begin Anchors' training while still in Form Two.

Playing for the Anchors is the ultimate honour of a school rugby player in Uganda. Every team wants to beat them – so often falling short. Partly due to the exploits of the likes of Seguya, Tumusiime did the Anchors build their winning reputation. The efforts of the rugby patrons at the College, Monsieur Valence Bizimana and Mr. Kakembo as well as the coaching staff played a role.

Upon leaving Namilyango, these students – those who opted to continue with the game – would play for one of three teams. Namilyango has been a feeder for Kampala Old Boys (KOBs) since the advent of the Schools' Championship, with majority of Namilyango alumni playing for KOBS and its understudy side, Boks. The third club that alumni have significantly played for is Makerere Impis, especially those that secured government scholarships to study at the University. The pattern of the Namilyango rugby player was to have their peak in their mid to late twenties while playing club rugby or for the national team, after which the reality of advancing their career at their daytime job took precedence over rugby. Tumusiime has admitted to not reaching his peak due to "mixing rugby with school and my professional career."

It is understandable why they would opt to grow their daytime jobs. The sports budgets in the country are dismal, and the crowds are few which hinders the growth of the professional game.

In contrast to this Namilyango pattern, Seguya's club rugby career was spent at Nile RFC (present day Jinja Hippos), Heathens RFC and Buffaloes RFC, playing club rugby for more than 15 seasons. He pursued entrepreneurship and private business, rather than a daytime job. And to commence his coaching career, he opted for Hana Mixed School, with no rugby history – or sports history for that matter.

Hana's Hegemony

As Namilyango celebrated its centennial year, Hana Mixed School was still in its first year of operation. Football was the main sports program offered at the new school. The school decided to switch their attention towards rugby. The Games Master formulated an agreement with Robert Seguya. Seguya focused on fitness, and he enlisted Lady Cranes' Christine Kizito to handle the fitness and conditioning of the team. Initially, the school struggled to gain promotion to the Premier Schools division, losing to Comboni College (2007) and Lango College (2008).

To build the program to his desired level, Seguya played a bigger role in the recruitment of players to Hana. Aware of youths from Naguru who had trained with Heathens junior sides, Seguya proposed the establishment of a scholarship program at Hana. Four of the first five beneficiaries of this scheme were Naguru-bred youths, including Alfred Bijik, Philip Wokorach, Kevin Keremundu and Ronnie Musoke. In 2010[MK1] , Hana's first year in the Schools' League, Seguya's team lost at the semi-final stage to eventual winners Budo. In October, at the annual Independence 7s tournament, Hana triumphed over Namilyango in the final. The following season, Hana lifted the Schools' League, becoming the second school outside the ancient trio to be crowned school champions (after Kyambogo in 2003). Hana swept all school rugby trophies on the domestic scene, and in August that year they were crowned East Africa champions.

Seguya's blueprint at Hana proved that the Big Three of schools' rugby could be trounced. Kololo SS adopted this system, establishing bursaries for Naguru-based teenagers. Between 2011 and 2015, the Schools' League title went to Hana on three occasions, Kololo took the 2014 title, with SMACK the only one of the Big Three to secure a championship (2015). The 2014 final was the first time in Schools League history that neither Namilyango, SMACK nor Budo played in the final. Some sections of the media and fans interpreted this as a shift in the balance of power.

Back to Normal Service

The Hana-Kololo hegemony didn’t last long. After 2016, Hana Mixed School reversed its scholarship policy, in a move that saw the school move away from the UNEB system towards the costlier International Baccalaureate curriculum. And with these changes, the rugby scholarship program ceased. Even in the absence of scholarships, five years had proven to be a short time to establish the kind of culture that prompts a thirteen-year-old to cultivate his rugby skills with an empty Quencher bottle.  In 2016, normal service resumed as Namilyango won the first of three Schools' League titles, only to be stopped by SMACK in 2019.

The game of rugby expanded to more schools, but they were more of the ilk of Namilyango-SMACK-Budo. Rugby programs were started at Mbarara High School and Ntare School, and the Makerere College School rugby program was revived.

In the years that followed, Seguya completed his World Rugby coaching certificate (Level 3), and returned to Heathens RFC as Head Coach, leading them to the Uganda Cup. He later took up coaching roles at Jinja Hippos and the Rugby Cranes (first as assistant, then as Head Coach).

Having learnt the game he loved through the merit-based system of Namilyango, Seguya believed in competition. And he believed competition was essential to growing the game of rugby. Rather than the norm of going back to Namilyango and helping coach the Anchors, he sought to provide better competition to the Big Three schools. He helped show the rest of the rugby fraternity that anyone could rise to the top if they got an opportunity to prove themselves. As a lasting testament to him, the greatest rugby player of the current generation might end up being a kid from Naguru who spent his school days at Hana.

Ceteris. Paribus.

 

References

Bugembe, D., (27th December 2014), “I was constantly insulted by fans when I quit – Edu,” in The Daily Monitor.

Campbell, M. and Cohen, E.J. (1960) Rugby Football in East Africa, 1909–1959. Published by the Rugby Football Union of East Africa

Collins, T. (2009). "Chapter 1: The Schoolboy's Game," A Social History of English Rugby Union. Routledge. 

Collins, T. (2009). "Chapter 7: The Imperial Game," A Social History of English Rugby Union. Routledge.

Kigongo, Ismail D., (26^th May 2021). "Seguya: Uganda's best ever rugger," The Daily Monitor.

Muziransa, M., (03^rd June 2016). "Battle-hardened Seguya mellows in search of rugby stars' affection," The Daily Monitor.

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[1] Deus Bugembe (27th December 2014), “I was constantly insulted by fans when I quit – Edu,” in The Daily Monitor