Photo: left to right - E. M. K. Muwazi, E.S. Lubulwa, Banoba in 1934.
These doctors were officially called Senior African Medical Assistants.
(© Makerere Medical School Archives)
From the first three graduates of Makerere Medical School in 1927 – Antonio Bamugye, Dionysius Bamundaga, and Yakobo Baziwane – the history of the Ugandan African doctor has been that of constant struggle for justice, recognition and fair remuneration. The early students and graduates of the medical school faced racist attitudes by European and Asian teachers, general practitioners and consultants. This remained the prevailing attitude until Uganda’s political independence in 1962.
The pioneering struggle for the rights and dignity of the African doctor was led by men and one woman whose names ought to be engraved on a monument right next to Uganda’s Independence Monument in Kampala, or at the main gate of Mulago Hospital. The list includes Drs Solomon B. Asea, Eria Babumba, Steven B. Bbosa, F. M. Bulwa, D. B. Byaruhanga, J. H. Gesa, D. F. Ibanda, Ivan S. Kadama, George W. Kafuko, George W. S. Kamya, J. W. Kasirye, A. K. Kibaya, John Kibukamusoke, Samsoni B. M. Kisekka, Barnabas Kununka, Sebastian Kyalwazi, Norman N. Kanyarutoke, Sebastiano Kyewalyanga, Emmanuel B. Lumu, Joseph S. W. Lutwama, Ivan Majugo, Latimer K. Musoke, J .D. Nfamba, Eria M. K. Muwazi, Josephine M. Namboze, S. K. Ndugwa, , Alexander Mwa Odonga, Kagai Samba, Peter H. Sebuwufu, F. George Sembeguya, and Y. B. Ssemambo.
These pioneering medical students, along with their colleagues from Kenya and Tanganyika, would study for seven to nine years, and get no degree. (Arts students would study for three years and get diplomas and, later, degrees.) Notwithstanding their excellent education and skills, they were considered less able than their European and Asian counterparts. They were first called Senior Native Medical Assistants, then Senior African Medical Assistants, then African Assistant Medical Officers. The British colonia doctors vigorously resisted all efforts to recognise their African colleagues as their equals. These doctors were officially not doctors.
It was not until March 1957 that the President of the General Medical Council of Britain, impressed by what he and his visiting team had seen at Mulago, recommended recognition of the Makerere Medical School qualification “for purposes of provisional and full recognition in the United Kingdom.”
It had taken 30 years since the first graduation to achieve this important recognition. However, it would take another seven years before Makerere University awarded the first degree of Bachelor of Medicine & Bachelor of Surgery (MB ChB). People who had been in practice for many years, some in their fifties, were finally recognized as doctors in 1964. The retroactive awards of degrees that these doctors had legitimately earned capped a phase of the struggle that was the strong foundation upon which subsequent generations would build their medical careers. The pioneers’ struggle succeeded because of their courage, foresight, and unrelenting demand for justice.
Some, like Babumba, Kibaya, Kyewalyanga, Majugo, Muwazi, and Sembeguya resigned from government service in protest, and started private practice. Furthermore, Kununka, Kyewalyanga, Majugo, and Muwazi became members of the Legislative Council of the Uganda Protectorate and used that platform to wage the struggle for their profession and for the rights of the larger community. Their struggle was eased by the presence of Sir Andrew Cohen, a liberal and progressive Governor of Uganda (1952-1957).
Today’s doctors in Uganda, especially the recent graduates, should be encouraged by the success of the pioneers. Whereas the current occupant of the State House may not have Sir Andrew Cohen’s disposition and respect for the professions, he is known to reconsider his decisions when a well-considered and argued petition is presented to him by people that he is sure are not his political opponents. I see an opportunity for the leaders of the Uganda Medical Association, and the leaders of the medical students and pre-internship groups, to seek the intervention of several medical doctors that President Yoweri Museveni considers to be his political allies.
Some of the doctors I have in mind are or have been active NRM partisans. Others are people that the president does not associate with opposition politics. All have served the president and his government in high capacity. This group includes Drs Jane Ruth Aceng Ocero (Minister of Health), Diana Kanzira Atwine (Permanent Secretary, Health), Charles Ayume (MP), Medard Bitekyerezo (former MP), Gilbert Balibaseka Bukenya (former Vice-President of Uganda), Rosemary Kusaba Byanyima (Executive Director, Mulago), Philip Byaruhanga (former MP), Stephen Chemoiko Chebrot (ambassador, Qatar), Alex Kamugisha (former minister of state for health), Apollo Karugaba (former MP), Margaret Blick Kigozi (former ED, Uganda Investment Authority), David Kihumuro Apuuli (former DG Uganda AIDS Commission), George Barnabas Kirya (former VC Makerere University & former high commissioner, London), Crispus Walter Kiyonga (Chancellor of Makerere University, former minister, former ambassador), Ben Mbonye-Girasi (former PS, Defence), Christine Ntegamahe Mwebesa (Deputy Chairperson, Uganda Health Service Commission, former MP), Henry Mwebesa (DG Health Services, Ministry of Health), Warren Naamara (Director, Health Monitoring Unit, State House), Vinand Mukatabala Nantulya (Chancellor, Busitema University, former chairperson, Uganda AIDS Commission), Joel Okullo (Chairperson, Uganda Medical & Dental Practitioners Council), Sam Ikwaras Okware (DG Uganda National Health Research Organization), Francis Gervase Omaswa (Chancellor, Soroti University, former DG Health Services), Christine Joyce Dradidi Ondoa (former minister of health, Senior Presidential Advisor on Health, former DG Uganda AIDS Commission), Emmanuel Otiam Otala (former minister of state for health, former MP), Ruhakana Rugunda (former prime minister), Specioza Wandira Kazibwe (former vice-president of Uganda, and Sam Zaramba (former DG Health Services)
Most of these doctors received all or part of their education at Makerere University Medical School during a period of relatively great privilege. Drs Chebrot and Nantulya received their undergraduate medical education at the University of Nairobi and the University of Dar es Salaam, respectively, sponsored by the Government of Uganda. All were guaranteed paid employment as interns, complete with comfortable accommodation and other support, even before they received their medical degrees. They were held in high esteem by the presidents who ruled Uganda during their early years in the profession. Although they faced the threats to personal security that was a universal experience for most citizens, they were generally respected and valued by the general population. They enjoyed this status because their path had been softened by the struggles of the pioneer medical students and doctors.
Most of these doctors are sober thinkers, endowed with caring hearts, and fully aware of the supportive obligations they have towards fellow doctors. Most are at a professional and age level that qualifies them to be parents and nurturers of their junior colleagues. So, I urge them to use their collective voice and influence to advocate on behalf of the younger generation of doctors whose services Uganda needs. Hopefully, President Museveni may listen to this group’s informed presentation.
Final thought: like all doctors, interns’ work exposes them to serious risk to their own health. Ugandans remember Dr. Matthew Lukwiya who died from Ebola in 2000 that he acquired at work at St. Mary’s Lacor in Gulu. Before Lukwiya, many. The first known Ugandan doctor to die in the line of duty was J.M. Siryegana. He treated a patient who had plague in 1936. Dr. Siryegana died two days later. After Lukwiya, many more, including those who were felled by Covid-19. Medical interns are the first doctors to meet patients with potentially lethal infections. They put their lives in harm’s way nearly everyday, to save people’s lives. That alone is enough reason to consider them heroes.
© Muniini K. Mulera