For his work in the fight against the destructive impact of HIV/Aids, specifically in rural communities, Herbert Mugumya deserves an award.
Mugumya, a younger brother to former police spokesperson Asan Kasingye, is the Country Representative for Management Sciences for Health (MSH).
MSH is an international organization that helps governments in strengthening health systems globally, with its presence in over 36 countries, majorly in Africa.
The organisation offers technical assistance in health pharmaceuticals, infectious diseases, family health and on leadership, management and governance at different government levels including health facilities.
When you meet Mugumya, you will be impressed by the passion with which he speaks to make healthcare services better in a country that has seen the health sector budget reducing almost every financial year.
Born in Kibingo in Sheema district, Mugumya grew up in a family, he says, that had nothing “to be proud of” in a rural setting. He explains that growing up, there was no need to have role models as the case is in this generation.
“In our days, we didn’t have dreams,” he says. “But I grew up largely to understand life during [former president Idi] Amin’s time. The schools those days were much better than the current ones [because we were provided with all scholastic materials.]”
But after his primary school, getting a good secondary school specifically in the western part of the country was a challenge in the 1970s and 1980s. This was the period when there were wars that saw the eventual overthrow of Idi Amin’s regime.
The few good schools at the time, such as Ntare School, set the bar so high that many students could not easily meet the standards.
“I started secondary school from Ruyonza School in Bushenyi in 1982, not because I liked it, but because it was the only option available having tried to make it to Ntare School, [in vain]”, narrates Mugumya.
“The Bishop of West Ankole diocese opened schools around the district to take those who could not make it to the best schools.”
But because they only had a day section, these schools didn’t impress Mugumya. He could not manage to transport himself daily because it was far from home. His father, John Kairukabi, was a trader who only operated in mobile markets to fend for a family of more than a dozen people. As a result, he could not meet extra costs.
After the first year, Mugumya shifted to Kyeizooba secondary school which had a boarding section. But again as fate would have it, there was another political disruption. That very year, the school turned into a girls-only.
By the time he joined Nganwa high school, Kabwohe, in senior three, his classmates were far ahead of him. Playing catch-up with some subjects such as physics was very challenging. In 1985/6, and 1988 when they eventually sat for their final O and A-level examinations respectively, Mugumya found himself opting for arts.
GETTING INTO HEALTH
While at Nganwa high school, Mugumya developed a sense of maturity and direction.
“I was made a health prefect, and that to me was a turning point. So, I was responsible for ensuring environmental and body hygiene among the students,” he says.
In that position, Mugumya started thinking critically on issues related to health that affected students around the school. The school nurse turned out to be one of his good friends; thus, he would spend most of his time in the school clinic.
“I started realizing it was a mistake for me to drop physics,” he says. “But I had no option because it was already dropped.”
Mugumya joined St Kagwa high school, Bushenyi for A-level and offered a combination of arts subjects. In 1988, when senior six examinations results were released, Mugumya had passed top of his class. He then joined Makerere University for a bachelor’s degree in Social Work and Social Administration (SWSA).
Joining Makerere saw him go to Kampala for the first time. He explains that during their time at Makerere, students were always given “good” termly and annual allowances to facilitate research work.
This was because the SWSA students would spend much of their time doing fieldwork and internship in different organizations or companies.
“When I started making choices for the fieldwork, I went in the health field. Those were the days when community healthcare was valued, and then the emergence of Aids. It started killing so many people, and then The AIDS Support Organization (TASO) came in about 1988, and Aids Information Centre in 1990,” he says.
One of his fieldwork placements as an intern was in Rakai through the Ministry of Health’s Aids control programme. HIV had become an epidemic in Rakai.
But this marked another turning point in Mugumya’s life to pursue a career in the health sector regardless of what he was studying at the time.
“People were dying day in, day out. Burials were everywhere. And that changed my whole life. When I came back, I became an agent of the Aids control programme of the ministry of health in the university,” he says.
In the same period, the government had embarked on a massive campaign aimed at sensitizing the masses to abstain from sexual intercourse until marriage, monogamy and using condoms as a last resort.
Mugumya’s work was to distribute condoms freely to fellow students, and his efforts were noticed by various agencies fighting HIV/Aids. Towards the end of his three-year course, Mugumya had started receiving several opportunities to work with various local NGOs. By the time he graduated, he was lost for choice.
His first job was in 1991 with Aids Information Centre. He was posted at a new branch in Mbarara, which was amongst the first HIV testing centers in the entire country outside Kampala.
During that period, his father and mother also contracted HIV and died in 1992 – shortly after his graduation and few months into his formal job posting.
When one fell sick at the time, they would not spend much time because majority of the communities had no idea on prevention and treatment measures to shield themselves from the epidemic.
“My mother was the first victim and my father died a few months later. My last great moments with them was on my graduation day…managing sick people shaped my ability to be able to work in the health sector,” he says.
CONCERNS ON THE HEALTH SECTOR
The ongoing strike by health workers across all public hospitals countrywide is a problem, he says, government should address immediately lest many Ugandans start self-medication or resort to traditional healthcare means.
“Ugandans [who cannot access essential medical services] are going back to traditional health care which is absolutely not regulated. This puts patients at increased risk,” Mugumya warns.
He adds that some will start sharing medication among family members because they are desperate. Every symptom seen as a failed system in this government is because there is insufficient information to guide government in decision-making.
Whether it is the cost of medicine, reasonable salaries for health workers or renovations of health facilities, it all rotates around the availability of information and resources, according to Mugumya.
“When we are dilly- dallying with politics, disease multiplication is increasing,” he warns.
In 1996, he got another job with Care International, an organization which is jointly funded by USAID. The project that covered the whole of Kigezi sub-region was community reproductive health.
In 2002, given his good performance and work ethic, he was given a scholarship in the Netherlands to study for a Master’s degree in Population and Health, with focus on reproductive health.
“My exposure in the Netherlands was extremely good because they are very good in research,” Mugumya says.
When he returned in 2004, Save the Children offered him a job as the programmes manager for HIV/Aids. Mugumya was mainly overseeing program activities in northern and western Uganda, which was at the time a hot bed of conflicts due to Joseph Kony’s Lord’s Resistance Army and the Allied Democratic Forces insurgencies.
His task was to accelerate support for children and develop community- based programmes.
“USAID team realized I would be more instrumental in developing programs for HIV beyond the conflict,” he recalls.
After serving two years, he moved to USAID Uganda as a program management specialist and technical advisor under the health and HIV department.
“I worked in the USAID mission for five years up to 2010 when I got another opportunity to go to Tanzania to work for Africare, which again was implementing a USAID-funded project,” he says. “I spent close to seven years in Tanzania and returned [to Uganda] in December last year.”
With his experience in healthcare, Mugumya has a lot to share about the key areas of intervention that government should focus on, which he says, have largely been affected by limited funding.
Andrew Kyambadde, a health system team leader at USAID describes Mugumya as a charismatic and calm person. He says, Mugumya is capable of fitting into any particular situation, regardless of how difficult one might presume it could turn out to be.
Kyambadde has worked with Mugumya for about five years at USAID.
“He is a good person at writing reports and developing programmes. Most of the directors for these foreign organizations are normally expatriates, but for Herbert’s sake, it shows how good and passionate he is about the health sector,” Kyambadde says.
Mugumya is passionate to support government realise health sector objectives through strengthening health systems such as health workforce, medicines and essential health supplies, governance, and health information to guide service delivery and improve health outcomes to all citizens.