Uganda – The Ugly Reality of a Key U.S. Ally

A must read by Helen Epstein on modern Uganda, political assassinations, and the dire state of its health systems, left in shambles by corrupt elites and decades of rule by Museveni – a long-time ally of Washington.

First families. From left: Janet Museveni, Michelle Obama, Yoweri Museveni, Barack Obama

First families. From left: Janet Museveni, Michelle Obama, Yoweri Museveni, Barack Obama

I found that around the time of the Arab Spring in 2011, a movement demanding democratic reforms emerged in Uganda too, but it was systematically quashed by Uganda’s leaders. Those who claim that Nebanda was assassinated maintain that these leaders wanted to intimidate anyone considering a challenge to their grip on power. Meanwhile, with the assistance of extremist American evangelicals, Museveni’s family has been secretly funding pastors throughout Uganda to frighten people into believing their problems are due to an international conspiracy of homosexuals bent on sodomizing their children. Thus, Museveni has been using gays the way past tyrants have sometimes used Jews: to divert popular attention from their crimes.2

One of the issues with which Nebanda was most engaged was improving public health. Uganda has some of the worst health statistics in the world, despite having received billions of dollars in foreign aid for health services, and having been host to thousands of advisers—including me—on everything from malaria control to hospital construction.

This wasn’t always the case. I was originally drawn to Uganda because of its remarkable medical history. Long before colonial times, the people of this region had their own gods to distinguish plague from tuberculosis, and performed successful Caesarian sections—a rare operation even in Europe before the twentieth century. The natives were in turn fascinated by missionary medicine. When Albert Cook, the doctor who founded Uganda’s first hospital in 1897, restored the sight of a man with cataracts, the ecstatic patient declared that Cook must be God himself. The first medical school opened in British colonial Uganda in the 1920s and competition for a place was so tough that “to get in you had to be a genius,” according to one young aspirant. By the 1970s, it was almost as safe for a woman to deliver a baby at Mulago Hospital in Kampala, the nation’s largest, as at some American hospitals at the time.3 Ugandan scientists helped pioneer treatment for childhood cancers and malnutrition and the mass immunization campaigns that UNICEF would later promote throughout the developing world. When Singapore was looking to reform its own health care system in the 1960s, it sent a delegation to Uganda. ….

In 2012, women were seven times more likely to die in childbirth at Mulago Hospital than when Idi Amin was president forty years earlier.4 Uganda loses one child to malaria every seven minutes, the highest death rate from that disease in the world, and in 2013, scores of people died of famine in this lush, fertile country for the first time in living memory, not because of food shortages, but because the government failed to provide the resources to send food where it was needed. ….

The cause of this mess is no mystery. Ever since Uganda began receiving generous amounts of foreign aid two decades ago, senior Ugandan politicians and civil servants have been stealing virtually every shilling they can get their hands on. In 1995, the World Bank recapitalized the defunct Uganda Commercial Bank with a loan of $72 million. Museveni then sold it to a consortium that included his own brother for $11 million. The remaining $61 million has never been accounted for.5 A year later, the World Bank provided Uganda with a multimillion-dollar loan to construct fifteen irrigation dams. Museveni’s agriculture minister reported to Parliament that the dams were nearly complete, but a few weeks later, an investigative team confirmed that they did not exist. A Nigerian contractor was blamed for having stolen the money, but most Ugandans believe their own leaders took it. Nevertheless, despite these and other scandals, the World Bank lent Uganda ever more money, and even praised it as a model of development from which other poor countries could learn.6

The US, Japan, and Europe also poured in aid, and as they did, ever more outrageous scandals ensued. Money intended for children’s vaccines ended up in the First Lady’s office; millions intended for forestry projects, AIDS and malaria sufferers, road building, and assistance to victims of the notorious warlord Joseph Kony turned up under ministers’ beds, in flower pots in the prime minister’s office, in Las Vegas casinos, in personal bank accounts, and in heaps on the floor in President Museveni’s official residence.7 Millions more disappeared into the accounts of nonexistent schools and hospitals, “ghost” soldiers and pensioners, and such initiatives as the “Rabbit Multiplication” project that perform no activities at all.

Cerinah Nebanda was one of a group of MPs trying to do something about this mess. She spoke out against corruption and joined a parliamentary movement to shift money from various ministries, including the lavishly funded Defense Ministry, to increase the salaries of government doctors. Uganda pays government doctors only $350 per month, far less than their counterparts earn in much poorer neighboring countries. Even in Africa, it’s impossible to support a family on this salary. As a result, thousands of Ugandan doctors have emigrated and some of those who remain live in slums. Only half of Uganda’s health workers show up to work on any given day, and nearly half of those are so ill-qualified they can’t diagnose pneumonia.8 ….

More than a dozen of Museveni’s critics had perished in mysterious car crashes or after sudden unexplained illnesses in recent years. They included senior army officers whom he suspected of plotting a coup, opposition party agents, and an attorney general who was trying to block Museveni’s campaign to eliminate presidential term limits. In Kampala, terrified MPs told me that they avoided driving after dark and establishing routines like going to a certain bar after work. In restaurants, they ate only from buffets, and never ordered from the kitchen. ….

Others had also cautioned her repeatedly to tone down her criticism of the president and his ministers. She dismissed these warnings. “I will leave my mark before I die,” she told another MP.11

The nature of Nebanda’s relationship with Kalungi is so far unknown, but her MPcolleagues told me that in the past, Museveni had frequently used attractive young people to seduce his political enemies and spy on them. They recounted several specific cases, although none involved murder.

Nebanda’s postmortem was carried out the morning after she died, and the results were inconclusive. Her pancreas was inflamed and her lungs, which would normally have been spongy, had congealed into a stiff mass. Two pathologists, one a police surgeon, the other an academic named Sylvester Onzivua who had been retained by Parliament to conduct an independent investigation, both concluded that she must have consumed something toxic. But they couldn’t determine what it was without further tests. Since Uganda didn’t have a lab capable of such tests, the police arranged to take one set of Nebanda’s tissue samples to a lab in the UK, and Onzivua arranged to deliver another set to a lab in South Africa.

As Onzivua’s plane to Johannesburg was about to depart a few days later, security agents rushed onboard, arrested him, and confiscated Nebanda’s tissue samples. Immediately, enraged MPs began speculating in speeches and on TV that the government might have had a hand in her death. Why else would the police have prevented an independent autopsy? The president called a hasty press conference. The MPs spreading such rumors were “fools” and “idiots,” he told reporters, and ordered their arrest. Four of them spent a week in jail.

When the deputy prime minister turned up at Nebanda’s funeral in Butaleja to offer condolences on behalf of the president, Nebanda’s mother grabbed the papers he was reading right out of his hands and tore them to pieces. As angry mourners chased him to his car, she threw the bits of paper after him. Later, police swooped in on the town and arrested several people for what the locals called “over-talking.”

Two toxicology reports on Nebanda’s tissue samples were eventually released, one on the police surgeon’s samples that had been sent to England, and another said to have been conducted on the samples confiscated from Onzivua at the airport and then sent to Israel. The results made no sense. The two labs had attempted to measure the amount of cocaine, heroin, and alcohol in Nebanda’s blood and in a sample of urine that the police said had been found in a basin in the apartment of Kalungi, Nebanda’s supposed boyfriend, and which the police insisted was hers. The findings of the two labs should have been identical, but the levels of the various substances differed by a factor of ten in some cases. According to the Israeli lab, the concentration of alcohol in Nebanda’s urine—or whomever it belonged to—was nearly four times higher than any previously detected in the history of toxicology, suggesting that alcohol had been poured directly into it.12


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