A COVID-19 testing center in Uganda on August 27, 2020 (XINHUA)

Washington Kiwanuka, 22, is heading to China to study medicine in January 2021. The Ugandan student's childhood dreams have been to become either a pilot or a doctor and he's now made his choice and decided to take off in a different way, opting to complete a medical degree.

"I want to be a doctor, not for the money, but to help save lives and put a smile on people's faces. My main concern has been cancer. Cancer is a big problem in Uganda and a big burden on the economy. The despair it leaves behind for relatives [is tragic], as they [often] have to sell [their] properties to pay for medical bills left behind," said Kiwanuka.

He will be studying oncology in China which normally takes five years to complete. The Chinese system is similar to the American curriculum. It includes two years of classroom study, another two years of actual practice in a hospital environment, and finally one to three years of specialized training in a specific hospital. This depends on the institution of study requirements.

"I want to ultimately become a urologist (surgeons trained in management issues of the genitourinary tract of men). It is a branch of oncology. Many Ugandans seek [specialized cancer treatment] in India and the United Kingdom. I have been accepted at Zhejiang University," said Kiwanuka.

The university ranks as one of the best medical schools in the world. According to the Academic Ranking of World Universities, it ranks 94th in the field of medicine out of about 6,000 institutions.

Building up resources

The young man is part of a program of cooperation between the Ugandan Government and Chinese Government, where scholarship opportunities for Ugandans have increased to study medicine in some of the best medical schools in the world. The Ugandan Government has flagged the high shortage of doctors in its population to cater for growing medical needs, specifically specialized doctors to deal with the global threat of emerging and neglected diseases.

The scholarships are fully paid for by the Chinese Government and in some cases the students are also given a monthly stipend to cater for living expenses in addition to tuition fees.

The Ugandan Government says that over 5,000 people will receive specialized medical training over the duration of this scholarship program, but insists it will decide on who benefits based on qualifications and individual needs. "In addition, we look at the branch of medicine and how it fares in the job market. [The students] will be enrolled in about 45 medical schools across China," said Jane Aceng, Minister of Health of Uganda.

The first batch of students were expected to leave for China in September 2020, but the global COVID-19 pandemic limited travel in most parts of the world.

"The first batch [of students] will now leave sometime in January 2021 in preparation for the spring semester which will begin between February and March. They have to be able to prove they can return to the country after the completion of their studies. We could extend the program further after the initial time has lapsed," said Aceng.

According to the World Health Organization (WHO), there was a total of about 48,115 doctors in Uganda serving a population of about 35 million inhabitants in 2015. The WHO says that the fatality rate of people hospitalized with mostly curable diseases, due to the prevailing shortage of doctors, is about 41 percent.

Aceng says that Ugandans are spending huge amounts of money seeking specialized treatment abroad and this new program will eliminate that in years to come.

"Our citizens are spending millions of dollars for cancer treatment abroad, mostly in India. The average amount of expenditure is about $5 million per year," said Aceng.

Working conditions in question

An average student will be funded to the tune of about $13,000 for five years, plus additional amounts that include stipends, depending on the institution.

According to the WHO, there were only 20 oncologists in Uganda in 2018/19, who had to deal with about 60,000 new cancer cases per year with a 37-percent annual mortality rate. Worse still is a shortage of specialized cancer oncologists, such as urologists, radiation oncologists (use of radiation to treat cancer), surgical oncologists (use of surgery to treat cancer), and medical oncologists (use of medicines to treat cancer).

Experts say that a major setback in the Ugandan health sector could be the issue of a brain drain. The country is losing talented and well-trained professionals who choose to work abroad for better opportunities. The major issue for Ugandan local medical professionals is poor pay, which is made worse by often being delayed.

"The disease burden is real, especially now that COVID-19 is also taking the lives of many of our doctors. If you delay the salary and allowances of a medic by three months, how do you expect the person to be productive? Obviously, they will go to other countries for new opportunities. A lot of issues remain to be addressed. So far, [there is] not much to celebrate," said Richard Muhereza, Secretary General of the Uganda Medical Association, an umbrella body representing the rights of over 6,000 doctors.

He added that in reality, Uganda needs about 170,000 doctors over the next six years.

Already a lot of Ugandan medical professionals have gotten refresher training courses under the Sino-Africa Joint Research Center, a program operating across Africa under the Chinese Academy of Sciences. This program partners with African scientists in research of treatment of infectious diseases, such as malaria.

According to Muhereza, Ugandan doctors are heading to China, the United States, India, the United Kingdom, United Arab Emirates, South Africa, Canada and Germany to work as specialists or in private practice.

Uganda also has a shortage of virologists. There are currently only 21 virologists registered in Uganda to deal with infectious diseases such as HIV and COVID-19.

As of December 2, 2020, there were about 21,409 recorded cases of COVID-19 infections and 206 deaths in Uganda, according to the WHO.

"We have not heard of a doctor strike since 2017 in Uganda. In coming months, we will agree with the government on better working conditions for doctors, such as better pay and more allowances and benefits. This will encourage doctors to work better. It will further encourage students to return home after the scholarships program, and reduce the burden of Ugandan doctors going abroad for new job opportunities," said Muhereza.