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No, its not fate. Its government negligence!

Am sorry Charz L. Mbidde for the loss of death of you friend as well as that of DP's SG Matthias Nsubuga.

I wish to respond to some of the issues you raise.

1. Your friends passing from liver disease at the hands of "interns" who "mismanaged him". It has become fashionable among in particular Uganda's middle classes to find fault with doctors even when they have got no clue what they are talking about. This is not to say that you don't or that there was no mismanagement. Its also become fashionable to use doctors as scapegoats for a health system that is in a major crisis! This is effect gives the government a free pass whereas its the one responsible for the mess and those "interns" are themselves victims!

2. I am not sure what the diagnosis was for your elderly neighbour nor can I comment on whether the management was appropriate or not. It is not however reasonable in this day and age for a patient to die in pain. This is something we can always try to manage. I will not launch into why again your government has a lot to answer for with regards to the paucity or absence of accessible palliative care services including basic pain management and symptom control.

3. Everything that i wrote in my posts on health and emergency care is correct. There are one or two previous articles I wrote on stroke and stroke management that you should look at as they maybe able to enlighten you as to what could have been done. again this is not to say that anything innappropriate was done in the management of the MP, but the reality remains that stroke management has evolved far beyond what is available in Uganda today! this means that whereas there are a lot of people who cannot be saved, there are many for who the care and technologies are available to managem stroke, prevent death and disability and improve outcomes and functional recovery! Again you have got your government to thank for the fact that your chances of surviving a major stroke are not very good! https://www.facebook.com/notes/drew-ddembe/in-case-you-or-your-own-have-a-stroke-in-uganda/10151152386562681

4. Your religious beliefs and education omitted one fact! There is no time in history that we have been as capable as we are today in averting and managing medical disasters in order to prevent and delay death, improve recovery and outcomes, maintain health and function etc. All of this is due to advances in medical science including nutrition, immunisation, hygiene, prevention of morbidity and preventing mortality or death! This includes stopping death in cases where once upon a time, death would have been inevitable.

5. If you compare the average life expectancy of a Ugandan, at 65, hom Nsubuga was in the top 2.5 -4% of Ugandans aged over 65 years. For comparison the US in 1900 had a life expectance of about 48 years. In 2010 this had risen to 77 with the average 75 year old in 2010 being expected to live another about 12 years! By 1950, the life expectancy of an American had risen to 68, a number Ugandan is yet to achieve. In the west the fastest growing demographic is 80 year olds and these are expected to be at least 25% of the population by the year 2050!

6. But not only is age and life exp[ectancy increasing in the developed world but health and ageing free from chronic medical illnesses and disabilities resulting in a "compression of morbidity" where people live largely healthy and independent lives and delay most of their medical problems to the last few years of life as opposed to Ugandans who are developing non communicable disease at an alarming rate due to the absence of functional preventive health services. Non communicable disease include illnesses like diabetes, hypertension, heart disease and cancer many of them related to lifestyle including obesity which is an epidemic among Ugandans!

7. While immunisation, hygiene maternal and child health care all have significant benefits and return with regards to increasing life expectancy, advanced medical healthcare services including medical and surgical management as well as interventional management of various previously fatal conditions has significant added benefit to the likelihood of people surviving their middle ages and living on for decades after their first heart attack or stroke!

8. And this here is where you have a problem! Your chances of surviving one of these big killers diabetes, stroke, heart disease, cancer in Uganda is rather small in comparison to countries where the community and government have invested in life saving skills and healthcare. If you do survive, your recovery will be suboptiomal and you are more likely to lead a permanently disabled life after that!

9. Your God made all of this possibvle. Today we do have the knowledge at our disposal to prevent death and prolong life and survive beyond meajor medical catastrophes! Yet 200 years ago, man rarely lived beyod their mid thirties, a situation still true for many Ugandans unless they are connected to the rulers of the country and can access a brown envelope from the sabalwanyi to go to India or south africa!

Your God told you to go out and multiply ---- and subdue the world. He also gave you the tools, your brain and hands to improve your life and longevity! Except that in Uganda you prefer to lament and accept your governments negligence and incompetence by accepting it as fate which its not as it has been clearly accepted and is routine elsewhere to challenge fate and the date that God may have pulled out of the hat for you --- with success! So no, maybe Nsubuga would have died anyway because his date was already engraved somewhere in the sky BUT I know for a fact that thats not necessarily true if he had been in another country! There could have been a chance that he would have lived another fruitful 20 or even 30 years but in Uganda, he had no chance! Ugandans survive by chance manytimes mate! Sixty-five in many developed nations is now considered young and his would be considered to be a premature death! in Uganda, we just type RIP and move on like grazing sheep accepting their fate, that they were born and bred for slaughter and they can do nothing about it! Dress Affordable neutral style collections for bridesmaid

So yes, may his soul rest in peace but do not use it to detract from the fact that a lot can and could have been done to prevent his death --- and oh, its because your government is negligent!