Focus

Occupational safety and health services in Uganda: constrained by limited resources

February 2001
by Paul Obua and Andrew Okimait

In Uganda, a Factories Inspectorate was launched as far back as 1925 within the Department of Labour. From 1948 to 1959, the Department of Health seconded a senior Medical Officer to the Department to look after the health of the workers. In 1965, a full-time, fully trained Ugandan Occupational Health Physician started an Occupational Health Unit in the Ministry of Labour, which was separate from the Factories Inspectorate.

This Unit grew and was later renamed the Occupational Health and Hygiene Department. The Department of Factories had meanwhile also grown and expanded to establish two up-country stations in the two other most industrialized towns of Uganda, i.e. Jinja and Mbale.

In 1984 and 1985, the International Labour Office (ILO) fielded and funded two missions to Uganda. Among their recommendations one was to merge the two departments. Thus in 1994, the current Department of Occupational Safety and Health was established.

Mission and mandate

The mission of the Department is to ensure safety and health at all workplaces and in the work environment. Its mandate is to evaluate and control physical, chemical, physiological, social and technical factors that affect a person at work and the work environment.

Objectives

To minimize occupational accidents, diseases and disabilities
To promote good health at the workplace
To promote a good work environment for workers
To promote the construction of environmentally friendly workplaces.

Organization

The department has an established staff of 52 officers with 38 professionals and 14 support staff. At present there are only 16 professional staff in place, with one officer in our only functional up-country office in the town of Mbale, about 200 km east of Kampala.

Occupational health training and research

There is no local formal training for occupational health professionals in Uganda, although occupational health is included in the Public Health Curriculum of both under-graduates and post- graduates. The cost of training occupational health professionals abroad is phenomenal, and funding has been hard to come by. Sustained research on local occupational health problems is minimal, since it has to originate from the Occupational Safety and Health Department, which has very limited manpower, no research facilities and very limited funds.

Occupational health practice

The practice of occupational health is so far limited to workplaces which can afford a doctor, nurse, medical assistant or nursing aide, on a full-time or part-time basis depending on the resources of the undertaking and the benevolence of the employer. This service is still limited to few big industrial enterprises.

When present, the "Occupational Health Service" is usually curative only, since the workers, employers and health staff have a preference for curative medical measures and little regard for prevention.

Trade unions, where they exist, may not know about the preventive orientation of occupational health and safety, but may rather portray occupational health as something for the future rather than for the present.

The smaller workplaces, which employ probably 60% of the workers in the formal sector, cannot afford even a curative service, however modest. This group is most unlikely to be supervised, even when the Occupational Safety and Health Department is doing its best.

The group of workers in the small-scale industries and the much larger group of "workers" in the rural agricultural sector have to utilise the services of the general health facilities, which may be up to 16 km from the home or the place of work.

The health personnel at the facilities do not recognize their patients as workers; and even for the workers from the industrial sector, the question "what is your occupation?" is rarely asked, if at all.

Constraints:

Publicity

In the 1970s the Ugandan national economy crumbled due to mismanagement. Many large industries collapsed and in order to bridge the gap and provide services, small-scale industries sprang up all over the country. Whereas the emergence of small- and medium-scale industries was a good industrial development, it was also the time when the Department was rapidly becoming unknown to the emerging small-scale industrialists.

Today the Department is gradually trying to reach out to the industries, but much more needs to be done. It is operating at about 20% capacity. Its role and functions are not widely known. This trend, where the Department is less popular, is slowly being reversed. Last year the CIS Headquarters in Geneva provided two computers to the Department, with an Internet connection for easy communication and access to occupational safety and health information.

Human resources

The Department also has a problem of understaffing because:

i) There is a lack of proper training institutions dealing with occupational health and safety in the country.

ii) This being a specialized field where mainly professionals are recruited, such people require attractive remuneration if they are to be retained on the job. The Occupational Safety and Health Department has received and continues to receive some funding from the Government to run its activities.

Obsolete legislation

The Factories Act, which was last amended in 1964, is still being used to enforce occupational safety and health in this country. These laws cannot adequately address the present problems of occupational safety and health.

However, an expert from the ILO has been contracted to help in reviewing the Act.

Transport and equipment

The Department has only two old vehicles for its operations countrywide and thus cannot adequately serve the needs of the Department.

Most medical and hygienic equipment is either defective or lacking. The library and information service does not have necessary equipment and updated publications, and therefore the dissemination of information is difficult.

Conclusion

Although the Department is mandated to offer occupational safety and health services in all parts of Uganda, the existing services fall far short of the ILO/WHO requirements and expectations.

As we struggle for internal solutions to improve our services, we greatly appreciate external support and advice.

Acknowledgment

This article was first published in the African Newsletter on Occupational Health and Safety, December 2000, volume 10, no. 3 pp. 64-66, published by the Finnish Institute of Occupational Health (FIOH). Health and Safety World appreciates and acknowledges the permission granted by the ILO, FIOH and the authors to publish the article here.

Paul Obua, Occupational Safety and Health Department, Kampala, Uganda
E-mail: osh.cis@infocom.co.ug

Note:
The African Newsletter is free of charge and it can be ordered through FIOH.

or it can be ordered from FIOH from the address below.
Marianne Joronen
Guest editor of African Newsletter
Finnish Institute of Occupational Health (FIOH)
Topeliuksenkatu 41 a A
FIN-00250 Helsinki, Finland
Fax +358 9 4747 2548
E-mail: marianne.joronen@occuphealth.fi