“Working within the community has helped me to learn lots of things, but the most important is that it takes time for understanding and understanding is key to effective progress,” shared Bernard Kakuhikire, Director of the Institute of Management Sciences, Mbarara University of Science and Technology (MUST), while speaking to Darden students last week.
While UVa and MUST have benefitted from their relationship since 2007, collaborations have largely focused on medical initiatives. MUST’s Bernard Kakuhikire and his colleague Geoffrey Bwireh’s visit to Darden last week allowed time for many discussions to take place about potential collaborations between the business schools. The guests came to learn about new business models, agribusiness initiatives, sustainability and entrepreneurship and also spoke to students both formally and informally.
The Emerging Markets and Development Club organized an evening event for Mr. Kakuhikire and Mr. Bwireh to present their thoughts on healthcare to students. The guests spoke about the impact that healthcare challenges have on business within Uganda and Africa as a whole.
Mr. Kakuhikire, as principal investigator of two donor funded projects related both to business and health, and Mr. Bwireh, as a Red Cross Society volunteer and national logistics strategy manager, provided insider perspectives on the cyclical nature of illness within a population: “Sickness decreases productivity, discourages investment and tourism, which results in decreased taxes flowing to the government. Sometimes children are required to drop out of school to look after their siblings or parents” said Mr. Kakuhikire. He went on to explain that while approximately 60% of the health system in Uganda is public, and 20% is mission or faith-based (with the remaining 20% being privately funded), the mission or faith-based facilities are by far the most effective. With corruption in the government, Mr. Kakuhikire estimated that only 20% of the public health systems are actually effective, meaning someone who needs medical care is able to receive it by going to a clinic or a hospital.
One student, who served as a Peace Corps volunteer in a neighboring African country, mentioned that she had observed that access to good healthcare depends largely on effective infrastructure systems. Mr. Bwireh and Mr. Kakuhikire agreed that without bridges or usable roads, it is impossible for trucks carrying medical supplies to get through. They established that in order for the healthcare system to function, the supply chain between system between the provider and the patient must become less complicated and fraught with logistical challenges.
Mr. Bwireh explained another challenge: Ugandan healthcare workers often leave to work in other countries. “Uganda has a good training program for healthcare workers, but employee morale is very, very low. The government does not pay them enough to keep them in the country and we’re losing a resource we need.” Mr. Kakuhikire added that “For proper [disease] management, it has to start at the household level. Some of the diseases should be manageable, but people do not know what to do so they go to a hospital, which is often already overcrowded, and risk the chance of picking up something else.”
In large part, Mr. Bwireh and Mr. Kakuhikire discussed healthcare challenges in terms of greater infrastructure and societal issues that lead to either the inability to distribute and use resources effectively or a lack of knowledge or concern about basic best healthcare practices that would otherwise be manageable. The challenges around healthcare involve questions related to a much broader scope of activity than simply a patient receiving care. In order to be effective, the system must be able to manage money appropriately, have infrastructure systems in place to support transportation, and be able be able to support flows of information. Even though none of these systems are directly related to healthcare, without them the task of reaching those in need or establishing preventative measures becomes increasingly difficult and complex.
Yichen Feng (MBA ’15) remarked after the discussion that “we study business problems at Darden through the traditional business plan framework of identifying a problem and providing a market driven solution. Our guests showed us a deeper way of thinking about problems that often don’t have straightforward solutions. Social issues involve addressing root causes, providing community support and thinking well into the future. Learning about what they’re doing with HOPENet was fascinating and we have a lot to learn.”