Dr. Ruby Dunlap’s Uganda Fulbright Blog
Uganda’s premier English language newspaper, The New Vision, had this article with the headline, “MEDICAL STAFF ABANDON HOSPITAL IN MITYANA” in the 23 September issue, page 7.

Over 40 medical workers in Mityana Hospital on Monday morning abandoned work, leaving 400 patients unattended to.
The workers went to attend a court session where their four colleagues were charged with manslaughter following the death of a pregnant woman in labor.
Sources in the hospital said workers reportedly agreed not to return to work unless their colleagues were granted bail.
Nurses Jane Nanfuka, Agnes Namirembe, Joy Namutebi and Dorris Nalwanga allegedly refused to attend to Sylvia Nalubowa and her unborn baby last month.
The hospital administrator, Charles Luzira, said the medical workers were not on strike but were only showing solidarity to their colleagues and would return to the hospital after the court session.
The nurses were backed by officials from the national midwives and nurses association.
Chief magistrate Justine Atukwasa granted the accused bail of sh200,000 each which they paid. She then ordered them to return to court on October 6.

I did not know any of this on Friday when student Agnes said, “Madame Janet, the president of the Uganda nurses’ union, will be coming through Mukono today. Would you like for her to speak to the class?” (This Madame Janet is not to be confused with Uganda’s First Lady, also a capable lady of heroic commitments.)

The course was on leadership role development in nursing and the topic for the day was “power, influence and conflict management.” Would I like the president of the Uganda nurses’ union to speak? It was a decision which seemed already made. A more perfect guest speaker could not have been dreamed of.

I had spent part of the morning trying to convince the nurses that use of coercive power need not be violent or even discourteous. Certain situations warrant coercive power, the sort of power which “tells” others what must be done rather than “sells” a course of action to others. (We are using sections of Daft’s textbook, “The Leadership Experience” and Diane Huber’s “Leadership and Nursing Care Management.”) I had taken one group to their assigned classroom for their statistics course. Another instructor and class were occupying our classroom. I phoned the room coordinator, Geoffrey, and reported the situation. Then I very politely but firmly informed the squatters that we had a prior reservation for the room and they must leave.

I had to do this again for the afternoon pathophysiology session. While standing there waiting the eviction of the unlawful occupants, I felt a firm nudge against my knee. I looked down to see a black and tan dog patiently looking back at me. From where he came I had no idea but that dog stayed close to me the rest of the afternoon, following me into the classrooms and later into the nursing lab. The students were amused, some of them a little alarmed. When I had situated myself in the room, he lay at my feet and went to sleep, after stretching and yawning in typical dog fashion.

“Madame Janet is coming,” one of the students said. “You’d better get rid of the dog.” I shooed him outside with the intent of shutting the door—almost always left standing open—once he was out. But just as I got him out, Madame Janet arrived. “I’m trying to evict this dog,” I said apologetically. “I’m so glad to meet you.”

“Oh, let the dog stay,” she said, reaching down to rub his ears. “I like dogs. I have two of them myself.” So the dog followed us all back in and flopped down on the cool cement floor where he snoozed through the next couple of hours of Madame’s visit. Sometime before she left, he disappeared, presumably to his home. (I insert the dog story to show Janet’s warmth and also to show that coercive power need not discriminate against species. And just because I like dogs. But you already knew that.)

Madame Janet proceeded to tell the students her perspective of the horrific story of the four nurses mentioned in the newspaper article and how close they had come to being lynched by the mob. In fact, the mob had threatened to burn the hospital down. Madame Janet, with union lawyers, had insisted on rule of law and that the nurses should have their day in court. The entire nursing staff, to make the point, had left the hospital to be present in the court. The accused nurses, said Madame, had followed protocol to the letter and their documentation was impeccable. The deaths of the laboring mother and her infant were tragic but were not due to nursing negligence.
What might have happened had Madame Janet not visited Mityana with the union lawyers is hard to say but everyone agreed it would not have been in the nurses’ favor. With her advocacy, at least they will get their day in court. And my students couldn’t have heard a stronger case study in nursing power rightly applied. Madame and her secretary spent about two hours with us, talking about the history of nursing in Uganda and their plans for the future. “Be assertive,” she urged the students.

They have a research forum every third Saturday of the month; we are signed up for participating in this in October. The students and I are looking forward to this.
Incidentally, “Madame” is the term of respect for any higher ranking woman in this society or even for medium ranking ones like myself. I’ve been “madamed” liberally. It’s one of the more entertaining features of being here. I’ve also been called “mama” out of respect. My students call me “Dr. Ruby.”