Why poor countries have poor services and rich nations have better services
Joseph Mukasa is a peasant in Uganda. He has been performing well in expanding the output of his three acres piece of land. From an income of about Shs5,000 per month in 1995, (which when adjusted to inflation comes to Shs18,000 in 2015 prices), he now makes Shs130,000 per month. This is because he begun employing modern agricultural techniques such as fertilisers, irrigation and improved seeds that are both fast maturing and high yielding. In real terms, Mukasa has actually grown his income by 700% in 20 years.
Mukasa has a wife and six children. In spite of his growth in income, he cannot afford to send them even to cheap private schools where it costs Shs 400,000 per student per term (Shs 2.4 million per term for six children). Good private schools charge Shs 1.5 million. He has to buy cooking oil, clothes, kerosene and salt as well. So he sends them to UPE schools where they get poor quality education. When the children fall sick, Mukasa cannot afford to send them to private hospitals. He sends them to government health facilities with poor services. However, Mukasa also has a drinking problem. He spends Shs13,000 (10% of his income) per month on crude waragi.
Meanwhile, Mukasa’s neighbor, Haji Nasur Nsereko, is a businessman. He has grown his net profit (income) from Shs3.5 million in 1995 (Shs 12m in 2015 prices) to Shs 17m in 2015 – an increase of 30%. He has only two children whom he educates at the prestigious Kampala Parents and pays Shs1.5m for each per term. He also sends his children to the private International Hospital Kampala when they fall ill. During the end of year season, he sometimes takes his family for holidays in Nairobi or even Dubai.
Nsereko also has a girlfriend at Makerere whom he bought a car and often travels with on business trips abroad. He has a mistress in Kampala for whom he rents an apartment where he stays when he is in city. And he has a couple of other girlfriends on whom he spends a lot of money in nightclubs when he is in Kampala shopping. He loves to party and is often in Govnor and Kampala Casino. In LC1 meetings, Nsereko says Mukasa is poor because he is lazy and cannot send his children to the best schools and hospitals because of drunkenness.
Mukasa’s children have internalised Nsereko’s criticism of their father. They are angry saying they do not get a good education or healthcare because their father is selfish and a drunkard. They complain that instead of spending his money on their education at Kampala Parents and treatment at IHK, he spends it on alcohol.
Mukasa’s children give Nsereko as an example of good parental care. They point at him sending his children to excellent private schools and hospitals and holidays abroad as evidence that he is not selfish like their father who “spends his money on alcohol.”
Mukasa’s children may be right to be angry with their father for his expenditure on alcohol. But they are wrong to claim that his drinking is the reason he does not send them to the best schools and hospitals.
They are also wrong to point at Nsereko sending his kids to the best private schools and hospitals or holidays in Dubai as evidence that he cares more about his family or uses his income better than their father. As we have seen from his lifestyle, Nsereko is more wasteful of his income than Mukasa. It is simply that his waste is covered-up by the large sums he earns.
This example is the crisis facing most analysis of governments in Africa. There are certain “obvious truths” we have created to explain our circumstances.