During the Ebola outbreak in Mubende District in September 2022, medical interns were deployed to frontline treatment units under conditions that have since raised serious ethical and labour questions.
The government classified them as “students” rather than employees, meaning they received no salaries, benefits, or hazard allowances. Yet, in practice, the interns worked full shifts of more than 40 hours a week in high-risk isolation wards due to mandatory licensing requirements that compel them to complete supervised clinical practice.
Among those affected was Dr. Muhammad Ali, a surgical resident who tragically died after contracting Ebola while serving at Mubende Hospital.
His death has reignited debate within the medical and labour sectors: if the work performed is life-saving and high-risk, why are those performing it still legally treated as “students”?
Frontline Role Under High Risk
Medical interns played a critical role in patient care during the outbreak, assisting in isolation wards and supporting treatment operations at a time when the health system was under extreme pressure.
However, their deployment raised concerns about exposure and protection. Critics argue that the absence of formal employment status meant interns lacked adequate compensation, insurance coverage, and consistent access to hazard allowances and protective equipment.
Health experts have warned that such gaps not only endanger healthcare workers but may also compromise patient safety in outbreak settings where infection control is critical.
Brain Drain and System Pressure
The situation has also been linked to broader concerns about retention of medical professionals in Uganda.
Stakeholders argue that failure to adequately compensate interns during crises risks accelerating the migration of young doctors to better-paying health systems abroad. Uganda already faces a shortage of medical personnel, and critics say crisis-time treatment of interns worsens the challenge.
Government officials have maintained that medical internship is primarily a training period rather than formal public service employment.
They further cite budgetary constraints as a limiting factor in extending full remuneration and employment benefits to interns during their supervised practice.
What International Labour Standards Say
The International Labour Organization (ILO) does not have a specific convention dedicated solely to interns, but existing frameworks provide guidance depending on classification:
- If considered “workers” (as in some jurisdictions such as Kenya), standards such as Convention No. 131 and Convention No. 155 require fair remuneration, occupational safety, and risk allowances.
- If classified as “trainees”, Recommendation No. 117 still calls for “adequate remuneration,” while Convention No. 187 emphasizes the need for strong occupational safety and health protections.
- If considered “students”, Convention No. 155 still obliges institutions to ensure safe working environments, particularly in high-risk medical settings such as Ebola treatment units.
The Bigger Picture
Observers note that medical interns form a critical component of Uganda’s healthcare delivery system, particularly during public health emergencies. Their contribution, they argue, should be recognized within national health financing priorities.
Some experts have called for increased health sector funding in line with the Abuja Declaration, which recommends that African governments allocate at least 10 percent of national budgets to health.
The Ebola outbreak in Mubende exposed a persistent policy dilemma: whether medical interns are students in training or essential frontline workers.
While training is an important part of medical education, critics argue that assigning interns to life-threatening outbreak environments without pay, insurance, or adequate protection undermines both ethical standards and public health preparedness.
Ultimately, the debate continues to center on one key question: can a system justifiably label life-and-death labour as “training”?
The writer is a Workers’ Member of Parliament (in recess).
Hon. Dr. Abdulhu Byakatonda, PhD. CEO, Environment Concern Initiatives Ltd
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