Imagine being told you need urgent, expensive surgery, only to find out later that nothing was ever wrong with you. Now imagine you have already had the operation and learnt afterwards that it was not necessary, and that the damage done to your body is permanent and irreversible. For many Ugandans, this is not just a story but a lived reality. Disease misdiagnosis is quietly becoming one of the most serious and least talked about problems in our healthcare system, and silence is making it worse. WHEN DOCTORS GET IT WRONG About two years ago, I developed sudden knee pain. The first orthopedic surgeon I visited ordered an X-ray and recommended urgent surgery costing over Shs 5 million. I sought a second opinion. A different surgeon ordered a CT scan and gave a completely different diagnosis. Two top specialists, two entirely different findings, both recommended different expensive operations. I chose to wait. With time and rest, the pain disappeared, no surgery was ever done. I had a similar experience with persistent stomach pain. I was repeatedly diagnosed with ulcers across several hospitals and kept on medication for months. A gastroenterologist recommended I undertake endoscopy, which would cost Shs 4 million. Having heard of a colleague who suffered intestinal injuries during the same procedure, I hesitated and sought yet another opinion. Another gastroenterologist examined me thoroughly and found all my organs perfectly normal. He then asked one simple but important question: “what is worrying you?” I had recently lost both my father and a close mentor, which had taken a deep toll on me. He diagnosed stress, referred me to a counsellor, and advised me to reduce my workload. After a few sessions, the pain disappeared entirely. No endoscopy. No millions spent. More recently, a pregnant colleague, during one of her final antenatal visits, was told at a top hospital that she had fibroids and that without an immediate operation costing Shs 10 million, both she and her unborn baby risked death. Terrified, she sought a second opinion. The next doctor found nothing wrong. The pregnancy was perfectly fine. She continued her pregnancy normally and delivered a healthy baby. I have since heard of several other misdiagnosis cases from workmates and friends. The full scope and scale of the problem at national level remains unknown, but available evidence is concerning. A 2023 doctoral study by Katongole and colleagues, conducted across five general hospitals in central Uganda, found that 9.2 per cent of hospitalised patients were misdiagnosed. The most commonly affected conditions included peptic ulcer disease, malaria, hypertension, gastroenteritis, and pneumonia. WHY IS MISDIAGNOSIS HAPPENING? Misdiagnosis in Uganda is not caused by one single problem. The 2023 study by Katongole and colleagues identified several contributing factors, including understaffing and work overload, inadequate training of healthcare workers, poor laboratory equipment, weak hospital leadership, and gaps in the patient referral system. Patients admitted at night were three times more likely to be misdiagnosed, due to staff fatigue and reduced service quality during those hours. Beyond these systemic failures, financial motivations also raise serious questions. Some costly procedures appear to be recommended not because they are medically necessary, but because they are profitable. Together, these overlapping problems create a healthcare environment where patients are left deeply vulnerable, often without even knowing it. THE COST OF MISDIAGNOSIS The consequences go far beyond wasted money. At its worst, a wrong diagnosis can cost a patient their life. Unnecessary surgeries leave some patients permanently disabled, while families drain savings and sink into debt for procedures they never needed. Being falsely told you have a life-threatening illness or that your unborn child may not survive causes deep psychological trauma. And while a patient is treated for the wrong condition, the real illness continues to worsen silently. Most Ugandans keep health struggles private, held back by social stigma, cultural stereotypes, fear of judgment, or simply not knowing that what happened to them was wrong. As a result, misdiagnosis cases rarely come to light and the problem continues to grow unchecked. If we spoke openly about our experiences, the number of stories would be overwhelming. Every one of us, regardless of status, income, or profession, is a potential victim. Even doctors themselves are not immune. WHAT NEEDS TO CHANGE The ministry of Health should recruit more healthcare workers, acquire better diagnostic equipment, and strengthen laboratory facilities so that doctors can make decisions backed by proper tests. Training should also improve, with particular focus on the most commonly misdiagnosed conditions. Nighttime hospital services, in particular, need urgent attention given that patients admitted at night are three times more likely to be misdiagnosed. Additionally, hospital leadership should foster a culture of accountability. When misdiagnosis occurs, there should be clear consequences, not silence. Most importantly, every patient should know they have the right to question a diagnosis, seek a second opinion, and report medical negligence. The ministry of Health should publicise these rights widely, at health facilities and through community outreach in local languages. As individuals, we must develop the habit of seeking at least two independent medical opinions before agreeing to any major procedure, unless it is an emergency. Questioning your doctor is not disrespectful — it is a responsible step that could save your life. The writer is an executive director at Blueprint Consortium Africa, Kampala.The post Disease misdiagnosis in Uganda: A crisis we can nolonger ignore appeared first on The Observer.