Imagine a family forced to sell their loved one's possessions just to keep him alive. This is the heartbreaking reality for the family of Dr. James William Rwanyarare, a revered Uganda Peoples Congress (UPC) elder and former champion for people with disabilities. In a recent ruling, the High Court Family Division has allowed them to sell his cars and livestock to settle a staggering Shs 65.4 million hospital bill. But here's where it gets even more complex: this decision, while seemingly practical, raises questions about the intersection of family responsibility, medical debt, and the legal system's role in personal affairs.
On October 21, 2025, Lady Justice Jeanne Rwakakooko greenlit the sale of three vehicles and 18 cows belonging to Dr. Rwanyarare, whose prolonged treatment at Nakasero Hospital has racked up a substantial debt since January 31, 2022. The court-appointed representatives, Caroline Kahamutama and Adam Kakuru Rwanyarare, had sought permission under the Civil Procedure Act, adhering to a 2024 court order that barred asset disposal without judicial approval.
Justice Rwakakooko’s ruling underscores a delicate balance: ensuring the patient’s welfare while maintaining transparency. She emphasized that failing to clear the debt could jeopardize Dr. Rwanyarare’s ongoing treatment, a grim prospect for someone already battling mental illness. “The welfare of the patient is paramount,” she stated, adding, “His treatment comes first, and neglecting these bills could worsen an already dire situation, especially when assets are available to address the issue.”
And this is the part most people miss: the family’s efforts to involve all of Dr. Rwanyarare’s children in the decision-making process. While most consented via email and a family WhatsApp group, two—Kevin Kiiza Rwanyarare and Lynda Mutesi Arinaitwe—remained silent. The court accepted this as sufficient consultation, but it begs the question: How do we ensure fairness when some family members are unreachable or unwilling to participate?
The assets authorized for sale include three motor vehicles (UAH 117R, UAW 751U, and UAH 876P) and 18 cows from the family farm in Nyabushozi–Kikatsi. The proceeds must be used exclusively to settle the Nakasero Hospital bill, with a detailed return filed to both the court and Dr. Rwanyarare’s children. The estate will also bear the costs of the application, adding another layer of financial strain.
Here’s where it gets controversial: While the court’s decision provides a legal pathway to address the debt, it also raises ethical questions. Should families be compelled to liquidate assets to cover medical expenses? And what happens when such debts become unmanageable? Dr. Rwanyarare’s case is not unique; it reflects a broader issue of healthcare affordability and the burden it places on families.
As a longtime advocate for disability rights and a prominent UPC figure, Dr. Rwanyarare’s plight resonates deeply. His family’s struggle highlights the complexities of managing long-term illness, both medically and financially. Is our healthcare system doing enough to support patients and their families in such situations?
What do you think? Should families bear the full brunt of medical debts, or is there a need for systemic reforms? Share your thoughts in the comments—let’s spark a conversation that could lead to meaningful change.
