There is something painfully strange about waking up one morning and realising that King Oyo, the little boy many of us grew up watching become a king, is no longer with us. For years, his name was simply Oyo. We watched him appear at national functions, grow from a child monarch into a young man and carry the weight of a kingdom that had placed its hopes in him. Now we are being asked to refer to him as the late King Oyo, and somehow those words still do not feel real. Uganda has lost a king we loved.
Omukama Oyo Nyimba Kabamba Iguru Rukidi IV died at only 34 after battling an aggressive and rare form of cancer. His death a tragedy for his family, the people of Tooro and the entire country. But perhaps, in the middle of our mourning, there is a conversation we owe ourselves an uncomfortable conversation about how we diagnose disease in Uganda and what happens when the first diagnosis is wrong.
Princess Royal Ruth Komuntale, while mourning her brother, said something that should not simply pass with the funeral speeches. She said King Oyo had been misdiagnosed in Uganda and that by the time doctors in the United States correctly identified the rare cancer, it had already advanced to a point where treatment could no longer save him.
Imagine that for a moment. A King, with access to medical care and the means to seek specialist attention, can spend time being treated for what turns out not to be the actual disease. What, then, happens to the ordinary Ugandan who has neither the money nor the connections to seek a second opinion abroad?
This is where King Oyo’s story becomes much bigger than King Oyo.
Every Ugandan probably knows someone who has been to hospital several times without getting a clear answer. Someone is treated for ulcers, another for malaria, another for an infection, and when the patient continues complaining, the family begins moving from one facility to another, hoping that the next doctor will finally figure it out. Sometimes they do. Sometimes they do not. And sometimes, by the time the correct diagnosis is made, the disease has already taken too much ground.
We have even developed our own language for these experiences. A patient goes to hospital expecting one thing and comes home with another. Social media then erupts with stories of someone who went to hospital with one problem and was allegedly treated for something completely different. The familiar Ugandan joke of asking for meat and being served beans suddenly stops being funny when the person on the table is fighting for their life.
But perhaps we should resist the temptation to turn every case of misdiagnosis into a trial of the doctor.
Of course, doctors must be accountable. A patient has a right to competent care, proper examination, accurate diagnosis and timely referral. Where there is negligence or professional misconduct, there must be consequences.
But there is another side of this story that we rarely discuss with the same passion: the capacity of the health system itself.
You cannot demand first-world diagnostic accuracy from a health system that has not been adequately resourced for first-world diagnostics. A doctor may be highly trained, committed and genuinely trying to help, but medicine becomes considerably harder when the equipment needed to see, test and confirm a disease is unavailable or unaffordable.
Rare cancers are difficult to diagnose anywhere, but the chances of catching them early improve when a country has modern imaging equipment, specialist oncologists, competent pathology laboratories, trained personnel and a referral system that works.
That is the conversation Uganda should now be having.
If we are serious about reducing delayed cancer diagnoses, then let us invest in the things that make accurate diagnosis possible. Equip our hospitals. Strengthen laboratories and pathology services. Train and retain specialists. Make advanced investigations more accessible. Improve referral systems and, perhaps most importantly, create a culture where doctors can seek second opinions without seeing it as an admission of failure.
The public would support this conversation. Ugandans who cheer doctors when they demand better pay should also cheer when those same doctors demand better equipment, adequate medicines and properly staffed hospitals.
Nobody is attacking doctors by asking these questions. We are asking how to give them a better chance of getting it right.
King Oyo’s death has created an opening for a national conversation about cancer, early diagnosis and the quality of healthcare available to Ugandans. His death should help turn a painful royal loss into an advocacy platform that reaches far beyond Tooro.
King Oyo was a King, but before everything else, he was a patient who needed the right diagnosis at the right time.
So as we mourn him, perhaps we should ask ourselves a question that concerns every Ugandan: what must we change in our health system so that the next person who walks into a hospital with persistent and unexplained symptoms has a better chance of hearing the right diagnosis before it is too late?