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Luuka: where mothers deliver on verandahs

A short trip outside Luuka district headquarters brings you to Kiyunga health centre IV.

There you find Sarah Nairuba attending to her son who is on drip with the bottle tied to a windowpane. Some of the windows are propped up by used boxes and polythene bags, exposing patients to mosquito bites.

When the Obote I government built Kiyunga health centre IV in 1963, the expectation was that it would grow into a fully-fledged hospital serving Luuka. Instead on January 26, 2013, a mysterious fire gutted the major block that comprised the male ward and some stores. All admitted patients now must stay in one ward irrespective of sex, age and illness.

Despite its dilapidated state, the health centre serves 300 patients daily. But most people who head there say they do so because they have no alternative.

“If I had had money, I would have taken my child to a private clinic, government should come to our rescue if we are truly also Ugandans,” Nairuba says, the sadness visible on her face.

According to Dr Matthias Panyoka Wangoye, who is in charge of the health centre, Kiyunga serves both in and out-patients. A third of the 300 patients at the facility are there for antenatal services.
However, there are only 14 beds to serve about 100 inpatients admitted at the facility.

“Of course the conditions are not good and patients are often advised to carry some mats for emergency because most of them have to sleep on the floor,” says Dr Wangoye.

Most patients are here for treatment for malaria, diarrhoea, pneumonia and tetanus although most of the facilities and equipment for treating them are lacking. The most miserable conditions are left for the expectant mothers, who are squeezed into a single cubicle room, which used to be used as the district health officer’s office with only three beds just close to each other.

Aisha Alitubera, a midwife attending to mothers in the labour ward, said sometimes deliveries are made on the verandah.

“We have only three beds with one delivery bed which was donated in February by Centenary bank but some days we have over 10 deliveries registered daily,” she says. “If a mother delivers, we may force her to leave the room and be nursed outside as another takes it up.”

Dr Wabwire, who also works at Kiyunga, says the health facility is bogged down largely by lack of staff accommodation and general infrastructure.

“We endeavour to make requisitions for medicine from the medical stores in time but the fact that all patients are squeezed in one ward irrespective of the disease one suffers from makes it relatively hard to cure some patients as they acquire more diseases in the course of treating the first one.” he said.

To add to the misery, the district’s quarterly allocation of Shs 6m is regularly cut to Shs 4m, mostly spent in paying the electricity bill. The solar system used to power the theatre was destroyed in the fire, limiting the power supply during load shedding.

The Luuka district health officer, Dr Enock Kwikiriza, admits that they struggle to provide basic health services and need all the support they can get.

“Whereas death is normal and expected on a daily basis, our biggest health centre lacks a morgue and when one dies, we order the relatives to immediately arrange for transport or keep the body outside the ward,” Dr Kwikiriza noted.

During the 2011 parliamentary elections, the current area MP John Bagoole donated an ambulance. Unfortunately the ambulance was involved in a traffic accident, and is now stuck in a Kampala garage for over a year.

Instead the facility has improvised with a double-cabin pickup donated to the district by the health strengthening programme.

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