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With no doctors or supplies, Uganda hospitals are ailing

Many little-noticed and large government health centres in the country continue to suffer drug stock-outs, health worker flights/shortages and rundown infrastructure, an independent, on-the-ground survey of some health centres has found.

The survey shows health units that are literally dying. For instance in Bwera general hospital in Kasese, four midwives deliver at least 500 mothers a month, in Mayuge district, a single doctor runs the 38 functional health units there, in Luweero, Kasana health centre IV has run out of diabetes drugs and some health centre IVs are run by nursing officers, instead of doctors.

In light of this grim picture, The Observer has learnt that the ministry of Health has decided to recruit some 7,000 health workers in order to deal with the human resource shortfall which threatens to cripple the sector.

According to the minister of state for Primary Health Care, Sarah Opendi, there’s a shortage of 10,231 health workers in the country.

“We recruited 7,211 health workers this June and these have been incorporated into the system to try and alleviate the crisis,” she said by telephone.

The minister added that they were in talks with the ministries of Finance and Public Service to meet the balance of the shortfall.

“We plan to meet before the end of this month, and after that this will be incorporated in this budget, so we can meet the entire staff shortage.”

But despite the intervention, the health sector is struggling with staff shortage. Every single day, some 20 mothers line up to give birth at Bwera general hospital in Kasese. But there are only four midwives to attend to them. Of these, two are on the night shift, and the rest on the day shift.

Thus, it is little wonder the four midwives complain of fatigue due to lack of rest, and end up turning away patients seeking treatment. The midwives say they are overwhelmed with the workload.

According to the hospital’s Principal Nursing Officer. Zebia Bakengana, Bwera delivers over 500 mothers every month. Bakengana, who was discussing the maternal and child health situation at a workshop in Kasese’s Verina Gardens hotel on October 14, had a message for the government.

“We need to recruit more midwives since the hospital is a referral for most health centre IIIs in the mountainous areas of Kitholhu, Ihandiro and Nyakiyumbu sub-counties,” she said.

But Bakengana’s wishes are shared across the country. For instance, Mayuge district is facing an acute shortage of health workers. The district has 38 functional health units, manned by one doctor and several nursing and clinical officers, nurses and health assistants – not enough to address the people’s health problems. According to one health worker at Kigandalo, the last two doctors resigned in 2008, citing overwork and poor pay and are yet to be replaced.

After touring the district, Dr Bernard Opara, the principal medical officer in the ministry of Health, admitted that the district was in crisis.

“I have found that we have only one doctor out of the five supposed to be in Mayuge district. There is a big gap that needs to be filled. For example Kigandalo health centre IV is being headed by a nursing officer yet it is meant to be headed by a doctor,” he said.

“The other striking issue that we saw was that in most of the health centres, staffing is low. We need to do something,” Opara added.

Consequently, the public is concerned that health services are deteriorating in the district.

“Visiting a government health centre is no different from staying at home because there is no one to attend to a patient. Hygiene and sanitation in these hospitals is poorer than in our homes,” said Bosco Muzaale, a resident.

An elderly woman near Kigandalo hospital says she suspects the operating theatre there has never been used because there are no doctors to carry out operations.

“At any one time, when you go there only three health workers are always present,” she said.

The story is the same at Gulu regional referral hospital, where staffing levels are appalling. The hospital has seven doctors and a further seven from Gulu University, who work on a voluntary basis. This is against a need of 40 doctors. The hospital also has 103 nurses and midwives, which is half the required number.

Broken infrastructure

But staffing levels are not the only problem the ministry is struggling to contain. Many health centres still lack drugs and patients are often sent away to look for medication in drug shops. In Luweero, the Kasana Health Centre IV, last week reported that it had run out of diabetes drugs, yet patients were queuing in droves to ask for their weekly dose.

According to the centre’s senior medical officer, Majid Mugisha, of the 30 elderly patients who arrive there each month, seeking medication for various ailments, 23 have diabetes.
In Kasese, Karusandara health centre III has ended night shifts after its solar power unit broke down.

The health centre was renovated by the UPDF, last year. The Karusandara LCIII chairman, Ezra Turyahabwe, admitted they had been forced into that decision, as they had a small budget for the health centre.

Additional reporting by Jeff Kiiza, Alex Otto, and Trevor Baleke.

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