{UAH} Who will save Uganda’s limping health system?SOME sycophants THINK THIS IS PROGRESS

Who will save Uganda's limping health system?

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One of the houses in the medical staff quarters in Moroto. 

By FREDERIC MUSISI

Posted  Saturday, April 4  2015 at  01:00

In Summary

Insensitive? As government plans to send at least 263 specialised medical personnel to the Caribbean island of Trinidad and Tobago, what is the health situation back home?

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• Who will save Uganda's limping health system?

On a good day at a rural government health facility, when doctors are present and nurses are not shouting, drugs will be out of stock. On a bad one when drugs have been stocked, health attendants will be out of sight.

It was such undoing, typical of majority health centres around the country, that Joyce Ategeka, a resident of Nyawaiga village on the shores of Lake Albert in Buliisa District, was left a widow at 35. Her husband succumbed to acute malaria and diarrhea, leaving her the burden of raising 10 children alone.

A nurse at a health centre III in the neighbouring village, Sebagoro, where the deceased had been admitted four days before his death, revealed that there was a high chance of saving him.

Problem was, there were neither drugs nor a qualified doctor so he could not be helped further. Admitting that the centre has a staff and drug shortage, the best the nurse, who spoke on condition of anonymity, says they all they could do was give him painkillers - Panadol. The doctor at the health centre had been transferred three months earlier.

The health centre in Sebagoro is a 20 by 40-feet container that moonlights for patient examination, emergencies, labour ward, antenatal and clerking, name it. The unit is shared by seven villages, with a daily patient influx of between 30 to 40 and a staff of seven.
Four hundred kilometers South West in Nyakashaka, Burere Sub-county in Buhweju District, the situation is perhaps slightly but not any better.

Regional referral hospitals
At the 14 regional referral hospitals in the country, the status quo is barely better.
According to the ministry's Annual Health Sector Performance Report for the FY2013/14 issued in October last year, seven out of the 14 regional referral hospitals have a staffing level below the average. These include Moroto (41%), Mubende (55%), Naguru (67%), Kabale (70 %), Soroti (74%) and Hoima (74 %). Having to serve five neighbouring districts of Nakapiripirit, Abim, Kaabong, Moroto and Kotido, Moroto Regional Referral Hospital has had to up its 115 bed capacity by 70, despite its laughable staff numbers.

Patient numbers, however, are quite low except for the maternity ward due to factors ranging from the bad roads, drought, famine, absence of specialised facilities and medical attendants and lack of electricity. With limited access to clean water, the hospital is forced to rely on the hard water available, which frequently breaks down the equipment.

The hospital's chief medical supretendant, Dr Filbert Nyeko, says they have to refer patients to as far as Soroti to access specialised services.

Nonetheless, health centres continue to face other challenges, including poor working conditions, excessive workloads, low salaries and poor remuneration, obsolete diagnostic equipment, medical workers stealing drugs, and drug shortages.

Yet in the face of all such challenges, government is making plans to send at least 263 specialised medical personnel to the Caribbean Island of Trinidad and Tobago, a deal which officials from both Health and Foreign Affairs ministries, say is intended at "accelerating diplomatic relations" between the two countries.

Uganda is number 149th in rankings of healthcare around the world. Trinidad on the other hand, is in the 67th position and in third position is the Americas after United States and Canada. With a population of 1.3 million people, Trinidad has 12 times as many doctors per capita than Uganda.

According to the shortlist, the personnel set to go include , 15 of the 28 orthopedics Uganda has, four of the six urologists, 15 of of 91 Internal medicine specialists, 15 of 92 paediatrics, four of the 25 ophthalmologists, four of the 11 registered psychiatrists and 20 of the 28 radiologists.

Others include 20 Radiologists, 15 of the 126 gynaecologists in Uganda, four of the 15 pathologists, 15 paediatrics, four Ophthalmologists, 15 general surgeons, among others.

But Dr Asuman Lukwago, the Permanent Secretary in the Health ministry, says the decision to offer Trinidad a helping hand has nothing to do with Uganda's health sector being afflicted.

"The sector has some human resource challenges, but this is not because of availability on the front line. There are some frontiers where we even have excess and the question that begs is what should we do for such people without work?" he asks.

Dr Lukwago argues that the challenges plaguing the health sector are bigger than the ministry, and a solution, if any, requires multi-pronged approaches.

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