{UAH} Katakwi hospital, like many public health facilities, is a tearjerker

Katakwi hospital, like many public health facilities, is a tearjerker

Written by Racheal Ninsiima

Created: 11 May 2016

At Katakwi general hospital's paediatric ward, a despondent pale girl clutches her hands in pain, writhing on a shawl laid on the floor.

Just a few metres away from her, other children lie on the beds, being attended to by guardians. Seeing many parents call out to the only nurse on duty is enough to tell a first-time visitor at this government hospital that there is inadequate staffing.

Sr Immaculate Akello, the hospital's senior nursing officer, rushes in to save a dying child. Immediately, she puts her stethoscope to use and watches the little boy's chest heave up and down.

"He will be fine. He needs to have more drips," she reassures the boy's scared mother.

Sr Akello says shortage of staff is a punishing challenge to the hospital, as some wards have only one health worker.  The maternal ward is crowded with expectant mothers waiting for assistance. In the postnatal ward, the floor is lined with mattresses being shared by new mothers.

The beds are not enough to contain them and some have to sleep on the floor as they wait for the bed occupants to be discharged. Mothers of premature babies have to be referred to Soroti regional referral hospital, 34km away, because the nursery at Katakwi hospital is ill-equipped.

Sr Immaculate Akello, the hospital's senior nursing officer, checks on a child during her rounds in the children's ward

As I continue through the corridor to another room, I notice several new beds and mattresses clamped together. Upon inquiry, Akello tells me there is great need for space to accommodate patients admitted in the hospital. Moreover, inadequate bed space is posing serious challenges among patients.

"The children's ward is built to accommodate 33 children but sometimes we can have as many as 90. This forces us to mix children with communicable diseases such as TB with others because there is nowhere else we can keep them," she laments.

She adds that the hospital received a donation of a CT scan and X-ray from Baylor College of medicine but these too are grounded because of lack of space.

MORE ILLS

To some, Katakwi general hospital is no longer a healing refuge for the sick and dying but, rather, a place with more ills than even the patients. One of the hospital's two ambulances is grounded because it has no tyres. Sr Akello reveals that the lone functional ambulance is used as a staff van and surveillance vehicle on top of performing its ambulance duties.

As if having one ambulance is not bad enough, this district hospital sometimes goes for weeks without running water. The recent drought has only exacerbated the problem.

"I often have to wake up early and collect water from a source outside the hospital. Sometimes the situation gets very desperate that attendants are forced to collect water from unsafe sources such as streams from which animals drink," one patient's attendant tells me.

On the far left side outside of the male ward, I spot four fading-blue metallic barrels and I am told it is where some patients reserve their water. The small theatre room is unbefitting a general hospital. Although the number of patients requiring surgery has increased over the years, the theatre space that holds at most two patients has remained unchanged for more than 10 years.

A child afflicted with malaria in the children's ward at Katakwi General hospital

With the situation of inadequate space so dire, surgeries have had to be delayed, which puts the lives of patients at risk. Moreover, lack of anaesthetists round the clock is making patients suffer for hours.

Another major grievance is the reoccurrence of drug shortages in the facility. The shortage has been attributed to receiving less than the order placed at the National Medical Stores (NMS).

"Many a time I come for diabetic treatment, I am told that some drugs are not available and I am referred to Soroti regional referral hospital," one of the patients says.

During a meeting with staff from ActionAid Uganda, Dr Isaiah Kikwabanga, the district health officer, said drug shortages sometimes force patients to buy medicines from pharmacies and drug shops. For example, when there is a stock-out of the free-at-the-hospital antimalarial, Artesunate; patients are forced to buy a dose at Shs 15,000.

This is too costly considering the population here relies mostly on subsistence agriculture. It is probably the laboratory that breathes life into this hospital. Constructed by Baylor a few months ago, it is teeming with modern equipment and air conditioning. However, what is an accurate diagnosis if it cannot be treated? Besides, not even this new feature has been spared a limp from trials.

"We need a minimum of 10 staff but we are six at the moment; there are often power outages which render the lab idle and chemical reagents are often out of stock," Anthony Obonguta, the acting in-charge of the lab, laments.

DEAD MORTUARY

The strange thing about this hospital is that since its upgrade from a health centre IV in 2011, its mortuary has never seen a facelift. In fact, it is not operational and the bereaved have no choice but to take their loved ones away quickly.

"The mortuary situation at Katakwi hospital is absurd. There are no fridges and sometimes the hospital does not have preservatives. We have the challenge of transporting dead bodies because ambulances do not carry dead bodies and when they do, they charge exorbitant fees," said Filbert Ocailap, Katakwi's resident district commissioner. 

Overgrown grass around the dilapidated mortuary dissuaded me from venturing further.

RECOMMENDATIONS

To resuscitate the limping district hospital, Sr Akello appeals to government to renovate the hospital and ensure all wards are extended and the theater expanded.

On the other hand, Dr Kikwabanga calls for increased funding of the primary health budget of the hospital, which is currently Shs 27m per quarter (every three months). Additionally, there is need to purchase new equipment, and train and recruit health workers in the facility.

ninsiima@observer.ug

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H.OGWAPITI
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