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NAMISINDWA - Metrine Nelima, 24, sought medical services at St. Elizabeth Magale Health Centre IV on March 21, after a private health practitioner at a clinic in Bumbo town council suspected she was anaemic.

Her father, Paul Musamali, took her to Magale Health Centre, a facility established and run under the Catholic Church in Magale town council, Namisindwa district.

Nelima and her family hail from Luwangatsi cell, Luwangatsi Ward, Bumbo town council in Namisindwa.

According to Musamali, upon arrival at the health centre, health personnel only identified as Shedrach checked Nelima’s eyes and concluded that she needed a blood transfusion. 

Musamali says Shedrach did not carry out any other tests on Nelima. That evening, Musamali left Nelima admitted at the health centre under the care of her mother and he returned home to look for money. On returning the next day, Musamali found his daughter’s right hand swollen. 

The cannula had been removed and fixed on her left hand but Nelima’s right hand continued swelling without showing any sign of receding.

On the third day, the swelling surged and the health centre’s management referred Nelima to Mbale Regional Referral Hospital for better management. 

Musamali was asked to pay sh182,000 for the treatment his daughter had received for three days while at Magale Health Centre. However, the written bill, a copy of which New Vision has seen, does not indicate a breakdown. 

Nelima and her family hail from Luwangatsi cell, Luwangatsi Ward, Bumbo town council in Namisindwa

One cannot tell what was being charged and how much — it was just a round figure of sh182,000.

Musamali said he did not have money that day and that the hospital retained his daughter for another night as he looked for money to clear the bill. 

Nelima and her parents first returned home instead of going straight to Mbale because they did not have enough money for transport and other costs.

On March 27, Nelima was taken to Mt Elgon Hospital where a scan was done and the report indicated that there was right radial artery occlusion, right upper limb deep venous thrombosis and right upper limb oedema. 

In simple terms, the report alleged that blood was directed into the wrong vein and that this killed the cells, leading to the swelling and rotting of her arm. 

“Thrombosis occurs when blood clots block blood vessels. There are two main types of thrombosis. Venous thrombosis is when the blood clot blocks a vein. Veins carry blood from the body back into the heart. Arterial thrombosis is when the blood clot blocks an artery,” the report read.

Owing to the situation, doctors at Mt Elgon Hospital recommended an urgent amputation of Nelima’s arm to save her because if the rotting went beyond the elbow, she would lose her arm. 

It was at this stage that Musamali went back to Magale Health Centre and explained his daughter’s predicament to the facility’s in-charge, only identified as Dr Lukia. 

Musamali asked the health centre to contribute to Nelima’s medication since the problem started at their facility. Lukia promised to talk to an unidentified priest, who is the chairperson of the board of directors for the Magale health centre. 

However, what came out of Lukia’s discussion with the priest did not bear any fruit.

Musamali was rushing against time to save his daughter’s life. He was tipped of amputation services at Bududa Hospital where he took his daughter. 

Nelima's rotting arm before she lost it.

Part of Nelima’s arm was amputated from Bududa Hospital on April 9, before the rot could go beyond the elbow. Musamali said he sold his piece of land to acquire money to enable his daughter get medical attention.

Thereafter, he sought a mutual agreement with the Magale Health Centre management on how to share costs and the way forward for his daughter, but in vain. 

He added that Dr. Lukia told him that if he wants any money from Magale Health Centre, he should wait for the facility to put him in their next budget and that if he cannot be patient, he should find other means pleasing to him.

In July, Musamali reported the matter at Magale Police Station and charges of a rush and neglect act were preferred against Magale Health Centre. 

The police doctor stationed at Mbale General Clinic did a report.

Musamali is devastated and stranded with a now disabled daughter. 

He is seeking help from good Samaritans who can reach out to him and support his daughter by way of counselling so that she can come to terms with her new condition. 

He is further seeking legal support to ensure that his daughter gets justice against Magale Health Centre.

“I sold my only piece of land and now I have nothing else to sell to facilitate the expensive legal process against the hospital,” he says.

Nelima comments 

Nelima is the fourth born among nine children. She dropped out of school while in P5 at Bumbo Primary School. She has two children, a 7-month-old baby and a five-year-old, who are entirely under her care because she separated from their father.

“It was painful watching my hand rot away. I spent sleepless nights in the hospital nursing my arm and at the same time I had to breastfeed my 7-month-old baby. I do not know how I am going to survive in this world. 

Nelima and her parents are seeking legal support to ensure that his daughter gets justice against Magale Health Centre.

I can no longer work at the food kiosk where I used to serve as a waitress because my right hand is now off. I cannot lift anything and the pain is still too much. My children and I now have to depend on my parents for survival. My mum is the one who bathes them and gets us what to eat. I need good Samaritans who can help me acquire skills for my survival,” Nelima said.

Namisindwa health dilemma 

Whereas it is a constitutional requirement that every constituency should have a health centre IV and a hospital per district, Namisindwa has none. Established in 2017, Namisindwa has a population of about 230,000 people according to the 2016 census. 

It has 29 sub-counties and town councils altogether. The over 230,000 people in the district are served by only 10 health centre IIIs and six health centre IIs. 

Magale Health Centre is a private not-for-profit hospital established under the Tororo Catholic Archdiocese. 

It operates as a health centre IV for Namisindwa and the Government of Uganda supports it with some staff and medical supplies in order to reduce the cost of treatment for residents.

Health ministry comments

The health ministry spokesperson, Emmanuel Ainebyona, said they have also been interested in the matter purposely to find out whether the procedures were done rightly by licensed professionals, and if there was any breach of professionalism.

“If we find out that there was a breach, then we shall hand over the issue to the Uganda Medical, Dental and Practitioners’ Council for investigations,” he said.

At the end of the investigations, including those done by Police, Ainebyona said those responsible shall be brought to book. “For now, let us allow the investigation teams to do their work before we draw conclusions.”

Health Centre, DHO speak out

When New Vision contacted Doctor Lukia, the in-charge Magale Health Centre for a comment, she said: “I am not in a position to give any information regarding the matter right now.”

Namisindwa District Health Officer Dr. Steven Masai dismissed claims that the amputation of the victim’s arm was a result of a wrong blood transfusion.

“Let them talk of something else for I have never seen blood causing amputation although there is blood that can react,” he said.

Masai added: “We need to find out why the amputation was recommended; maybe it could have been as a result of the reactions from the drugs that were administered to the patient.”

He appealed to the victim’s family to be patient, promising that anytime, he would meet them and forge a way forward. Masai, however, disclosed that he had not yet read the patient’s file, saying he did not have much to say.

“At least I heard about the case though I have not yet read the file to check for details, but as far as I know, even if the blood is bad, it would still move. If they put it in an artery, it would not move, but if you put it in the vein, it would obviously move because veins are the ones that take blood back to the heart for oxygen and nutrients,” he explained.

He also decried the lack of a hospital and a government health centre IV in Namisindwa.