State House health unit finds patients without toilets in Namisindwa
At Bukhabusi Health Centre III in Bukhabusi subcounty, the team found that the facility had operated for about three years without a pit latrine for patients. The absence of a patient latrine has raised concerns about sanitation and the potential spread of disease at the facility.
Jerome Mpaata, the team leader, said the complaints ranged from absenteeism among health workers and poor sanitation to alleged extortion, inadequate supervision and mismanagement of health facility funds. (Credit: Andrew Nakhaboya)
NAMISINDWA - The State House Health Monitoring Unit has uncovered widespread anomalies in the health sector in Namisindwa District following complaints from residents about poor service delivery at several health facilities.
The monitoring team, which has spent the past 10 days in the district, said preliminary investigations had established that most of the complaints submitted by residents through its dashboard were genuine, including concerns over basic conditions at some facilities.
Jerome Mpaata, the team leader, said the complaints ranged from absenteeism among health workers and poor sanitation to alleged extortion, inadequate supervision and mismanagement of health facility funds.
Patients lack sanitation
At Bukhabusi Health Centre III in Bukhabusi subcounty, the team found that the facility had operated for about three years without a pit latrine for patients.
The absence of a patient latrine has raised concerns about sanitation and the potential spread of disease at the facility.
During a community baraza held at the health centre, residents called for the transfer of the facility in-charge, James Mukhwana, whom they accused of failing to address the sanitation problem.
Ronald Watuwa, a resident, said the facility had gone for more than three years without a patient latrine, describing the situation as frustrating.
He said patients were forced to use a two-stance latrine meant for health workers, which he said was inadequate for the number of patients visiting the facility.
Watuwa said the situation was particularly difficult for mothers who deliver at the facility and require bathing facilities before they are discharged.
Another resident, Joseph Makombe, accused the facility management of failing to prioritise construction of a patient latrine.
Makombe said several facility in-charges had served at Bukhabusi previously, but blamed the current in-charge for what he described as incompetence.
He said residents had repeatedly asked the district health officer to transfer Mukhwana, but their calls had not been heeded.
Makombe said residents had at one point considered demonstrating against the in-charge but decided to give him more time to improve the situation.
Margret Musuya, a mother, also raised concerns about the availability of medicines at the facility.
She alleged that patients were sometimes told medicines were unavailable even when the facility had recently received supplies.
Musuya said on one occasion, she arrived at the facility with a patient at about 7:00 am and waited until 6:00 pm before they were reportedly informed that the required medicines were unavailable.
Moses Watti, the chairperson of the Bukhabusi Health Centre III health unit management committee, confirmed that the facility was operating under difficult conditions.
Watti said the facility receives about sh15.7m in Primary Health Care (PHC) funds, but alleged that there had been no accountability for the money.
He said he had repeatedly asked the facility in-charge to provide accountability without success.
Watti called for an investigation into the matter, saying he would not allow the situation to continue during his tenure as HUMC chairperson.
Absenteeism flagged
The monitoring unit also reported widespread absenteeism among health workers at several health facilities in the district.
The team said the situation was undermining access to healthcare and raising questions about the quality of services provided to patients.
According to the monitoring unit, Namisindwa has 10 health centre IIs and four health centre IIIs, but some facilities had in-charges who had reportedly reported for duty fewer than 10 times.
If proved, the allegations could amount to misappropriation of public funds and falsification of accountability records.
However, the allegations against the DHO and other officials had not been proven by the time of publication, and investigations were still ongoing.
Volunteers running facilities
The monitoring team also found several health facilities being operated by volunteers who are not formally employed or paid by the Government.
Dr Elijah Semaganda, the assistant director of the monitoring unit, warned that relying on unpaid volunteers to provide health services could expose patients to exploitation, including possible extortion.
Semaganda said the team was also following up on allegations of theft of medicines at Soono Health Centre III.
He identified Peter Wabusa, a volunteer, as a suspect in the alleged theft and said police were searching for him.
According to Semaganda, Wabusa fled after allegedly seeing the monitoring team and abandoned his motorcycle, which authorities are holding as investigations continue.
Semaganda said efforts were underway to apprehend the suspect and have him face the law if the allegations are proved in court.
Janet Babigumira, the principal monitoring and evaluation officer, said the team had also found that some health workers in Namisindwa did not live near their duty stations, contributing to absenteeism.
She alleged that some facility in-charges had never reported to their respective facilities but continued to draw salaries.
Babigumira described the situation as unfortunate, saying public funds were being spent on workers who were allegedly not providing services while many unemployed people were seeking jobs.
Filled up pit latrine at Bukhabusi Health Centre III. (Credit: Andrew Nakhaboya)
Health workers arrested
The State House Health Monitoring Unit has caused the arrest of several health workers in Namisindwa over alleged accountability failures involving medicines and PHC funds.
One of those arrested is Evelyn Masibo, the in-charge of the medicines store at Bukhabusi Health Centre III. She was arrested after allegedly failing to account for medicines supplied to the facility by National Medical Stores.
Others, including Martin Mutuma, the facility in-charge at Magale Health Centre III, and Peter Wabusa, the in-charge at Soono Health Centre III, were arrested over alleged failure to account for PHC funds allocated to their respective facilities every quarter.
Dr Semaganda said the officers were arrested and charged before being released on bail as investigations continue.
DHO responds
Responding to the concerns raised by residents, Dr Stephen Masayi, the acting Namisindwa district health officer, denied receiving kickbacks from health facility in-charges.
Masayi, however, confirmed that Mukhwana, the in-charge of Bukhabusi Health Centre III, would be transferred with immediate effect.
He also acknowledged the absence of a patient latrine at Bukhabusi and said the district planned to construct one after receiving funds for the current quarter.
He thanked the State House Health Monitoring Unit for supporting the district in identifying gaps in health service delivery and pledged to improve supervision and service delivery.
Lomomgin Joseph, the Namisindwa chief administrative officer, who has been in the district for about two months, said he would not tolerate negligence or other forms of misconduct among civil servants.
Joseph said he was still studying how civil servants in the district operated but warned that officials found culpable would face disciplinary action.
“I will begin to bite those who are found culpable and are not ready to change,” he said.
LC5 chairman unhappy
Emma Bwayo, the Namisindwa LC5 chairman, said the district leadership was unhappy with health workers who neglect their duties.
He questioned why someone would secure a government job and subsequently fail to perform their duties.
Bwayo said some absentee health workers were reportedly powerful and protected by influential individuals in the district, but vowed not to tolerate such behaviour.
He said the only powerful people he recognised were the residents who entrusted him with their votes to serve them.
Bwayo added that health workers who were not ready to work should step down and allow those willing to serve to be recruited.
Stalled construction
At Bumbo Health Centre III, a theatre construction project estimated at more than sh400m has stalled.
The facility is earmarked for an upgrade, but the stalled construction has raised concerns about the district's capacity to provide comprehensive health services to residents.
The delay has also left residents questioning when the facility will acquire the capacity to handle more complex medical cases locally.
Call for Health Centre IV
Health facilities in Namisindwa face additional challenges due to the absence of a Health Centre IV in the district.
On average, each health centre III in Namisindwa delivers about 100 mothers every month. However, mothers who develop complications are often referred to facilities in neighbouring Manafwa District, more than 20 kilometres away.
There have been calls for the Ministry of Health to establish a health centre IV and a district hospital in Namisindwa to improve access to emergency and specialised health services.
Appearing on the floor of Parliament recently, Metrine Nanjala Musufwa, the Member of Parliament for Namisindwa County, decried the lack of a health centre IV in the area, saying the gap remains one of the major hindrances to effective health service delivery in the district.
Probe continues
The State House Health Monitoring Unit is expected to compile a comprehensive report of its findings and make recommendations on the challenges affecting health service delivery in Namisindwa.
The recommendations are expected to guide interventions by the district and other relevant authorities aimed at improving healthcare services.
The latest findings come against the backdrop of the government's ongoing campaign to expose corruption in local governments, led by Minister of State for Local Government Balaam Barugahara.
The campaign has resulted in the arrest and interdiction of several civil servants accused of corruption and other forms of misconduct.
With the latest findings in Namisindwa, questions remain over whether previous interventions have achieved the desired improvements in the district's public service.