Woes of Tororo hospital

By Frederick Womakuyu

The staff housing facilities at Tororo Hospital can make you sick to the stomach; hearing what goes on in the hospital may depress you

OSUNA DIED
“We looked around for money for transport and upkeep that would help us while in Mbale. But by the time we got the money, it was too late. Osuna was dead,” says Martin Obbo, the father

Three-year-old Moses Osuna came down with a fever and vomiting, so his mother took him to Tororo Hospital for treatment.

However, health workers at this government facility determined that there was nothing ailing him. Nevertheless, he was given some treatment, which signi_ cantly reduced the fever.

“We were asked to go home after being given good news that my son would be okay,” says 35-year-old Stella Agalo, Osuna’s mother, a resident of Paya Parish, Tororo district.

However, at home, the boy’s condition worsened. His fever soared; vomiting became worse, sending his parents into panic. When they rushed to a nearby private clinic, the health workers noticed that the boy needed a paediatrician.

They referred him to Mbale Hospital — 50km away from Tororo Hospital, which also has no paediatricians. The parents did not have transport so they requested Tororo Hospital,which has an ambulance, to help them. But they had no fuel.

Tororo Hospital grapples with dilemmas, challenges and consequences daily, due to shortage of health workers, drugs, inadequate infrastructure, and shortage of equipment and inadequate power and water.

Dr. David Okumu, the Tororo district health offi cer, says the hospital that was built to accommodate less than 50,000 people 74 years ago, has seen its catchment population soar to over a million.

However, despite the increase in population, the hospital continues to get sh290m
from the Government. This money used to be allocated to the facility 10 years ago, when it had only 100 beds, but has since increased to 250 beds.

The dilapidated staff_ quarters.

The Japan Technical Cooperation refurbished the hospital seven years ago and this has attracted a huge number of patients from as far as Butaleja, Bududa, Manafwa, Sironko, Budaka and Bugiri.

The overall staffi ng for the hospital stands at 47% compared to the nationwide average of 51%. The facility is supposed to have 12 doctors but currently has eight, which is still better than other hospitals with either one or none.

Tororo Hospital receives complicated cases that need the attention of specialists, but because the hospital has none, they refer them to facilities with specialists, where many people end up dying.

One of the critical cadres essential for any facility is midwives. According to the health ministry, Tororo is supposed to have 204 midwives but they currently have less than 104.

The bottom line is that the available work force is overworked, have very poor or no housing and the drug supply is very low.

Tororo also has less than 193 nurses of the required 315 recommended by Ministry of Health. This is not enough staff to attend to the ever increasing population with complex diseases.

Dr. Okumu says it has become hard for them to attract and retain health workers. He reveals that every year, they advertise for health workers, but top cadres never apply.

“Most of the specialist physicians stay in the city, where they can get higher pay and better social services,” Dr. Okumu says.

DILAPIDATED HOUSING
The housing situation is pathetic. The 74-year-old quarters paint a picture of a slum, with rotten doors and dirty tiles. The municipal health inspectorate and engineering department have condemned the structures but health workers continue to live there because they have no alternative.

HORRIFIC SANITATION
Poor sanitation is evidenced by careless disposal of rubbish. Holes have developed in the aging asbestos roofi ng material as cracks also run across the walls of the staff quarters, presenting a risk to occupants.

Sarah Apendi, a resident, narrates shocking tales of snakes in the structures. “Last week, a boy was bitten by a snake, but he survived,” Apendi says. One other major problem is sewerage management.

Okumu regrets that since inception, the hospital has not been connected to the national sewer system.

“Even when the refurbishment was undertaken five years ago, the primitive sewerage system built 74 years ago when the population was still very small has been left in place,” he explains.

Consequently, the hospital, whose outpatients have grown from 230 to 600 patients, faces an overfl ow. The hospital administrator, Amos Obokech, says the sewerage system has become expensive since they have to empty it almost daily to prevent overfl owing.

The hospital sets aside sh4m every month to facilitate emptying of the sewer by a private company. However, the money is not always readily available, so they suffer.

“However, we face frequent blockage. We fear that unless the facility is connected to the national sewer soon, there will be a disease outbreak,” he says.

The hospital superintendent, Dr. Andrew Opete, says sometimes the lawn of the hospital overfl ows with sewerage, discouraging patients from coming to the facility.

“With such a situation, we risk exposing our patients to diseases. We request National Water and Sewerage Corporation to fi x our sewer,” he adds.

The Chief Administrative Offi cer, Vitalis Oswan, says many of the problems hitting the hospital are beyond the capacity of the district and the Government must intervene.

For example, the hospital’s labour suit has defective delivery beds. The hospital has eight delivery beds but unfortunately, seven are defective.

Cissy Apio, a midwife at the facility, says they have to manually hold the beds during delivery.

Irene Lamwo, another midwife, says they worry that exposed sponge patches may get drenched, thus posing a health hazard to the next mother in line to give birth.

EQUIPMENT
The hospital has ultra-modern X-ray and CT Scan machines donated by the US-Atlanta based centers for disease control. However, until six months ago, it was not functional because the hospital had failed to recruit a radiographer to operate the equipment.