2,300 quack nurses exposed

Thousands of incompetent nurses from fake training schools have been treating patients in Uganda, according to findings of an investigation commissioned by President Yoweri Museveni, writes Joyce Namutebi

They hold the lives of thousands of patients in their hands, but at least 2,300 nurses in Uganda have not undergone adequate training.

In a recent survey of eight illegal nurse training schools sampled from five districts, the Medicines and Health Service Delivery Monitoring Unit (MHSDMU) found that 2,307 individuals had been passed out as nurses over periods ranging from one to 10 years without adequate training. The investigation was done in Ntungamo, Lira, Mayuge, Kamuli and Old Kampala

The report warned that such nurses endanger the lives of Ugandans. Whereas they are unlikely to get jobs in government health facilities, private clinics and hospitals usually employ them.

In addition to operating illegally, the unit discovered that the training schools were offering courses which are not relevant to Uganda’s health system. They were also operating in appalling conditions, the report issued by Dr. Diana Atwine, the head of the unit, said.

“Nearly all the schools  lacked adequate clinical experience for training students. The schools were being run by people who had no qualifications at all,” the report presented to the social services committee of Parliament on Thursday, read in part.

The majority of the students, according to the report, were below the age of 18, with some just having completed Primary Seven. The legal age of entry into nursing school is 18 years. The entrants are also required to have completed Senior Four with a background in science subjects and must have passed with at least three principal passes.

Most of the schools were found to be running without support staff.

The unit team further established that the schools, in many cases, were operating with the knowledge of senior district health officials. 

Some of the tutors in these schools were found to be quacks. For example in Kamuli district the head of the dental department at Were Clinic Nursing School, Simon Bazanya, the report said, claimed to be a public health dental officer, but further investigations revealed that he was not. “He confessed that he had no academic documents. Verification with UNEB revealed that the O’ level certificate he had submitted belonged to a lady.”

It was also established that the nursing students in the illegal schools would work as nurses during the day, without pay and then attend classes in the evening. 

Some of the schools were also found with stolen equipment.

Many of these schools were found to be offering obsolete courses as well as issuing not only forged certificates, but also stealing exams from recognised institutions and offering them to their students.

Atwine proposed that health educational institutions be transferred back to the Ministry of Health from that of education. 

The investigations also unearthed over 900 illegal clinics and drug shops across the country. In Kamuli alone, 412 unlicensed drug shops and clinics had operated for over eight years.

The unit attributes poor service delivery in the health sector to mainly weak supervision and implementation of planned programmes.

At the health centres visited, the report shows that there was 52% absenteeism of staff. In some health centres in Mukono, Wakiso and Kamuli, it was as high as 80%. “Due to high absenteeism some health facilities are left to run by unqualified staff,” the report stated.

Investigations also revealed that many health workers had left for studies without informing the districts and yet they continued to receive salaries.

Some heath workers were found to be engaging in corruption, negligence of duty and making dangerous decisions that jeopardise national  health. 

Poor waste and infrastructure management, non-functional theatres and ambulances, vandalisation of vehicles and other properties, poor record keeping, expired drugs and unaccounted for funds were some of the other problems cited

Atwine told the committee that there is urgent need to put in place systems to check misuse of funds in the sector. In 99% of the districts she  visited, funds were being stolen.

Some higlights from the report
One Pancrass Okojoi in Mayuge, a former porter in St. Francis Buluba Hospital, the report says, forged a certificate as a nursing assistant and then proceeded to start up a cancer clinic and nurses training school. “He was convicted and fined sh500,000 which is not comparable to the damage inflicted on the community.”

In Musinga Teaching Hospital in Ntungamo, the only tutor doubled as the principal and lecturer, one of the students acted as a bursar, while the rest took turns to do maintenance work for the school.

The community training institute for lab technologists in Kamuli was run by a health worker in Kamuli Hospital whereas in Ntungamo, Musinga Christian School teaching hospital had the district health officer on its board of directors, despite overwhelming anomalies.