MOH, please intervene in Butabika saga

May 19, 2004

SIR — The Ministry of Health (MOH) has embarked on improving the delivery of mental health services by expanding and extending them to all the districts in Uganda

SIR — The Ministry of Health (MOH) has embarked on improving the delivery of mental health services by expanding and extending them to all the districts in Uganda. Hitherto, Butabika National Referral Hospital had almost been the only hospital responsible for the care and treatment of the mentally sick, though Mulago Hospital too, provides similar services, to some extent.

This is commendable. the strategy to achieve this has been to train the psychiatric clinical officers (PCOs) at the psychiatric clinical officer training school at Butabika hospital itself. Butabika is now under renovation and mental health units are under construction in all regional hospitals in Uganda.

Following successful completion of their course, the PCOs will head a regional referral hospital or district hospital or work with the district medical officer throughout the country. However, there is need for urgent intervention by both MOH and by the Ministry of education (MOE). The PCO trainees are scared and frustrated by talk that they will be required to undergo a one-year internship training at Butabika after the two-year course is over. This is not just rumours because it is the very people in charge of Butabika who are suggesting it. The idea of the internship would not be a problem but it is not going to be funded by either MOH or MOE. This can only mean that the internship idea is a brainchild of the authorities at Butabika in charge of clinicals.

The PCOs are in-service people with family responsibilities upcountry where they hail from. If the internship must be part of the course why can’t it be done from their nearest referral hospitals? After all, that is where they will end up after the course. In the last 12 years, only students from within Butabika Hospital used to apply for the course. This explains why not more than six or eight students could be admitted at any one time.

They had no problem because they worked at and received their salary from Butabika hospital. They comfortably stayed in staff quarters with their families and therefore did their internship without a hitch. With the peripheral extension of mental health services, 27 health workers were admitted in 2002/03 while 24 were admitted in 2003/04. Surely, if these students are not going to be funded during their internship why can’t they be posted to their respective stations and be supervised from there?

With or without financial support the internship would not be a problem. Staying at Butabika for internship will obviously require them to rent houses, furnish them, buy food and at the same time cater for their families upcountry. If this is allowed to happen, the course is going to be messed up!

Name withheld

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