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New health centres a blessing but lack doctors

By Vision Reporter

Added 2nd June 2005 03:00 AM

LYING on her hospital bed, Rwandese Anastanzia Mabarire, 40, is looking at the snow-white ceiling of a glittering Chahafi Health Centre IV (HCIV) with a blank expression.

LYING on her hospital bed, Rwandese Anastanzia Mabarire, 40, is looking at the snow-white ceiling of a glittering Chahafi Health Centre IV (HCIV) with a blank expression.

By Matthias Mugisha

LYING on her hospital bed, Rwandese Anastanzia Mabarire, 40, is looking at the snow-white ceiling of a glittering Chahafi Health Centre IV (HCIV) with a blank expression. The bout of malaria she is suffering from has shrank her facial features. Her white eyes threaten to pop out and her lips are so dry that they have began to crack.

Mabarire cannot afford the medical fees, but because of the $24.5m Spanish loan the Government utilised to build and renovate health centres in Kamuli and Kisoro districts, Mabarire is getting free medical treatment at Chahafi in Kisoro near the Uganda-Rwanda border.

After the construction of the new health centres and renovation of the existing ones in Kisoro, the services have improved. In response, hordes of Congolese and Rwandese nationals cross to seek free medical treatment in Uganda.

“The problem we have now is that between 20% and 30% percent of the patients we get are non-Ugandans. Sometimes, it is hard to detect them,” says Kisoro district director of health services Dr Assy Ndizihiwe.

Kisoro has a population of 221,868 people and 12 doctors with a ratio of 18,489 people per doctor. The Government pays sh1,700 as medical insurance for each person. “We have to cater for aliens the Government did not budget for,” Ndizihiwe complains.

The Spanish loan was used to construct one main hospital in each of the two districts and a number of health centres. Kamuli got four HC IVs, 10 health centre 111s (HCIII) and state-of-the-art medical equipment, including furniture.
In Kisoro, two HCIVs and 11 CH IIIs were constructed and equipped.

The contractors were Dragados, Arab contractors, Excel Construction, Dott Services Ltd, Spencon Services Ltd and BAU Technical Services.

Most of the construction work was completed by August last year, with impressive structures. But due to lack of medical staff, some health centres, especially in Kamuli, threaten to become white elephants.

The dusty road from Kamuli town after 35km suddenly gives way to spotless clean structures that make up Kidera Health Centre IV Compared to the surroundings, and bearing in mind that Kidera is considered backward, the health facility looks like Long John Silver and Little Jim’s Treasure Island. Like all HCIV’s in the two districts, Kidera has a laboratory, a theatre, running water trapped in giant rainwater tanks, a generator and solar power.

According to records covering three months, Kidera Out Patients Department (OPD) treats an average 2,032 patients per month and an average of 67.7 per day. In July and August, 50 and 58 babies were born it its maternity section. Kidera county has a population of 40,402 though some patients come from as far as Apac district.

The figures look impressive until you look at the medical staff. Kidera has one enrolled nurse and two enrolled midwives. Though they have a doctor, the theatre is not operational due to lack of support staff. The same applies to all the health centres, including the main hospital in the district.

Kamuli district, with a population of 712,079, has five doctors, a ratio of 142415.8 people to one doctor.

According to the district director of medical services, Dr David Tigawalana, the district has only two laboratory technicians yet, it has 64 health centres, 37 of which are government owned.

“Where there is a doctor, there is no support staff, the equipment in Kamuli Hospital theatre is gathering dust,’’ says Tigawalana, who says most qualified people are hesitant to work upcountry. All health centre IIIs and HCIVs have wards and a fair supply of drugs, but most of the new beds supplied are still in their polythene wrappings because they are not used.

“There isn’t anybody to care for the patients when admitted,” he explains.
Though people no longer move long distances to get medical services, it is the opposite in Bulamogi and Budiope, the northern parts of the district. The areas are big and sparsely populated and some people move about 20km to the health centres. Bugabula north also faces the same problem.

Though lack of medical workers is a chronic problem in the country, Kisoro fares better than Kamuli in medical staffing.

The main hospital functions to almost its maximum capacity and is reasonably well staffed. All the theatres in HCIVs are operational. Between 2004 and 2005, the hospital had 69,399 patients treated in the OPD department.

According to available records, Kamuli Main Hospital cared for 11,609 patients, an average of 2902.25 in four months.
The Minister of State for Health, Mike Mukula, says the Government is working tirelessly to address the shortage of medical staff nationwide.

“We are soon launching a recruitment drive countrywide,” he says.
If the recruitment of more medical workers is not implemented, all health centres in Kamuli will be treasure islands with no treasure.

New health centres a blessing but lack doctors

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