Medics stealing drugs from health centres, stocking their private clinics

Mar 22, 2008

AT LEAST 73% of drugs mysteriously go missing from Uganda’s health centres, according to a report by the Centre for Global Development.

By Carol Natukunda

AT LEAST 73% of drugs mysteriously go missing from Uganda’s health centres, according to a report by the Centre for Global Development.

Statistics show that the leakage rate could range from 40% to 94% in any 10 randomly-picked health centres; leaving patients to purchase drugs from private clinics at exorbitant prices or at the mercy of death.

High demand medicines such as Coartem or anti-malarials, Measles vaccine, Depo Provera for family planning, oral rehydration salts to treat diarrhoea and Cotrimoxazole for cough, should be available in all health centres, according to the Uganda’s Health Sector Plan. But contrary to the Government guidelines, such drugs are in short supply, if there at all.

Recently, Saturday Vision reported massive theft of government drugs from the National Medical Stores under the pretext that they were being taken to government health facilities.

Now the new reports reveal that even the drugs that make it to the health facilities are siphoned out massively, implying that only a tiny fraction of government drugs ever get to the patients free of charge.

The report titled Governance and Corruption in Public Health Care Systems particularly accuses health workers, saying they take them to their private clinics to sell them at higher prices.

“Drugs tend to be a commonly “leaked” product given that it can fetch a higher price in the private market. Health workers and the Health Unit Management Committee members, the entities meant to provide local oversight, (have) expropriated them,” the study says.

Earlier this year, President Yoweri Museveni echoed these words in his State of the Nation address: “The health centres continue not to have drugs and health workers are always absent from duty stations…drug thefts by health workers, as revealed recently by the civil society must be dealt with.”

A number of health workers’ survival strategies have been found to depend on use of drugs supplied to the health centres, according to a report titled Informal Health Markets and Formal Health Financing Policy by Makerere University Institute of Social Research, health ministry and the Royal Tropical Institute.

“Health workers always claim to purchase drugs for their drug shops and clinics from nearby towns but other sources of information frequently contradict this,” the report notes.

“Drugs with essential drugs labels are said to be purchased from health workers’ shops; health workers seem to know where ‘out of stock’ drugs can be found in nearby shops and clinics.”

In one of the Anti-corruption Coalition leaflets, there is a cartoon depicting one Dr. JB in a public hospital, who was telling his patient that the drugs had run out, but could only be bought at Dr.JB’s clinic – his very own private drug shop!

The findings show that community members, management committee members and health workers themselves frequently blame each other of supplying or receiving consignments of drugs originally supplied to the health centre.
In one facility, a health worker immediately opened a drug shop on assuming the in-charge position.

Treatment at home and sale of drugs from home are also facilitated by use of the unit’s drug supply, the report stresses.

As such, the centres inflate registers with the ‘ghost’ patients as to appear accountable.
“In some facilities, the observed number of patients was higher than the recorded rate.

Where ‘ghost’ patients are recorded, the reason is undoubtedly to record prescriptions to account for drugs used elsewhere,” the report states.

President Museveni agreed with anti-corruption activists and civil society that there is need to label and brand the government drugs “not for sale” to ensure that they are not channelled and re-sold in private clinics.

The health minister, Dr. Stephen Mallinga, says he is aware of the problem and warns that culprits would be prosecuted. In addition to prosecution, the minister has asked the health professional councils to penalise those implicated.

Already, massive raids and arrests of health workers believed to be stealing the drugs are being conducted jointly by the Police, health ministry and the National Drug Authority across the country.
Mallinga said they had recently arrested a nurse, only identified as Sulphina T and Dr. Kapuru, all staff of the gynaecology department, Mulago Hospital. The two were running Maria Assumpta Clinic in Kifumbira Zone in Kamwokya, a Kampala suburb.

Did you know…
- Up to 73% of the medicine distributed to the health centre is leaked. It means that amount is stolen from you
- The medicines should be free of charge. User charges were abolished in 2001 in all government health facilities in Uganda
- You have a right to access essential medicines like Coartem(anti malarial), Measles Vaccine, Depo Provera(family planning), ORS(diarrhoea and dehydration), Cotrimoxazole(e.g. cough)
- You have a right to receive full and equal treatment irrespective of age
- You have right to get unexpired drugs
- You have a right to seek redress

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