Health care ailing in Iriiri sub-county
Jul 19, 2009
IRIIRI sub-county sits on the periphery of the fertile plains of Moroto district. It is home to over 56,000 semi-partoral Karimojong and is renowned for its mouth-watering citrus fruits, sorghum and millet.
By F. Womakuyu
IRIIRI sub-county sits on the periphery of the fertile plains of Moroto district. It is home to over 56,000 semi-partoral Karimojong and is renowned for its mouth-watering citrus fruits, sorghum and millet.
But it is also characterised by inadequate social services. The region lacks electricity and has no secondary school, save for the 13 bore-holes and a dusty road.
Inadequate healthcare delivery and malnutrition has killed about 16% of Karamoja children in the last three years.
Sitting on top of a large mountainous outcrop of rock, I could see the whole of Iriiri land, including the settlements, spread out before me.
The LC3 chairperson of Iriiri sub-county, John Ogwel, pointed at four small houses shining with reflected rays of the sun and foundations of two other new buildings scattered in the compound of a health facility.
Ogwel stared at Iriiri Health Centre III for a moment and then proceeded to explain why he and his people are frustrated by the poor health service delivery.
Ogwel says Iriiri Health Centre reflects attempts by the Government and Non-Governmental Organisations to provide “equitable health services†to the Karimojong.
However, he explains that “health service delivery†in the region is based on inadequate supply of health equipment and staffing shortages.
“Although the well-built structures indicate the Government’s will to provide health care, shortage of drugs means we do not even get basic health care,†he says.
Pointing at the facility’s maternity ward, Ogwel say, he lost his pregnant daughter to a “simple complication†he thought the health centre would have cured last year.
“I brought my daughter here. She had labour pains but her small pelvis trapped the baby and they both died,†he recalls miserably.
He says the facility did not have a single qualified midwife to deliver the baby. “It was late to refer us to Moroto Hospital because the facility’s ambulance did not have fuel.â€
Iriiri Health Centre III head Joshua Kodet, a nursing officer, agrees that they face many obstacles in healthcare delivery.
“The health centre is supposed to serve a population of 17,000.
However it, serves over 40,000 people, which is beyond its capacity,†Kodet said.
This has affected on the facility’s ability to deliver effective services. Kodet says they receive three to four cases of acute malnutrition per week.
“Our capacity to respond is limited and there’s only one nursing assistant in charge of the nutrition unit.â€
Out of the five staff members at Iriir, three nursing assistants, a nurse and a store keeper none is qualified for the positions they hold.
A sheet pinned on his office wall, entitled “Top ten causes of death in Iriiri,’ tracks incoming cases.
It indicates the most infectious diseases that include acute malnutrition, polio, malaria, diarrhoea, trachoma, guinea worm, tuberculosis, meningitis, measles and rabies.
Kodet says they receive 80 cases of malaria every day “Cases soar in the rainy season. The malarial drugs like coartem are often expired or inadequate,†he says.
“When it is brought, it is either expired or lasts for two weeks and quickly runs out of stock due to high demand.â€
The clinicians are forced to administer chloroquine which patients do not respond well to.
He also says malnutrition is another problem plaguing the region, adding that “two to three children die every month from acute malnutrition.
“At times we refer critical cases to either Matany or Moroto Hospital. But lack of fuel or break-down of the ambulance service may hinder attendance to emergencies,†says Kodek.
But Iriiri Health Centre III is not isolated. Moroto district health officer, Michael Ebele, says health care delivery in the region is difficult. “It’s not possible to achieve all the required results. Only 52% of the district health staff positions are filled.â€
Moroto Hospital is supposed to have seven doctors, but has only two. While there are supposed to be 25 midwives, the hospital has only seven.
According to Ebele, the hospital advertised 38 vacancies of midwives, but only 14 people applied, three turned up for the interviews and only two showed-up for work.
“It is difficult to attract and retain staff. There is no transport, accommodation or a place to buy basic supplies because people do not want to come here.â€
Government funding to the health sector in the region also remains dismal.
Ebele says the district receives about sh300 million for health equipment and worker’s salaries. “But this is very small. We need about sh2b to operate ideally,†he adds.
According to the Ministry of Health, a health facility should be within a radius of 5km from home, but in Karamoja, a resident will trek over 65km to a healthcare unit.
Ebele says under the Plan for Recovery and Development Programme, the Government of Uganda has promised to give Moroto district sh3b to build health facilities.
IRIIRI sub-county sits on the periphery of the fertile plains of Moroto district. It is home to over 56,000 semi-partoral Karimojong and is renowned for its mouth-watering citrus fruits, sorghum and millet.
But it is also characterised by inadequate social services. The region lacks electricity and has no secondary school, save for the 13 bore-holes and a dusty road.
Inadequate healthcare delivery and malnutrition has killed about 16% of Karamoja children in the last three years.
Sitting on top of a large mountainous outcrop of rock, I could see the whole of Iriiri land, including the settlements, spread out before me.
The LC3 chairperson of Iriiri sub-county, John Ogwel, pointed at four small houses shining with reflected rays of the sun and foundations of two other new buildings scattered in the compound of a health facility.
Ogwel stared at Iriiri Health Centre III for a moment and then proceeded to explain why he and his people are frustrated by the poor health service delivery.
Ogwel says Iriiri Health Centre reflects attempts by the Government and Non-Governmental Organisations to provide “equitable health services†to the Karimojong.
However, he explains that “health service delivery†in the region is based on inadequate supply of health equipment and staffing shortages.
“Although the well-built structures indicate the Government’s will to provide health care, shortage of drugs means we do not even get basic health care,†he says.
Pointing at the facility’s maternity ward, Ogwel say, he lost his pregnant daughter to a “simple complication†he thought the health centre would have cured last year.
“I brought my daughter here. She had labour pains but her small pelvis trapped the baby and they both died,†he recalls miserably.
He says the facility did not have a single qualified midwife to deliver the baby. “It was late to refer us to Moroto Hospital because the facility’s ambulance did not have fuel.â€
Iriiri Health Centre III head Joshua Kodet, a nursing officer, agrees that they face many obstacles in healthcare delivery.
“The health centre is supposed to serve a population of 17,000.
However it, serves over 40,000 people, which is beyond its capacity,†Kodet said.
This has affected on the facility’s ability to deliver effective services. Kodet says they receive three to four cases of acute malnutrition per week.
“Our capacity to respond is limited and there’s only one nursing assistant in charge of the nutrition unit.â€
Out of the five staff members at Iriir, three nursing assistants, a nurse and a store keeper none is qualified for the positions they hold.
A sheet pinned on his office wall, entitled “Top ten causes of death in Iriiri,’ tracks incoming cases.
It indicates the most infectious diseases that include acute malnutrition, polio, malaria, diarrhoea, trachoma, guinea worm, tuberculosis, meningitis, measles and rabies.
Kodet says they receive 80 cases of malaria every day “Cases soar in the rainy season. The malarial drugs like coartem are often expired or inadequate,†he says.
“When it is brought, it is either expired or lasts for two weeks and quickly runs out of stock due to high demand.â€
The clinicians are forced to administer chloroquine which patients do not respond well to.
He also says malnutrition is another problem plaguing the region, adding that “two to three children die every month from acute malnutrition.
“At times we refer critical cases to either Matany or Moroto Hospital. But lack of fuel or break-down of the ambulance service may hinder attendance to emergencies,†says Kodek.
But Iriiri Health Centre III is not isolated. Moroto district health officer, Michael Ebele, says health care delivery in the region is difficult. “It’s not possible to achieve all the required results. Only 52% of the district health staff positions are filled.â€
Moroto Hospital is supposed to have seven doctors, but has only two. While there are supposed to be 25 midwives, the hospital has only seven.
According to Ebele, the hospital advertised 38 vacancies of midwives, but only 14 people applied, three turned up for the interviews and only two showed-up for work.
“It is difficult to attract and retain staff. There is no transport, accommodation or a place to buy basic supplies because people do not want to come here.â€
Government funding to the health sector in the region also remains dismal.
Ebele says the district receives about sh300 million for health equipment and worker’s salaries. “But this is very small. We need about sh2b to operate ideally,†he adds.
According to the Ministry of Health, a health facility should be within a radius of 5km from home, but in Karamoja, a resident will trek over 65km to a healthcare unit.
Ebele says under the Plan for Recovery and Development Programme, the Government of Uganda has promised to give Moroto district sh3b to build health facilities.