Procurement red tape leaves Mulago cancer patients stranded
Sep 20, 2010
JOSEPH (not real name), has for the third week in a row failed to get radiotherapy treatment at Mulago Hospital. The father of two was diagnosed with cancer of the bones in August after he was bedridden for almost six months.
By Chris Kiwawulo
JOSEPH (not real name), has for the third week in a row failed to get radiotherapy treatment at Mulago Hospital. The father of two was diagnosed with cancer of the bones in August after he was bedridden for almost six months.
Medics told Joseph that since his cancer was detected early enough, he could be treated and there was hope for better results. He was optimistic that he would go back to his job in Atutur, Kumi district with less pain.
Joseph says he was supposed to start with his treatment on September 6 but the only cobalt machine that carries out radiotherapy at the hospital had broken down about a week before. It is now three weeks since it broke down and Joseph has to wait until it is repaired.
He fears that his situation might worsen if the machine is not repaired early enough yet he has no money to go abroad for treatment.
Joseph is just one of the hundreds of patients stranded at Mulago after the machine broke down.
At least 80 cancer patients who receive radiotherapy treatment at Mulago hospital everyday are stranded, says Dr. Kigula Mugambe, the head of the radiotherapy department. Radiotherapy is the process of using radiation rays to burn cancer cells among patients thereby reducing pain.
“Cancer patients are supposed to get radiotherapy treatment for five consistent days in a row, say from Monday to Friday and then report again for follow up after a month. They then report again after three months and thereafter come back after six months,†explains Mugambe.
The patients are now on pain killers and other soothing drugs until the machine is repaired. Those who cannot go abroad have no option but to wait.
Acquired in 1995 as a donation from the International Atomic Energy Agency (IAEA), the machine needs replacement. The IAEA is an international organisation that seeks to promote the peaceful use of nuclear energy, and to inhibit its use for any military purpose, including nuclear weapons.
Mugambe says the machine has for close to two years been intermittently breaking down. A new cobalt machine costs around $1m (over sh2.2b). But Mugambe says the machine requires spareparts at a cost of $5,000 (over sh11.3m) to work again.
Reliable sources reveal that Dr. Edward Ddumba, the hospital executive director, approved the purchase of spare parts in April but the bureaucratic procurement process has dragged on.
If the spare parts are availed, the technician needs two or three days to fully repair the machine.
The machine uses radioactive material and all radioactive materials use the half-life principle, Mugambe points out. Half-life is the time taken for half the amount of a radioactive substance to stop emitting radiations, which radiations in this case are used for treatment.
The half-life of cobalt is about five years meaning that in 2000, the machine’s effectiveness had dropped by 50%. In 2005, the efficiency of what remained had dropped by a further 50% and now, 2010, “the radiations are too weak to treat patients,†Mugambe says.
Dr. Jackson Orem, the head of the Uganda Cancer Institute at the hospital says for every 100,000 persons in Uganda at any time, there are 200 new cases of cancer. The facility handles an average of 1,000 new cases every month, 600 of them children. There are also about 9,000 continuing adults and about 4,500 children.
In order of frequency, Orem says Burkitt's lymphoma, Kaposi sarcoma, other lymphomas, Wilms tumor, Leukeamia, Hodgkin’s disease and brain tumours are the leading cancer cases reported at the institute.
Most of them are from the eastern region, particularly Pallisa, Budaka, Kumi, Soroti and Mbale. Patients from northern Uganda can be handled at Lacor Hospital, West Nile-Kulva Hospital while those from western Uganda are treated at Mbarara Hospital. But when the cases worsen, the regional hospitals refer the patients to Mulago.
JOSEPH (not real name), has for the third week in a row failed to get radiotherapy treatment at Mulago Hospital. The father of two was diagnosed with cancer of the bones in August after he was bedridden for almost six months.
Medics told Joseph that since his cancer was detected early enough, he could be treated and there was hope for better results. He was optimistic that he would go back to his job in Atutur, Kumi district with less pain.
Joseph says he was supposed to start with his treatment on September 6 but the only cobalt machine that carries out radiotherapy at the hospital had broken down about a week before. It is now three weeks since it broke down and Joseph has to wait until it is repaired.
He fears that his situation might worsen if the machine is not repaired early enough yet he has no money to go abroad for treatment.
Joseph is just one of the hundreds of patients stranded at Mulago after the machine broke down.
At least 80 cancer patients who receive radiotherapy treatment at Mulago hospital everyday are stranded, says Dr. Kigula Mugambe, the head of the radiotherapy department. Radiotherapy is the process of using radiation rays to burn cancer cells among patients thereby reducing pain.
“Cancer patients are supposed to get radiotherapy treatment for five consistent days in a row, say from Monday to Friday and then report again for follow up after a month. They then report again after three months and thereafter come back after six months,†explains Mugambe.
The patients are now on pain killers and other soothing drugs until the machine is repaired. Those who cannot go abroad have no option but to wait.
Acquired in 1995 as a donation from the International Atomic Energy Agency (IAEA), the machine needs replacement. The IAEA is an international organisation that seeks to promote the peaceful use of nuclear energy, and to inhibit its use for any military purpose, including nuclear weapons.
Mugambe says the machine has for close to two years been intermittently breaking down. A new cobalt machine costs around $1m (over sh2.2b). But Mugambe says the machine requires spareparts at a cost of $5,000 (over sh11.3m) to work again.
Reliable sources reveal that Dr. Edward Ddumba, the hospital executive director, approved the purchase of spare parts in April but the bureaucratic procurement process has dragged on.
If the spare parts are availed, the technician needs two or three days to fully repair the machine.
The machine uses radioactive material and all radioactive materials use the half-life principle, Mugambe points out. Half-life is the time taken for half the amount of a radioactive substance to stop emitting radiations, which radiations in this case are used for treatment.
The half-life of cobalt is about five years meaning that in 2000, the machine’s effectiveness had dropped by 50%. In 2005, the efficiency of what remained had dropped by a further 50% and now, 2010, “the radiations are too weak to treat patients,†Mugambe says.
Dr. Jackson Orem, the head of the Uganda Cancer Institute at the hospital says for every 100,000 persons in Uganda at any time, there are 200 new cases of cancer. The facility handles an average of 1,000 new cases every month, 600 of them children. There are also about 9,000 continuing adults and about 4,500 children.
In order of frequency, Orem says Burkitt's lymphoma, Kaposi sarcoma, other lymphomas, Wilms tumor, Leukeamia, Hodgkin’s disease and brain tumours are the leading cancer cases reported at the institute.
Most of them are from the eastern region, particularly Pallisa, Budaka, Kumi, Soroti and Mbale. Patients from northern Uganda can be handled at Lacor Hospital, West Nile-Kulva Hospital while those from western Uganda are treated at Mbarara Hospital. But when the cases worsen, the regional hospitals refer the patients to Mulago.