Does your district have a hospital?

Jul 02, 2013

So you are planning to conceive? You need to be sure there is a hospital in your district before it is too late. In Kaliro District, 12 expectant mothers died last year as they were being transported to Iganga Hospital for proper healthcare during delivery. Kaliro has been in existence for 10 year

According to the Ministry of Health, each district ought to have a public hospital, but this is not the case for all the 112 districts in Uganda. The Sunday Vision team reports

 So you are planning to conceive? You need to be sure there is a hospital in your district before it is too late.  In Kaliro District, 12 expectant mothers died last year as they were being transported to Iganga Hospital for proper healthcare during delivery. Kaliro has been in existence for 10 years, but lack a modern hospital. 

“Most mothers with complications always die on the way as they are being transported to Iganga Hospital,” says the district chairperson Wycleaf Ibanda.  More than half of the districts in Uganda do not have any public hospital, according to official records from the Ministry of Health. Uganda has only about 57 govern-ment district hospitals. This is much less compared to the 112 districts in the country. 

According to the ministry policies, each district must have a district hospital, a county must have a health centre IV, while a sub-county and parish must have a health centre III and health centre II respectively. While some districts have been lucky to have private investors and non-governmental organisations building hospitals for them, others like Bukedea, Amuru, Amuria, Buvuma, Buliisa, Kaliro and Kalangala among others, do not have a single hospital to boast of. 

The health ministry spokesperson Rukia Nakamatte confirms that most of the newly created districts do not have any hospital in them. “Many of them have health centre IVs but the challenge is that they do not have the facilities like a major hospital would have,” she told Sunday Vision on phone. The paradox was that more health facilities seem to be concentrated in the old and better towns like Kampala, Jinja and Wakiso, while in the rural areas, the average number of hospitals seems to be one, if at all.
In a mini survey by Sunday Vision we sampled some districts to see how they were coping without a hospitals

Patients’ dilemma

Kalangala Islands which were transformed into a district status in 1989 has only a health centre IV to boast of to-date.

“It is unfortunate that even the theatre at the health centre IV is not functioning. For any major operation, the patient is referred to Masaka Hospital on the mainland,” says William Lugolobi, the district chairperson.

In fact, patients have to hire a boat and buy fuel from Kalangala to Bukakata landing site where they are required to get a special hire a taxi to Masaka District and the road is impassable. Kalangala Islands have a ferry, the only free public transport linking the islanders to the mainland. This ferry only operates during day time, which means if you were badly in need of specialised treatment in the middle of the night, your life is at stake.

“The worst situation the patient in Kalangala can face is when he or she is referred to Masaka Hospital at night when there is no ferry,” says Lugolobi.

Sunday Vision has learnt that a trip on water from Kalangala to Bukakata landing site on your way to Masaka consumes approximately 80 litres of fuel when using boat. A litre of fuel in Kalangala costs between sh4,500 and sh5,000. Therefore, it requires between sh500,000 - sh800,000 for a private trip from Kalangala to Masaka.

 This has forced some of the patients go back home and wait for their death since they cannot afford the cost. In fact, some women leave Kalangala when they are seven months pregnant.  “They go and rent near Masaka or Mulago hospital in Kampala hoping to get access to immediate treatment should they feel the need,” he says.  Like Kalangala, Buvuma District, which was curved from Mukono District three years ago is also in the same dilemma.


The district has over 52 different islands with only one health centre IV,  The nearby hospitals are Kawolo Hospital in Buikwe district and Jinja Hospital. It is expensive to buy fuel or hire a ferry.  “A patient must save more than sh300, 000 to help in transportation to either Kawolo or Jinja  Hospital,” says Buvuma District chairman, Wasswa Ddungu, adding that they feel isolated due to lack of access to treatment.Mukono District, the mother district for Buvuma, is also suffering. It lost the only Kawolo Hospital which it owned to Buikwe District, which was created five years ago.


Patients in queue

Prossy Namwanje an expectant mother at Mukono health centre IV, has been waiting for antenatal care for hours.

“The Government tells us not to give birth from traditional birth attendants. Now you come to a hospital and it has all this line, no one cares for you. Should we go back to the traditional birth attendants?” Namwanje asks.

In Namayingo District’s only health centre IV, there are about 600 patients on a daily basis.

Justine Nyanzi, a patient from Misindye in Goma division sleeps on the floor because there are not enough hospital beds. “Many people simply head to Mulago Hospital but it also fills up fast. We are in a dilemma,” says Nyanzi.

At Buyana health centre IV in Kaliro District, most of the patients are from the neighbouring districts of Namutumba and Buyende who have no hospitals.

Hospitals are still grappling with shortages of equipment and drugs



Shortage of supplies
The Namayingo District health officer, Dr. James Magola, says majority of the people who visit the health centre require operations.However, the theatre requires major repairs since it has broken down.“The theatre broke down three years ago and efforts to have it repaired have hit a snag as Government claims there are no funds,” he says.Magola says health personnel are forced to use torches during minor operations and the most complicated are referred to major hospitals in the neighbouring districts like Bugiri.

Workload on health workers

In Busia District, patients travel to Tororo District since the only health centre IV they have cannot meet their demands. The district health inspector, Dr. John Laamu, says several patients from neighbouring Kenya always seek services from the centre.

He says the absence of a better referral hospital is affecting service delivery in the district. Laamu says on average, they receive 500 patients for the outpatient department but cannot effectively handle them due to the absence of a better hospital.

Consequently, many unskilled personnel are handling cases outside their area of specialty. In Kalangala, for instance, we have authorised health centre IIs to carry out deliveries due to the shortage,” says Lugolobi.

The director for health services Mukono District, Dr. Elly Tumushabe says after the loss of Kawolo Hospital to Buikwe, they tried to push for a hospital, their request has not been considered. “The population of 60,000 people is too big and it needs a hospital. With that population, the district only has two health centre IVs at Mukono and Kojja health centre IV.

Mukono Health Centre IV always receives insufficient drugs and funds. It gets the same drugs and funds like the health centers IVs in villages serves less population,” Tumushabe narrates. He adds that the district is normally overwhelmed with accident victims since the Kampala-Jinja highway has several black spots.

Dr. Anthony Konde the principal health officer for Mukono Municipality, says they are overwhelmed with a big number of patients from different parts of the district. “By the time a doctor retires at the end of the day, they are tired to the bone.”


By Carol Natukunda, Henry Nsubuga and Moses Bikala

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