Patients 'smuggling illegal drugs' into Butabika

By Chris Kiwawulo & Sarah Nakamwa

A cross-section of patients who check into Butabika Hospital are on treatment for drug abuse. However, efforts to rehabilitate them are being hampered by a thriving underground drug trade, which is worrying the hospital authorities.

The most common illegal drugs being peddled are marijuana and cocaine. In addition, some alcoholics undergoing treatment at the facility have also been implicated in smuggling alcohol into the facility.

Drug kingpins
 

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According to investigations, the drugs are mostly smuggled into the facility by mental patients who have been discharged, but return as outpatients. This enables them to smuggle the illicit drugs into the facility without raising suspicion since they are common faces at the hospital, a source said.

Drawing parallels with an incident thousands of kilometres away in the US, in April last year, Lori Sullenberger, 38, a patient at Pittsburgh Hospital in Pennsylvania, was found selling heroin from her bed in the Intensive Care Unit. A search in her room yielded 380 packets of heroin, syringes and $1,400 in cash.

At Butabika meanwhile, the drug peddlers also include some caretakers of the mental health patients and visitors. A nurse who spoke on condition of anonymity said they have ever found sticks of marijuana stuffed inside the food flask of a patient.

Fingers have also been pointed at men who bake and sell chapatti just outside the main gate of the facility.

In addition, scores of encroachers on land belonging to the hospital have been implicated in the sale of drugs, especially marijuana and alcohol to patients, given their proximity to the health facility. Investigations reveal that these uninvited neighbours, who craftily roll sticks of marijuana in chapattis popularly known as ‘rolex’ are the biggest suppliers of drugs to patients.

Consequences

The practice not only makes recovery for patients difficult, but also causes a financial loss to the Government which funds the hospital, a source at the facility said. Over time, the patients become chronic drug abusers and resistant to treatment, thereby making recovery impossible, the source added.

Dr. David Basangwa, the hospital’s executive director, says treating patients who take drugs is a waste of taxpayers’ money. According to the 2014/15 budget projections, Butabika is expected to get sh9.82b.

“The Government is spending a lot of money on fighting drug abuse, but there is a group of people in society creating the problem by selling the drugs, which makes it counterproductive,” Basangwa said.

The supply of narcotic drugs to the mental health patients is of big concern to the hospital administration.

“If our work is to re-habilitate the addicts, then that will defeat our effort, since the drugs are accessed,” Basangwa said.

The senior consultant psychiatrist said although the encroachers on their land may not be growing marijuana around the hospital, they get it from distant places and supply it to patients. He said they began noticing the problem when encroachers began to settle on the hospital land.

More than four acres of the 200-acre piece of land, on which Butabika sits have been encroached on by between 50 to 100 families, and these intruders freely interact with patients.

Basangwa said the hospital tried to evict the encroachers by issuing them a notice, but failed. It then sought the intervention of Environmental Police, since the land is a reserved wetland. Attempts were reportedly made to evict the encroachers from areas such as Kiganda, Kireka II parish in Kiira Town Council in Wakiso district and Banda Zone B1 in Kampala’s Nakawa division, according to the commandant of the Environmental Police Protection Unit, Taire Idhwege.

However, the encroachers did not budge an inch, despite Police intervention.

A cross-section of the people who live here, however deny supplying drugs to patients at the facility and claim they bought the land.

“The hospital says this land belongs to them, but we asked them for documents proving ownership, which they have never provided,” Suleiman Kiyingi, the chairman of the people living in the area, said.

However, Basangwa said: “For the last three to four years, there were no settlers on the contested land, but some people say they have been here for all their life, which is not true.”

Capacity challenge

Currently, the hospital has 810 inpatients, though its capacity is 550 patients. This means the facility has an excess of 260 patients, leading to overcrowding. Most of the wards were planned to serve 60 patients, but have 100 and above. In some cases, some patients share beds and others sleep on the floor.

Out of the total hospital patient population of 810, about 20-30% (over 240 patients) are admitted over drug-related illnesses. Of these cases, about 5% (12 patients) have been found to use drugs while on treatment, Basangwa said.

Whereas the hospital has a specialised ward for patients on drug-related treatment called Alcohol and Drug Unit (ADU), it only takes 30 patients and the rest are accommodated in the general ward.

The staffing level at the hospital is also low compared to the number of patients the hospital receives, Basangwa said.

According to the Auditor General’s report for the year ending June 30, 2014,

The drug peddlers also include some caretakers of the mental health patients and visitors

Butabika has a staff shortfall of 87 employees. Out of the 433 approved positions, only 346 have been filled.

Basangwa said the staff are overwhelmed and work under risky conditions, since aggressive patients need more manpower. This makes it difficult to monitor all patients to curtail drug re-use.

According to Basangwa, 20% of the patients can completely do away with drugs upon receiving treatment, 40% may continue taking them on an on-and-off status, although the quality of their life improves.

Basangwa said another 20%, who use drugs while on treatment, face a lot of problems in life while 20% cannot stop using drugs due to too much addiction.

“Whatever effort is put in place to help them, they cannot get off drugs,” he said.

Some patients are drug addicts, Basangwa stated, but can easily learn from others if they access them.

Recovery programme

“The Butabika Hospital programme is designed to help addicts realise their problem and accept it. They are counselled to make them start working on recovery,” he explained.

The hospital helps them to keep away from peer groups and finding alternative constructive things than drugs.

“The increasing unemployment in the country has affected many, some resort to drugs just because they have nothing to keep them busy,” Basangwa notes.

There are only 28 psychiatrists for a population of over 33 million people in Uganda. Basangwa says most of the psychiatric work is being done by clinical officers and nurses since specialist doctors are few.