Posted in: News / By Saturday Monitor Team / May 31, 2008
When Mr Sam Babalanda felt he could no longer manage the waiting he had to endure every time he wanted to see a specialist about his high blood pressure or get the medicine prescribed for the condition at the regional referral hospital in Jinja, he gave up.
Having lost faith in the conventional health system, he opted for herbal remedies, which he claims are working well for him. Two times every month now, he visits his herbalist's clinic in Jinja Municipality.
Mr Babalanda, a peasant, is not alone. Even wealthier Ugandans cry about the country's health system. Responding in 2003 to a Daily Monitor story, President Museveni readily acknowledged that he offered the presidential jet to fly his pregnant daughter to give birth to her baby in Germany rather than trust Ugandan doctors.
"When it comes to medical care for me and my family, there is no compromise," Mr Museveni said in a seven-page statement. "The issue is about security given some of the hostile doctors we have in the medical system here."
For most Ugandans, the concern is not really security but quality of service.
Many local leaders complain that the 11 strategically located regional referral hospitals, which were supposed to be the centrepiece of the Uganda health system in the countryside, are so sick they should be on life-support themselves.
They cite consistently poor services, medicines that are hard, if not impossible, to get, interminable and often unsuccessful waits to see experts, corruption and other problems.
The regional referral hospitals in the spotlight include Arua, Gulu, Hoima, Lira, Soroti, Mbale, Jinja, Masaka, Fort Portal, Kabale and Mbarara.
Malaria and Aids patients and pregnant women make up the biggest number of clients at these hospitals.
In a series starting this week, Saturday Monitor will examine problems at some of these key health entities.
Why are so many patients and their political representatives frustrated? Can services be improved? Or is the public asking for too much?
We sought out the views of local leaders and technocrats, some of whom spoke candidly about the state of the regional referral hospitals.
Mbale Deputy RDC Henry Nalyanya said the [Mbale] regional referral hospital is sick itself and requires immediate surgery.
"The medical personnel are rough, don't respond to patients with care, ask for money before any treatment is given and tell patients to buy medicine outside in drug shops as though there is no medicine in this government referral hospital," Mr Nalyanya said. "The situation is bad, and requires urgent attention."
He said his office is reviewing medical services at the hospital to determine whether the problem is weak management or failure by the government to provide for the hospital or both.
Up north, leaders in Gulu District are equally disappointed with their referral hospital. "Drugs get stolen, water tanks get lost, patients' foodstuffs are stolen and when we ask the heads of department they cannot explain," said Ms Betty Kibwota, the LC5 councillor for Pece Laroo Division in Gulu Municipality.
Gulu District Health Officer Paul Onek said the area's major hospital should not be seen as a referral hospital because it lacks, among others, essential diagnostic equipment needed to do x-ray, and ultra-sound scans.
District Chairman Norbert Mao said the government has neglected the hospital. He also alleged corruption has made the situation worse.
"The hospital doesn't even have the facilities a Health Centre IV is supposed to have," Mr Mao said. "We have complained and written to the Health Ministry, and I personally talked to the health minister about the hospital when he came to Gulu last year but no action has been taken."
Only last Saturday, this newspaper ran a story based on an April 10 letter President Museveni wrote the Minister of Health saying:
"Whenever I travel up-country, I am accosted with complaints of lack of drugs and absenteeism of health workers in the health units." The President demanded an explanation on a whole range of issues afflicting the country's public healthcare system.
In Jinja, LC5 Chairman Hannington Basakana said he is not sure of what goes on at the regional referral hospital. "We do not get reports from the hospital," he said. "I cannot comment on something that I am ignorant about."
But members of the public are commenting. And loudly at that. Writing in the Daily Monitor recently, Ms Stella Wanyenze wanted some answers on the meaning of a government hospital following her experience at Mbale Regional Referral Hospital.
"I thought we are supposed to get free services from a referral hospital, but surprisingly it is not free at all. In fact, it's even
worse compared to private clinics because there, you pay once, and are given enough treatment and good care before you are discharged," she wrote.
The managers of these hospitals describe the complaints as unfair given the conditions under which they work. Mbale Regional Referral Hospital Medical Superintendent Vincent Ojoome said blanket accusations do not help. "It would be good if those reports are brought to our attention directly instead of people running to the media all the time," he said.
"Coming to us would help the administration to follow specific cases."
The question is whether addressing specific cases will be enough, or whether the entire hospital system needs urgent overhaul.
The first article (See page 11) in our series, "Our Sick Hospitals," will explore that question by looking at how the poor performance of regional referral hospitals arises, at least in part, from serious problems at lower health centres.
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