NEWS: Mulago rots as doctors flee country

This is a truly tragic story which reveals the need for further medical missionary work in Uganda. Pray that God would provide a door for His workers...........

Mulago rots as doctors flee country



Sunday, March 22, 2009 from MONITOR ONLINE

Tereza Aol, 49, lies on a thin, old mattress writhing helplessly in pain. This ward at Mulago Hospital’s Cancer Institute has been a ‘neglected’ sickbay of sorts for her in nearly a month. Her right breast is charred by cancer. She says she has not been attended to.

“They only gave me this fluid to drink,’ she said, showing a bottle marked “Morphine Oral Solutions”.Mr John Okot, the husband, says the syrup is for pain relief. But Ms Aol needs more than just that to assuage the pang. Her tear-filled eyes and fading, feeble voice underlined years of intolerable suffering.

Ms Aol, fighting cancer of the breast, arrived at Mulago Hospital on February 23 upon referral from St. Mary’s Lacor Hospital in Gulu District, and it was not until March16 that doctors performed an X-Ray to ascertain the cancer damage to her breast.

Dr Jackson Orem, the director of the Cancer Institute at Mulago said the Institute is grossly under-staffed, under-funded and ill-equipped to deliver meaningful health care to the growing patient numbers.

The Institute receives an average of 60 patients a day, with 85 per cent of them coming from the countryside. This drains the skeletal staff and imposes pressure on use of the limited facilities.

As Ms Aol’s case demonstrates, accessing treatment at the country’s largest and only national referral hospital is a nightmare for many people as doctors battle to keep the hospital running under the most adverse circumstances.Mulago Hospital, which has reported Shs50 billion arrears, is also short of health care professionals and basic diagnostic equipment.

The hospital’s director, Dr Edward Ddumba told a visiting team of MPs on the Social Services Committee on March 16, that he only had half of the 1, 000 doctors required to run the hospital.
Dr Ddumba attributed the scarcity of human resource to a de-motivated staff. Currently, government offers newly-recruited medical officers a gross monthly salary of Shs626, 181 as a result, the hospital has lost doctors particularly to Rwanda which has been offering more lucrative salary packages.

“Rwanda pays a doctor $2, 000 [Shs4 million] per month compared to the Shs900,000 that Uganda gives to [senior] doctors,” Dr Ddumba said.

Dr Ddumba, however, could not give figures of the number of health professional who have emigrated but said “the rate is alarming.”

According to a report in yesterday’s Sunday Monitor, the government reportedly spent more than Shs1 billion on the treatment of eight well-placed public officers. The money would have gone a long way in motivating the team of doctors and nurses at the hospital.

Against the backdrop of rising cancer infections in Uganda, the few radiotherapy machines at the hospital are reported to be too old and falling apart due to irregular maintenance.

Dr Joseph Mugambe, who heads the Radiotherapy department, said the cobalt machine which helps in external chemotherapy (the treatment of cancer) is now fragile due to over use. The device installed in 1995 breaks down frequently, raising the risk of death for cancer patients.
Dr Mugambe said the unit receives 120 patients every day, overwhelming staff using rickety machines.The hospital’s decay is more manifest in the Maternity or Ward 5C as it is commonly called. The ward is crowded and stinks, yet many expectant women lie on the floor and corridors due to shortage of beds. There is limited privacy overall.

Built to handle only 20 mothers a day, the labour suite today handles an average 65 deliveries daily.“This number is too big for us to handle. We are seeing thrice the number that we should be seeing and so some end up delivering on the floor and in the corridors,” he said.

Dr Kalisoke, who heads the hospital’s gynecology and Obstetrics department, said the hospital carries out some 20 cesarean births each day in a theatre of one bed.With few staff and rapid turnover of women delivering on the same bed, the possibility of improper cleaning exposes mothers to cross infection.

Dr Kalisoke said on average, 12 doctors, nurses and mid wives are available to handle the maternity section.But Mulago’s woes do not end at the maternity ward. A visit to the Special Care Unit, where premature babies are incubated, reveals a thin line between life and death for the new babies.

Only two of the 29 incubators at the unit are fully functional and doctors have to devise crude means of using the others to keep the premature babies alive. Dr Jamil Mugalu, a neonatologist (a pediatrician trained in the care of premature babies) said the unit receives about 60 babies every day forcing them to share the incubators.

The hospital administration is aware of these problems, though. Dr Dumba said the main reason for the disastrous state of the hospital is chronic underfunding and understaffing. The hospital currently runs on a paltry Shs5 billion annually.

MP Rosemary Sseninde, who chairs the Social Services Committee shocked at the sight of the hospital’s decay, said that although the medical workers are doing their best amidst limited resources, government needs to come in and increase funding to the hospital in the next financial year.

Dr Orem said with the poor state of health care, many curable diseases have returned with a vengeance like Tuberculosis, typhoid, diarrhea and other waterborne illnesses.