Since the outbreak of the Covid-19 pandemic, Kasangati Health Center IV has only received Shs 2.5m to alert the public about and manage the Covid-19 pandemic during the lockdown, the hospital in charge, Dr Paul Kabazzi, told The Observer.
“In regard to Covid-19 funds, only five people here received Shs 500,000 each to facilitate them for five days and respond to alerts of Covid-19 from the public. In total, the five health officers were given Shs 2.5m,” he said.
Kabazzi said the Shs 2.5m which was given to these health officers was deducted from the Wakiso district budget of Shs 165m that was meant to manage Covid-19, including sensitizing the public within the district about the pandemic.
Recently in August, the ministry of Health issued a statement listing all Covid-19 testing centres within Kampala and Wakiso. They include Kiswa Health Centre IV, Kasangati Health IV, Kisenyi Health Centre IV, Kibuli hospital, Kawaala Health Centre IV, Kitebi Health Centre IV, Nsambya hospital, Kira Health Centre IV and International Hospital Kampala.
“The director general of Health Services, Dr Henry Mwebesa, recently said Kasangati Health Center IV is one of the Covid-19 testing centers in the country, but we haven’t received any funds to test people despite the increasing number of patients coming here daily seeking for testing services. We are now taking samples from the suspected patients and forwarding them to laboratories for testing,” Kabazzi said.
He, however, disclosed that the district has been sending them some few testing kits to take samples from Covid-19 suspects; in a day, they take between five and 10 patients’ samples, too small a number dictated by the lack of materials to collect samples.
NO ISOLATION CENTRE
“There is no isolation center for Covid-19 patients at Kasangati, and when we find positive results after testing, we hand over the patient to Mulago hospital for management,” he said.
Because of the increasing numbers of Covid-19 cases, the ministry now appeals to all people found positive with Covid-19 to isolate themselves at home since there is no space in the hospitals. Kabazzi said the Covid-19 surveillance team which follows suspected contacts is not also active at the moment at Kasangati Health Centre IV due to lack of funds to run it yet they have been doing a lot of Covid-19 management.
“We don’t have any budget for Covid-19 management. Otherwise, we could have gone to the communities and taken random samples, given out sanitizers, sensitized people about the dangers of the disease and how to prevent it, but there are no funds.”
Kabazzi appealed to the government to at least give them some hand sanitizers and masks to be available to all health workers that handle different patients daily.
Dr. Kabazzi said the biggest challenge now at Kasangati Health Centre IV is the number of patients they receive daily yet the facilities are very limited, adding that they anxiously want the health centre to be upgraded to hospital level.
“We have sent different budgets and proposals to the Ministry of Health requesting for more funding to upgrade Kasangati Health Center IV to a hospital due to increased population in the area, but we don’t get any feedback.”
“Once this health centre is upgraded to hospital level, we shall get more specialists in different departments like pediatricians to help sick children, gynecologists and obstetrician for pregnant mothers. It will also help to decongest the national and regional hospitals since their number of referrals will reduce,” Kabazzi said.
“In a month, about 300 mothers give birth here, 43 of whom give birth through cesarean. We get about 100 general-category outpatients daily and in specialist departments such as HIV/Aids, maternity, tuberculosis, pediatrics and others, we get between 250 and 300 patients daily. This is a very big number of patients that needs to be managed at a hospital level.”
Kasangati Health Center IV receives only Shs 14m every quarter of the year to run all these departments with increasing number of patients daily. It also receives very few drugs from the National Medical Stores; hence majority of the patients are advised to buy drugs from private pharmacies.
However, despite the challenge of few health workers at the health centre, the workers are always available and during the lockdown imposed to manage the spread of Covid-19, they handled many patients who couldn’t move long distances to pick drugs from their main hospitals. Out of 45 health workers at Kasangati Health Centre IV, at least 25 were retained at work during the lockdown.
Kabazzi said due to the big number of patients that flock this health center daily, especially expectant mothers and yet the utilities used while giving birth are very scarce, the centre tells the expectant mothers to buy delivering items like gloves, cotton, stitches and others.
MEASURES
Some of the patients in Kasangati HC-IV labour ward who had just given birth accused nurses of demanding from them between Shs 30,000 and Shs 50,000 as payment bills for delivering in this health centre. However, this service is supposed to be for free since this is a government facility.
Robina Nassuna, the midwife nurse and head of the maternity ward at Kasangati HC-IV, said they have been fighting all issues of corruption at this health facility for a long time though some of the nurses could still appear to be practicing such behavior.
“We shall investigate such cases and the nurses who will be found guilty will be disciplined by the district health committee; and they might end up losing their jobs. This being a government health center, it is not allowed to charge money from patients,” she said.
Nassuna said they still have a challenge of a small maternity ward yet they have a big number of women giving birth at this health center every day. Oftentimes, some of the women who have just delivered babies end up sleeping on the floor since most of the beds are occupied by other mothers.
“This forces us to refer most of our mothers to bigger hospitals due to lack of space in the labour ward. Some of them have ended up losing their babies on their way to referral hospitals.”
Nassuna requested government to use funds from the Results-Based Financing (RBF) grant for health programmes to buy an oxygen concentrator to increase the oxygen levels to newborn babies especially those born prematurely or those born when tired at Kasangati Health Center IV.
They also want to buy a machine where they can properly dispose placentas and other used up materials from the health centre since at the moment they dispose them in the nearby bushes which could pose a risk to neighbouring communities.
ACCU’S INTERVENTION
Kabazzi said, during lockdown, they also received some contribution from Anti-Corruption Coalition Uganda (ACCU) in form of fuel which they put it in the hospital ambulance to take patients who were in critical condition to hospitals.
“This fuel was also put in the ambulance to transport hospital staff from their homes to Kasangati Health IV for work due to lockdown as there were very few vehicles allowed to move,” he said.
ACCU also donated to the health centre a water tank, waste bins, 1,000 mattresses and mattress covers for each mattress, face masks both re-usable and non-reusable, gloves, sanitizers, Jik, Vim, detergent and other cleaning items to help patients and staff during the lockdown.
Marlon Agaba, the head of Programmes at ACCU, told The Observer that ACCU was working with the Rotary Club of Kasangati to support the maternity ward where they provided delivery mattresses with their mattress covers, dustbins and a water tank at the maternity ward.
He explained that ACCU has been providing assistance to Kasangati Health Center IV, through their pilot short-term project called Covid-19 Citizens’ Transparency Initiative for Uganda. The short project started in April this year and it’s expected to end at the close of 2020.
“However, there are higher chances of getting more funds from the donors to support this project at Kasangati Health Center IV since it is surrounded by a very big population and needs a lot of support in almost all departments,” Agaba added.
Agaba said they are also improving accountability at this medical facility by engaging staff, users and other stakeholders to identify problems and also provide solutions to improve service delivery at the facility. Mr. Agaba further called upon the ministry of Health to upgrade the facility into a Hospital since it already serves a big population.
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(This article was produced with support from the Anti-Corruption Coalition Uganda and Partnership for Transparency Fund.