But the quality has arguably diminished and corruption is rife six years after completion, according to multiple interviews with patients there. Nestled approximately five kilometres north of Mulago hospital along the Kampala–Gulu highway and about eight kilometres, north of the capital, Kampala, Kawempe hospital is a heavily congested facility yet it was built to decongest Mulago, to free up the national referral hospital to treat more serious ailments like cancer.
The hospital is housed in a nine storied block. The administrative unit occupies the three-storied building that has the office of the deputy executive director, stores, and other officers. On arrival at the hospital, the unmissable sight is the swarms of frustrated patients and expectant mothers sitting or sleeping under the stairs or on the floor in the antenatal area.
In the antenatal section, this writer saw about 100 pregnant women waiting to see gynaecologists. Interviewed at 1:00 pm, most expectant mothers claimed they had not seen a doctor since morning. The hospital is overwhelmed by the number of expectant mothers. Dozens of new mothers and pregnant women sleep on the floor.
A walk through the antenatal area to the maternity ward located on level six is another grim adventure. Many patients sleep on the floor right from level one. Interviewed, hospital managers insisted the health facility was built to serve at least two million patients annually but that number has jumped to over 4.5 million patients. The maternity ward is so jammed, that no patient can get a bed or space for a mattress.
HEALTH RISKS
According to medical experts, sleeping on the floor puts patients at risk of contracting staph infections, which can cause skin, bloodstream infections, and pneumonia, which is resistant to many common antibiotics. Patients are also at risk of urinary tract and wound infections.
CAREGIVER SPEAKS OUT
Interviewed last month for a comment a 22-year-old caregiver who declined to be named said, “I am looking for a bed or a space where I can place a mattress for my sister who is yet to deliver but I have not gotten it yet her time is near,” she said.
“She was admitted yesterday (July 18). She is currently in the ward and is expected to deliver in the next few hours,” she said.
Another caregiver (name withheld) said that on December 25, 2021, his wife was admitted to Kawempe Hospital.
“We spent four days at Kawempe hospital and we were formally discharged on December 28, 2021,” he said.
He said his wife was delivered by c-section on December 25.
“Doctors are shameless, after the operation (c-section) one of them approached me and said the operation had been successful. I couldn’t hold it; I threw my hands in the air and thanked the Lord. The doctor then said today is Christmas day give us something. As the norm is I gave her Shs 20,000. She said this is mine but we were six doctors who operated on your wife so look for more money. Because there are cameras planted all over the hospital, the bribe money is put in drug sachets and that is how it is exchanged with the nurse/ doctors. You will not find a patient giving a cash note nor coins,” he said.
“I spent Shs 280,000 on drugs and other kinds of treatment for the few days we spent at the health facility. Every service at that facility goes for a certain amount of money be it Shs 1,000 or Shs 10, 000,” he said.
Treatment at a government hospital like Kawempe is supposed to be free for Ugandan nationals. He said he spent over three hours looking for a bed or space for his wife to rest after delivery.
“I was schooled on how beds and spaces are obtained if you fail to find one yourself. I approached one nurse as advised. She asked for Shs 5,000 and within 10 minutes she found a bed. She told one patient to shift from the bed to the mattress on the floor,” he said.
He said they didn’t get any free medicine either. Interviewed for comment, hospital managers strenuously denied claims of rampant corruption at Kawempe. One gentleman said they installed cameras all over the place to catch the corrupt.
DEPUTY EXECUTIVE DIRECTOR REACTS
Interviewed, the deputy executive director, Dr Lawrence Kazibwe said the health facility is overwhelmed by patients.
“Except for pregnant mothers and babies, when babies are sick, they go through the acute care unit and the mothers are accessed and given care based on their pregnancy conditions. We expect to have a healthy baby and mother at the end of the journey,” he said.
To achieve that, Dr Kazibwe said government procures all the equipment, laboratory tests, and reagents to run those tests, and scanners but the uniqueness of Kawempe hospital is that it is serving greater Kampala areas.
“The number of patients is so huge. We can’t keep pace with the rate at which equipment breaks down and we need to have the equipment replaced. Every two months we need to buy equipment because they break down…” he said.
“We expect 70 mothers and we receive 300. What do you expect to happen to those machines after two months, they break down. Our partners came in to help. They have so far given us Shs 2 billion. They have procured blood pressure machines, ultrasound machines, curtains, patients’ consumables, mama kits, and others,” he said.
He said Stanbic bank and Unicef have refurbished level five for babies, repaired machines, theatres, and others.
“The hospital operates a minimum of 30 mothers every 24 hours and 900 mothers every month minus safe deliveries. We receive all mothers, even those who were managed or mismanaged from clinics around us,” he said.
According to the 2020/2021 Annual Health Sector Performance Report, maternal deaths reported by health facilities across the country increased by 126.4% from 1,102 in FY19/20 to 1,228 in FY20/21 with a maternal mortality ratio of 92/100,000 and the institutional maternal mortality ratio has dropped from 108 to 92 per 100,000 deliveries in the last five years.
Dr Kazibwe said; “The hospital registers between six and 15 maternal deaths every month, of which between six and nine are brought in dead for us to investigate backward. In some cases, police are called in to establish what could have happened before the death of a patient. But once you are given a dead body because the health system is interested in knowing the health of the population, we are supposed to work backward to find out what happened.”
“The remaining two to six are probably brought in late and the remaining few may be brought in with stable parameters but die due to system delays. We lost 90 mothers last year,” he said.
EXPANDING THE HOSPITAL
Dr Kazibwe said the permanent secretary of the ministry of Health Dr Diana Atwine promised that government plans to expand Kawempe hospital and is in advanced talks with neighbours to acquire more land.
“In the very beginning, people had resisted the hospital but once the neighbours were invited to this facility, some of the administrators of the properties in the neighbourhood granted the government’s plea to buy their land in the interest of expanding the facility,” he said.
inarticle} inarticle}
