TIME TO HAVE COST SHARING APPROVED BY GOVT. IN HEALTH FACILITIES

We have seen it all. time is ripe to have cost sharing back in Government health facilities. President Museveni makes one big mistake, for example in imagining that when he scraps cost sharing he is helping the people he simply gets it wrong. Time is now for him to live with the reality.If his Government cannot afford to increase the pay to the health service providers, it makes alot of sense for these people to pay shs 2,000 on average so that they boost the morale of the health service providers. Buganda government has given people free medical services and those who deliver the service are overwhelmed by the numbers. Poverty is the order ofthe day.If Government can provide the drugs and have health staff in place,given the prevailing conditions,for any body with some logic,it is sensible to pick a small bill and have drugs after the doctors have diagnosed the patients.
William Kituuka Kiwanuka

HEALTH MINISTER VISITS MITYANA HOSPITAL
Sunday, 7th February, 2010
By Luke Kagiri
THE health minister, Stephen Malinga, last Friday visited Mityana Hospital following reports of negligence in the maternity wards.
Malinga said he had visited the hospital to establish the cause of death of Sylvia Nalubowa, who died in the labour ward, and Harriet Nabubenje, who died in the maternity ward last year.
On his arrival, the minister toured the hospital with the administrator, Francis Muzira and the district health officer, Fred Lwasampijja.
He later met the staff and other district leaders, whom he asked to explain the death of the two women.
As Lwasampijja explained that the women had first visited clinics in villages, he was interrupted by the minister, who insisted the women had died because of the negligence of doctors.
“How can a doctor give orders on phone? How long was the patient admitted before she could see a doctor? We should call a spade a spade if we are to improve,” Malinga said.
He asked the Police to arrest the owners of the clinic and investigate the case.

INSIDE MITYANA'S MAIN HOSPITAL
11 October 2009
Mityana Hospital, a 100-bed facility, now admits an average of 160 patients, against a staff ratio of eight midwives and nurses. Last week Sunday Monitor's Kikonyogo Ngatya gained unprecedented access inside the facility. Read on:
Two nurses and a doctor had been on duty that day for the last 24 hours working non-stop in the very busy maternity ward section.
They successfully delivered 57 women, carrying out 10 caesarean procedures along the way. It is now 4 p.m. into the second day and the trio is still on the job. One of the nurses returns to the delivery room from the operating theatre, 30 metres away, with a bundle of joy - a baby girl and shows the father of the child who had witnessed most what his wife went through.
Outside, a queue of about 30 more women ready to deliver wait to enter the same maternity ward. "I am collapsing. I think I am done," the nurse tells me as she runs back to the theatre to bring the mother back to the post surgery recovery room.
In this small room furnished with seven beds, 10 mothers are groaning in pain. Their attendants jam every other space in the room. Some women are on the ground with intravenous drip apparatuses superimposed on windows or are hand-held by attendants. There are no drip stands here. The nurse says they improvise. It is hard to imagine when this room, which in ideal circumstances ought to have been in pristine conditions, was last painted or swept.
The smell is oppressive and speaks volumes about the hygiene conditions.
In the meantime, three other women are ready to deliver. The doctor looks tired, but can still afford a smile, and calms their nervousness by saying they will be all right. Every delivering mother here comes with a razorblade, gloves and a polythene bag. It's not the hospital policy - they are simply not in stock, the doctor says. The doctor then rolls up his long-sleeved checkered shirt and duty continues. Just outside the theatre, is an overflowing manhole. Blood from the facility overflows down the compound into the thick overgrown grass. Two pigs drink from the sewer. They then roam about , stepping on bed sheets that had been washed by patients' attendants and left spread out on the ground to dry. There are no clotheslines in sight.
Roaming pigs, chicken and goats seem to be normal here. Many more move about up and down. Is this healthy, one wonders. Patients seem not to mind about hospital infections here- it simply looks normal as attendants go about preparing their meal near this filth. As the sun blazes away, a groan of pain rips through the air.
On investigation, we establish that it comes from the main operating theatre where I am later told a man who fell off a boda boda and fractured his leg is being attended. At about the same time, in what passes for a mini theatre (a very small room really), a woman who also fell off a boda boda is undergoing surgery on the knee. The nurse working here says she has been on theatre duty for more than 24 hours.
Block after block in this hospital one is confronted with the face of misery and dereliction. A signpost in the waiting rooms reads in Luganda: "Amadagala agasinga wegali era gabwerere", meaning 'Most of the essential drugs are in stock and are for free.' I pass more than five such signposts and head to the children's ward, before checking at the dispensing window last.
It was immunisation day and a confused chorus of young souls crying away tells the story of their pain. A single nurse applies the jab left and right. She uses disposable syringes. The slender nurse adjusts her white head gear and continues her jabbing routine as a long queue of mothers snakes its way from inside a tiny cubicle to the outside and into the blazing sun. The best post-injection counselling and advice she can afford is to demonstrate how to handle the injection area by massaging not rubbing. It's not easy for her to explain the reasons behind this as there are so many mothers with babies waiting to be attended to.
A mother who said her child was HIV positive was present that day. She begged to be allowed have a more private interaction with the nurse. The nurse stops the injecting routine to take her to another filthy cubicle, filled with files and dusty folders. She tells the nurse, some people are telling her to stop giving the kid antiretroviral syrups. But the nurse simply tells her to continue with the medication but without explaining enough why this is important - she cannot because there just isn't enough time. Within three minutes, the mother is out but doesn't seem contented.
The environment here and quick advice given point to the official figure of 25,000 babies born with HIV annually, and mothers who shun hospital because of the little privacy.
I sort of get used to the confused chorus in the paediatric ward. But you must need pain killers to calm your nerves. In the general men's ward, two nurses have been working here for five straight days. They sat down after doing routine check and administering injections and wound dressing to have a cup of coffee, pancakes and 'dry' tea. "This is now our home. The best we can do is to go back and shower, change clothes and come back," one of them tells me.
Here complaining, even with official communication channels, is not an option. One of them got a sacking letter from the Chief Administration Officer at the district for complaining. She was accused of inciting protests, and endangering the lives of nurses. Remember this is the same hospital where a mother and her newborn died because of the alleged negligence of the nursing g staff. That matter is in court. My next stop is the nurses and midwives quarters. Broken windows and doors. Overflowing toilets. It is not a reassuring sight.