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Uganda: Adjumani to fine women who give birth from home

By Martin Okudi

Authoritiesmaternity in Adjumani district are mooting a by-law that will penalise women who give birth from home.

The move is intended to reverse the trend of women shunning health centers and having unsafe deliveries at home. The district council is finalising a by-law prohibiting the practice, and that would see the women and their male partners both fined.

Adjumani LC5 chairperson, Mr Nixon Owole says women should utilise the available health facilities. He says that the by-law is an intervention meant to promote safe deliveries in the district.

“My official vehicle has in the past few months been used to transport seven pregnant women to the health facilities. But regrettably about five of them died due to late arrival to the facility because they had opted to deliver at home. So we should reverse this trend with a by-law in place,” Owole said.

In an interview with the Daily Monitor, the medical superintendent of Adjumani hospital, Dr Dominic Drametu, said that despite the presence of health facilities in the district, 33 out of every 100 pregnant women report for normal delivery in health facilities.

The by-law at glance
If passed, the by-law will give powers to the village health committees and the LC1 authority in every village to charge every pregnant women who gives birth at home Shs50, 000.Their partners will also pay the same amount. The fine has to be paid regardless of the outcome of the delivery.

Source: http://www.monitor.co.ug/News/National/-/688334/1369914/-/ax91jbz/-/index.html

UGANDA: Senior health officials suspended amid TB drug shortage

KAMPALA/GULU, 23 March 2012 (PlusNews) – Uganda’s Minister of Health, Christine Ondoa, has suspended several senior health officials, including the managers of the national HIV/AIDS and tuberculosis programmes, for poor performance and drug shortages.

Health centres across the country have been facing critical shortages of TB drugs in recent weeks and officials say the lives of an estimated 50,000 people have been put at risk as a result.

Dr Francis Adatu, the national manager of the TB and Leprosy Control Programme, was suspended over a critical shortage of TB drugs, and Dr Zainab Akol, programme manager for HIV/AIDS, over the unstable supply of antiretroviral (ARVs) drugs. Her suspension comes one week after a national AIDS Indicator report revealed an increase in the HIV prevalence rate from 6.4 percent to 6.7 percent.

Three other senior managers – Dr James Sekajugo, the programme manager for non-communicable diseases, Sarafin Adibaku, in charge of the Malaria Control Programme, and Rachael Senyange, from the UN Expanded Programme on Immunization, were also asked to leave office immediately. Dr Robert Basaza, a senior planner arrested on 20 March to assist the police with their financial investigations, was also suspended.

“I have withdrawn her [Akol] and four others from their assignments. I have adopted the changes to overhaul the departments in order to improve on service delivery, supervision, monitoring and financial management,” Ondoa told IRIN/PlusNews. “I have left it to the technical persons [permanent secretary and director general of health services] to get people to take over the management of the programmes.”

At Gulu Hospital in northern Uganda, 37 newly diagnosed patients and more than 50 continuing patients are without TB medicines. “The TB clinic has been running without drugs for the past three months,” said Rebecca Akuu, the senior nursing officer at the TB clinic. “We are telling patients to keep checking.” IRIN/PlusNews found frustrated and frightened patients at the clinic. “I don’t know what to do, my life is in danger,” said Otto Ayella. “My cough is getting worse… making it hard for me to breathe.”

Blame game

Shortages of ARVs and drugs to treat TB and malaria occur frequently in Uganda.

Dr Asuman Lukwago, permanent secretary in the Ministry of Health, told IRIN/PlusNews that most public health facilities had run out of drugs due to changes in the procurement and supply responsibilities introduced by the new Public Procurement and Disposal of Public Assets Authority (PPDA) international guidelines.

Drugs were previously procured by the National Tuberculosis and Leprosy Centre, but since late 2011 the procurement and distribution of drugs and pharmaceutical products has been handled by the National Media Stores (NMS), an autonomous government corporation. The new procurement policies are aimed at improving the management of the supply chain.

“It’s true we have some problems… The transition will be managed. We are doing everything possible to have drugs distributed to the affected hospitals,” Lukwago said.

Moses Kamabare, the NMS general Manager, blamed the current drug shortage on a shortfall in foreign funding. “The government has just now started funding the drugs,” he said. “The country had some problems with the Global Fund [to fight AIDS, Malaria and Tuberculosis]. This brought some shortages. However, we now have… drugs… for three months.”

Kamabare said part of the blame also lay with local health authorities who did not put in requests for drugs on time. “If they don’t requisition, we can’t know whether they have the drugs or not. We can’t keep following up on them.”

Photo: Charles Akena/IRIN

Supply chain problems have led to regular drug shortages

Rectifying the situation

Health Minister Christine Ondoa said the government has procured enough TB drugs to cater for 50,000 patients for the next three months. “We want to assure the public that there is no cause for alarm as there are now sufficient drugs. All patients are therefore advised to report to health facilities for treatment,” she told a recent media briefing.

The procurement of medicines for the next six months with funding from the Ugandan government was ongoing she said, and the government had also, for the first time, procured second-line TB drugs for 250 patients diagnosed with multidrug-resistant TB. “The first consignment of TB drugs under the Global Fund arrangement will arrive in the country in September,” she added.

Dr Nathan Nyachi the director of Gulu Hospital, confirmed that medicines were now available. “We have the drugs. I have just been collecting the hospital’s consignment, and for several other health units in the district,” he told IRIN/PlusNews.

An estimated 102,000 Ugandans become infected with TB annually, and about 50,000 cases have been diagnosed and are on treatment. The country ranks 16th on the UN World Health Organization’s list of 22 high-burden countries that make up 80 percent of global TB cases.

Source: http://www.plusnews.org/PrintReport.aspx?ReportID=95134

Rights body sues Government, Umeme for blackout in hospitals

By Anthony Wesaka

A Human Rights body has lodged a complaint against the government, power distribution company UMEME, and the Electricity Regulatory Authority (ERA) over indiscriminate load shedding in public hospitals, which has led to many avoidable deaths of patients.

Center for Health, Human Rights and Development (CEHURD) lodged the complaint before the Human Rights Commission (HRC) in Kampala recently.

The complaint follows a story which ran in Daily Monitor on January 12 about how doctors in Jinja Referral Hospital were grappling with the challenge of keeping patients alive against constant power cuts. It was reported that over 150 patients had died in a space of six months due to unstable power supply and load shedding.

The complaint also highlights the temporary closure of Entebbe hospital recently due to rampant load shedding, which action they say violates the right to life and is discriminatory.

“This complaint is about the indiscriminate load shedding, including public hospitals, which has denied the citizens of their right to access to health care and in some cases either directly or indirectly led to the death of patients,” reads the complaint in part.

CEHURD faults the government for failing in its obligation to protect its citizens from third parties (ERA and UMEME).

The rights body furthers states that load shedding public health facilities which already have electricity supply is retrogression on the part of the government.

“Indeed the delegation of the government’s responsibilities of providing these essentials such as electricity (even to health facilities) to entities such as the ERA and UMEME does not mean delegation of the government obligation,” the complaint further read.

The complaint comes at a time when 24hr load shedding is set to continue until May this year.

CEHURD now wants the HRC to declare that electricity load-shedding in public hospitals is a violation of the right to health and the right to life.

They also want a permanent injunction restraining Umeme from load-shedding health centers and hospitals.

Background 
The complaint is brought under Articles 51, 52, 53, 45 of the constitution and Section 7 of the Uganda Human Rights Commission Act Cap 24. Under Article 53 of the constitution, the commission has the mandate to investigate complaints of human rights violations before it from a person and or a group of persons.
In so doing, the Commission is independent and is endowed with powers to commit anyone for contempt of its orders and order for any legal remedies, redress and other redresses.

awesaka@ug.nationmedia.com

Activists drag government to court over ‘abusing’ the mentally ill

By Flavia Lanyero

Public health activists have dragged government to the Constitutional Court demanding that it changes its reference to mentally ill people as idiots and imbeciles in the Penal Code Act and the Trial on Indictment Act.

The petitioners: the Centre for Health, Human Rights and Development and Yiga Daniel through their lawyers Kabanda and Co. Advocates, said both laws are “too abusive, archaic” and do not conform to the Constitution and the United Nations Convention.

The petitioners are also aggrieved with laws that deem persons with mental disabilities, who are not proven guilty, by referring to them as criminal lunatics.
They said detaining them in prisons for years awaiting a minister’s order on whether they are able or unable to stand trial violates their rights guaranteed under the Constitution.

The petition was filed in December 2011 and scheduling interparties on February 21 adjourned it to March 22 after the State Attorney, Mr Kasibayo Kosia, in a letter said he misplaced his scheduling notes and asked for adjournment.

A February 20 petition letter reads in part: “It is unfortunate that the State plays with very important issues that need quick response.”

Source: http://www.monitor.co.ug/News/National/-/688334/1355260/-/axxi37z/-/index.html

Bugiri Hospital suffers brain drain

By Frederick Womakuyu

FROM the Bugiri-Malaba highway, Bugiri hospital appears to be a deserted facility. The tin roofs hovering over the facility are rusted, its doors broken down and the infrastructure is dilapidated. But coming closer to the facility, you see a number of patients are lining up for different services.

This is around 9:00am in the morning. However, a keen look around the facility reveals absence of the senior workers — the medical superintendent, the administrator and junior cadres, are yet to show up. I am told to wait. Within half an hour, the administrator shows up but she tells me to wait as she attends to the Resident District Commissioner of Bugiri, who had also showed up to check on the facility.

The hospital is in dire need of equipment ranging from beds to drugs. A fresh coat of paint would also be nice

After almost three hours, the administrator, Sarah Nabulime, a short talkative woman, invites me to her office. Nabulime starts by lamenting that as much as sick people fl ock the facility for treatment, the centre itself is “like a patient on drip.” Nabulime laments that the hospital has failed to retain its staff who vanish after training.

On the day I visited, the medical superintendent was away. He went for further studies but, unfortunately, after the course that was sponsored by the Government, he vanished.

TWO DOCTORS

The facility is also supposed to have three doctors but only two are available — the third went to Nairobi, Kenya for further studies. However, Nabulime fears that when he completes his studies, he is also likely to look for greener pastures elsewhere. Nabulime has lost count of the number of doctors from Bugiri hospital who enroll for further studies but never return. “Every year, we lose about three doctors who go for further studies and do not come back. According to Dr. Stephen Kirya, the Bugiri district director of health services, the staff of the facility stands at 52% against the 65% recommended by the Ministry of Health. “This seems like a good percentage but it’s the core staff who are missing,” he said. Kirya explains that while the facility is supposed to have about 12 doctors, they have only two. Out of the five specialists they should have, there is none. Because there are no specialist gynaecologists and obstetricians, every month, two babies and a mother die at the facility due to this shortage. Thankfully the facility has an x-ray and c-scan machine but no expert to operate it.

The infrastructure can best be described as sick. The beds in each ward are broken, mattresses torn or missing and the few available ones are dirty. The beds are also few forcing some of the patients to sleep on the floor.

The ceiling needs to be replaced

Yet deep in the toilets and bathrooms, a sanitation problem that is likely to cause disease is going on. The toilets are all broken down; sewerage leaks inside the wards and into the consultancy. The floor, walls and the entire infrastructure is dirty, dilapidated and unsuitable for human use. The facility uses water from an electric pump. However, power cuts have forced the facility to go without water for weeks. The maternity ward has become so filthy – a powerful stench that is indescribable threatens lives there. “Life is tough in this hospital. We have talked to the district to give us more money to buy fuel for the generator to power the whole hospital but the district is also broke,” adds an health worker, who preferred anonymity.

SHOE STRING BUDGET

Bugiri district prepares an annual budget of sh20b but they get only sh50m. However, at the end of each month, they use over sh20m to run the hospital. The facility budgets for sh1m per month to buy fuel for the generator but their annual budget for running the generator is about sh15m. “This clearly shows you the shortage we face,” adds Dr. Kirya.

Dr. Kirya explains that when there is no power or generator, they are always forced not to carry out any surgeries refering the cases to Iganga or Jinja hospital. However, by the time they cover a distance of about 30km to Iganga or 60km to Jinja, the patients are dead. No wonder, at the facility, 600 people – including children, women and men die annually. While the facility, like any other in the country receives its drugs, medicines and supplies from the National Medical stores, the supplies are often inadequate. Essential drugs like malaria, anti-biotics are often out of stock. And simple supplies like gloves, gauze, cotton, syringes and intravenous fluids are often out of supply. But she is also frustrated that they have promised each year in and out but nothing has so far come. Patients like Alice Nantume who has just given birth without the help of a doctor but a nurse, are desperate.

“I came here to get better care but life is instead tough. At least in the village, a traditional birth attendant will give you some herbs but here there is nothing.” Nantume explains that she did not fi nd any gloves, so she was advised to buy some. She also brought her own soup since the facility did not have any. “We request the government to help us,” she pleaded.

WAY FORWARD

Dr. Kirya calls upon the Government to help them recruit human resource and pay them well, “because the districts do not have capacity to attract and retain health workers. It is a pity but we need help.” Nabulime calls on the government to speed up the plan to rehabilitate the facility to give it a new facelift. Bugiri district chairman Malijani Azamwa Balubireire called upon the Government to increase funding to local governments and also stop creating more districts so that they are able to pay health workers well.

source:  http://www.newvision.co.ug/news/629245-bugiri-hospital-suffers-brain-drain.html