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Health ministry needs sh3b to fight Ebola

By Anne Mugisa & Norah Mutesi

The health ministry says sh3b is needed to fight the deadly Ebola haemorrhagic fever. This includes the money needed to run the operations centre at the health ministry and to trace and care for all the reported cases and for local governments, the health ministry has said.

Five ebola cases have been confirmed to date, three of whom are dead, the ministry said. However, 13 other people connected with these in Kibaale died and were buried before their samples could be collected.

Health minister Christine Ondoa told journalists Friday that 32 cases were being investigated, while 312 others, who had contacts with the suspects were being monitored.

She said an inter-ministerial task force, as well as the national task force on Ebola, had been formed, the latter headed by the health ministry.

Health Minister needs 3 billion to fight Ebola

Ondoa said the ministry was also working with the World Health Organisation (WHO), the Centre for Diseases Control, Medicine San Frontiers, Uganda Red Cross and others, to contain the outbreak.

She said those suspected were in isolation centres, including health workers.

The ministry, she added, had sent an ambulance to Kibaale to collect the sick and an equipped vehicle to help bury the dead.

WHO representative Dr. Joaquim Saweka, ministers Ephraim Kamuntu, Mary Karooro Okurut and Asuman Kiyingi also addressed the press.

They expressed dismay that some people were exaggerating the Ebola issue to scare others away, yet the WHO says there is no need for travel restrictions.

The Mbarara and Makerere suspected cases were false, Ondoa said.

http://www.newvision.co.ug/news/633742-health-ministry-needs-sh3b-to-fight-ebola.html

Living positively behind bars

By Petride Mudoola: Robert Sebunya, who is serving a 45-year jail term for murder in Luzira Maximum Prison, is HIV-positive. His life in jail has been one hell of a nightmare. “Its double tragedy living positively behind bars,” he says.


Sebunya is in bad shape and is required to use Antiretroviral (ARVS) drugs which he is able to get but finds it difficult to take.

“I cannot swallow them on an empty stomach. I end up throwing them away,” he says.

For a man whose state of health requires constant and proper feeding, Sebunya is in danger of experiencing more serious complications.
He says that even though inmates receive the required medication, there is need for authorities to consider supplementary diet for HIVpositive inmates.

The prisons lack the necessary nutrition to cater for HIV-positive inmates, yet those on ARVs are meant to take a balanced diet. Gabriel Mugaga, another inmate living with HIV, says many of his colleagues fear to take ARVs due to the bad feeding in the prison.

“We throw away the ARVs because we cannot swallow them on empty stomachs.” Mugaga wishes to have healthy meals from his family in Kibaale, but they are far away and cannot bring food for him.

Poor feeding is one of the major challenges that HIVpositive prisoners in Uganda face. This has made the already appalling conditions of HIVpositive prisoners even worse.

Frank Baine, the prison’s publicist, observes that while the prison is supposed to cater for HIV-positive inmates, its budget is too small to do.

“We have no specific budget for feeding inmates on ARVs,” he said. He adds that those on treatment are sometimes provided with vegetables and eggs from prison farms.”

Baine says as a prerequisite, prisoners are subjected to an HIV test upon being imprisoned.

Those found to be positive are referred to the inmate’s health facility for treatment and restricted from engaging in hard labour. But there is little support in curbing the spread of the virus among the inmates, he adds.

The HIV prevalence among inmates has also been heightened by the increased sharing of sharp objects among prisoners.

HIV challenges in Ugandan Prisons

According to the prisons department, Uganda’s prisons has over 2,000 HIV-positive prisoners. Three hundred and fifty inmates living with HIV are in Luzira Maximum Security Prison. Only 178 of them have access to ARVs on a regular basis.

During celebrations to mark World AIDS Day at Luzira Prison, Dr. Joseph Andama, the medical superintendent Murchison Bay Hospital, said HIV prevalence among inmates was higher than the national average. He urged the Government to invest in the management of HIV/AIDS and Tuberculosis (TB) in prisons to reduce more infections.

“This investment should consider timely diagnosis, early treatment, observing the dosage strategy, ensuring that HIV inmates are screened for TB and those with latent TB receive isoniazid treatment so that they don’t develop fullblown TB,”Andama explained.

Andama said prisoners’ misuse of sharp objects has worsened the situation. And due to shortage of counsellors, many inmates find it hard to cope with their condition.

Johnson Wavamuno, an inmate in charge of prisoners living with HIV in Luzira Upper Prison, says the limited number of counsellors due to understaffing leaves inmates unable to deal with the consequences of HIV.

He says more trained counsellors should be attached to the detention facility.

HIV at a glance

According to AVERT-An international HIV/AIDS charity, the number of people living with HIV globally rose from around eight million in 1990 to 34 million by 2010.

The World Health Organisation (WHO) statistics for 2010 corroborate this figure. WHO adds that 17% of people living with HIV by 2010 were women.

The overall spread of the epidemic, according to AVERT, has stabilised in recent years. The number of AIDS-related deaths has also declined “due to the significant increase in people receiving antiretroviral therapy.”

Since the beginning of the epidemic, nearly 30 million people have died from AIDS-related causes.

In 2010 there were an estimated 23 million people living with HIV in Sub- Saharan Africa.

This has increased since 2009, when an estimated 23 million people were living with HIV, including 2.3 million children.

In Uganda, incidence rates have stalled at 6.4%. According to the Uganda AIDS Commission (UAC), close to 128,980 people acquired HIV/AIDS last year up from 124,261 in 2009.
UAC estimates that 64,016 people die in Uganda from HIV/AIDS per year.

Source; http://www.newvision.co.ug/news/632631-living-positively-behind-bars.html

Unqualified doctors operate on patients

By Sampaul Nakhaima and Pascal Kwesiga


Most of the surgical procedures in hospitals and health centres across the country are performed by health workers who are not surgeons, a new study has revealed.

A study conducted by researchers from the College of Health Sciences of Makerere University has disclosed that there are only 200 surgeons out of the 2,105 registered doctors in the country. This, he said, means there is only one surgeon for every 400,000 Ugandans.

An associate professor of anatomy (structure of the human being), Sam Luboga, who led the study said yesterday that crucial surgical operations continue to be conducted by nonsurgeon physicians and non-physician clinicians in general hospitals and health centre IVs.

Luboga was launching a programme that will see surgeons from the college give necessary surgical skills to general doctors in the country’s hospitals and health centres. He said some of the surgical theatres are redundant at the hospitals.

He blamed the high maternal mortality rate, high fatality rate from injuries and other surgical emergencies, high prevalence of surgical preventable disabilities, unnecessary referrals to regional and national referral hospitals, heavy surgical work load and limited access to lifesaving surgical services to shortage of surgeons.

For one to become a surgeon, they must have pursued a master’s degree in surgery for three to five years after an undergraduate degree in medicine.

Luboga who said surgeons are concentrated in urban areas attributed the shortage to brain drain as a result of low remuneration in Uganda, long training periods and few institutions offering the specialised training.

Luboga noted that the project will improve the access to quality surgical services, reduce mortality rate and disability attributed to surgically treatable conditions.
The college students also announced a plan to start offering free screening services to young women for cervical and breast cancers.

Source: http://www.newvision.co.ug/news/632613-unqualified-doctors-operate-on-patients.html

MPs want sh400m for nodding disease research accounted for

By Moses Walubiri Legislators on a select committee instituted to carry out an onspot check on areas affected by nodding disease have ordered ministry of health (MoH) to account for sh400 earmarked for research into the causes of the debilitating syndrome.

This comes on the heels of a field visit by MPs to the districts of Gulu, Kitgum, Lamwo and Pader, which showed that the said research has not been carried out.

While interfacing with MPs from the areas affected by the disease through their umbrella body, the Acholi Parliamentary Group on Tuesday, the chairman of the select committee Medard Bitekyerezo said “the ministry had lied to Parliament about the research funds.”

“We have just completed an onspot visit to all the affected districts, but no research has been carried out, yet money was earmarked for this activity.  We have summoned MoH to account for this money,” Bitekyerezo said.

The sh400m research fund was part of a holistic government response to stem increasing cases of nodding disease in the Acholi sub-region, tabled before parliament in May  by Dr. Richard Nduhura, state Minister of Health (General Duties).

Other interventions include establishment of treatment centers and provision of fortified food supplements to children afflicted by the disease.

Need answers

Meanwhile, MPs Tuesday clashed over the causes of nodding disease as they demanded for expeditious research into the causes of the disease.

The MPs, especially from Acholi said uncertainty over the true cause of the disease has spawned anxiety and conjecture, thus giving way to superstitions.

This, they noted, has seen witch doctors take advantage of desperate parents to fleece them.

“The witch doctors are making a kill over the disease because little is known about its cause. In Amuru, a witch doctor was arrested after 15 children afflicted with nodding disease were found at his shrine,” Gilbert Olanya (Kilak County) said.

Some parents, MPs said, have abandoned nodding children thinking that the disease is either contagious or caused by spirits.

Odonga Otto, however, refuted Olanya’s earlier submission that the disease could be linked to the protracted war in Northern Uganda, reproaching the remark as incendiary.

Otto also stridently rejected Alice Alaso’s submission that a report into the cause of the disease by the Center for Disease Control in the USA suggests a possible link to heavy metal poisoning. This normally occurs in war-prone areas.

“As leaders, we should be the last people to alarm people. This kind of remark can make people flee entire villages,” a visibly riled Otto said.

The Aruu County MP contends the disease is caused by malnutrition, especially chronic deficiency of Vitamin B6 that is key to brain development.

However, when contacted, the health ministry spokesperson, Lukia Nakamate, said a number of research protocols on nodding disease have already been commissioned by the national task force on nodding disease.

Nodding disease is characterized by head nodding, mental retardation, stunted growth, blindness, and wasting of the body.

Little is currently known about the cause, mode of transmission and treatment of the disease. However, area politicians have chided both government’s response, which they have deemed sluggish, and its failure to declare the affected region a disaster area.

Source: http://www.newvision.co.ug/news/632622-mps-want-sh400m-for-nodding-disease-research-accounted-for.html

For lack of Shs300,000, teacher bleeds to death in Labour Ward

18th/september/2011
The contractions had started at dawn. Cecilia Nambozo, a teacher at Busamaga Primary School in Mbale Municipality, knew it was time, so she did what was expected—checked into a hospital at 6am so she could give birth with expert attention at her disposal.
But that was not to be, for more than 10 hours after Nambozo checked into Mbale Regional Referral Hospital to bring unto the world a life, she was ignored, neglected and writhing in pain. Her crime? She did not have Shs300,000 the hospital medical staff demanded before they could attend to her. And so she wasted away as her husband, Mr Richard Wesamoyo, made desperate runs around the village to raise the money.
That chilly September 6 still haunts Mr Wesamoyo. Nambozo arrived in the hospital at 6am but was reportedly neglected in the Labour Ward until 8pm when she breathed her last. Even then, it is the hospital cleaners who helped remove the baby from her womb. “The lady could not push because the baby was big. The doctors demanded for Shs300000, which we could not raise,” said Ms Grace Acham, a neighbour who had helped transport her to the hospital.
Ms Acham said they had spent the little money they had to purchase surgical equipment. “And when I came back, I found her in pain, crying, there was no help. The medical workers looked on as they asked for money,” she added. Ms Acham said after three hours of waiting and sensing that Nambozo’s situation was deteriorating, she approached a midwife and asked her to attend to her as the husband ran to the village to sell property and raise the money but the midwife and a doctor allegedly declined.
“At about 6pm, Nambozo started gasping; she fell on the floor and was bleeding. That was when the doctor responded and took her into the theatre but it was too late; her life could not be saved. She died.” she said.
The doctor emerged from the theatre after about 10 minutes and announced that both the child and the mother had died, Ms Acham added.
Mr Wesamoyo told Sunday Monitor that his humiliation was iced when medics abandoned his wife’s body in the Labour Ward with the foetus in her womb. He said the body was removed by cleaners
“They rolled the bed out in the open and started operating her naked for all to see. It was very dehumanising and humiliating for her to be stripped naked by cleaners,” said Mr Wesamoyo. He said they had been going for antenatal check-ups at the hospital and the midwives had told them the baby was big and that it would be difficult for her to have a normal birth. Apparently, the midwives had recommended a caesarian operation for Nambozo.
Police investigate
Dr Bernabas Rubanza, a police surgeon who carried out the postmortem, said the baby weighed 5.2 kilogrammes and that Nambozo died due to failure to push that made the uterus to rapture. He added that due to neglect after the uterus malfunctioned, Nambozo had bled to death.
“This lady reached the hospital at 6am and pleaded with the medical workers for an operation because she knew her status but the medics refused to attend to her until her uterus raptured. This is a pure case of neglect,” said Dr Rubanza. He added: “And this is not the first case at this hospital; many women have died in labour out of neglect.”
Mbale District Police Commander Jacob Opolot said a case has been registered and investigations have started. “We received a complaint and we have opened a file and summoned the medical staffs on duty that night and the day to furnish us with information,” said Mr Opolot.
However, the hospital director, Dr BenonWanume, said at the time of Nambozo’s death, there was another woman undergoing an operation in the theatre and that it was inadvisable to halt the ongoing operation.
“And in any case, it is not the patient who asks for theatre but we examine the patient and recommend. Doctors on duty examined her and by the time they recommended her for theatre she had already raptured her uterus,” he said.
Dr Wanume added: “She was bleeding and we could not save her life. I can’t rule out the issue of asking for money. Some staff do it but we need to investigate this further because it has no proof.”
He said the people who operated Nambozo to remove the foetus where not hospital workers but imposters who sneaked into the hospital.
Source: Daily Monitor
http://www.monitor.co.ug/News/National/-/688334/1237880/-/bj7s7pz/-/index.html