Kawolo: A hospital on its death bed

Though Mulago Hospital has taken the lion’s share of attention as a derelict health facility, many others are in a similar state of helplessnes. Kawolo Hospital, in Lugazi, is one such.

The first thing that welcomes you to Kawolo Hospital is a gigantic signpost showing visiting hours. It bears an image of a smart doctor, clad in a green lab coat with a stethoscope. His infectious smile, let alone its broadness, gives the impression that all is well, in what some people call “Mukono’s grave.”

A heartbeat away from this signpost is a long ditch with stagnant water and floating algae. Mosquitoes are ‘happily’ breeding. From the outset, the buildings speak volumes about their inside. Plants grow on the iron sheets, which bear holes.

A few people are scattered all over the fairly neat compound. Palms are stuck on the cheeks for some while others do light laundry. The mood is generally dull and mildly tense.

Officers not on duty
At the entrance to the administration block is a notice from the senior sadiographer dated 11 December 2012 to all Clinicians and Medical staff. It reads, “This is to inform you that the X-ray machine is out of service due to a mechanical problem. However, the ultra-sound machine is working.”

At this point, I get more energised to have, “a feel, see, touch and smell,” experience of Kawolo Hospital, as I explain my mission to the receptionist. It is 9.30a.m. but most offices are still locked. The ward-in -charges and senior hospital officials have not yet reported for duty. Some report later around mid-day. “Well, the problems of Kawolo could be more than what meets the eye,” I whisper to myself as I head to the men’s ward.

The elderly, youthful, adults and teenagers are all crowded here. The challenge of space is obvious from the sight of some patients lying on old mats below tied beds. Apparently, the ward is designed for 24 patients but accommodates twice the number.

There are a few idle beds. However, they are not just idle but broken beyond repair though some are supported with bricks. One feature cuts across the bedding structure here; from the mattresses without covers (mackintoshes) to torn nets and blankets, everything old and mal-functional seems to be condemned to this ward. Otherwise what explains the broken, rusted and dirty lockers beside every bed? Even the broom with which the cleaner is sweeping is old and shabby. It is just that she uses her palm to shield her sharp nose from the dust raised from the potholed floor. But it is clear even if she had gloves or gumboots, they would be either too old or torn or both.

Nurses are helpless
I force myself to imagine the nurse’s room is different and check in there. A broken tap with a collapsing sink and cobwebs welcome me. “We have not had water here for over a month now,” an elderly nurse emotionally says, begging to leave as she is exhausted, thanks to the night duty. She sympathetically holds a syringe and stares at the steriliser.

“This steriliser is too old, at times it jams but we have no option,” she says, hitting it with her palm as if begging it to resume work.

“In Kawolo we improvise most things, otherwise you can’t manage,” she says. She speaks of the problems in this particular ward with impressively thorough knowledge. The patients, she says, are mixed up in this one ward regardless of their ailment.

Those with malaria, tuberculosis, HIV/Aids, asthma, high blood pressure, and any other disease are all here. Yes, even accident victims are rushed here. But at least not Ebola. Actually the hospital has never admitted an Ebola case but ones imagination can only stretch itself far and wide. I take time to interact with one of them, who stubbornly refuses to reveal his name.

Angry patients
One patient, amid a flurry of coughs, told me he just came to the hospital to die in the doctors’ hands. He harangued Government for buying tear gas, jets and cars, yet he was suffering in hospital. He rounded it off saying the hospital was built by Dr Apollo Milton Obote, but that the current regime had left it to rot away.

He hitting his bare and bony chest with his fist as he spoke. When the conversation takes on a tense and sensitive political twist, I signal the nurse so we can move on. “When we have accident victims and there is no free bed, we treat them from the floor,” her colleague, visibly a trainee nurse, speaks without traces of morale on her face.

Their eyes grow almost teary as they speak in chorus, “We are not safe here. We attend to patients with all sorts of diseases but without masks, at times gloves are not there. Look at that cleaner, that dust can infect her with tuberculosis!”

From their resilient tone and facial language, they appear ready for anything and everything these risks pose to their health but what remains a bother is lack of equipment. “We have sacrificed for the sake of our profession but what can we do when drugs, water, electricity and other supplies are not steady?