State House, Mulago boss clash over hospital decay

Parlaiment.

A State House official yesterday clashed with Health ministry Permanent Secretary and Mulago hospital director over the crumbling state of the national referral hospital.

The head of Medicines and Health Service Delivery Monitoring Unit at State House, Dr Diana Atwine, had criticised the rot in the health sector and downgraded Mulago National Referral Hospital as a health facility in shambles and likened it to a market.
“Medicines are getting spoilt, they are doing shoddy work and stealing money in construction, some doctors close facilities and go for weddings, doctor houses are filled with sorghum and others turned into chicken houses and medicines cannot be accounted for,” Dr Atwine said.
“Referral system broke down long time ago. Mulago has been reduced to a health centre IV treating malaria and we are lost into non-issues. I don’t expect Mulago to treat malaria, we need to go back to the basics and see where we went wrong.”
Dr Atwine, who was invited to the Parliament’s Health Committee to update MPs on the problems in the health sector, talked of a “total breakdown of medicines accountability” in public hospitals, corruption through shoddy work, rampant absenteeism of doctors, the awkwardness of a national referral hospital reduced to a health centre IV treating “malaria and headaches” and a national health facility that has lost focus.
“Sixty per cent of health centre IVs are not operational because there are no anesthetists since 2005, when they constructed theatres yet there are doctors and equipment,” Dr Atwine said. “In Kisoro (Lubuguri health centre IV, doctors are just drinking and they have a generator they cannot operate simply because it is big. What a ridiculous answer!”
Dr Atwine’s comments, rubbed the wrong way both Mulago Hospital executive director, Dr Baterana Byarugaba, and Health ministry Permanent Secretary Dr Asuman Lukwago. Dr Baterana and Dr Lukwago, who were also in the Health committee to present the 2016/17 budget requirements, dismissed Dr Atwine’s claims as populist, saying Mulago was ill-funded and is steeped in debt owed by government ministries, departments, and agencies.
“What we are doing in Mulago hospital is purely scientific and it is done by people who are underpaid but don’t sleep in order to deliver the services within the available means,” Dr Lukwago said.
Dr Byarugaba, who described Mulago as “the supreme court of medicine” reminded Dr Atwine and the MPs that the hospital is too under funded to the extent that they are spending Shs1,500 on breakfast, lunch and supper for the patients. The Hospital also spends Shs7,000 to operate a patient.
“I don’t have MRI machine [the magnetic Resonance imaging, a non-invasive medical test that physicians use to diagnose and treat medical conditions], where do you want me to get the images. I need the money to buy the machine.”
He added: “You give me money for essential services and you demand super survives, I get them from where? We cannot send people away because there are no other government hospitals where they can go to. We are handling Katogo and as far as absenteeism is concerned, we don’t condone misconduct, we delete the culprits from the payroll.”
On the mishandling of drug stores at Mulago, Dr Byarugaba told MPs that five people were doing the work of 30. He also informed the committee that the hospital was demanding millions from government agencies such as Ministry of Defence (Shs600m), police (Shs297m), State House (Shs200m) and Health ministry (Shs140m).
Highlighting the unfunded priorities for Mulago hospital, Dr Byarugaba said Shs100b has not been provided for the procurement of medicines, Shs2b for laboratory services, consumables (Shs4b), sundries (Shs12billion), Imaging equipment ($4.5m), utilities (Shs5b), food (Shs2.8b).

On cancer machine
And following the breakdown of a cancer machine at the Uganda Cancer Institute (UCI), the Parliament’s Health Committee also heard that the only ex-ray machine in Butabika hospital also broke down recently. The hospital’s executive director, Dr David Basangwa, yesterday tabled a request for Shs400m for a new machine.
State Minister for Health, Dr Chris Baryomunsi, said: “What happened was an accident, the machine broke down the same way people fall sick. The technicians are assessing whether the machine can be repaired and next week, a team from International Atomic Agency is expected in the country to assess safety measures.”

What they say

“Referral system broke down long time ago. Mulago has been reduced to a health centre IV treating malaria and we are lost into non-issues. I don’t expect Mulago to treat malaria, we need to go back to the basics and see where we went wrong,” Dr Diana Atwine, head of Medicines and Health Service Delivery Monitoring Unit at State House.

“If you tell a person in Rwanda or Kenya that Mulago spends Shs7,000 to operate a patient, that person will collapse. But we have no choice because if government gives Mulago hospital beans, don’t expect me to serve meat. It is scientific,” Dr Baterana Byarugaba, Mulago Hospital executive director.

“What we are doing in Mulago hospital is purely scientific. Populism will not help us if we want to deliver services and develop the country. It is not fair to undermine health workers who work in difficult conditions,”
Dr Asuman Lukwago, Permanent Secretary in the Ministry of Health.

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