It is midday in Hoima District and Mr Byaruhanga Muhereza has brought his wife to Care Medical Centre. Two weeks ago, she gave birth by caesarean section and she requires medical attention to remove the surgical sutures. The couple first saw their baby in Hoima Referral Hospital where she was delivered.
“We tried clinics in Bombo but they said they could not help us. Right now, the doctor is working on her, I know he will manage,” Mr Muhereza says.
The resident of Bombo village, Kigorobya, Hoima district chose a private health centre for his wife’s postnatal care. The family cannot afford to incur the high transport costs associated with returning to Hoima Referral Hospital.
“I do not know how much it will cost me here. The service at the referral hospital is free. But I would have to spend Shs20,000 on transport for both of us. However, I spent Shs40,00 on each of us on a boda boda to come here,” Mr Muhereza says.
They are issues like these that touched the heart of Mr Nicholas Kwikiriza Magambo. He says quality health services in Hoima have for a long time been concentrated in the urban area, about 25 kilometres away from Care Medical Centre. For instance, it was his wish to see women quickly saved in times of pregnancy related complications. And, a reduction in infant mortality due to lack of oxygen.
“We would resuscitate a child born weak with difficulty in breathing and then refer parents to Hoima referral hospital yet it is far and these parents are poor. More so, there was no readily available ambulance,” Mr Kwikiriza says.
In 2015, the resulting struggles of Kigorobya patients many of whom come from peasant and fishing families and suffer from malaria, diarrhea, bilharzia, HIV/AIDS among other diseases, demonstrated the need for a medical centre. It is in rented premises that Mr Kwikiriza has to date provided private medical services.
“We provide outpatient and inpatient care as well some surgical services,” he says.
“There are services we would like to offer in a good theatre but this premise was built for a different purpose and you cannot modify it to fit our purpose.”
Exempted employment benefits
Within a year, limitations of the rented premises forced him to make changes for his private practice to make a huger impact in the rural community. For his plans to materialise, he would have to withdraw his National Social Security Fund benefits.
The 34-year-old doctor first saved with National Social Security Fund (NSSF) in September 2011 while working as a medical officer at Kumi Hospital and later Infectious Disease Institute, where he appreciated the discrepancy in service delivery between urban and rural communities. His last savings hit the NSSF account in June 2015 having taken up a job in public service.
“I visited Hoima branch. I was told to attach my employment identity card, pay slip for civilians, bank statement showing salary received in three previous months, and my appointment letter. So on April 1st 2016, I applied under what is called exempted employment benefits,” Mr Kwikiriza explains.
Care Medical Centre has saved lives by investing money Shs22.4m from NSSF. About Shs15m paid off the land on which the new health centre sits. An oxygen concentrator for the centre cost Shs3m and the rest of the money afforded the centre new equipment for basic surgery. With the savings from the clinic, construction of the new structure started. In the new structure are wards, maternity unit, theatre, outpatients’ unit and labs.
“I have been able to earn income to meet my family’s needs. Beyond income, I also feel happy when I save lives. We have also been able to increase our services following the benefits. So the community is also benefiting by reducing costs associated with having to travel far,” Mr Kwikiriza says about his achievements so far.
Counting costs of medical care
“The challenge in the medical business is that skilled labour and infrastructure are very costly. Procuring an operation bed can cost up to Shs14m, ultrasound machine at Shs10m. Had it not been NSSF, we would not have procured the land. So this cash prize would be a boost to services, profits and staff numbers,” he says.
Today, the health centre employs two midwives, two laboratory attendants, three nurses, a radiographer and two part-time doctors. To keep expenses low, he recruits workers who can multitask such as a nurse who can run the reception desk.
The centre now treats between 10 and 20 patients a day and earns Shs4m as profit per month. Because the centre must be sustainable, it is run on business principles of book keeping, proper procurement and reinvestment of profits.
In the next five years, he wants to create a centre of excellent medical care to serve clients from all over Hoima, Buliisa up to Nebbi districts.
“I am very happy with what I have done with my NSSF contribution. To be honest, at first I joined because it was a policy and did not think it would come to me this early,” Mr Kwikiriza says.
“I encourage people to save because it helps you to invest. It can save the day when you cannot work.”
Boosting medical services
The NSSF Friends with Benefits contest, which has a Shs30m cash prize for the winner, he says, will be a good boost to his medical facility.
Kwikiriza who anticipates a win because of the humanitarian nature of the investment hopes to use the Shs30m cash prize to finish construction and offer better services.
To vote for Nicholas Kwikiriza in the NSSF Friends with Benefits competition, dial *254# or go to www.nssfug.org