Uganda’s health sector is a tragedy

On August 15, 2018, I saw my mother, Mego Josephine Apiyo Okeny, breathe her last at my brother’s house in Lacor village, Gulu District. She was 72.
In her remembrance, one year after her untimely demise, I am writing something decrying Uganda’s ill health sector. My mother had lived a healthy life until the war between Lord’s Resistance Army and government broke out.
Our family, like many others in northern Uganda, was uprooted and displaced in Lacor, near Gulu Town. Certainly, as internally displaced persons, we lacked proper feeding, medical care and lived under acutely depressing life conditions.

Consequently, my mother’s health started deteriorating. She, together with many other displaced persons, acquired diseases that hitherto were unheard of in our community. She was first hit by meningitis. Later she became hypertensive. Then she suffered from bacterial infection, etc.
Her life was basically between home and hospital. She would be admitted in the hospital for days or weeks and return home for a few days before going back to the hospital again. In due course, dementia also set in. In early 2018, she was diagnosed with a bacterial infection that nearly killed her. She was rushed to St Mary’s Hospital Lacor. She was treated but unfortunately, before she could fully heal, she was discharged and taken back home.

Soon after, her condition seriously deteriorated. Our attempts to take her back to the hospital were not welcome by the medical personnel. They said there was little they could do to help the ailing lady. We, thus, had no alternative but to return her back home where she later died. This dangerous attitude is ubiquitous among medical workers currently. In 2014/5 when my late father, Mzee Amitayo Okeny Lugwero, fell ill, he was also prematurely discharged from the hospital. He died a few days later at home.

With this attitude, one wonders how many people are dying in our hospitals because medical workers feel they have ‘little’ to do to save the lives of their patients. The Hippocratic oath says in part, “I will apply, for the benefit of the sick, all measures that are required, avoiding those twin traps of overtreatment and therapeutic nihilism. I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug…”

Medical personnel are, therefore, expected to do all that is humanly possible to save lives. Even if the condition in question is terminal, medical personnel are obligated to offer optimistic counsel to their patients. In situations where the patient in question is going through serious pain, medical workers are expected to give palliative care to assuage the pain.

But what has gone wrong with Uganda’s medical sector? Is it a question of ill training? Is it lack of motivation? Is it lack of equipment and facilities? Is it a personnel-patient ratio problem? Or is it all those problems combined? I think Uganda’s health sector faces all those problems. There is not a single government health facility that does not lack personnel. None of Uganda’s public health facilities has adequate medical equipment to serve patients. Not even Mulago National Referral Hospital.

St Mary’s Hospital Lacor, one of the biggest hospitals in the country, is a private, missionary founded institution. It had some of the most qualified and well trained medical personnel. It also had some of the best medical equipment, including a chemotherapy machine. However, because of the rot in public health facilities, Lacor hospital is absolutely overwhelmed with patient numbers. This has seriously impacted on the quality of care that the hospital can give to patients.

That is how the fatal practice of discharging patients without due regard to their obtaining health condition crept in. On Tuesday, I visited a nephew in the hospital. He suffers from sickle cell anaemia. He had serious pains in the back and chest. His mother had brought him to the hospital at about 8am. By about 1pm, he had not yet seen a doctor because of the sheer numbers of patients. Another child, about seven, died few hours after being brought to the hospital because, among other things, the hospital lacked blood to transfuse him. What a tragedy that our health sector is!