Mulago women hospital: Fancy facility without fancy services

Entrance. The refurbished look of Specialised Women and Neonatal Hospital at Mulago. Some patients who seek services at the facility say they are never helped for various reasons. PHOTO BY KELVIN ATUHAIRE

What you need to know:

  • Official opening. The specialised hospital with a 450-bed capacity and nine floors was opened by President Museveni on October 2 last year. The ninth floor is the executive wing with presidential suites.
  • The women and neonatal hospital offers specialised healthcare services on emergency obstetric care, treatment of cervical cancer, repairing fistula and other complications related to reproductive health upon referral from other hospitals.
  • Patients. Total number of patients who have sought medical services from the Women’s Specialised Hospital since its commissioning last year.

The new Specialised Women and Neonatal Hospital at Mulago was built purposely to handle women and neonatal (new born) health complications.
However, one year later since its opening, the nine-level multibillion imposing tower remains a shadow of itself.
It lacks the required medical personnel and equipment. The few medical personnel available are often away attending to patients at their private clinics in the vicinity.

Even the few modern equipment that has been imported is lying idle at the hospital because either there are no trained personnel to operate them or the devices are still undergoing endless installation.
If one gets lucky and finds a doctor to attend to a patient at the hospital, the cost of treatment is costly.

The hospital, which was built at Shs94.5b, a loan from Islamic Bank, to be the country’s one-stop health facility in regard to women and neonatal services, is now more of a transit centre for referring patients to private clinics owned or run by some of the doctors employed to be at the hospital, according to findings of our undercover investigation.
Our investigations established that the core reason for referring patients with infertility problems to private clinics is because the fertility section of Specialised Women Hospital is “open” but “not operational” due to lack of equipment and personnel.

The investigation followed several complaints by patients who visited the magnificent facility but did not receive the services sought and were referred to private clinics of the doctors who should have attended to them at the hospital or received poor services that did not match the medical bill they paid.
In one case earlier this year, a pregnant woman, whom we shall name Annet to protect her and for ease of reference, sought maternity services in the Presidential Suites of the hospital.

A senior nurse pulled her aside and confided in Annet: “My sister, sometimes, it is not about the comfort or luxury that you want to experience just because you have the money. It is about the medical personnel who will be ready to attend to you as you enjoy the luxury of this hospital. I would advise you to book into the Silver package (standard) where the majority of mothers-to-be are catered for all the time. But if you insist on comfort, try and check at other private hospitals within town. Here, we are not ready. This medical equipment you see is very sophisticated for some of us. I tell you the truth, we are still undergoing training on how to operate them,” the nurse told Annet.

Undercover report
Our undercover reporters carried out an investigation to establish what the issues at the hospital are. They acted-out as a “couple” and set out to seek treatment for “infertility”.
Before showing up at the facility, the reporter asked her colleague “husband” to first call the doctors to fix an appointment. The doctor was called and she identified herself as Dr Beyeza. She said she was in the theatre that day (Thursday) and would not attend to us.
Dr Beyeza advised the “couple” to visit the hospital the following day, which would be Friday, reasoning that infertility doctors such as Dr Gideon Mugisa would be available to see them.

The reporters did as advised and below is their narrative.
“We reached the hospital at around 10am. We went through the payment process and paid the consultation fees in Stanbic Bank on ground floor of the hospital. We were told to wait for the doctors who manage fertility issues.

The wait took us to 1pm but no doctor showed up. There was no communication about the doctors’ absence either. After three hours of endless waiting, we asked one of the nurses whether the doctors would come. The nurse told us to wait for a while as she made inquiries.
In the meantime, the nurses on duty informed us that if we wanted quality fertility services, we had to wait for either Dr Davis Rujumba or Dr Mark Muyingo Tamusange or the doctor on duty, who was not a specialist in fertility, would place a phone call to either Dr Rujumba or Dr Muyingo and attend to us while receiving instructions.

They also directed us to a private clinic in Kamwokya, a nearby suburb, where they said we would find some of the expert fertility doctors we were looking for at Mulago.
‘If you feel you badly need to see them and it’s urgent, you can go to Neogenesis Fertility Centre in Kamwokya. You will find them there. Their consultation fees are higher than ours here but they are good doctors,’ one of the nurses advised.

The nurses also provided phone contacts of Dr Rujumba and Dr Muyingo.
‘This first one (Dr Muyingo) does not normally pick phone calls, especially when he is seeing his patients. I would advise when you call him and he is not picking, just send him a text message,’ the nurse further advised.
At this point we were pouring out our “frustrations” to the nurses. Other patients with fertility issues stormed the reception to inquire what was happening about the doctors. They had waited for too long.”

Fertility centre ownership
Having established the frustrations at the Specialised Hospital, the reporters set out to go to the Uganda Registration Services Bureau (URSB) to establish who owns Neogenesis Fertility Centre where patients at Mulago specialised hospital are referred.
The search at URSB revealed the directors as: Dr Mark Muyingo Tamusage and his colleague Dr Davis Rujumba (both doctors that the nurses at Mulago directed us to), Dr Robert Busingye Bazare, Mr Enoch Mwanje and Dr Dennis Kinene. The private hospital was incorporated on February 14, 2017.

When contacted for this story, Dr Rujumba said: “I have not received any patient referred from Mulago Women’s Hospital. I am not even there at that clinic. If there is anyone who has referred any patient to me, it’s not my making. That is not part of me to refer the government patients to a private clinic. No, no way,” Dr Rujumba said by telephone yesterday.

Dr Rujumba advised that the reporters contact Dr Muyingo, whom he said was the director of the clinic. Efforts to contact Dr Muyingo were futile throughout the investigation period as he was unreachable on telephone.
The director of the Women Specialised Hospital facility, Dr Evelyn Nabunya, said she was not aware of patients being referred to private clinics but said she would investigate the matter.

Inside sources speak out
Medical sources privy to the operations at the luxurious Specialised Women Hospital told us the fertility section is “open but not operational”.
“The challenge we have is in the fertility section. It’s a neglected area as little resources are allocated to it. The focus was to facilitate couples who don’t want to have many children through family planning programmes and they forgot about those who are struggling to bear children,” a source said, adding: “What I know is that the fertility centre has not fully started its operations although the hospital is open to the public.”

This version was corroborated by senior communications officer of the Ministry of Health, Mr Emmanuel Ainebyoona.
He conceded that the fertility section is “open but not functional”.
He said installation of the theatre equipment is still ongoing.
He said currently, when women with fertility issues go to the facility, they are assessed and advised to wait pending completion of the installation process.
“We are also still waiting for the organ and transplant law which is still at Cabinet level, which law will aid in surgeries for infertility cases,” he said.

Sources said expert doctors have instead chosen to spend most of their productive time at their private clinics.
“Infertility has been a lucrative business outside there. Instead of them (expert doctors) waiting for patients at the Specialised Women Hospital in Mulago, they go to their private clinics and make money,” one source said.
Another challenge is inadequate manpower at Mulago main hospital, which was subdivided into subsidiary hospitals for Kawempe and Kiruddu. Sources said the specialised doctors also have to provide health services at the subsidiary hospitals, leaving few at the fertility wing at Mulago.

Exorbitant fees
One would expect to get quality and quick neonatal services from this health facility to match the huge charges on the patients. It is not the case. The prohibitive fees at the government owned hospital has already attracted litigation by a civil society organisation, Centre for Health, Human Rights and Development.
“The act of turning a public service into a private service at the Mulago Specialised Women’s and Neonatal Hospital is a violation of the State’s obligation to protect women and their rights taking into account their unique status and natural functions in society and provide facilities necessary to enhance the welfare of women provided for in Article 32 (1), 32 (2) and (3) of the Constitution,” the suit in court reads in part.
Mr Francis Serunjongi, a father, whose baby was recently born at the facility, recounted the ordeal he faced when his wife delivered at the hospital.

“I thought my wife had gone to the usual free Mulago. So I went there to check on her and the new born baby but I looked around for them in vain. I decided to telephone them and she directed me to the specialised hospital,” Mr Serunjongi said.
“Little did I know that I would be charged Shs3.1m for the three days my wife spent there. I was shocked. What hurts is that the private hospitals around town don’t charge such exorbitant fees,” he said.
One patient Daily Monitor reporters met at the facility also complained about the high medical fees.
“Considering that this hospital was built using a loan, it means as citizens, we have to repay it using our taxes. So for them to come up and charge these high fees is unfair. It is like double payment,” she said.

Not all is gloom
However, despite the shortcomings of the fertility hospital, other sections such as general gynaecology, delivery section, and mother and baby unit are fairly doing well.
“What is operating well is the delivery section since we have more staff although they are overworked. We want to match the name of the hospital to the services but we are still struggling,” a source said.
Statistics obtained from the hospital management show 8,648 patients have sought medical services from the Women’s Specialised Hospital since its commissioning last year.
Dr Evelyn Nabunya, the director of the hospital, said this is a good number of patients since the facility is a specialised one, meaning it is not expected to have huge patient numbers.

As of June this year, 2,536 patients had sought ultra-scan services, 91 for mammography, 2,291 for laboratory services while ward admissions accounted for 1,504 patients. Patients seeking operations were 785, referrals (119), maternity (638) with C-section accounted for 307, of which there were 13 pairs of twins and two pairs of triplets.
Those receiving antenatal services were 2,920, gynaecology out-patients (3671), immunisation (1281), family planning (505) and postnatal clinic (271).