Hospitals run out of essential drugs

A drug stock-out in most public health facilities in the countryside has forced a number of patients into a costly plan B, a Monitor survey has revealed.

The facilities that include regional hospitals, district hospitals and health centres have essentials such as antimalarial drugs in scant supply.  This has forced patients like Mr Elly Nyesiga’s two-year-old son to seek treatment elsewhere.

Mr Nyesiga’s son was present with cough and breathing complications when he was checked into Mbarara Regional Referral Hospital last Wednesday. 

The resident of Mbarara City South Division told Monitor that the turnaround time was tolerable before a diagnosis of pneumonia was made.

“They gave him one dose of medicine as soon as we reached the hospital. After one hour they gave him another dose, and again a third dose after another hour,” he said of the treatment his son received, adding,

“After three doses, they had to discharge him. They didn’t give us medication but directed me to the pharmacies outside the hospital. They were simple tablets for flu and cough, but they were not in the hospital.”

Whistleblowers
Mr Nyesiga spent Shs35,000 on the medication. Our investigation reveals that he is one of many Ugandans who have had to buy drugs outside public health facilities.  Such is the scale of the drug stock-out problem that last week ombudsman Beti Kamya revealed that she has it on her radar. Ms Kamya was in Ankole Sub-region to launch the Whistleblower’s Rewards Scheme.

Mr Halison Kagure, the spokesperson of Mbarara Regional Referral Hospital, told this publication that supplies from National Medical Stores (NMS) do little to insulate them from drug stock-outs. 

He attributed this to the “big number of patients.”  Mr Kagure said “the drugs supplied run out of stock within a short period of time.” The issue, he added, has since been brought to the attention of the Health ministry.
While NMS is spared criticism in Mbarara, this isn’t the case in Kabale where the district health educator says they “are currently experiencing drug shortages because NMS have delayed the supplies.”

We expected drug supplies in December and January but nothing has been delivered. We are still waiting,” Mr Alfred Besigensi said.

NMS responds
Ms Sheila Nduhukire, the NMS spokesperson, acknowledged that there have been delays attributed to “ack of timely payment of funds for distribution.” 

She said the financial bottlenecks “have been brought to the attention of the Ministry of Finance and Economic Development and Ministry of Health.”

“We are confident that they will be resolved soon,” she said.
Clearly not soon enough for the health centres IIs and IIIs in Masindi where the district health officer told us that they “have missed out two cycles.”

“We only received some drugs which were meant for the district hospital and health centre IV,” Dr Jino Abiriga said, adding that the most affected facilities include Nyakitiibwa Health Centre III, Biizi Health Centre II and Kyatiiri Health Centre II.

In Buliisa District, Ms Laurian Kirabo—the officer in-charge of Avogera Health Centre III—told us that they “last received drugs last year in September.” 

In Tororo, the district’s referral hospital has missed two cycles. This has created what Mr Walter Uryekwun—a senior administrator at the hospital—describes as “an acute drug stock-out.” The last supplies they received from NMS were last November.

It was also last November that Mbale city, Njeru Municipality, and Buikwe District had their supplies restocked.  

Dr Richard Mbosa, the District Health Officer, acknowledged that NMS last delivered drugs to the health centres in November 2022.

“We are really constrained especially in the hospitals,” Dr Mbosa admitted, adding, “There are no emergency drugs in the facilities. Health workers are there to attend to patients and patients have to go elsewhere to buy these drugs to be treated.”

Rare breakthrough
For others, like Kamuli, the ray of hope materialised this week when supplies arrived. This though is a rare breakthrough. 

In Busia District, the government health facilities have run out of essential medicines and medical supplies for about two months. 

Busia has one hospital, one health centre IV, 11 health centre IIs and 14 health centre IIIs. All of them have run out of medical supplies.

“We have been diagnosing and prescribing medicines to our patients to go and buy from private facilities and then come back for treatment because we have no drugs,” a source in one of the public health facilities told us. 

Negative impact
The drug stock-out has not been particular about those it has negatively impacted. 
In Magoro Sub-county, the LC3 chairperson witnessed the effects firsthand when he was checked into a medical unit after feeling unwell. 

Mr Francis Aruo—to his dismay—discovered that Magoro Health Centre III has not been restocked with essential antimalarial drugs since last December.

“We are still waiting for the drugs,” he told Monitor this week, adding that the delay is unacceptable since “28,000 people rely on [the health facility] for malaria treatment.”

Ms Mary Iteit, 67, visited Magoro Health Centre III twice in as many days only to be told there are no drugs. Mr Simon Peter Icumar—the Katakwi district health officer—told us drug stock-outs have handicapped Magoro health centre III, Toroma Health Centre IV, Ngariam Health Centre III, Palam Health Centre II, Ongongoja Health Centre III and Usuk Health Centre III. 

The dire situation is mirrored in Soroti District where Dr Charles Okhadhi—the health officer—said  health centres II in Ojom, Arabaka and Aukot have been adversely affected. 

We also discovered that the key health centre IIIs of Gweri, Dakabela, Tubur , Asuret  and Kamuda are also operating without drugs to dispense to patients.

Elsewhere in Apac, the district secretary for health and education—Mr Sam Opira—revealed that health facilities in the district have reported drug stock-outs.

“NMS has written to us that the drugs will be delivered soon,” he said, adding, “We received the last consignment of drugs in October 2022.”

In Koboko District, Mr Robert Adeku—the officer in-charge of Dranya Health Centre III—said they haven’t received drugs for the last two cycles.

“What we only do is to test the patients and prescribe for them drugs that they have to buy from pharmacies,” he said, adding that “the absence of drugs is affecting those with chronic illnesses like tuberculosis and diabetes a lot.” he said.

Dranya Health Centre III serves about 15,754 people. 

Outdated data
Mr Ashirafu Mambo, the Koboko District chairperson, said the government supplies drugs according to the census of 2014. This, he reckons, is outdated. 

“Currently, we have over 280,000 people yet the ministry only delivers for 266,000, which is the old population and they normally deliver what is not demanded by the community,” he said.

In Moyo District, Mr James Draciri—an attendant at Moyo General Hospital—told Daily Monitor that expectant mothers are forced to buy things like gloves.

In Yumbe District, Mr Pontius Amatre—the officer in-charge of Okubani Health Centre III—said the International Rescue Committee has helped them soften the blow.

“It’s coming to two to three cycles that drugs and other supplies are not delivered to the health facilities and this poses risk to the patients. Why are the people failing to bring the drugs?” he wondered, adding, “These people don’t inform us on what is going on and yet they are deducting 50 percent of our primary healthcare funds for medicines but they don’t supply.”

Last received drugs in November
Mr Lou’s Muhindo, the Kayunga Regional Referral Hospital principal administrator, said they are facing a biting drug shortage. Dr Richard Bbosa, the Buikwe District health officer, said they last received drugs in November and expect another consignment in either February or March.

“Currently, we are turning away some of the patients. In some situations some facilities are using their meagre resources to purchase medicine to help those in critical condition. It is painful, but we have nothing to do. Even supplies like gloves are also lacking,” he said

Mr Charles Tumusiime, the Masaka Regional Referral Hospital principal administrator, said they expected to get supplies from NMS last December.

It’s not all doom and gloom. The Wakiso District Health Officer, Dr Mathias Lugoloobi, said the district currently has enough medicine at all its health centres.

“Wakiso District has about 109 health centres and right now they all have medicine because the government delivered drugs last week and they have delivered them to their respective destinations and we have no complaints so far regarding drug scarcity in health centres,” he revealed.

On Tuesday, Mr Sisto Oyet, the Lamwo District chairman, said they were negotiating with humanitarian organisations supporting refugees in the district to secure drugs for public facilities.

“The health facilities outside refugee settlements depend purely on drugs from NMS and as I speak, we have not yet got an assortment of drugs and there is a huge shortage for now three months, the workers are there but the drugs are not there,” he said.

More challenges
He added that the problem of drug shortage in Palabek-kal, Palabek-ogili and Palabek-gem sub-counties have been compounded by the absence of private clinics to offer alternative sources of medicines. 

According to Mr James Nkaata, chief administrative officer of Mukono, they last received supplies in November. The December consignment didn’t come through, he added.

“I am receiving complaints from all the facilities and I am urging our people to remain calm as we engage NMS to deliver on its mandate “he said.

Affected Health Facilities

Western Uganda
Avogera Health Centre III
Biizi Health Centre II
Buhara Health Centre III
Buliisa General Hospital 
Buramba Health Centre III
Burondo Health Centre III
Bushenyi Health Centre IV
Butanda Health Centre IIII
Bwama Health Centre III
Kabwohe Health Centre IV 
Kaharo Health Centre III
Kakomo Health Centre IV
Kamuganguzi Health Centre III
Karujanga Health Centre III
Kasheregyenyi Health Centre III
Kasunganyanja Health Centre III
Kibito Health Centre IV
Kisomoro Health Centre III
Kitooma Health Centre III
Kyanamira Health Centre III
Kyatiiri Health Centre II
Maziba Health Centre IV
Mbarara City Health Centre IV
Mbarara Regional Referral Hospital
Mitooma Health Centre IV
Nyakitiibwa Health Centre III
Rubaare Health Centre IV
Rubaya Health Centre IV

Central Uganda
Balika Health Centre II
Bbale Health Centre IV
Bugoye Health Centre II
Buntaba Health Centre III
Busaana Health Centre III
Bwagaale Health Centre II
Ddamba Health Centre II
Goma Health Centre III

Jungu Health Centre II
Kabanga Health Centre III
Kangulumira Health Centre IV
Kasaana Health Centre II
Kasambwe Health Centre II
Kasenge Health Centre II
Kateete Health Centre II
Katente Health Centre II
Kawolo Hospital
Kayunga Regional Referral Hospital
Kigogola Health Centre II
Kimenyedde Health Centre II
Kitimbwa Health Centre III
Kiyoola Health Centre II
Kiyumba Health Centre IV
Kojja Health Centre IV
Koome Health Centre III 
Kyabalogo Health Centre II
Kyamipisi Health Centre III
Masaka Regional Referral
Mbaliga Health Centre II
Mpooma Health Centre III
Mpunge Health Centre III
Mukono General Hospital
Mwanyanjiri Health Centre II
Nabalamba Health Centre III
Nama Health Centre III
Namasumbi Health Centre II
Namuganga Health Centre III
Njanja Health Centre II
Ntenjeru Health Centre IV
Nyende Health Centre II
Seeta-Nazigo Health Centre III

Eastern Uganda
Arabaka Health Centre II
Asuret Health Centre III
Aukot Health Centre II
Busia Health Centre IV
Dakabela Health Centre III 
Dranya Health Centre III

Gweri Health Centre II 
Kamuda Health Centre III
Kisoko Health Centre III
Magoro Health Centre III,
Masafu Hospital
Mukuju Health Centre IV
Ngariam Health Centre III 
Ojom Health Centre II 
Ongongoja Health Centre III 
Palam Health Centre II
Pallisa Hospital
Poyameri Health Centre III
Toroma Health Centre IV,
Tororo District Referral Hospital
Tubur Health Centre III 
Usuk Health Centre III.

Northern Uganda
Aganga Health Centre II
Akokoro Health Centre III
Alworoceng Health Centre III
Amuru Health Centre II
Anyangatir Health Centre III
Apoi Health Centre III
Apyeta Health Centre III
Barapwo Health Centre III
Boroboro Health Centre III
Chegere Health Centre III
Guruguru Health Centre II
Ibuje Health Centre III
Kidilani Health Centre III
Ogili Health Centre III
Okungedi Health Centre II
Olelpek Health Centre II
Olwal Health Centre II
Ongica Health Centre III
Teboke Health Centre III

By Felix Ainebyoona, Milton Bandiho, Ronald Kabanza, Julius Byamukama, Coslin Nayiira, Robert Muhereza, Obed Kankiriho, Emmanuel Arineitwe, Alex Ashaba, Biira Moureen, Ismail Bategeka, Longino Muhindo, Andrew Mugati Al-Mahdi Ssenkabirwa, Herbert Mugagga, Fred Muzaale, Malik F Jjingo, Joseph Kiggundu, Robert Elema, Rashul Adidi, Scovin Iceta, Bill Oketch, Santo Ojok, Patrick Ebong, Fred Wambede, Joseph Omollo, Phoebe Masongole, Simon Peter Emwamu, Jessica Sabano & Tobbias Jolly Owiny