
The main gate to Mbale Regional Referral Hospital. PHOTO | FILE
Mbale Regional Referral Hospital, a key healthcare facility serving 16 districts and one city, is struggling to meet the region’s growing medical needs.
With a 500-bed capacity and an annual budget of Shs180 billion, the hospital faces significant resource gaps.
The facility operates with only 28 percent of the required workforce.
Sources said the funding is insufficient to address critical issues such as outdated equipment, dilapidated infrastructure, and severe understaffing.
These limitations not only compromise the quality of care but also exacerbate patient dissatisfaction due to long waiting times and overcrowding, leaving both medical professionals and patients and their caregivers to improvise, often with devastating results.
Mr Robert Kisesi, who is the area councillor of North Central Ward and the speaker of Northern City Division, said underfunding is partly to blame for the facility's poor service delivery.
“The hospital is understaffed and most of the senior doctors have retired yet the hospital serves a big population. I think the government needs to increase funding for the entire health sector,” he said.
Ms Irene Nambozo, an intern nurse in the hospital’s dialysis unit, said the facility does not have necessary medical supplies to provide services to the overwhelming number of patients.
“Even if we had more doctors, the lack of supplies would still limit what we can achieve. You can’t provide quality care without the right tools,” she said.
She added: “Sometimes we have to turn patients away because the machines are either down or supplies like dialysis fluids are out of stock.”
The burden of drug shortage falls heavily on patients and their families. For many, the financial strain compounds their grief, as they are forced to source medical supplies from private pharmacies or forego treatment.
Mr Samson Katende, a caregiver at the facility, told Monitor that he spends more than Shs200,000 to buy drugs every day. “If you don’t have money, you’re helpless,” he said on February 3.
Another caregiver, Ms Aisha Namuwaya, said the hospital can only provide cheap supplies like gloves but they ask patients to buy drugs, which are expensive.
“It’s very expensive to try to save a loved one when the hospital can’t provide everything, if you don’t have the means to purchase these supplies, your loved one is as good as lost. It’s heartbreaking,” she said.
Mr James Wabwire, a boda boda rider in Mbale City, said it’s useless to seek medical care in such a hospital that cannot offer services.
“When you go to the hospital, you expect to find everything needed to save lives, but instead, they rudely tell you to buy things yourself,” he said.
However, Mr Steven Masiga, a researcher based in Mbale City, said Mbale hospital has a history of misappropriating public resources.
“Corrupt behaviours in public life must be confronted with full force without any sympathy for the lawbreakers. Public institutions have regulations and policies that dictate how public resources should be spent,” Mr Masiga, said.
Last year, the State House Health Monitoring Unit (HMU) arrested the director of Mbale hospital, Dr Stephen Obbo, and other administrators on allegations of forging accountability.
Dr Obbo and others were accused of lying that Shs80 million was used to train health workers on using social media apps Whatsapp, Facebook and Tiktok.
The probe also revealed that the hospital spent Shs350 million on cleaners every year and bought a realm of papers for Shs28 million for the last financial year, an amount which the investigators said was abnormal.
The investigations also found cases of understaffing, missing drugs worth millions of shillings, extortion, and brokering of patients to private health facilities outside the hospital.
Dr Badru Wawa, the principal administrator of Mbale hospital, acknowledged that the facility is grappling with constraints that undermine its ability to deliver quality healthcare services to its vast catchment area.
“Despite its essential role, the hospital is severely struggling to meet the healthcare demands of its growing population. With a 500-bed capacity, the hospital was originally designed to serve a much smaller population,” Dr Wawa said.
He further noted the limited number of staff means longer waiting times for patients. “This not only affects patient satisfaction but also erodes the relationship between the hospital and the community," he said.
When Daily Monitor visited the hospital, it found that some of the infrastructure also urgently need renovation. For instance, buildings are falling apart, the ceilings are collapsing, and the floors are cracked.
“We need urgent repairs and renovations to ensure a safe and conducive environment for patients and staff,” Dr Wawa said.
He said most medical equipment are outdated and no longer meets the demands of modern medical practices.
“The budget is insufficient to replace old equipment, purchase new furniture, or improve essential facilities like fridges and medical devices,” he said.
The hospital also faces the challenge of water scarcity, especially during dry seasons, which adds another layer of difficulty.
“The hospital is forced to purchase water, a practice that is both costly and unsustainable. We cannot operate without water, as it is crucial for infection prevention and control,” Dr Wawa, pointed out.
He added that electricity bills have also become a significant strain.
“With the introduction of an oxygen plant to better serve our patients, the cost of power has risen sharply. We are struggling to keep up with electricity bills, which are a major burden on the hospital’s already limited resources,” Dr Wawa, said.
The casualty unit, one of the busiest departments, is similarly overwhelmed.
“The congestion in the casualty unit is unbearable. We need more space and better facilities to provide quality emergency care,” one of the health workers who preferred anonymity said, adding that services are often conducted in cramped, unsafe conditions such as on verandas due to the lack of adequate space.
The stalled work on the surgical ward for the past eight years has put immense pressure on the hospital’s existing resources and worsened the overcrowding in other wards.
Patients who would benefit from specialised care at the intensive care ICU are left without the necessary facilities, leading to complications in patient management.
“This delay has severely hindered the hospital's ability to provide critical care services to patients who require intensive monitoring and treatment,” Mr Wawa said.
The Ministry of Health Spokesperson, Mr Emmanuel Ainebyoona, when contacted for comment, said the hospital knows where to address the issues of financial shortages but quickly added that the administrators also need to utilise the Shs180 billion well.
“That money [Shs180 billion] is not little and maybe you need to find out if it's being utilised well. Anyway, as a ministry, we plan according to the envelope we receive from the Ministry of Finance,” Mr Ainebyoona said.