Patients on their own on weekends at govt facility

Residents across multiple sub-counties in Masindi District are raising concerns over the weekend closure of government health facilities, citing disruptions to essential healthcare services. A recent mini-survey conducted by this publication between February 8 and 9 revealed that key health centres, including the Outpatients Department (OPD) at Masindi General Hospital, along with several Health Centre IIs and IIIs, were closed from Friday evening until Monday morning. This left patients stranded, forcing them to either delay treatment or seek care at private facilities at an extra cost.

The affected facilities include Masindi General Hospital’s OPD in Masindi Town, Pakanyi Health Centre III in Pakanyi Sub-county, Kibwoona Health Centre II in Karujubu Division, Nyabyeya Health Centre II in Budongo Sub-county, Kigezi Health Centre II in Mirya Sub-county, Kikingura Health Centre II in Bwijanga Sub-county, and Kasongoire Health Centre II in Budongo Sub-county. Residents argue that health emergencies do not adhere to a schedule, emphasising the urgent need for uninterrupted medical services. Many are now asking the Health ministry to intervene.

According to Ministry of Health guidelines, OPDs are designated to provide treatment and diagnosis for non-emergency cases without requiring hospital admission. However, residents say these services are unavailable when needed most. Mr Fred Kwamanya, a resident of Masindi Town, described the situation as unacceptable, emphasising that a district hospital should operate 24 hours a day. “This is the only big hospital we have in the district that is supposed to work 24 hours because it serves as a referral for lower health facilities. But what surprises me is that on weekends, the Outpatients Department (OPD) operates for only a few hours on Saturdays and remains completely closed on Sundays,” he said.

Mr Kwamanya recalled an experience when he suffered a toothache on a Saturday night and he hoped to get treatment early the next morning, he rushed to Masindi Hospital, only to find the OPD locked. Similarly, Mr Ronald Byaruhanga, a resident of Pakanyi Village in Pakanyi Sub-county, said Pakanyi Health Centre III has been consistently closed on weekends for years. “For years, we have known that our facility does not operate on weekends. If someone falls sick on a Friday or Saturday night, they must wait until Monday for treatment,” he said.

Similarly, Moses Opio from Kigezi Village in Mirya Sub-county recounted how he was unable to access medical attention for a leg injury because Kigezi Health Centre II was shut. “I injured my leg after stepping on a sharp nail, but since today is Sunday [February 9], I have no access to medical care. Even though Kigenzi Health Centre II is just a short distance from my tre II, speaking on condition of anonymity, confirmed that they do not operate on weekends. She added: “Weekends are for us to check on our families. You need to balance both. But if you find me here and I haven’t travelled to town, I can attend to you because it’s my duty.”

At Kibwoona Health Centre II, a similar situation was observed. Despite a list of services offered, including immunisation, antenatal care, HIV testing, and maternity services, residents said these services are only available on weekdays. Mr Julius Wandera, a health worker at the facility, attributed this to staff shortages, stating that Health Centre IIs generally do not operate on weekends unless there is an emergency. Mr Godfrey Kasamba, the chairperson of the Kibwona Health Centre II management committee, said the facility is struggling to meet the healthcare demands of the growing population.

“We have an inadequate number of staff, and the facility is not connected to electricity, relying solely on solar power,” he noted. Ms Easter Byenkya, a nursing officer at the facility, cited additional issues, including a lack of staff housing, unreliable water supply, and transportation challenges for emergency referrals. “We are overwhelmed by the high number of patients, yet we have limited resources. We are supposed to have nine staff members, but we currently have less, which affects service delivery,” she said.

District officials respond

The Senior Assistant Town Clerk of Karujubu Division, Mr Julius Isingoma, acknowledged the need to upgrade Kibwona Health Centre II but stated that the process is currently delayed by land acquisition. “We are in the process of securing a land title, and once that is done, we will lobby the Ministry of Health for the facility’s upgrade,” he said.

Dr Brian Mugisah, the Masindi district assistant health officer, during the interview, stated that all health facilities in the district are required to operate 24 hours a day, including weekends. Dr Mugisah, however, acknowledged that some facilities face operational challenges. “Health centre IIs are supposed to operate throughout the week, but the problem is inadequate staffing. Ideally, a health centre II should have nine staff members, but some only have three.

These staff members work for eight hours a day from Monday to Friday. You can’t force them to work extra hours when they won’t be compensated,” he said. He added: “Health workers are human beings, not machines. They need rest too. However, we are working on upgrading some of these facilities to Health Centre III status, which will help address this problem.”

Dr Mugisah noted that health centre IIIs are better equipped to handle maternity cases and emergencies. Regarding concerns about Masindi General Hospital’s OPD being closed on weekends, Dr Mugisah said he was unaware of the situation, as the facility is supposed to have two clinical officers on duty to handle OPD operations even during the weekend. “I will follow up with the hospital administration to find out why the OPD is not operational on weekends,” he said.