Sigulu Island residents struggle to access better health services

Rabachi Health Centre, the only health facility in Rabachi Island, was abandoned because of its poor state. PHOTOS BY RONALD SEERE

NAMAYINGO- A new report on access to healthcare in Sigulu Islands, Namayingo District has highlighted glaring gaps in the realisation of universal health coverage for island communities in Uganda.

Sigulu Islands are an amalgamation of islands in Namayingo, which include Rabachi, Nampongwe, Haama, and Lolwe, among others.

For instance, Nampongwe Islands, with an estimated population of more than 3,500 people, does not have a single health facility and the people there have to travel by boat to access the neighbouring islands with health centres.
Access to health services comes at an exorbitant cost.

Residents have to part with an average of Shs300,000 to hire a boat, pay a boatman and purchase fuel to access a nearby health facility.

The 2017 study conducted by the Initiative for Social and Economic Rights [ISER], a non-governmental organisation, launched recently on Sigulu Islands found that access to basic healthcare remains a big challenge.
According to the report, island communities have been neglected.

There are severe deficiencies, including limited health centres on the island offering a few services, lack of emergency services such as boat ambulance, severe understaffing and dilapidated infrastructure.

The study was conducted in April 2017 and sought to assess the state of healthcare on the Sigulu Islands, considering various factors including availability of health centres and ambulances during emergencies, sufficiency of health workers on the islands, and the range of health services provided.

Ms Salima Namusobya, the executive director of ISER, while addressing residents at the launch of the report at Rabachi Island, said despite the Ministry of Health highlighting universal health coverage as a cornerstone in the Health Sector Development Plan 2015/16-2019/20, disparities in access to quality healthcare in mainly remote communities remain a big challenge, leading to unavoidable deaths of especially expectant mothers and young children.

Ms Milisen Nabwire, a community member from Nampongwe Island, says the absence of health units and health workers puts their lives at risk and just within the past three months, three mothers had died during labour while on their way to Buyinja Health Centre IV on the mainland in Namayingo.

“I always help mothers to deliver and I have been doing it for the past 20 years. These three mothers died due to excessive bleeding,” Ms Nabwire narrates. She adds that these mothers would have survived if there was a boat ambulance to rush them to the Health Centre IV.

Similarly, Mr Godfrey Okunga, a resident of Hama Island, reveals that he lost his wife and unborn child four years ago during labour.

He adds: “I spent close to six hours mobilising funds to transport my wife to the mainland to deliver. I needed Shs400,000 for transport alone.”

Ms Alice Oundo, a Village Health Team (VHT) member in Nampongwe Island, says: “It is by God’s grace that mothers on Nampongwe Islands are alive today amidst the hardships they go through during delivery because we have no health centre.”

Ms Ruth Achieng, a health worker at Hama Health Centre II, says Sigulu Sub-county has a Health Centre III, but it is ill equipped, with no power, no water, one delivery bed and it is also understaffed.

She urges the government to increase hard-to-reach allowances to attract health workers to work on the islands as current staffing at the facility is at only 30 per cent.

Demands from residents
While launching the report entitled: “Here when you are poor you die: The state of healthcare on Sigulu Islands,” Commissioner Zaminah Malole of the Equal Opportunities Commission (EOC), said they were going to work hand-in-hand with government to see that the healthcare on Sigulu Island is improved.

She also received a complaint from residents, including the area MP, Ms Abbott Ouma, Bukooli Islands Constituency, to the EOC about the disparities in access to health services which amount to discrimination of island communities in comparison to persons living on the mainland.

They want the Ministry of Health to take affirmative action to redress these imbalances and specifically, for the construction of health facilities, upgrade the existing facilities to facilitate the provision of a wider range of services on the islands in order to minimise the long travels and provide boat ambulances for emergency cases and referrals.


According to the Ministry of Health Annual Health Sector Performance Report for the financial year 2016/17, Namayingo District, where the Sigulu Islands are situated, was among the districts which showed the most decline in healthcare, scoring below the national average of 66.2 per cent and was ranked 103 out of 116 districts.
Reducing persistent inequalities and ensuring equal and universal access to reproductive health and rights is one of the keys for Uganda to obtain middle income country status by 2040.


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