Underneath the mango tree at Butabika hospital

The site of Butabika National Referral Mental Hospital is one of the most hauntingly beautiful places I have ever been, and I have been to quite a few. I always found myself marvelling at the genius of the people who chose the site. If you have been there when the sun is setting and the lake breeze is blowing in, you may know what I mean. 
Under other circumstances, it is the ideal site for a retreat from the troubles of the world. I have to give credit to the staff who run the facility. It is not an easy job watching over people from all walks of life and ages; seeing the children’s ward always broke my heart.

 But you have young and old, men and women, in various stages of treatment and recovery from mental conditions. 
The other thing that always struck me is the expanse of land on which the facility sits, or should I say, used to, because in 2006, it came to light that about half of the more than 300 acres had been sold to connected individuals. Still, with whatever remained, I wondered why the facility did not expand as much, since the need for mental health treatment has only grown. The country’s largest mental health facility and the only national mental referral hospital admits thousands every year.

I suppose the answer to my questions can be found in the current crisis over emergency healthcare for Covid-19 treatment. Before this, the healthcare system was limping along just fine. ICU beds and oxygen supply were not a big deal. The powerful and the connected had ways of getting treatment outside of the broken system and the corporate class and other middle class (and I say this with clenched teeth because this has proved a fallacy) were otherwise covered. Unless one was dealing with cancer or a heart condition, there was not much a health insurance card could not handle. 

Families dealing with serious conditions cried privately over the limitations in health care. If they were lucky, friends crowdsourced funds for their treatment. Some people lost the battle when they shouldn’t have. We were outraged for a while and then we moved on. If you complained about the gaps in healthcare, your friends were most likely to look at you like you brought the misfortune on yourself for daring to get admitted to a public hospital. 

However, some of us knew some things for a fact. The personnel in the broken public facilities were also some of the most experienced. If there was a condition, they had seen it just by virtue of the sheer volume of patients they saw. And all this while working with minimal and sometimes barely there resources.

The air might be beautiful at Butabika but like many of Uganda’s health facilities, the hospital has been due for an upgrade for some time. Perhaps we need to develop some other centres to match today’s demands. Sure, this might be one of those facilities you think you will never need. Scratch that. According to one psychiatrist, one in every four Ugandans is a potential psychiatric patient. You would be surprised how easy it is to step over the line into mental ill health.

With all the strife that we are going through as a result of illness, bereavement, job loss, economic slowdown and growing drug use, more people may need to check in at the beautiful facility. In 2021, we need to move a few steps ahead in expanding psychiatric care. At least let’s do it in honour of the beautiful minds who designed the facility and those who have kept it going against all odds.

Ms Nampewo is a writer, editor and communications consultant     
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