Christopher Mason Bundibugyo
23 February 2008
Kampala — AS word began to spread through Bundibugyo District that a mysterious, and seemingly highly contagious, virus was appearing among residents in the Rwenzori Mountains, health care workers in the area were faced with a potentially life-or-death decision: to stay on and fight the virus but risk death, or flee to safety.
Those who decided to continue working did so at considerable risk given that health- care facilities in the region, and throughout much of the country, are not only under-staffed, but also under-equipped to the extent that many lack even the most basic equipment such as rubber gloves.
A patient was instructed to take some stool samples but at that point we didnot have protection so we didnot have gloves, said Isaac Kiiza, a nurse at Kikyo Health Centre IV and the first health worker to get Ebola.
The outbreak shone a light on the equipment and staffing shortages that hamper the country's health system, limit care to patients and endanger the health workers.
In the last part of a series examining the aftermath of the Ebola outbreak that killed 37 and infected 149, Daily Monitor today examines those staffing and equipment shortages in the Ebola-affected region.
Now back at work and able to talk about his ordeal with the virus, Mr Kiiza said he knew staying to work through the outbreak put himself in danger of also dying.
But as a nurse, there are professional ethics, Mr Kiiza said explaining why he kept working despite not having adequate protection. "You are supposed to prevent the suffering of others".
He added that he is convinced the lack of protection contributed to the spread of Ebola. Down the hills from Kikyo, the situation was similar at Bundibugyo Hospital.
The Kikyo health centre and hospital in Bundibugyo received all of the region Ebola patients. The equipment situation was marginally better in Bundibugyo, but its staffing levels put a major stress on the hospital's ability to respond to the outbreak, especially when some workers began fleeing.
The workload is great, it is not possible to achieve all the required results, said David Muhindo, in charge of nursing at Bundibugyo Hospital.
The Ministry of Health establishes how many staff should be at each health facility, and what roles should be filled. Comparing the Ministry of Health guidelines and the actual staff lists at Bundibugyo Hospital is a comparison of the ideal versus the reality. Only 65 per cent of the hospital staff positions are filled.
The hospital is supposed to have seven doctors, but instead only has two.
While there are supposed to be 46 enrolled nurses, they only have 26. Rather than the 25 midwifes the Ministry of Health says the hospital should have, the facility instead only has 10.
One figure among the list that stands out is nursing assistants. The hospital is supposed to have 15, but instead has a whopping 52. Some time back, nurses were failing to come here, Mr Muhindo said. So the district began employing nursing assistants who were trained locally.
The issue of worker shortage remains after Ebola, but the government has tried to address the shortage of supplies by spending Shs 3 billion to distribute equipment to health centres around the country.
The drugs and supplies are being distributed country-wide, Dr Sam Okware, commissioner for community services in the Ministry of Health said.
However beyond that one influx of funding, no long-term plan has yet been introduced to address the shortage of staff and supplies that contributed to the spread of Ebola.
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