Last week, the district health officer of Arua District, Dr Patrick Anguzu revealed that Arua Referral Hospital could not immunise anyone due to a shortage of immunisation vaccines forcing hundreds of patients to return home without the vaccinations.

The vaccine shortage was caused when health centres ran out of gas for the fridges in which the vaccines are stored for preservation.

Without the gas, the vaccines could not be delivered to these centres for fear that they would get spoilt. 11 other health units that provide the service in Arua were also closed.

These include, Pajulu, Aroi, Orivu, Bondo, Offaka, Akino, Odubu, Olujobo, Paworo, Inde and Ogoko health units. However, this didn't only happen to health centres in Arua District; many other districts are grappling with the same problem.

Already, 198 health centres across the country can no longer offer the services after they ran out of gas. "The last supply to the health centres was on January 17 and it got finished two months ago," Dr Anguzu said.

According to statistics obtained by Daily Monitor from a sample survey done in 22 districts by a concerned party within the Ministry of Health, out of the 534 health centres sampled, 198 had stopped offering the services by the beginning of March.

There has been no delivery of gas to the centres since January 15. The story might not be different with the remaining 60 districts. As a result, district health officials technically started, one at a time, to close health facilities whenever vaccine security was threatened.

Vaccine shortage poses grave risks to pregnant mothers and their babies when they do not get the tetanus shots at the time of delivery. Uganda has at least 1.2 million children born every year countrywide.

According to the World Health Organisation, vaccines which protect against disease by inducing immunity are widely and routinely administered, based on the principle that it is better to keep people from falling ill than to treat them once they are sick. Suffering, disability and death are avoided through immunisation.

In Mbarara District, out of the 31 units, 15 have been closed while in Mpigi District, 19 out of 35 centres have been closed. The worst hit district is Pader where 35 out of the 44 centres have been closed.

Other districts where the survey was carried out include Bushenyi, Kabarole, Kayunga, Bugiri, Tororo, Mbale, Butaleja, Kamuli, Namutumba, Pallisa, Bududa, Manafwa, Kaabong, Nakapiripirit, Apac, Arua, Nyadri, Nebbi and Masindi. In Bushenyi District, many centres cannot carry out the routine immunisation because the vaccines could not be refrigerated.

The most hit according to reports from the district were Kitagata Hospital, Kyabugimbi, Mitoma and Bushenyi health centres. The immunisation is only conducted on specific days. The immunisation programme is under the Uganda National Expanded Programme on Immunisation (UNEPI) under the Ministry of Health.

According to a source within the Ministry of Health who preferred anonymity because he is not authorised to speak to the press, "Without gas which is used to keep the vaccine fridges functional, UNEPI has not delivered the vaccines to the districts with a fear that the vaccines would get spoilt."

UNEPI provides vaccines against Meningitis and Hepatitis B that cost Shs7,000 per dose. On a monthly basis, UNEPI is expected to refill 1,416 gas cylinders and deliver them to districts that are in turn responsible for delivering them to the health facilities.

With an impending halt to immunisation services delivery, UNEPI requested the districts to have vaccine fridges that operate on electricity, and use gas whenever there was selective electricity supply known as load shedding.

However, this can only do so much as many districts are not yet on the electricity grid. The gas is supplied by Shell (U) Ltd, a petroleum company which has been the sole supplier of gas to UNEPI since 1983.

"The non-delivery of gas to districts occurs when Shell (U) Ltd stops its routine supply of gas to UNEPI. They (Shell) stop supplying gas whenever UNEPI reaches a credit limit of Shs120m or when any of the proforma invoices issued after supply of gas is not paid within 60 days of invoicing," the source told Daily Monitor.

The country director of Shell, Ivan Kyayonka said that Shell has the gas and that the problem was not with them. "We have the gas. Only they can tell you why they cannot get it," he said, without giving much detail.

According to the source, changing suppliers would be difficult because the vaccine fridges are already fitted with Shell valves.

The State Minister for Health, Emmanuel Otaala says the problem is being sorted out as the ministry is looking for another supplier to supply alongside Shell.

"There was a misunderstanding between the suppliers and the ministry. They misunderstood the agreement they signed but the matter is being sorted," Dr Otaala said on phone, adding that it was useless for the health ministry to deliver the vaccines to the health centres without the gas.

"It is better to keep the vaccines in Entebbe where there is enough gas and fridges to preserve them," he said, adding that, "Now that we have addressed the problem of gas in these rural areas, we will start delivery of the vaccines soon."

The assistant commissioner for UNEPI, Dr Issa Makumbi said that supply of the gas had resumed last week. "We had a problem with the supply but we have rectified it," he said.