Kampala — BUILT in 1938, Peter Omoyo, the hospital's administrator, says the hospital enjoyed better times in the 1980s, when it had five doctors. Services collapsed when the region succumbed to the two decade LRA civil war.

The hospital's operation theatre could no longer be used. "The ceiling had fallen through; there were no operating tools like blades, supplies like anesthesia and power to perform emergency surgeries.

There were daily water shortages, people could not bathe or drink water and the hospital's sewerage system often got blocked resulting in a stench of smell and ill health.

Omoyo explains that the entire hospital was connected to a single power line and when it went off, the hospital went into darkness. "We could not even carry out caesarean sections."

Even with a standby generator, they could not afford fuel because the entire facility operates on a budget of sh32m annually that hardly meets a third of its running costs, says Medical Superintendent, Dr. Alex Layoo.

"We are expected to use 50 percent of this money to buy drugs and a quarter to buy food for patients and pay staff allowances. This is impossible."

Although the hospital treated over 15,000 children and 10,000 adults per month during the brutal conflict, Omoyo says they had only one doctor on staff, performing surgeries, treatment, delivery of mothers and served as a physician as well as an administrator.

With ICRC's eminent departure, staffing disparities remain a challenge at the hospital.

Dr. Du Mortier philosophically says, "A vehicle without fuel cannot run. The hospital has only one doctor doubling as its medical superintendent. Will he manage to work in the entire hospital?"

He advised the authorities at national and district level to wake up, "to motivate staff, not by only increasing their remunerations, but by also providing better staff welfare.

When I was working in South Africa, they gave me a house, vehicle, and a small salary of about 1000 dollars, yet I was an expatriate. But the welfare was better."

He says that health workers need accommodation, transport and top-up allowances to enable them work better. Layoo agrees, saying, the hospital has failed to attract and retain staff because of lack of commitment by the local authorities to meet better staff welfare.

"We have advertised several times requesting for doctors, but none is willing to come here. In other districts, local councils have passed by laws, increasing the allowances of health workers by 200,000 or 500,000 shillings depending on their scales."

He cited Kaabong, Moroto, Bundibugyo and Kalangala district councils to have increased allowances of health workers and provided accommodation to improve service delivery.

He laments that only 65 percent of the staff positions at Kitgum hospital are filled. Taking a closer observation, the hospital is supposed to have eight doctors, but instead only has one.

While they are supposed to have 46 enrolled nurses, they only have 30. Rather than the 25 midwives the Ministry of Health says the hospital should have, the facility instead only has 10.

Although the district health officer Alex Olwedo promised to recruit more health workers, he did not give a specific time when this will be done.

But he was hopeful, promising that when the Government centralises recruitment of health workers, they will look into the problem of lack of facilities and allowances to motivate health workers.