The Observer (Kampala)

Uganda: Hospital, 85, Has No General Surgeon

At Uganda's Independence in 1962, Masaka regional referral hospital was one of the few functional hospitals in the country.

As years went by, the hospital slowly and steadily degenerated into one of the worst run hospitals earning itself a code name of a national mortuary where people went to die instead of getting healed. The hospital was built in 1927 by Buganda King Daudi Chwa II as a response to the increasing cases of gonorrhoa that had reached threatening levels in Buganda kingdom.

After some years, the central government agreed to take it over. In its 85 years, Masaka hospital has gone through a lot of challenges, the major one coming in 1979 when the advancing troops of the Tanzania People's Defence Forces razed the hospital to the ground with the support of UNLA, in their pursuit of the late Idi Amin Dada.

"We don't have records, the records we have start from 1979, the others before that which would have been preserved were destroyed during the war," says Dr Florence Tugumisirize, the hospital director.

In years that followed, health service delivery at this hospital deteriorated, leading the public to look at the hospital as a place one went to, on their way to death.

"People would easily advise a colleague against bringing their sick here, and once a patient was brought here, relatives would begin preparations for burial," she adds.

The hospital's standing only improved in 2000 following increased funding, making it the best performing regional referral hospital. But this does not mean that all is well at Masaka hospital.

"The hospital has structures but without drugs. I came here to get drugs for syphilis, but I have got only a few Panadol tablets. It is a waste of time coming here," a woman only identified as Nakakande furiously told us.

Nakakande's source of rage is the 50km she travelled to get to the hospital. She is one of the over 2,000 patients that come to this hospital per day, of whom 450 get admitted.

The challenge here is that the government only gives this hospital funds for 330 patients; the hospital's official bed capacity, yet most patients are to be found lying on the floor.

"The number of patients are more than the hospital's bed capacity, we end up having floor cases who consume water, electricity, etc. And if the budget is based on the number of beds, we end up getting domestic arrears for utilities," Dr Tugumisirize lamented.

Despite its elevation to a regional referral hospital in 1995, Masaka's staff levels have not increased.

"This means that the number of people that are supposed to be in the hospital don't tally with the services we are supposed to provide. We have 299 staff instead of the required 540," she said.

The hospital lacks a general surgeon after the last job holder relocated to Rwanda in 2008 after securing a more lucrative job there. Until recently when the hospital's management resolved to hire the services of a private surgeon, patients were being referred to either Kitovu hospital or Mulago in Kampala.

"We were incurring a lot of expenses every time we referred a patient to Mulago or Kitovu; that's why the hospital management resolved to hire private services of a surgeon to help us with major surgeries and we give some little facilitation," she told us.

However, the administration is silent about the private surgeon since he stealthily serves at Masaka hospital without the knowledge of his other employers. However, The Observer has learnt that this surgeon takes home at least 30% of the revenues generated by the hospital's private clinic plus a weekly transport facilitation of Shs 100,000 each month.

Other than this, there are only four other senior surgeons. These include three obstetric/gynaecology surgeons and one orthopaedic surgeon. Interestingly, this hospital is referred to as Mulago in Masaka, partly because of its history. Legend has it that after the colonial authorities started Mulago in Kampala, the locals who could not afford to go there began to look at the Buganda kingdom-owned hospital as equivalent to its more endowed counterpart.

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