In the absence of qualified nurses, Mulago, the country's biggest referral hospital, is failing badly to help an ever-increasing number of patients who need basic care, hospital authorities have said.
In a recent interview, Dr Byarugaba Baterana, the hospital's executive director, said the hospital needed at least 946 nurses to cope with a daily influx of about 1,000 patients.
But on the ground, there are only 882 nurses, leaving the hospital 64 nurses short. The emergency paediatric unit alone receives 200 patients daily, whereas the Uganda Heart Institute receives about 100 patients daily. The maternity ward receives between 80 and 100 expectant mothers, while three to 10 children are received daily at the Mwana Mugimu clinic depending on the season.
In the emergency paediatric unit, there are only four nurses daily to handle 200 patients instead of at least eight. "At night, there needs to be at least five nurses on duty but there are usually three and yet they have to handle 80 patients," Dr Opika Opoka, the head of the unit, told The Observer in an interview.
This dire situation is similar to what is in the Mwana Mugimu clinic where there are only 11 qualified nurses out of the required 25. "There is a lot of work to do such as preparing therapeutic foods and feeding the children every two hours, which cannot be done by only 11 nurses," said Sr Julian Eyotaru, in charge of Mwana Mugimu.
At the Uganda Cancer Institute (UCI), more than double of the 52 nurses currently available is needed. This is because of the large number of in- and outpatients the institute receives. Dr Jackson Orem, the director of the institute, says at any one time, the institute handles about 4,000 patients. Last year alone, UCI received 34,000 visits.
Dr Byarugaba said there was need for government to recruit new senior consultants and increase their salary. Mulago hospital has only 30; 15 more are needed. "Although they are among the highly-paid civil servants earning about Shs 2.1m, this is not commensurate with the number of years spent in school. They need at least Shs 15m," he said in an interview.
He adds that nurses should be paid at least Shs 530,000 a month. The hospital has an approved structure of 2,166 positions, of which 1,877 are currently occupied. It is only the medical officers that are full. Two senior medical officers and 283 health workers are lacking and more neurosurgeons, biomedical engineers and pharmacists are needed.
Dr John Omagino, the head of the Uganda Heart Institute, attributes the shortage of human resource to the existing narrow structure. "The structure does not allow for a mix of diverse skills and yet to carry out any operation, one needs these," he says.
There are 192 workers at the institute and yet this is still below the bar. Omagino says management is in the process of hiring more staff to bring the numbers to at least 60 per cent.