By ZURAH NAKABUGO & NICHOLAS BAMULANZEKI, The Observer, 11/14/2017
At 2pm yesterday, Aisha Namaganda rushed her sister’s son to Good Samaritan hospital in Mbuya, Kampala.
The boy, about four years old, had suffered massive burns from the head, across the torso down to his thighs. The red flesh glistened where skin had been burnt off by hot water.
Unable to deal with the extreme injuries, staff at Good Samaritan pointed Namaganda to the National Referral Hospital Mulago. Under normal circumstances, Mulago’s burns unit would have treated the boy’s case as an emergency.
But these are unusual times: Mulago is being renovated and Kiruddu hospital to which they were referred is one of the three facilities built to accommodate these kinds of cases but is also essentially shut-down by the crippling doctors’ strike.
Wailing from the pain, the little boy and his aunt were shown to the waiting area by receptionists; no sense of urgency in their response to what was a clear emergency.
In shock at what had befallen her little one, the boy’s mother had remained at home. By press time, 8pm, this emergency case had not been attended to – another example of the grief which government’s refusal to increase doctors pay is causing.
Across town, a teary Mariam, a resident of Matugga, narrated the excruciating pain she went through to deliver her child last Saturday at Kawempe General hospital, also a subsidiary of the National Referral Hospital Mulago.
If she had known better, Mariam would have paid up front as it later became clear that those who could shell out the cash were being treated as ‘emergencies’.
The young mother says she reached Kawempe General last Tuesday (November 7) at 1pm. There were very few doctors around since most of them had laid down their tools as the pay dispute with government rambled on.
“The labour pains had started but the nurses advised me to be patient and wait for the few intern doctors who were moving around the ward and they advise them on what to do since I had remained with a few centimeters to give birth,” she said.
As the labour pains intensified, the nurses seemed unbothered even when Mariam called for them. She suffered through blinding pain throughout that day.
Not a single doctor checked on her since the available few doctors were busy with other patients whom the nurses described to her as emergency cases.
“The next day my mother struggled so much and brought a doctor to check on me if I was ready to go in the labour ward due to the much pain I was feeling. The doctor advised me to go for a cesarean operation since the baby was tired and could no longer manage to push itself through normal delivery and I might lose it,” Mariam said.
She said, doctors lined her up on the list of patients to be operated that day and ordered the nurses to prepare her.
“I kept on waiting for nurses to take me to the theatre but it was in vain. After some hours, they told me that I was removed from the list because the doctors were working on the emergencies and I was rescheduled for the next day,” Mariam said.
Mariam said she just managed to save her baby’s life after getting advice from a patient on the hospital bed next to hers who told her to give money to the nurses.
“The following day in the morning, I called the nurse and gave her Shs 50,000. She immediately understood what that meant without even telling her anything. She took me to the theatre very fast saying that I was also an emergency,” she said.
Mariam was shedding copious tears as she spoke to The Observer, recalling how the skeleton staff of doctors on call during this strike will not ask a patient for money directly either because they fear or because of untidiness of it all.
They instead work through a subtle arrangement with nurses: the money is funneled by nurses on their behalf.
WOMEN VOTE MUSEVENI
She said before paying for her operation as she waited outside the theatre, a group of nurses abused them, saying that it’s women who always vote for President Museveni, so let them suffer.
The implication being that Uganda’s mothers should pay for the failure by Museveni’s government to sort out public health service delivery.
They said, “When they say temugikwatako, you keep quiet but when they say bagikwateko you say yyeeeeeeee…., okay. We shall cut you.” I got scared. I thought that I was not even going to make it, but thank God I was operated successfully and my baby is okay,” she said.
Mariam was operated upon on Saturday and has been on treatment. The doctors prescribe drugs which she buys from outside the hospital.
“None of us here has ever been given a single free drug; neither paracetamol nor cannula because we buy everything from out and a few doctors available help to administer the drugs.”
Another patient, Margaret, whom The Observer found in the elevator moving to the 5th floor to breastfeed her baby in the Neonatal Intensive Care Unit (NICU) was also weeping. Margaret was tired and hungry; she had not eaten a thing since morning because all the money she had, she had given to the nurses and doctors to help her deliver.
She said when the strike had just started, doctors were accepting between Shs 20,000 and Shs 50,000, but as the strike progressed, the going rate doubled to between Shs 50,000 and Shs 100,000 for normal deliveries, and between Shs 300,000 and Shs 400,000 for an operation.
“But if the strike continues, the charges will go up to Shs 1 million. The government should help us and find an immediate solution for the doctors’ salaries and welfare,” Margaret said.
She said many mothers who come to deliver in the night are ignored if they don’t have money; so, the majority are forced to leave. Only God knows what becomes of them.
Speaking off the record, sources at Kawempe General also said that an unknown number of mothers and babies have died during this strike since there are very few intern doctors working and they can’t manage complicated issues.
“Every time you see people crying when they have lost their dear one because they have no money to bribe doctors and the few doctors available can’t manage all the patients,” a source said.
The doctors at Kawempe who didn’t want to be quoted said, they are being very understanding with their fellow Ugandans and that is why they still come and work.
“In Kenya, all the doctors, nurses and midwives went on strike and they never returned to work until their problems were solved. But in Uganda at least a few of us have managed to work to save the lives of Ugandan mothers who are giving birth any time yet our problems are not yet addressed,” a doctor said.
One doctor said if the strike continues, they are also going to give up because they are very few and can’t manage the overwhelming number of patients flooding the hospital.
At the Naguru-based China-Uganda Friendship hospital, Jesca Bereebera who had come to pick her drugs for high blood pressure and diabetes, arrived at 8am. She left at noon without seeing any doctor.
“I came here for doctors to prescribe drugs for my pressure and buy drugs outside because I wasn’t feeling well. But since morning, none of the doctors has attended to us apart from seeing them moving around pretending to work yet they are doing their own things,” she said.
Melesa Nalumamsi, a resident of Muyenga, also left Naguru hospital without seeing a doctor. One of her breasts hurts so bad she needs urgent attention.
Sarah Nakandi at Naguru hospital said if you have money and pay doctors, they work on you. “I have also given them money and they are now looking for some drugs to give me,” she said.
However at Naguru hospital, the children’s clinic for immunisation was still open and all babies were receiving their vaccines, although the nurses too threatened to join the strike if the government doesn’t address their problems too.
“We have been immunizing children every day since the strike started and our senior principal nursing officer told us to work saying that the strike is for doctors, not for nurses. But our worry is that we are working as nurses while doctors strike but if the government considers doctors only and leaves out nurses, we shall also strike,” a nursing officer at Naguru said.
She said they immunise over 60 babies at Naguru hospital every day and they can’t leave babies to suffer.
The doctors’ strike has entered its 10th day with no end in sight. Their long-standing demands for better remuneration remain unmet.
Instead, Health minister Jane Ruth Aceng last Thursday threatened to sack doctors on strike before addressing their problems. Her threats aggravated the situation, deeply upsetting the few intern doctors who were assisting patients, prompting them to also lay down their tools in solidarity with their senior colleagues.