LIRA COMMUNITY MEMBERS PETITION THE DISTRICT COUNCIL OVER LOW LEVEL OF EMERGENCY HEALTH CARE SERVICES FOR PREGNANT WOMEN

Patrick Ogwang

WRA Uganda (WRA Lira District Media Coordinator)

Tommy Ojan Egits presenting the petition at Amach Sub-county headquarters 
during  Lira District World AIDS  Day commemoration 

White Ribbon alliance Lira in collaboration with residents from the two sub county of Ogur and Amach petitioned Lira District Local Government to allocate a budget in the financial year 2014-2015 to support Emergency obstetric and newborn care services at health center s III and IV. The petition signed by over 1000 community members was presented to the District Council through the District Speaker.

While handing over the petition to the district leaders at the commemoration of World Aids Day district event at Amach sub county headquarter, Tommy Ojan Egit who is a WRA Lira member and newly elected representative at the WRA Uganda board said that the petition followed an assessment by White Ribbon Alliance, leaders and community members carried out in all the health facilities at level of III and IV in Lira with the indicator that none of the two HC IVs is able to provide comprehensive emergency obstetric and newborn care services due to theater functionality issues.

Ojan further stressed that shortage of running water, power and non-functional theaters at Ogur and Amach HC IVs, stock-outs of injectable drugs for basic obstetric complications, inadequate resuscitation devices, lack of blood pressure machines and incomplete delivery instruments among others has put the lives of pregnant women and their newborns at risk since most of them are referred to the main regional referral hospital which is far away from them.

Tommy Ojan Egits handing-over EmONC petition to Lira District 
Vice Chairperson at Amach Sub-county headquarters

“The petition requested the district officials to allocate sufficient funds for emergency care services in the financial year 2014-2015 in an attempt to reduce the death rate of women in childbirth. The White Ribbon Alliance is not an NGO but Alliance whose aims are to advocate for safe motherhood.” Said Tommy

Mr. Andrew Ogwang Oyang the District Vice Chairman and the leader of government while receiving the petition on behalf of the District Speaker and the council thanked The White Ribbon Alliance for their effort of carrying out an assessment saying it has helped a lot the district to get documented information for planning. The Chairperson promised to handle the petition with urgency it deserves so that the issues raised are considered in the district budget.

Subsequently, on 6^th December 2013, The White Ribbon Alliance members held a meeting with the members of the district committee for health and education to further advocate for prioritization of emergency obstetric care services in the district budget. Mr. Moses Ogwang Adonyo the Chairperson of health and education committee said that his committee will make sure the report findings are brought to council for further scrutiny and approval so that a budget is allocated in the financial year 2014-2015.

WRA Lira and community members march during World AIDS Day commemoration
event at Amach Sub-county headquarters, Lira district before presenting their petition

The petition is part of a series of activities under the accountability campaign code named ACT NOW TO SAVE MOTHERS coordinated by The White Ribbon Alliance Uganda in three districts of Lira, Mityana and Kabale aimed at asking Government of Uganda to uphold its commitment of increasing comprehensive emergency obstetric and newborn care in all health centres IV from 17% to 50% and ensuring that basic  emergency obstetric and newborn care is available in all health centres before its target timeline of 2015. #ActNowToSaveMothers

ACT NOW TO SAVE MOTHERS

White Ribbon Alliance Members in Kabale Petition District Speaker over Low Status of Emergency Obstetric Care in the District

Members pose for a photo after presenting and handover a petition to Hon. Twinomuhangi Pastoli, Kabale District Council Speaker at his office.

By Robert Muhereza

WRA Kigezi, Media coordinator

Today December 2, 2013 White Ribbon Alliance Uganda-Kabale district and community members joined by district councilors petitioned the District Speaker Hon. Twinomuhangi Pastoli on the LOW STATUS OF EMERGENCY OBSTETRIC AND NEWBORN CARE SERVICES IN KABALE HEALTH CENTRES IV AND III. After the damning findings of the health facility assessment of emergency obstetric care status conducted by White Ribbon Alliance, District Health Office, community members and leaders, members are asking their district council and leadership to prioritize funding for EmONC in FY 2014/15.  The Speaker pledged to table the petition before the district council for discussion and consideration of the issues contained in the petition.

Members will meet the district Standing Committee of Health to discuss further and advocate for prioritization of making theaters at HC IVs function. All the 7 health centre IVs of Kabale do not provide C-sections and blood transfusion due to lack of medical officers. 

Join WRA advocacy campaign in Kabale to Save the lives of many pregant women in Kabale- #ActNowToSaveMothers 

Accessing Services at Ogur Health Centre IV: A Journey into Hell!

For our esteemed visitors and readers of this blog page, Bill Oketch a Journalist based in Lango sub region treats you to yet another article about the status of life saving services at Ogur HC IV, Lira district. 

I hope those who understand Luo it will be provoking, insightful and swing you into a discussion and action.

Unreliable Referral System Make Poor Women Shun Delivering From Health Facilities

Compiled by Senfuka Samuel

bsenfuka@gmail.com

A patient being transported to a health centre using an improved "Engozi"

This is a community ambulance commonly used in the mountainous Kabale district, south western Uganda to transport patients and pregnant mothers to health facilities. It's an improved "Engozi" (a locally made stretcher), which has been traditionally used to transport sick community members through a community support system. It is now a push and pull ambulance unlike the stretcher where they have to get energetic men to lift the patient or a pregnant woman through the steep slope terrain to a health centre. On the White Ribbon Alliance for Safe motherhood (WRA Uganda) mission of health facility assessment of EmONC in Kabale district, we came across this on the way to Ikumba health centre III and the patient was being taken to  Hamurwa health centre IV, Rubanda East which was still about 16 KM away!

This makes the referral of pregnant women with complications and other patients a huge challenge to healthcare providers and a burden to the poor families hence women end up delivering from home or with assistance of traditional birth attendants because they can not afford referral costs. The situation is worsened by poor birth preparedness.

Join the Act Now To Save Mothers Advocacy Campaign by ASKING the Government of Uganda to uphold its commitment of increasing comprehensive emergency obstetric and newborn care (Cesarean sections and blood transfusion) to 50% in health centres IV and basic emergency obstetric and newborn care (treatment of hemorrhage, infections/sepsis, eclampsia, newborn resuscitation) in all health centres by 2015.

Citizens Voice and Experiences from Participatory Health Facility Assessment of Emergency Obstetric and Newborn Care in Mityana District

Compiled by
Senfuka Samuel
bsenfuka@gmail.com

"My name is Kigiongo Annet, a Village Health Team (VHT)/community health worker attached to Ssekanyonyi Health Centre IV in Mityana district. Our theater has been redundant for the past one year with no equipment making poor women who face complications to be referred to Mityana hospital, which is far away. I appeal to the government to urgently equip our theater and save women from long distances and losing their lives".

“If I were the President of Uganda I would ensure that midwives are deployed in all health centres that provide maternity services. I would also equip our theater with all necessary equipment and medicines that save women’s lives because women travel long                                                                distances to access comprehensive emergency care”

Scovia attending to a woman in labor

"I've worked here for 10 years. The most challenge I face is transporting women who are referred to Mityana main hospital about 40 km away. Most of these referrals happen at night but it is very difficult to get transport at night. We are always worried on duty when you refer a woman and cannot meet her transport costs. We end up using personal money to pay for women who fail to meet their transport costs. We request the government to functionalize the theater to save us from these challenges. Our health centre relies on solar power but it is down. We have a generator but there is no fuel to run it due to inadequate primary health care funds given to the facility. As a midwife I improvise and use my home lantern or a telephone torch." Laments Scovia Namaganda a midwife at Kyantungo Health Centre IV Mityana district.

 

Poorly designed main entrance into 
Kyantungo theater 

Doctors say that despite being fully equipped, Kyantungo Health Centre IV Theater requires urgent renovation in order to start any surgery work.

Mr Bernad, Chief Kalangaalo sub county

Mr. Tunankye Bernard, Chief, Kalangaalo sub-county Mityana district while at Kyamusisi Health Centre said: “As a sub-county chief, there things I have known today which need quick attention. It is not acceptable to have a water tank to the maternity ward and there is no water flowing directly to the labor ward. The In-charge should put it in writing and I go with the letter for immediate action. The In-charge of maternity together with In-charge of the facility should make a budget for kerosene for both the maternity lantern and boiling delivery instruments and submit it to me for review. The In-charge should write a formal complaint about the non-function new solar installation and I follow it up with the district officials. This is the only source of power to this facility, it should work. I thank White Ribbon Alliance for this                                                   assessment because it has showed us many things which we would not                                                   have known”

Harriet Nkugwa SNO Mityana hospital

Sister Harriet Nkugwa a Senior Nursing Officer at Mityana Hospital who was one of the technical lead during the health facility assessment of EmONC shared her experience: “This assessment has been very enriching and empowering far better than the way we have been conducting support supervision as district health team. It has helped us to discover many things and some have been upsetting. I am a member of the District Health Team but the way we have been conducting our support supervision and monitoring is shallow as compared to this assessment. We just go and sit with a health worker for a few minutes and proceed to another facility without physically checking on different departments and services. We are going to use this assessment tool to update ours and strengthen our supervision” 

“This has been a unique approach and it has helped to bring us together for collective action. Bringing health workers, political leaders, community members and the media for a common goal is important. We have been blaming one another for the poor service delivery but now we have realized that each one of us has a role to play. We need each other if we are to improve life saving services for our mothers” Sarah Katumwa, a midwife at Kyamusisi Health Centre and Chairperson WRA Mityana district.

Participatory health facility assessment of EmONC status at Kyantungo HC IV, Mityana District 

National Medical Stores Bring Us Condoms Instead of Medicines!

Bill Oketch

An article written by Bill Oketch, a journalist with Arabkop-a Luo News Paper for Lango Sub-region. Bill also works as a regional correspondent for Daily Monitor  News Paper (national) in charge of Lango and Acholi sub-regions (Northern Uganda). He was part of the journalists who participated in a participatory health facility assessment of emergency obstetric and newborn care services in Lira district coordinated by The White Ribbon Alliance for Safe Motherhood Uganda under an accountability advocacy campaign "ACT NOW TO SAVE MOTHERS" in collaboration with the office of District Health Officer Lira. Bill was part of the team that visited Aromo HC III and Ogur HC IV in Lira district and writes from first hand information.
For our friends who understand Luo enjoy the article and the comments are very welcome!

A Host of Challenges Hinder Delivery of Life-Saving Services for Pregnant Women in Mityana

 By Senfuka Samuel

bsenfuka@gmail.com

Ruth showing a lamp she uses during delivery of mothers at
her health centre

Ruth is a #midwife at Bulera health centre III a rural health centre in Mityana district, central Uganda.

Despite the challenges she narrated to us during assessment of basic emergency obstetric and newborn care services at her facility Ruth still puts on a smile because she loves her profession as a #midwife. Many times she delivers mothers at night using the kerosene lamp or her mobile telephone torch. "My only delivery instrument set lacks key instruments like episiotomy scissor, cord scissor, forceps. I always improvise. We only have rain harvested water at the facility. During dry season we pay someone to fetch for us from the community well which is away from here. Attendants have to fetch their own water for the women in labor or pay the same person to fetch for them." Ruth added that: "Some mothers/women come without any attendant and a single coin but as a midwife you have to ensure that she has a safe delivery. If there is a complication we refer to Mityana hospital but transport is a big challenge.     

Non-functional Blood Pressure Machine at
Bulera HC III

Mothers have to look and pay for their transport but some of them do not come with money. I have paid transport for some of the mothers. If I were a president I would ensure that health centres are well equipped to save the mothers"

The blood pressure machine for maternity unit at Bulera HC III has been non-functional for over a year due to lack of batteries! This means with the focused antenatal care a midwife can not check the pressure of a pregnant woman or those in labor. They diagnose by symptoms and observation! Studies show that 8% of all maternal deaths in Uganda are caused by pre-eclampsia and eclampsia hence not checking                                                                                     the pressure of pregnant mothers can be disastrous.

The government should ensure that sufficient funds are allocated to meet such simple but high impact means of saving the lives of thousands of mothers in Uganda - #ActNowToSaveMothers

Pregnant Women Still Travel Long Distances to Access Life Saving Services

Dr. Richard Okello at a health facility
assessment meeting of EmONC at Ogur HC IV

By Senfuka Samuel

Despite recruitment of medical officers none of the only two health centre IVs in Lira district, northern Uganda conducts cesarean sections, uterine rupture repairs and blood transfusion services to save lives of women who face obstetric complications. "We feel demotivated because we are redundant. The theater is well equipped but we cannot do our work because it needs urgent renovations to avoid any infection contraction during operations. My colleague is contemplating of leaving" Dr. Richard Okello, Senior Medical Officer Ogur HC IV, Erute North.

In response to Dr. Richard's frustration, the Ogur Sub county Chief Ms Toli Eunice said that: "This health facility assessment of emergency obstetric and newborn care services by White Ribbon Alliance has been an eye opener to us because we have not been taking emergency care services as a key priority. When we got a doctor we only thought of renovating his house but now we are also going to prioritize the theater in 2014/15 financial year"

Community members, health-workers and leaders conducting a health facility assessment of the
facility at Aromo health centre

White Ribbon Alliance for Safe Motherhood Uganda is coordinating an accountability campaign code-named "Act Now To Save Mothers" aimed at advocating to the Government of Uganda to uphold its commitment to ensure that comprehensive emergency obstetric and newborn care increases in health centres IV from 17% to 50 % and the basic emergency obstetric and newborn care services are availalbe in all health centres by 2015. WRA Uganda is conducting a health facility assessment of EmONC together with community members and district health office and leaders in Kabale, Lira and Mityana to generate evidence for requesting sufficient funds in 2014/15 financial year so that local governments deliver these life saving services.

Surgical bed @Ogur HC IV

Theater building @Ogur HC IV which
requires urgent renovation

Inside the theater @Ogur HC IV

KEEP YOUR PROMISE TO THE MOTHERS AND CHILDREN OF UGANDA

A new mother with her newborn at Ogur HC IV, Lira district Northern Uganda

Robina Biteyi

National Coordinator, WRA Uganda

At the 68th UN General Assembly in New York the World Bank Group, UNICEF, the U.S. Agency for International Development and the Government of Norway committed $ 1.5 billion in financing over the three years to help achieve Millenniums Goals  (MDGs) 4 and 5, which focus on reducing child mortality and improving maternal health and reproductive health including access to contraception. Both MDG 4 and 5 are most off-track of all the development Goals.

This commitment and the renewed efforts to accelerate the achievement n of both MDGs 4 and 5 must be commended and applauded. However, this must be supported by an equally committed national local response.

Estimates show that ensuring all women who want to use contraception can access it the maternal mortality would be reduced by 30 percent globally. Uganda’s maternal mortality ratio stands at 438/100,000 live births (UDHS, 2011). Neonatal mortality is estimated at 21/1,000 live births. First day deaths are estimated at 15,100 in total the country looses 42,000 newborns annually; this contributes to 12% of the under-five mortality rate.

It is clear that family planning plays a big role in reducing maternal mortality. Every woman should be supported to choose if and when to become pregnant in the course of her life. This will keep more women and their children alive and productive members of their society.

However, let us not lose sight of the important life saving role of ensuring that every woman and her newborn have access to both basic and comprehensive emergency obstetric care. It is estimated that at least 15% of all pregnant mothers will need life saving emergency obstetric care. Uganda has committed to providing basic emergency obstetric and neonatal care (EmBONC) at health centers 111 and comprehensive emergency obstetric and neonatal care (EmCONC) at health centers 1V. This effort has been constrained by inadequate human resources with life saving skills (doctors, midwives and nurses with midwifery skills. This coupled with inadequate equipment and supplies have  put the lives of mothers and their newborns at risk and have contributed to the persistent high maternal and neonatal mortality in Uganda.

With only 829 days until the MDG deadline of December, 31, 2015. We would like to appeal to our Government to uphold its commitment to ensure that no woman dies during pregnancy and childbirth and every newborn is born alive and survives to be a healthy and productive member of his/her society.

See President Museveni's Statement at 68th UN General Assembly: http://www.newvision.co.ug/news/647622-president-museveni-s-address-to-un-general-assembly.html

We ask you to keep your Promise. Act Now To Save Mothers

Health sector suffers underfunding as maternal deaths rise

By FLAVIA LANYERO

Posted  Saturday, September 14   2013 at  01:00

IN SUMMARY

Crucial items needed by health workers such as antiseptics, surgical blades and gloves missing in government health centres leading to deaths in some instances.

KAMPALA

For Leah Nambirige, life as a midwife is no longer fun. For six months now, she says Mityana Hospital has not had antiseptics, surgical blades, and gloves.

These are crucial items needed by health workers without which child delivery cannot take place. As a result, Ms Nambirige says they have had to turn away several mothers who have not come with these items.

“Some mothers accept and buy these items but others refuse and decide to go to Mulago Hospital. We cannot always chip in and use our money to buy these items,” Ms Nambirige says adding: “Ultimately, this running back and forth of expectant mother to buy these commodities becomes a delay which contributes to a maternal death.”

Ms Sarah Nyombi, a board member of the National Medical Stores (NMS), however, says it is peculiar that the hospital has not had these commodities since NMS delivers only what is requisitioned by hospitals and said the issue would be probed.

But then, the nurses face another challenge. According to Ms Nambirige, nurses are overworked and intimidated by politicians who have come up with a new by-law to cause arrest and prosecution of medics in whose hands a maternal death occurs.

Ms Robina Biteyi, the National Coordinator White Ribbon Alliance for Safe Motherhood, says it is no longer women dying every day due to maternal complications but now 17 mothers and 106 newborns die every day in Uganda partly due to inadequate government investment in life-saving emergency obstetric and newborn care.

Dr Olive Sentumbwe, a family health advisor at the World Health Organisation, says that at the rate at which Uganda is moving, the MDG of 131 deaths per 100,000 live births by 2015 is still unattainable.

Although government’s contribution to the health sector has increased, it hardly matches the growing population needs. This financial year, government allocated only 8.7 percent of the budget to the health sector up from 7.8 percent the previous financial year but this is still below the 15 percent commitment in the 2001 Abuja declaration.

State Minister for Finance in-charge of planning Matia Kasaija, however, says that it is too late to add any money for the health sector this financial year. Mr Kasaija said that although it is possible to increase funds next financial year, governments priority remains infrastructure and electricity.

flanyero@ug.nationmedia.com

Source: http://www.monitor.co.ug/News/National/Health+sector+suffers+underfunding+as+maternal+deaths+rise/-/688334/1991380/-/2jfedp/-/index.html

Give our health sector attention

EDITORIALDaily Monitor Posted  Wednesday, August 14   2013 at  01:00

The unrelenting reports of human resource challenges within the country’s health sector should cause us to pause and consider the health sector situation in order to make practical and progressive steps.

Last week, figures from the Uganda Medical and Dental Practitioners Council showed that more than 2,000 (nearly 50 per cent of the registered number of medical practitioners) had left the country in the past 10 years.

Now the latest report on human resources for health shows that some 1,124 health workers had not reported for duty as of June this year yet they were expected to take over their new offices by the beginning of 2013.

There are clear indications of government’s willingness to deal with these problems and some commendable steps have been taken in that direction. The release of an additional Shs46 billion for recruitment of health workers last year is one of those commendable steps.

Unfortunately, according to the Human Resources for Health report in some districts, there was a notable failure to attract some workers, particularly anaesthetic assistants, ophthalmic clinical officers, public health nurses, dispensers, theatre assistants, cold chain assistants, midwives, and mostly senior medical officers.

Reports from some districts show that the rate of health workers reporting to work after appointment was greatly affected by lack of staff accommodation. Still, for the health workers who reported to work, their retention will be greatly determined by the availability and state of their accommodation, according to the report.

Despite assurances from Health minister Ruhakana Rugunda, that the recruitment exercise was continuous and that other health personnel continue to report for duty as their accommodation issues are being resolved, the government will have to do more in regard to improving the remuneration and working conditions of the health personnel.
Unsustainable stopgap measures will only work to aggravate the current health sector problems.

The government would indeed do well to heed the recommendations of the report, as it calls for partners and all stakeholders to prioritise staff accommodation as a strategy to address the issue of health worker attraction, retention and motivation.

Source: http://www.monitor.co.ug/OpEd/Editorial/Give-our-health-sector-attention/-/689360/1947080/-/3o8y6oz/-/index.html

Kadaga petitioned over maternal deaths

By Umaru Kashaka

Publish Date: Aug 08, 2013

KAMPALA - A coalition of over 40 civil society organizations, united in the fight against preventable maternal and child mortality in Uganda, mid-this week petitioned Speaker Rebecca Kadaga over the crisis of maternal deaths in the country.

Samuel Senfuka presented the petition in the Speaker’s boardroom on behalf of the coalition before holding a vigil of prayer within Parliament for the late Remmie Wamala, a victim of maternal death.

Senfuka, from White Ribbon Alliance, called on Parliament to show its commitment to correcting the crisis through concrete action of increasing investment of sh43.5bn in wages for midwives and other critical cadres.

“We congratulate you for prioritizing health workers in last year's budget through sh49.5bn investment in the recruitment exercise that has deployed thousands of new health workers to health centers IIIs and IVs,” he said.

But he was quick to add: “But Parliament’s work is not done. Without sh43.5bn to enhance pay at local gov’t health facilities, these health workers will simply give up, leading to massive societal and financial waste.”

We must not allow Wamala’s death to be in vain or the thousands of other Ugandan women who, like Wamala, die preventable deaths while giving birth, he pointed out.

Wamala, who was the coordinator of the Uganda parliamentary forum for children, died recently while giving birth at International Hospital Kampala (IHK) of excessive bleeding and a ruptured uterus. 

Her death brought into sharp focus the issue of maternal mortality in the country.

Senfuka said the financial year 2013/2014 budget should prioritize wage enhancement for midwives and other health workers, improve oversight of healthcare, and expand pre-service training for health workers.

“Some of our health facilities are becoming no-go zones for pregnant women and the ultimate responsibility of monitoring them by the health ministry is too weak,” said Mable Kukunda of Uganda National Health Users'/Consumers' Organisation (UNHCO).

The petitioners called on the Legislature to intervene and impose a system of strict oversight so that preventable deaths trigger urgent investigation and action.

“And maternal death audits result in policy change rather than merely reports that sit on shelves,” Kukunda added.

The coalition also called for expansion of pre-service training for health workers in scarce supply, including midwives, lab anesthetists and the public health nurses over the next three years.

This, they reasoned, would enable the health workers offer maternal health services within their health facilities while additional midwives are produced in their training institutions.

Source: http://www.newvision.co.ug/news/645883-kadaga-petitioned-over-maternal-deaths.html

Five Ugandan youth to attend Women Deliver 2013

By Vision Reporter
Publish Date: May 22, 2013

Five Ugandan youth are among 100 youth leaders from all over the world selected to attend Women Deliver 2013, a global conference that will bring together over 5,000 leaders, experts and advocated from 160 countries in Kuala Lumpur, Malaysia next week.

Women Deliver is the decade’s largest global conference focusing on girls’ and women’s health and empowerment.

The conference aims at keeping on the global agenda the issue of investments in girls and women.

Uganda has the largest number of youth leaders from one country. The youths will have the opportunity to learn more about women and girl issues and connect with experts from around the world.

Elman Nsinda, a journalist volunteers at the White Ribbon Alliance to advocate for maternal and newborn health issues. He is one of the delegates.

Nsinda believes that to improve women and children’s health, men need to be tasked to explain when their wives deliver at home and get complications.

“In our community boys don’t understand women issues. I have just started appreciating that what I need, a woman also needs,” he says.

He argues that men in our society are the ones with the economic muscle. “It is their role to save money, to make decisions,” he says.

Orphaned in Primary One, Nsinda was raised by a grandmother. At 17, she too passed away and he was taken on by a paternal aunt.

“I was raised by women and I have seen and understand their challenges,” he explains and this inspires him to work for their cause.

Martin Wanzala, another of the young delegated to Women Deliver believes culture is the biggest impediment to progress in achieving reproductive health.

The team leader at Allied Youth Initiative–Uganda, a youth organization in Mbale has observed that culture envelopes the discussion around sexual and reproductive health issues.

He says young people cannot freely discuss reproductive health issues because of cultural taboos.

“We use drama, music and dance to deliver the message in a gentle way,” he says.

Humphrey Nabimanya, another young leader and founder of Reach A Hand Uganda testifies to the power of the arts in engaging young people for health.

Source:  http://www.newvision.co.ug/news/643037-five-ugandan-youth-to-attend-women-deliver-2013.html

Doctors have decried the poor health-seeking behavior common among Ugandans, saying the practice is not only costing patients a lot of money but is also costing the country lots of lives.

By John Agaba
Publish Date: Feb 27, 2013

Dr. Simon Peter Eyoku, a senior nephrologist [kidney expert] at Mulago Hospital says most Ugandans wait until they are critically ill until they can go to hospital.

“They come when it is already late and they want to be saved. How? But most of these diseases can be prevented or stopped when diagnosis is done early.”

Citing kidney disease, Eyoku says the loss of function usually takes months or years to occur. “So when urine samples tell someone is developing the disease, they can be given medication to support the organ and prevent it from shutting down.”

The kidneys are responsible for cleansing the blood stream.

The medic says people have to learn to test for kidney disease, diabetes, hypertension, cancer, and any other ailments every after five months even if they feel fine, no matter their age.

He explains that patients with mature disease (end-stage renal disease) usually are put on dialysis, “but do you know how expensive the treatment is?”

“At Mulago Hospital, for a week, patients pay sh1m; two weeks it is sh2m. And that is at Mulago, other hospitals charge more than sh2m per week.’’

“Now if you are to spend a year on the machine, how much money is that? And can you afford it?”

He admits that much as medicine has evolved and doctors can carry out transplants, kidney transplants are still not possible in Uganda. The patient has to be flown to India.

“The patient has to first get a kidney donor and then be flown to India. And not everyone is transplantable. At times the body can refuse the other kidney despite the drugs and the patient has to be put back on dialysis.’’

Diabetes and high blood pressure are the commonest causes of kidney disease.

‘Healthy lifestyle’

Earlier, last week, during the health journalists conference at the Kampala Imperial Royale Hotel, medical experts stressed the need for emphasis on preventive health than curative health.

Dr. Fred Okuku, an oncologist and head of the cancer institute at Mulago Hospital urged people to start practicing healthy lifestyles.

He underscored the need for people to involve themselves in physical exercises, to avoid eating fatty and sugary foodstuffs ‘to minimize on some of these non-communicable diseases’.

The doctor said there was lots of illiteracy surrounding the cancer disease yet the disease is growing by the day. And that the numbers of cancer patients at the institute are ever going up and most of them are presented with advanced disease.

“Right now if a patient comes to the institute and his prostate has to be taken out, he is booked for 2014,’’ said Okuku.

He said cancer of the cervix which is caused by the HPV virus was the commonest, closely followed by breast cancer.

Elsewhere, Dr. Olive Ssentumbwe Mugisa, the chairperson of the White Ribbon Alliance Uganda Chapter called on women to try and have pregnancies at the right age – between 20 years and 34 years – to avoid child-birth related complications.

“And don’t get pregnant too frequently,” was her crisp reminder.

“Space and use family planning. Someone has a baby today. But before the baby is off the breast she is already pregnant. This wears the body.”

The maternal mortality ratio in Uganda has changed minimally over the last decade and about 16 women still lose their lives daily. This statistic is coupled with some 45,000 newborns dying every year as a result of pregnancy-related causes.

But about 88% of these maternal deaths can be prevented.

“For nine months someone is pregnant,’’ said Dr. Olive. “During this time they don’t attend antenatal classes and they think they will give birth at home, perhaps with the help of a traditional birth attendant.”

“What happens when they develop complications at the last hour? They don’t have money. The nearest health facility is about 10 kilometers away. They reach the hospital when the baby is already dead. Now what do you want the midwife to do?”

“Both you and me – men and women – have a duty to see that we reduce the numbers of women and children who die because of pregnancy-related complications. (And for) the man, you need to start setting aside some money the moment your wife gets pregnant, and accompany her for antenatal classes.”

Source: http://www.newvision.co.ug/article/fullstory.aspx?story_id=640188&catid=10&mid=53

CSOs Reaction to the FY 2013/14 Budget Speech

Civil Society Coalition to Stop Maternal Mortality in Uganda

Reaction to the Financial Year 2013/14 Budget Speech

For more information contact: Samuel Senfuka, White Ribbon Alliance Uganda: 0704920043

Dennis Odwe, AGHA Uganda: odwedennis@yahoo.com, 0772637740

Nakibuuka Musisi, CEHURD: nakibuukamusisi@gmail.com 0782496681

Asia Russell, Health GAP: asia@healthgap.org, 0776574729

(Kampala) In reaction to the release of the Budget Speech 2013/14 today 13 June, 2013, a coalition of health advocacy organizations released the following statement: “The 2013/14 Budget does not prioritize the most important issues facing Ugandans—it contains massive budget increases for State House and for Defense while health investments that literally mean the difference between life and death for millions of Ugandans have been starved for funding.

‘The economic growth described by President Museveni’s in his June 8 State of the Nation Address is virtually meaningless when communities cannot reliably obtain essential health care in facilities that have the staff, medicines, and equipment needed to save lives,’ said Nakibuuka Musisi of CEHURD.

Furthermore, Government is proposing new regressive taxes in a misguided attempt to fill a revenue gap triggered by aid suspension in the wake of massive theft of donor funding. This policy decision by government will further punish ordinary Ugandans—the victims of theft of public funds—while corrupt officials walk free. ‘Government’s proposed 18% VAT on water is actually a typhoid tax,’ continued Musisi. ‘Corruption already makes us sick—why does government want to punish us further?’

We call on Parliament to stand by their constituents and insist that this Budget is not passed unless and until the following changes are reflected in the 2013/14 Appropriations Bill:

1. Wages for priority health worker cadres must be increased across the health sector, in particular at HC IVs and HCIIIs, in particular midwives, anesthetists, and laboratory technicians. At minimum this will require an investment of Ushs 77.9 billion. Without this investment, the successful recruitment of thousands of new health workers will be in vain—they will be not be motivated to work and will move on to other jobs. Non-financial motivation (staff housing, etc.) for health workers must also be expanded.

2. Dramatically increase the investment in priority medicines, including ARVs and ACTs, recognizing the large unmet need for HIV treatment and anti malaria treatment (including in particular prevention during pregnancy, which will contribute to a reduction in maternal mortality). Government funding for HIV treatment must be scaled up, given the new HIV treatment coverage gap that will be created in 2013 as a result new WHO treatment guidelines, and in order to leverage the fact that Uganda can massively reduce HIV incidence through earlier access to HIV treatment—while saving lives: evidence shows that

Providing treatment for all in need in Uganda would help decrease new HIV infections by 60% and more than 100,000 deaths could be averted over just 4 years.

3. Absorb the costs of an expiring donor grant for paediatric HIV treatment and Early Infant Diagnosis. The total cost for paediatric ARVs and for diagnostics for this grant is Ushs 10.8 billion.

4. Absorb costs required to continue the donor funded, expiring program on Integrated Community Case

Management for malaria.

5. Ensure recruitment of sufficient numbers of staff at General Hospitals and Regional Referral Hospitals

(through second wave of recruitment in remainder of FY 2012-13 and/or through budget for FY 2013-14).

6. Reflect the President’s London Summit Family Planning commitment with increase in additional expenditure for reproductive health commodities by 5 billion shillings each year for 5 years.

‘Uganda lags behind the region and much of the continent in addressing crucial health priorities, from rising HIV incidence, to persistently high rates of maternal death, to preventable deaths from malaria and vaccine preventable illnesses. This is shameful and unacceptable,’ said Dennis Odwe of AGHA Uganda.

‘Uganda cannot be strong economically without tackling these preventable health crises,’ said Samuel Senfuka of White Ribbon Alliance Uganda. ‘Our development suffers when Ugandans cannot gain access to essential health services.’

‘We are well aware that diarrhea diseases are the second leading cause of under five mortality, and an 18% VAT on water is self defeating in achievement of our health goals. Moreover we know that access to safe water is key in the fight against HIV and retention of children in schools,’ said Hellen Kasujja of CIDI. ‘Such a regressive tax will have grave implications, especially on women who are at the epicenter of our economy.’