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