The deteriorating state of Health care In Kalangala District

 

 By Nakibuuka Noor Musisi

Uganda will join the world to celebrate World Tourism Day in September this year. The celebrations will take place at the islands. The state of health care however is worrying. With lack of a District Hospital, many lives are lost on boats trying to reach nearby hospitals of Entebbe and Masaka Districts. The question of how then such an event will be successfully celebrated remain unanswered.

Kalangala has eighty four (84) Islands and only 64 have people with a population estimate of over 54293 (census report 2014). It’s one of the country’s tourist attractions and becomes densely populated during the festive season. “If you want to come and rest here, you must book by November otherwise after November you can’t get where to stay. It’s usually packed but we lack a hospital to cater for health needs of such a population” Ssekaddu Francis, Kalangala District forum of people Living with HIV/AIDS Network.

I traversed Kagonya village in Lulamba Parish, Bufumbira sub county, Kalangala District, the nearest village to Kalangala Health Center IV, which is located on Bugala Island. The village is approximately 2km away from the hospital (on water). It has approximately three hundred thirteen (313) households with up to One hundred and thirty nine (139) children ages 0-7 years.

No health facility is located on this island and the nearest school about 3km away, a primary school that runs up to primary five. At this site I was eager to know how the community accesses health care. It’s unbelievable. A person needs up to three hundred thousand shillings (300,000/-) to access health care. Broken down, about one hundred thousand  to one hundred fifty thousand shillings (100,000-150,000/=) for boat and engine hire, and about one hundred thousand shillings (100,000/=) for fuel and fifty thousand (50,000/=) for hiring a person to sail the boat.

At the time of this visit, the islands major activity of fishing was at the stand still as authorities were fighting illegal methods of fishing. What this means is that a person could hardly earn or spend the above amount of money to access health care leaving the disadvantaged poor with no access at all. While Kagonya is nearer to the health Center IV, questions on how then people for instance expectant mothers reach Masaka or Entebbe for services become worrying. We were told that many die in the boats or within the facilities as means of transport are being prepared to take them, while others fail to raise the required transport fees to access care.

Most worrying the village is served by one toilet with houses in a very poor state. Asked why this one toilet, one resident responded that “we are proud of our toilet. This is the best we can have, at least we have one” Resident of Kagonya Village.

During the meeting conducted by Action Aid Uganda in partnership with CEHURD on the state of health care in Kalangala, residents thought that advocating for a district hospital was among the best options. These, while citing the names of people that had died while trying to access care including their district planner, were quick to mention that Kalangala looks like a less populated place but this is the opposite. They noted that at least legislation concerning marine should be changed to give preference to the district.

“When the night falls we are cut off. We cannot take any patients to the nearby facilities of Entebbe and Masaka because ferries, boats etc are not allowed to move at night. We have been promised a district hospital by the president and the Minister of Health but this has not matured yet. With the hospital we will solve health care problems here” Kizito Henry, Kalangala District forum of people living with HIV/AIDS Network.

Indeed without a district hospital one is not sure of his state of health while at the islands. While motor boats may be present, questions on who fuels them to the main land, time of sailing, the boat payments to the sailor  come into play. Even when these are availed, one still wonders whether in the neighboring districts of Entebbe and Masaka services will be availed on time. Communities narrated that this also calls for either renting a house or staying in hospital with questions of feeding the sick, washing etc which may seem simple when near a health facility but very difficult when one has no home near the facility.

It’s the state’s obligation to ensure that health care is accessed by all. Even when the Constitution does not expressly provide for the right to health in the substantive bill of rights but only muted from the national objective and directive principles of state policy, the country has signed a number of regional and international legislations that advance the realization of this right. The state thus needs to prioritize Kalangala Islands and provide a well-equipped and staffed Hospital to the District to boost health care accessibility there.

 

Advancing access to Maternal Health Services – Launch of Save the Mother Campaign

By Germinah Nanfuka

On the 4th August the team from CEHURD joined members of the Civil society, Ministry of Health Officials, Health Service providers, Members of Parliament, officials from Kaliro District in Eastern Uganda, Health service providers from Bumanya Health Center IV and the general public to launch the “Save A Mother Campaign” organised by the Rotary Club of Kampala Wandegeya. The campaign whose broader aim was to improve maternal health care as well as to reduce the scourge of fistula among Ugandan mothers started with a Charity Walk from Kolping Hotel in Bwaise to Wandegeya and was concluded with speeches to seek for opinions and perspective on how to have a successful campaign.

This campaign was based on the maternal mortality rate which stands at over 336 deaths per 100,000 live births as well as about 2000 new cases of fistula registered in Uganda annually according to the UBOs Demographic Health Survey. This campaign for the project tagged “Healthy Child Birth through improving and constructing Maternity and Fistula Ward at Bumanya Health Center IV in Kaliro District,” was therefore intended to initiate developments aimed at constructing and equipping a maternity and fistula ward at Bumanya Health Center IV which literally serves over six communities including Jinja, Kamuli, Iganga, Kaliro, Tororo, Mbale among others.

Bumanya Health Center IV which is located in the heart of Busoga and serving over 30,000 clients annually is in a sorry state with continuous drug stock out, dilapidated structures and no ambulance. The sorry state of the only HC IV in the district has on many occasions subjected patients to move long distances of about 68kms to Iganga to seek services.

The facility which was constructed in the 1970s, has in-patient rooms designed to accommodate only five people but currently accommodating over one hundred people with a mix up of male, female and children.

According to Hon. Margaret .K. Mbeiza the Woman MP for Kaliro District, Bumanya Health center offers services to a big number of patients with over 369 in patients at the maternity section daily. She added that the long distance travelled in case of referrals has led to the death of expectant mothers from complications such as over bleeding.

Dr, Olive Sentumbwe from the World Health Organisation called upon the Ministry of Health to come up with a multi-sectoral approach in reducing maternal mortality. She emphasized the need to revamp the leadership in the health care system to address maternal deaths if Uganda is to achieve the Sustainable Development Goals targets by 2030.

Addressing maternal health challenges calls for collective efforts from everyone, including midwives who must be committed to their work, expectant mothers to attend antenatal care services during pregnancy as well as fathers to ensure safety and support of their wives during pregnancy.

CEHURD’s blend of programs excites partner.

 By Nakibuuka Noor Musisi

Over the years, CEHURD has grown into an organization that stands out to use the law to advance the realization of the right to health in Uganda and East Africa. Like any growing organization, CEHURD has taken steps to become what it is now.

Today, the organization is known as one that reaches out to the communities, undertakes research, litigates and advocates for the enjoyment of the right to health. CEHURD’s blend of its programs ; Strategic Litigation, Community Empowerment and Research, Documentation and Advocacy excited one of its long time partners.

Roxana Bonnell has been CEHURD’s development partner for years. She worked with Open Society Institute’s Public Health Program at the time CEHURD was being formed. She facilitated some of the first funding to CEHURD and worked with staff to think through the first Strategic Plan in 2011, an experience that we still hold so dearly.

“I am in Uganda to offer whatever assistance I can to another young organization thinking through their first Strategic Plan, I am not here at CEHURD for a formal visit but rather to say hello to my friends” she noted on her visit to CEHURD offices on 27/7/17

She has a strong belief that not all lawyers will think about and do what CEHURD does. Most times lawyers think about practicing law in mainstream courts and relevant tribunals but CEHURD’s uniqueness lies with allowing lawyers speak to people in a “common ways” that are impactful to their live, ways that aim at sensitizing and empowering the communities, she added.

While speaking with the team about CEHURD’s work since 2011, she was excited and inspired with the strategies employed by the organization. “I am so excited for the fact that you the lawyers empower communities- this is important. The three programmatic approach is very unique and it’s rare to find an organization with a bigger percentage of lawyers doing what you do. This is impactful, it has been such an honor to be considered a CEHURD friend” she explained.

Roxana still works for the Open Society Foundation, as well as a consultant to several other social justice funders. She discussed with the team the new trends in access to medicine, noting the important role CEHURD has played for years in access to medicines advocacy in East Africa. She explained that OSF has broadened its support around access to medicines to include efforts that look at how innovation is prioritized and conducted. To ensure access to the medicines we need, we will need to change the current system and shift decision making power around medicines, away from transnational pharmaceutical industries back to governments. She believes that when governments acting for the public good have the powers to prioritize medicines, do clinical trials, and help regulate prices we will see a change in accessing affordable medicines for our countries.

Roxana is one among the friends of CEHURD that has come back to us after years. She was so impressed with CEHURD’s growth and work, she strongly advised us to find opportunities to publish and tell our story to the broader global social justice community.

CEHURD is hiring 2 Program Officers and 4 long term Volunteers.

CEHURD is recruiting two Program Officers and four long-term Volunteers to support its Research, Documentation and Advocacy (RDA), Strategic Litigation (SL), Community Empowerment (CEP) Programs and the Communications department.

For the volunteer-ship arrangement, the selected candidates bring their professional skill sets and work with one of CEHURD’s programs for a period of between 6 – 12 months.
The arrangement involves mentorship opportunities for the candidates to gain valuable experience and advice for career development in research, advocacy, litigation and communications in the field of health, law and human rights.

Below are the links to the FULL JOB Descriptions:

JOB DESCRIPTION FOR A VOLUNTEER UNDER RESEARCH, DOCUMENTATION AND ADVOCACY.

JOB DESCRIPTION FOR A VOLUNTEER UNDER STRATEGIC LITIGATION

JOB DESCRIPTION FOR A VOLUNTEER UNDER COMMUNITY EMPOWERMENT PROGRAM

JOB DESCRIPTION FOR A VOLUNTEER UNDER COMMUNICATIONS DEPARTMENT

Please see the job advert below for details.

World Population Day 2017: Promote Access to Safe and Voluntary Family Planning for Ugandans.

Today, Uganda joins the rest of the world to commemorate World Population Day under the theme “Family Planning: Empowering People, Developing Nations.”

Out of 7.5 billion people in the world, 34,634,650 million are Ugandans according to the Uganda National Population and Housing Census 2014. The country’s average annual population growth rate of 3% is attributed to the high fertility rate caused by inadequate access to safe and voluntary family planning for the people.

The high fertility rate in Uganda is thus evident of inadequate availability of a range of contraceptive methods, married with insufficient support from partners or communities, making it difficult for women to attain methods appropriate to their needs. A study by Center for Health, Human Rights and Development (CEHURD) on the status of the 13 UN Lifesaving Commodities in Uganda (2015-2016) indicated that while some of the reproductive health commodities (female condom, contraceptive implants such as Implanon Jadelle and the emergency contraceptive pills) were most available, others such as the female condom and the long term contraceptives were poorly available in less than 50% of the health facilities.

The high fertility rates in the country place emphasis on the need to increase provision and access to family planning commodities by scaling up efforts on provider training and consumer awareness about the commodities. This is in tandem with exerting price controls in the private sector to ensure family planning commodities are available, accessible, acceptable and are of good quality to all potential users.

Government should therefore invest in making family planning commodities and services readily available for those in need through developing programs that provide counselling, information and a wide range of contraceptive methods to yield economic growth and other gains that can boost sustainable development.