18th/september/2011
The contractions had started at dawn. Cecilia Nambozo, a teacher at Busamaga Primary School in Mbale Municipality, knew it was time, so she did what was expected—checked into a hospital at 6am so she could give birth with expert attention at her disposal.
But that was not to be, for more than 10 hours after Nambozo checked into Mbale Regional Referral Hospital to bring unto the world a life, she was ignored, neglected and writhing in pain. Her crime? She did not have Shs300,000 the hospital medical staff demanded before they could attend to her. And so she wasted away as her husband, Mr Richard Wesamoyo, made desperate runs around the village to raise the money.
That chilly September 6 still haunts Mr Wesamoyo. Nambozo arrived in the hospital at 6am but was reportedly neglected in the Labour Ward until 8pm when she breathed her last. Even then, it is the hospital cleaners who helped remove the baby from her womb. “The lady could not push because the baby was big. The doctors demanded for Shs300000, which we could not raise,” said Ms Grace Acham, a neighbour who had helped transport her to the hospital.
Ms Acham said they had spent the little money they had to purchase surgical equipment. “And when I came back, I found her in pain, crying, there was no help. The medical workers looked on as they asked for money,” she added. Ms Acham said after three hours of waiting and sensing that Nambozo’s situation was deteriorating, she approached a midwife and asked her to attend to her as the husband ran to the village to sell property and raise the money but the midwife and a doctor allegedly declined.
“At about 6pm, Nambozo started gasping; she fell on the floor and was bleeding. That was when the doctor responded and took her into the theatre but it was too late; her life could not be saved. She died.” she said.
The doctor emerged from the theatre after about 10 minutes and announced that both the child and the mother had died, Ms Acham added.
Mr Wesamoyo told Sunday Monitor that his humiliation was iced when medics abandoned his wife’s body in the Labour Ward with the foetus in her womb. He said the body was removed by cleaners
“They rolled the bed out in the open and started operating her naked for all to see. It was very dehumanising and humiliating for her to be stripped naked by cleaners,” said Mr Wesamoyo. He said they had been going for antenatal check-ups at the hospital and the midwives had told them the baby was big and that it would be difficult for her to have a normal birth. Apparently, the midwives had recommended a caesarian operation for Nambozo.
Police investigate
Dr Bernabas Rubanza, a police surgeon who carried out the postmortem, said the baby weighed 5.2 kilogrammes and that Nambozo died due to failure to push that made the uterus to rapture. He added that due to neglect after the uterus malfunctioned, Nambozo had bled to death.
“This lady reached the hospital at 6am and pleaded with the medical workers for an operation because she knew her status but the medics refused to attend to her until her uterus raptured. This is a pure case of neglect,” said Dr Rubanza. He added: “And this is not the first case at this hospital; many women have died in labour out of neglect.”
Mbale District Police Commander Jacob Opolot said a case has been registered and investigations have started. “We received a complaint and we have opened a file and summoned the medical staffs on duty that night and the day to furnish us with information,” said Mr Opolot.
However, the hospital director, Dr BenonWanume, said at the time of Nambozo’s death, there was another woman undergoing an operation in the theatre and that it was inadvisable to halt the ongoing operation.
“And in any case, it is not the patient who asks for theatre but we examine the patient and recommend. Doctors on duty examined her and by the time they recommended her for theatre she had already raptured her uterus,” he said.
Dr Wanume added: “She was bleeding and we could not save her life. I can’t rule out the issue of asking for money. Some staff do it but we need to investigate this further because it has no proof.”
He said the people who operated Nambozo to remove the foetus where not hospital workers but imposters who sneaked into the hospital.
Source: Daily Monitor
http://www.monitor.co.ug/News/National/-/688334/1237880/-/bj7s7pz/-/index.html
Activists want extra Shs75b health funds
As the Social Services Committee in Parliament prepares to pass Shs1 trillion health budget this afternoon, activists demand that an additional Shs75 billion be passed as a supplementary budget for the health sector to address staff recruitment and remuneration.
This, they say, will be key in curbing the current sorry state of maternal health, with about 6,000 women dying while giving birth annually.
According to the activists, an additional Shs75b is enough to recruit 5,000 professional health workers and enhance their allowances, which is the ministry of health target this year.
The country Director International HIV/Aids Alliance, Mr Leonard Okello, said there was no need to spend money on supervision when there were no workers to oversee the health centres.
“Rural health facilities are understaffed that is why regional and national hospitals are always flooded. Why can’t government facilitate only one supervisor and use the rest of the money to staff health centres?” Mr Okello said.
Source: Daily monitor
www.monitor.co.ug/News/National/-/688334/1232842/-/bjb9w2z/-/index.
Whose interests do the honourable MPs represent?
From a vantage point in the Parliament Watch, I watched with disbelief on Monday as one of the authoritarian chairpersons, Mr Tim Lwanga, hit the roof and evicted journalists from the Budget Committee. The only reason this man gave was that “his” committee was going to discuss “technical matters” and therefore, no need for journalists.
Well, that’s Lwanga for you. But for some of us who have over the years watched MPs come and go, we are reliably informed that by the nature of our training and experience, we are knowledgeable in public spending than some lawmakers.
So, the accusation that the journalists were not needed because the Budget Committee was going to discuss “technical matters” is a complete conjecture whose inner meaning insults journalism and confuses the symbiotic relationship between Parliament and the media.
Well, that’s not all folks! In the face of the current economic crisis and the biting shortages the country is facing, this Budget Committee abandoned free meeting rooms in the House and pitched camp in one of the luxurious hotels on Entebbe Road to discuss the proposed Budget cuts. The Budget Committee has more than 30 members.
According to my sources in Parliament, each MP was paid Shs1 for pocket money. To show how wasteful these MPs are at a time when they were meeting to cut ministries’ wasteful expenditures, for two days, they wasted more than Shs100 million.
What is not clear though is why these MPs decided to blow public funds in expensive hotels yet they could have used Committee rooms at Parliament and save that money for striking teachers and other suffering Ugandans who cannot afford ARVs or even those without drugs.
Why the MPs, including the opposition preach water and drink wine at night, will be a discussion for another day. But this week, let us look at the importance of an open Parliament, focusing on answering a fundamental question: Whose interests do MPs serve?
In the West, there is this idea that unless, public institutions are open to public scrutiny and susceptible to public opinion, true democracy cannot flourish and therefore, progress will always be like a dog chasing its tail.
On account of this principle, as part of the global movement toward more open and accountable government, citizens have become increasingly concerned with obtaining access to information particularly on budgets. In fact, Commonwealth Parliamentary Association (CPA) to which Uganda is a member, recommends unhindered media access to Parliament and its committees.
Similarly, the Inter-Parliamentary Union (IPU) to which Uganda is also a part and is hosting its 126th global summit here next year, believes that for a Parliament to be ‘open’ means, most obviously, that its proceedings are physically open to the public.
This may not always be straight forward in an age when the security of public figures is a pressing concern. However, other serious parliaments have found it possible to strike a balance between openness and security; in such a way that Parliament is manifestly seen to belong to the people as a whole, and not just to its members. This urge is premised on a belief that the best weapon of a dictatorship is secrecy, but the best weapon of a democracy is openness. The inner sense we draw from this counsel is that secrecy, breeds corruption and corruption kills public and private institutions.
Indeed, secrecy, particularly in public offices like Parliament breeds dishonesty, laziness, nepotism, and many other social ills. Certainly, secrecy means evasion, and evasion means a problem to the moral mind.
Why the secrecy?
By locking out the media from covering the Parliament proceedings, our representatives in the 9th Parliament, clearly began their five-year journey off-side. Unfortunately, this weird behaviour in Parliament is gradually eating into the House’s creed and has of late permeated committees, including the Budget Committee, which is supposed to encourage transparency.
When Lwanga evicted journalists from the Budget Committee meeting as if the discussion threatens national security, the Shadow Finance Minister Geoffrey Ekanya tried to plead on behalf of the journalists, but without any success, and in the end our lawmakers discussed the amendments to the budget behind closed doors in one of the lavish hotels outside Parliament building.
However, it should be clearly understood that under Section 20, subject to the Parliament Rules of Procedure, the sittings of Parliament or of its Committees including the one Lwanga chairs shall be public. With exception of Section 20(2) where the Speaker may, with the approval of the House and having regard to national security, order the House to move into closed sitting.
By allowing Mr Lwanga, whose dictatorial leadership appears to have betrayed him in many ways, there was a conspiracy of silence from the rest of the committee members. They purely looked comical especially when their chairperson claimed that they were going to discuss “technical issues” as if the 9th Parliament is the first to discuss the budget. These inexcusable events in Parliament will evidently remind Ugandans how Mr Lwanga’s leadership is a contradiction to Mr William Okecho and Ms Rose Akullo (Bukedea Woman), among others, who venerated an open-door policy in the handling of the Budget.
Call for action
Even so, in this column, we urge the rest of the MPs to see sense in openness and in the same spirit, the office of the Speaker should have a joint meeting with all the committee chairpersons/vice chairpersons to orient them on matters of good governance. Surely, Parliament should be the last institution to be seen promoting secrecy, wastage in government and corruption for that matter.
The lawmakers should know that the overarching purpose of access to information legislation, which is operational, is to facilitate democracy and rule of law. This Act does so in two related ways: It helps to ensure first; that citizens have the information required to participate meaningfully in the democratic process, and secondly, that politicians and bureaucrats remain accountable to the citizenry.
Parliament needs to foster a culture of openness in government. For that matter, the media undertake to work with Parliament to ensure public trust prevails, establish a system of transparency, public participation, and collaboration. Unlike secrecy, openness will strengthen our democracy and promote efficiency, honesty, transparency and accountability and effectiveness in government.
The rising assertiveness of committees is a welcome development. But for those locking out journalists on flimsy grounds need to reverse this naughtiness, it is not helping anyone.
Mr Lwanga and others should know that the media and Parliament share a responsibility to contribute to political, economic and social development in ways consistent with democratic principles by pursuing fact-based, fully substantiated reporting. Ultimately, economic development is best achieved and sustained in societies where the people are democratic and well-informed.
Source: Daily Monitor
http://www.monitor.co.ug/OpEd/OpEdColumnists/YasiinMugerwa/-/878670/1233862/-/item/0/-/yjflij/-/index.html
CSOs recommend Shs75 billion budget reallocation to recruit health workers.
September 8, 2011
A coalition of Civil Society organizations (CSOs)where CEHURD is a member, have demanded parliament to reallocate funds in the 2011-2012 draft budget expected to be passed today afternoon, for recruitment and retention of health workers.
The CSOs have recommended a minimum total of approximately Shs75 billion to cater for the deployment of an additional 5,000 professional health workers and an increase in allowances to motivate them.
This is due to the fact that the increasing shortage of health workers like nurses and midwives at health centres II, III and IV, commonly found in rural areas has greatly contributed to the shoot-up in maternal death rates in Uganda.
According to the press statement read at the conference hosted by Action Group for Health, Human Rights and HIV/AIDS, Uganda (AGHA) on September 8, the Ministry of Health national target for this budget cycle indicates that an additional 5,000 health workers would increase staffing norms from the current 56 per cent to 65 per cent.
The statement further reads, “A report by the Social services committee of parliament recommended an initial reallocation of Shs34 billion and suggested the remaining 41 billion required, to be reallocated from non-essential spending in other sectors’ budgets.”
It however states that recent reports on the discussions of the budget committee indicate that the recommendations of the report may be disregarded, despite the fact that parliament agreed to them.
In reaction to this, the country director, International HIV/AIDS Alliance in Uganda, Mr. Leonard Okello, said, “if the pronouncement of parliament are disregarded in the Appropriations Act of 2011, then Uganda must approve a supplementary budget to correct this needless epidemic of maternal and morbidity.”
He added that, “People are suffering rural women in particular. The time for action is now.”
Mr. Okello requested government to invest in health centers II, III and IV where a bulk of rural women get health assistance, which means that they will be serving majority good and reducing overload in referral hospitals.
He appealed to the President Mr. Yoweri Museveni to respond to the matter by providing supplies, medicine and human resources required by the rural women in payment for voting him back into power since majority of his votes were from these women according to statistics.
The Advocacy and communications manager, Community Health and Information Network (CHAIN), Ms. Dorcas Armoding, said, “This crisis will not be corrected without the nurses, midwives and clinical officers, whose jobs are to save lives.” “Without this reallocation, we are gravely concerned that preventable maternal death rates will continue at a rate of 16 pregnant mothers per day.
The Executive Director, AGHA, Ms Apophia Agiresaasi, expressed her worries on Uganda still having unacceptably high maternal and infant mortality rates, which she says would be improved if there was political will to deliver on the promise of African governments in 2001 to invest at least 15 per cent of their budget in health.”
Maternal Deaths Focus Harsh Light on Uganda
ARUA, Jennifer Anguko was slowly bleeding to death right in the maternity ward of a major public hospital. Only a lone midwife was on duty, the hospital later admitted, and no doctor examined her for 12 hours. An obstetrician who investigated the case said Ms. Anguko, the mother of three young children, had arrived in time to be saved.
Her husband, Valente Inziku, a teacher, frantically changed her blood-soaked bedclothes as her life seeped away. “I’m going to leave you,” she told him as he cradled her. He said she pleaded, “Look after our children.”
Half of the 340,000 deaths of women from pregnancy-related causes each year occur in Africa, almost all in anonymity. But Ms. Anguko was a popular elected official seeking treatment in a 400-bed hospital, and a lawsuit over her death may be the first legal test of an African government’s obligation to provide basic maternal care.
It also raises broader questions about the unintended impact of foreign aid on Africa’s struggling public health systems. As the United States and other donors have given African nations billions of dollars to fight AIDS and other infectious diseases, helping millions of people survive, most of the African governments have reduced their own share of domestic spending devoted to health, shifting to other priorities.
For every dollar of foreign aid given to the governments of developing nations for health, the governments decreased their own health spending by 43 cents to $1.14, the University of Washington’s Institute for Health Metrics and Evaluation found in a 2010 study. According to the institute’s updated estimates, Uganda put 57 cents less of its own money toward health for each foreign aid dollar it collected.
Rogers Enyaku, a finance expert in Uganda’s Health Ministry, disputed the assertion, saying the country’s own health spending had increased, “but not that substantially.” Still, the government set off a bitter domestic debate this spring when it confirmed that it had paid more than half a billion dollars for fighter jets and other military hardware — almost triple the amount of its own money dedicated to the entire public health system in the last fiscal year.
Poor people surged into Uganda’s public health system when the government abolished patient fees a decade ago. Increasingly, African countries are adopting similar policies, and experts say that many more people are getting care as a result. But Uganda’s experience illustrates the limits of that care when a system is poorly managed and lacks the resources to deliver decent services, experts say.
At regional hospitals like the one here in Arua, more than half the positions for doctors are vacant, part of a broader shortage that includes midwives and other health workers. A majority of clinics and hospitals reported regularly running out of essential medicines, while only a third of facilities delivering babies are equipped with basics like scissors, cord clamps and disinfectant, according to a 2010 Health Ministry report.
The hospital where Ms. Anguko died handles obstetric emergencies for a region of almost three million people, but it recently had no sutures in stock to sew up women after Caesarean sections. Dr. Emmanuel Odar, the hospital’s sole obstetrician, said that even in childbirth emergencies, families must buy missing supplies themselves, typically at nearby pharmacies. Patients without money must beg or borrow it, Dr. Odar said.
“We are overwhelmed with cases of people looking for free services, and they expect a lot despite supplies not there, human resources lacking and the beds not enough,” he said.
Dr. Olive Sentumbwe-Mugisa, a Ugandan obstetrician and adviser with the World Health Organization, participated in the Health Ministry’s investigations of the deaths of both Ms. Anguko and Sylvia Nalubowa, a second woman named in the lawsuit against the government, and concluded that both women arrived in time to be saved.
“We are in a state of emergency as far as maternal services are concerned,” Dr. Sentumbwe-Mugisa said. “We need to focus on the quality of care in our hospitals and address it in the shortest period of time. That will mean more resources. We cannot run away from that.”
In its lawsuit filed in March, the Center for Health, Human Rights and Development, a Ugandan nonprofit group, contended that the government violated the two women’s right to life by failing to provide them with basic maternal care.
Source: http://www.nytimes.com/2011/07/30/world/africa/30uganda.html?hpw